Türkiye’deki Deprem Felaketlerinin Sağlık Çalışanları Üzerindeki Psikolojik Etkisi

Yıl 2025, Cilt: 10 Sayı: 1, 52 - 59

Meltem Gürü , Özge Şahmelikoğlu Onur

https://doi.org/10.26453/otjhs.1589646

Öz

Amaç: Türkiye’de Kahramanmaraş merkezli depremler, bölgedeki sağlık çalışanlarının ruh sağlığını derinden etkilemiştir. Bu çalışma, sosyodemografik ve klinik değişkenler, algılanan sosyal destek ve psikolojik dayanıklılık ile Travma Sonrası Stres Bozukluğu (TSSB) gelişimi arasındaki ilişkiyi araştırmayı amaçlamaktadır.
Materyal ve Metot: Adana, Adıyaman, Diyarbakır, Gaziantep, Hatay, Kahramanmaraş, Kilis, Malatya, Osmaniye ve Şanlıurfa illerindeki sağlık çalışanları arasında kesitsel bir anket çalışması yapılmıştır. Katılımcılara, DSM-5 TSSB Kontrol Listesi (PCL-5), Beck Anksiyete Ölçeği (BAI), Beck Depresyon Ölçeği (BDI), Çok Boyutlu Algılanan Sosyal Destek Ölçeği (MSPSS) ve Connor-Davidson Dayanıklılık Ölçeği (CD-RISC) uygulanmıştır.
Bulgular: Sonuçlar, katılımcıların %17,3’ünün yüksek düzeyde travma tepkisi gösterdiğini, %82,7’sinin ise düşük düzeyde travma tepkisi gösterdiğini ortaya koymuştur. Orta veya ciddi hasar görmüş evlerde yaşayan (%13,5, p=0,009) ve eğitimleri deprem nedeniyle kesintiye uğrayan asistan doktorlar (%5,87, p= 0,019) arasında daha yüksek TSSB oranları görülmüştür. Ayrıca, TSSB tanısı, anksiyete (33±9, p<0,001) ve depresyon skorları (28±13, p<0,001) ile pozitif, dayanıklılık ile negatif bir ilişki göstermiştir (43±13, p<0,001).
Sonuç: Bu bulgular, sağlık çalışanlarının ruhsal etkilerle başa çıkabilmesi için çalışma koşullarının iyileştirilmesi ve uzun dönem takip çalışmalarının uygulanması gerekliliğini vurgulamaktadır.

Anahtar Kelimeler

Depremler, sağlık çalışanları, post-travmatik stres bozuklukları, psikolojik dirençlilik

The Psychological Toll on Healthcare Workers Following Türkiye's Earthquake Disasters

Öz

Objective: The Kahramanmaraş-centered earthquakes in Türkiye profoundly impacted local healthcare workers' mental health. This study examines the relationships between sociodemographic and clinical variables, perceived social support, and psychological resilience in Post-Traumatic Stress Disorder (PTSD) development.
Materials and Methods: A cross-sectional survey was conducted among 104 healthcare workers from ten affected provinces: Adana, Adıyaman, Diyarbakır, Gaziantep, Hatay, Kahramanmaraş, Kilis, Malatya, Osmaniye, and Şanlıurfa. Participants completed the PTSD Checklist for DSM-5 (PCL-5), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Multidimensional Scale of Perceived Social Support (MSPSS), and Connor-Davidson Resilience Scale (CD-RISC).
Results: The results revealed that 17.3% of participants exhibited severe trauma responses, while 82.7% had low trauma responses. Higher PTSD rates were associated with individuals living in moderately to severely damaged homes (%13.5, p=0.009) and assistant doctors whose education was interrupted by the disaster (%5.87, p= 0.019). Furthermore, PTSD diagnosis was positively correlated with anxiety (33±9, p<0.001) and depression scores (28±13, p<0,001) and negatively correlated with resilience (43±13, p<0.001).
Conclusion: These findings emphasize the urgent need for improved working conditions and the implementation of long-term follow-up studies for healthcare workers in earthquake-prone areas, to address the psychological impact of such disasters.

Anahtar Kelimeler

Earthquakes, healthcare workers, post-traumatic stress disorder, psychological resilience

Kaynakça

• 1- World Health Organization. Türkiye earthquake: external situation report no. 2: 20–26 February 2023. No. https://www.who.int/europe/publications/i/item/WHO-EURO-2023-7145-46911-68571. Accessed January 1, 2024.
• 2- Sehlikoğlu Ş, Yilmaz Karaman IG, Yastıbaş Kaçar C, Canakci ME. Earthquake and mental health of healthcare workers: A systematic review. Turkish J Clin Psy. 2023;26(4),309-318. doi:10.5505/kpd.2023.70845
• 3- Harrell M, Selvaraj SA, Edgar M. Danger! Crisis health workers at risk. Int J Environ Res Public Health. 2020;17(15):5270. doi:10.3390/ijerph17155270
• 4- Robinaugh, DJ, Marques L, Traeger LN, et al. Understanding the relationship of perceived social support to post-trauma cognitions and posttraumatic stress disorder. J Anxiety Disord. 2011;25(8):1072-1078. doi:10.1016/j.janxdis.2011.07.004
• 5- Simon N, Roberts NP, Lewis CE, van Gelderen MJ, Bisson JI. Associations between perceived social support, posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD): Implications for treatment. Eur J Psychotraumatol. 2019;10(1):1573129. doi:10.1080/20008198.2019.1573129
• 6- Kukihara H, Yamawaki N, Uchiyama K, Arai S, Horikawa E. Trauma, depression, and resilience of earthquake/tsunami/nuclear disaster survivors of Hirono, Fukushima, Japan. Psychiatry Clin Neurosci. 2014;68(7):524-533. doi:10.1111/pcn.12159
• 7- Uyar B, Salman BC, Aydar S, et al. Retrospective evaluation of post-traumatic stress disorder data of healthcare workers who received counseling from psychosocial support unit after the kahramanmaraş earthquake. TJCL. 2023;14(4):753-759. doi:10.18663/tjcl.1384085
• 8- Weathers FW, Litz BT, Keane TM, Palmieri PA, Marx BP, Schnurr PP. The PTSD checklist for DSM-5 (PCL-5). National Center for PTSD. 2013. Scale available from the National Center for PTSD at www.ptsd.va.gov.
• 9- Boysan M, Guzel Ozdemir P, Ozdemir O, Selvi Y, Yilmaz E, Kaya N. Psychometric properties of the Turkish version of the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders (PCL-5). Psychiatry and Clinical Psychopharmacology. 2017;27(3):300-310. doi:10.1080/24750573.2017.1342769
• 10- Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: Psychometric properties. J Consult Clin Psychol. 1988;56(6):893-897. doi:10.1037//0022-006X.56.6.893
• 11- Ulusoy M, Sahin NH, Erkmen H. Turkish version of the Beck Anxiety Inventory: Psychometric properties. Journal of Cognitive Psychotherapy.1998;12(2):163-172.
• 12- Beck AT. An inventory for measuring depression. Arch Gen Psychiatry. 1965;12:63-70.
• 13- Hisli N. A study on the validity of Beck Depression Inventory. Psikoloji Dergisi. 1988;6:118-122.
• 14- Zimet GD, Dahlem NW, Zimet SG, Farley GK. The multidimensional scale of perceived social support. Journal of Personality Assessment, 1988;52(1):30-41. doi:10.1207/s15327752jpa5201_2
• 15- Eker D, Arkar H, Yaldız H. Factorial structure, validity, and reliability of revised form of the multidimensional scale of perceived social support. Turk Psikiyatri Dergisi. 2001;12(1):17-25.
• 16- Connor KM, Davidson JRT. Development of a new resilience scale: The Connor-Davidson Resilience Scale (CD-RISC). Depress Anxiety. 2003;18(2):76-82. doi:10.1002/da.10113
• 17- Karairmak Ö. Establishing the psychometric qualities of the Connor–Davidson Resilience Scale (CD-RISC) using exploratory and confirmatory factor analysis in a trauma survivor sample. Psychiatry Res. 2010;179(3):350-356. doi:10.1016/j.psychres.2009.09.012
• 18- Satilmis D, Yildiz E, Cevik E. Posttraumatic stress disorder in healthcare workers after two major earthquakes centered in Kahramanmaraş, Turkey. Turk J Emerg Med. 2024;24(1):27-32. doi:10. 10.4103/tjem.tjem_192_23
• 19- Tahernejad S, Ghaffari S, Ariza-Montes A, Wesemann U, Farahmandnia H, Sahebi A. Post-traumatic stress disorder in medical workers involved in earthquake response: A systematic review and meta-analysis. Heliyon. 2023;9(1):e12794. doi:10.1016/j.heliyon.2023.e12794
• 20- Shrestha R. Post-traumatic stress disorder among medical personnel after Nepal earthquake. J Nepal Health Res Counc. 2015;13(2):30-39. doi:10.33314/jnhrc.v0i0.639
• 21- Forkus SR, Raudales AM, Rafiuddin HS, Weiss NH, Messman BA, Contractor AA. The Posttraumatic Stress Disorder (PTSD) Checklist for DSM–5: A systematic review of existing psychometric evidence. Clin Psychol (New York). 2023;30(1):110-121. doi:10.1037/cps0000111
• 22- Sakuma A, Takahashi Y, Ueda I, et al. Post-traumatic stress disorder and depression prevalence and associated risk factors among local disaster relief and reconstruction workers fourteen months after the Great East Japan Earthquake: A cross-sectional study. BMC Psychiatry. 2015;15:58. doi:10.1186/s12888-015-0440-y
• 23- Kang P, Lv Y, Hao L, et al. Psychological consequences and quality of life among medical rescuers who responded to the 2010 Yushu earthquake: A neglected problem. Psychiatry Res. 2015;230(2):517-523. doi:10.1016/j.psychres.2015.09.047
• 24- Kocyigit BF Rehabilitation needs after earthquakes. J Korean Med Sci. 2023;38(17):e153. doi:10.3346/jkms.2023.38.e153
• 25- Yılmaz Y, Güleç S, Sarıçam, H. Posttraumatic stress disorder in the aftermath of the Turkey earthquake: exploring the role of demographics, level of exposure, and personality traits. Anxiety, Stress, & Coping. 2024:1- 12. doi:10.1080/10615806.2024.2376611
• 26- Dai W, Chen L, Lai Z, Li Y, Wang J, Liu A. The incidence of post-traumatic stress disorder among survivors after earthquakes: A systematic review and meta-analysis. BMC Psychiatry. 2016;16:188. doi:10.1186/s12888-016-0891-9
• 27- Breteler JK, Ikani N, Becker ES, Spijker J, Hendriks G. Comorbid depression and treatment of anxiety disorders, OCD, and PTSD: Diagnosis versus severity. J Affect Disord. 2021;295:1005-1011. doi:10.1016/j.jad.2021.08.146
• 28- Herzog P, Voderholzer U, Gärtner T, et al. Predictors of outcome during inpatient psychotherapy for posttraumatic stress disorder: A single-treatment, multi-site, practice-based study. Psychother Res. 2021;31(4):468–482. doi:10.1080/10503307.2020.1802081
• 29- Yıldız, Mİ, Başterzi AD, Yıldırım EA, et al. Preventive and therapeutic mental health care after the earthquake- expert opinion from the Psychiatric Association of Turkey. Turkish Journal of Psychiatry. 2023;34(1):39-49. doi:10.5080/u27305
• 30- Halkiadakis PN, Mahajan S, Crosby DR, Badrinathan A, Ho VP. A prospective assessment of resilience in trauma patients using the Connor-Davidson Resilience Scale. Surgery. 2023;174(5):1249-1254. doi:10.1016/j.surg.2023.07.012