Lack of access to medical care during Hurricane Sandy and mental health symptoms.
Lack of access to medical care during Hurricane Sandy and mental health symptoms.
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DOI：
10.1016/j.pmedr.2018.04.014
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发表时间：
2018-06
影响因子：
2.8
通讯作者：
Schwartz RM
中科院分区：
文献类型：
--
作者：
Ruskin J;Rasul R;Schneider S;Bevilacqua K;Taioli E;Schwartz RM
自然灾害造成的破坏损害了医疗服务提供者和医院提供护理的能力。飓风桑迪造成的破坏尤其严重，导致该地区医疗服务大规模中断。这项研究旨在确定飓风桑迪期间缺乏医疗服务是否与创伤后应激障碍（PTSD）症状和其他心理健康/药物滥用结果有关。第二个目的是检查是否有慢性疾病缓和这些协会。在飓风桑迪之后，在“领导者一起聚集希望”项目（2013年10月23日-2015年2月25日）和“恢复项目”（2014年6月5日-2016年8月9日）下，从纽约市和长岛居民（n = 1669）中获得了自我报告的医疗服务和心理健康状况。多变量逻辑回归被用来确定缺乏获得医疗保健和心理健康结果之间的关系。在1669名参与者中，994名（59.57%）为女性，866名（51.89%）为白色，平均年龄为46.22岁（SD = 19.2）。与那些能够获得医疗服务的人相比，那些无法获得医疗服务的人出现PTSD症状（AOR = 2.71，CI = [1.77-4.16]）以及抑郁（AOR = 1.94，CI = [1.29-2.92]）和焦虑（AOR = 1.61，CI = [1.08-2.39]）的几率显著更高。缺乏护理与感知压力量表评分增加2.12分相关（SE = 0.63）。患有慢性病和缺乏医疗保健之间的相互作用与任何结果都没有显着相关性。研究结果强调了在自然灾害期间使慢性病和急性病患者更容易获得医疗服务的重要性，以有利于他们的身体和心理健康。没有获得医疗护理的个人有显着更高的几率表现出心理健康问题的症状。慢性疾病并没有缓和缺乏获得护理和心理健康结果之间的关系。在自然灾害期间获得医疗保健可能有益于患有或不患有慢性病的幸存者的心理健康。</span>
Destruction caused by natural disasters compromises medical providers' and hospitals' abilities to administer care. Hurricane Sandy was particularly devastating, resulting in massive disruptions of medical care in the region. This study aimed to determine whether a lack of access to medical care during Hurricane Sandy was associated with posttraumatic stress disorder (PTSD) symptoms and other mental health/substance abuse outcomes. A secondary aim was to examine whether having a chronic illness moderates those associations. Self-reported medical access and mental health symptomatology were obtained from New York City and Long Island residents (n = 1669) following Hurricane Sandy under the Leaders in Gathering Hope Together project (10/23/2013–2/25/2015) and Project Restoration (6/5/2014–8/9/2016). Multivariable logistic regressions were utilized to determine the relationship between lack of access to medical care and mental health outcomes. Of the 1669 participants, 994 (59.57%) were female, 866 (51.89%) were white, and the mean age was 46.22 (SD = 19.2) years old. Those without access to medical care had significantly higher odds of showing symptoms of PTSD (AOR = 2.71, CI = [1.77–4.16]), as well as depression (AOR = 1.94, CI = [1.29–2.92]) and anxiety (AOR = 1.61, CI = [1.08–2.39]) compared to those with access. Lack of access to care was associated with a 2.12 point increase in perceived stress scale score (SE = 0.63). The interaction between having a chronic illness and lack of access to medical care was not significantly associated with any outcomes. The findings emphasize the importance of making medical care more accessible to patients, both chronically and acutely ill, during natural disasters to benefit their physical as well as their mental health. Individuals without access to medical care had asignificantly higher odds of showing symptoms of mental health difficulties. Chronic illness did not moderate the relationship between a lack of access to care and mental health outcomes. Access to medical care during natural disasters may benefit the mental health of survivors with and without chronic illness.</span>