Objective To investigate the mental health status, perceived social support, as well as the relationship between them among middle school students in Wenchuan Earthquake region, so as to provide references for the relevant department to formulate appropriate strategies and intervention measures. Methods A cluster sampling method was adopted to select all 1698 students (excluded the students in Grade 3) as the research subjects from three middle schools in the disaster regions. All students were investigated with self-designed basic information questionnaire, Symptom CheckList 90 (SCL-90) and Perceived Social Support Scale (PSSS) through self-administered questionnaire. Results The overall positive rate on the SCL-90 was 46.3% among 1690 students, of whom 66.6% had mild psychological problems and 26.5% had moderate to severe psychological problems. The positive rate on the SCL-90 and the score for each factor of SCL-90 were statistically higher in the female students than male students (Plt;0.05). Compared with the senior middle school students, the score on the phobic anxiety subscale of the SCL-90 was statistically higher in the junior middle school students (Plt;0.05), while the score on the obsessive-compulsive subscale was otherwise statistically lower (Plt;0.05). With the exception of the hostility subscale, the score on each subscale of the SCL-90 in the urban students was statistically lower than the rural students (Plt;0.05). The median score on the perceived social support subscale was 60.00, with significant differences between the students of different sexes and grades (Plt;0.05). The overall score on the perceived social support subscale was negatively correlated with the SCL-90 score (r= –0.261, Plt;0.05). The score was negatively correlated with the SCL-90 score in the students regarding different sexes, grades and living areas prior to the earthquake (Plt;0.05). Conclusion The middle school students in the disaster regions have prominent psychological problems; perceived social support is helpful to promote the development of their mental health. In conducting psychological intervention, the difference of individuals’ mental health among different student groups should be concerned, so as to carry out targeted counseling and education.
Objective To provide a disaster triage method by analyzing the data of the hospital transferring casualties after Wenchuan earthquake. Method The data of the patients’ admission and hospital transferring in the West China Hospital were collected after the earthquake in two weeks. Moreover, the reason and the method of the hospital transferring were analyzed. Result In the first two weeks since the earthquake struck Wenchuan, the number of the available bed for earthquake patients in West China Hospital was 124 per day, but in the 2 227 earthquake patients treated, 1 181 patients were admitted. Comparing with the number of the total hospitalized, the percentage is 53.03%. The hospital was overloaded. After a reasonable hospital transference, the daily number of inpatients was stable and all the patients were treated sufficiently. Conclusion After a natural disaster, an effective administration transferring patients to suitable medical recourse should be performed, so that more right treatments should be given to more right patients in the right time and right place.
Objective To access and identify risk factors related to death and injuries in earthquakes. Method We searched The Cochrane Library, SCI, PubMed, CBM and CNKI from establishment to June 2008 to identify cohort, case-control and cross-sectional studies involving risk factors related to death and injuries in earthquakes. The methodological quality of included cohort and case-controlled studies were assessed, and the potential risk factors of earthquake related death and injuries were systematically enumerated. Results Two cohort, 2 case-control and 4 cross-sectional studies were included. Some included studies might be associated with selection bias. Risk factors for earthquake death and injuries included age, gender, mental disease, physical disabled, socioeconomics status, type/ age/ height/ collapse of building, motor vehicle driver and geographical location when the earthquake occurred. Conclusions Death and injuries in earthquakes may be attributed to 3 categories: demographic characteristics, building features, and seismic/ geographical/ location factors. However, the conclusion of this review and its implications may be limited by the potential selection bias of included studies and the regional characteristics of the included populations. Original studies from Chinese seismic areas are especially needed.
ObjectiveTo evaluate prehospital treatment strategies of rescuers and first-line hospitals for thoracic trauma victims after Lushan earthquake, and provide reference for making emergency response plans, staff training, and preparedness of material and human resources for future disasters. MethodsClinical data of 365 victims in Lushan '4.20' earthquake who received treatment in West China Hospital were retrospectively analyzed. Among them, 63 victims had thoracic trauma, including 40 males (63.5%)and 23 females (36.5%)with their age of 49.08±19.10 years. There were 244 victims with orthopedic trauma, including 133 males (54.5%)and 111 females (45.4%)with their age of 41.59±22.74 years. Prehospital treatment methods (including specific treatment and general treatment)were compared between thoracic trauma victims and orthopedic trauma victims. ResultsAmong all the thoracic trauma victims, 51 victims required specific pre-hospital treatment, but only 10 (19.6%)victims actually received it. Among all the orthopedic trauma victims, 220 victims required specific prehospital treatment, but actually 162 (73.6%)victims received it. The percentages of thoracic and orthopedic victims who received specific prehospital treatment were statistically different (P < 0.01). There was no statistical difference in the percentage of victims who received general treatment between thoracic and orthopedic trauma victims (P > 0.05). ConclusionsThoracic trauma victims receive less specific prehospital treatment than orthopedic trauma victims from rescuers and first-line hospitals after Lushan earthquake. More specific prehospital treatment is needed for thoracic trauma victims in disaster rescue in the future.
Objectives To evaluate the effectiveness, safety, applicability and economy of psychological assessment instruments including checklists, questionnaires and scales used in population exposed to earthquake. MethodsWe searched PubMed, EMbase, The Cochrane Library, CBM, CNKI, VIP, WanFang Data, and CiNii databases, as well as special websites about earthquake and disaster management from inception to July 30th, 2014 to collect studies related to psychological assessment of population exposed to earthquake in the first month after quake. A descriptive analysis was conducted to analyze the positive detection rate of psychological problems, rate of informed consent, and effective response rate in population exposed to earthquake, as well as the cost of psychological assessment. ResultsA total of 67 studies were included which involved 4 instruments including Symptom Checklist 90 (SCL-90), Self-Reporting Questionnaire-20 (SRQ-20), Chinese Psychosomatic Health Scale-134 (CPSHS-134) and 12-item General Health Questionnaire (GHQ-12). SCL-90 was the most commonly used scale. Forty-five studies reported the positive detection rate of psychological problems in population exposed to earthquake. The positive detection rates by using SCL-90, GHQ-12 and SRQ-20 were 8.6% to 77.8%, 65.6% to 89.9% and 65.6% to 89.9%, respectively. Informed consent was reported in 27 studies, and effective response rate was reported in 20 studies with the highest one 99.56% for CPSHS-134. No study reported the cost of psychological assessment. ConclusionSCL-90, RQ-20, CPSHS-134 and GHQ-12 are mainly used instruments for assessing psychological problems in population exposed to earthquake in the first month after quake. The reporting of important information related to effectiveness, safety, applicability and economy of psychological assessment instruments is insufficient and not standardized. A concise and authoritative psychological assessment instrument for population exposed to earthquake is warranted.
Objective To discuss the treatment of craniocerebral injuries caused by earthquake. Methods Retrospective analysis of clinical information for 256 patients with craniocerebral injury caused by an earthquake. Results The ‘Classification and Treatment’ was applied to the patients, whether or not they were operated on. A total of 146 patients were cured, 68 improved, 24 remained dependent on the care of others, and 8 died. The mortality rate was 3.13%. Conclusion Applying the ‘Classification and Treatment’ to patients with craniocerebral injury following an earthquake supported the use of medical resources and was associated with a low rate of death and disability.
During the medical rescue of Wenchuan earthquake, on the condition of ensuring the security of producing environment and food, following the four concepts including standard production, instant cooling technology, networking management and nutrition guidance, the CPU of West China Hospital stopped the production of possibly uncontrolled food, developed a reasonable plan for materials in stock, reinforced the inspection of sources of raw materials and quality of food, adjusted styles of dishes, proviced made special food for the wounded and their relatives from different districts and nationalities, new dishes for the wounded and the medical staff, so as not only to assure the nutrition for the slightly wounded, but also to provide the individualized nutrition treatment for the severely wounded. A total of 70 077 person-times for the wounded from the disaster area (36 330 person-times for the wounded and 33 747 person-times for their family members), and 36 273 person-times for doctors and nurses have been served. Meanwhile, the food service has also been offered as regular to other patients and hospital staff, with a maximum of 18 372 person-times per day.
ObjectiveTo explore the relationship between severity of gastrointestinal symptoms and psychological stress after the earthquake. MethodsThe sample was teachers from Baoxing county which was most affected by the earthquake. Post-traumatic stress disorder checklist civilian version (PCL-C) scale was used to assess the symptoms of psychological stress at 2-3 weeks, 2-3 months, and 6 months after the earthquake, and gastrointestinal symptoms were evaluated using three questions of patient health questionare (PHQ)-15 at 2-3 months and 6 months after the earthquake. Spearman rank correlation was used to explore the dynamic relationship between the symptoms of psychological stress evaluated at the three waves and gastrointestinal symptoms evaluated at 2-3 months and 6 months after the earthquake. ResultsPrevalence rates of gastrointestinal symptoms in teachers were 6.7% and 4.7% for stomach and abdominal pain, 6.7% and 5.6% for constipation and diarrhea, and 9.1% and 8.1% for nausea and gastrointestinal flatulence or dyspepsia at 2-3 months and 6 months after the earthquake. The relationships between three gastrointestinal symptoms evaluated at 2-3 months and 6 months after the earthquake and psychological stress symptoms evaluated at the three waves were all significant (all P<0.05). ConclusionGastrointestinal symptoms are common among the teachers. The association between psychological stress symptoms and severity of gastrointestinal symptoms at the same point after the earthquake is most strong, and psychological stress symptoms in the early period can predict the severity of subsequent gastrointestinal symptoms, and gastrointestinal symptoms in the early period can predict symptoms of subsequent psychological stress.
ObjectiveTo summarize the nursing experience of vacuum-assisted closure (VAC) technology for deficiency of skin and soft tissue in "4·20" earthquake damage. MethodsWe used VAC to treat 20 patients suffering from deficiency of skin and soft tissue who were injured in "4·20" earthquake (35 wounds) from April 21st to 28th, 2013; and we observed closely the results of nursing for pain and psychological care. ResultsA total of 35 wounds were all cleaned after 5 to 7 days; 20 wounds were healed after VAC treatment; 15 wounds recovered well by covering autogenous split-thickness skin; 20 patients had stable emotion and all left the hospital with the recovery. ConclusionVAC for deficiency of skin and soft tissue caused by "4·20" earthquake damage may obviously decrease the time of wound healing, relieve the pain caused by changing fresh dressing, and reduce the length of stay in the hospital.
ObjectiveTo analyze injury sites and radiologic features of 60 patients with severe earthquake trauma in Min-Zhang earthquake in 2013. MethodsWe retrospectively collected clinical data of 60 patients with severe earthquake trauma who were sent to major hospitals in Lanzhou city within 7 days after the earthquake. The software of Excel was used to input and analyze clinical data. ResultsAmong 60 patients with severe earthquake trauma, there were 20 cases with single-site injury and 40 cases with multi-site injury, amounting to 120 injury sites. A total of 41 cases were injured in the limbs, involving 53 parts of fracture, of which, 11 cases were injured in the upper limbs (12 sites) and 34 cases in the lower limbs (41 sites). A total of 14 cases were injured in the skull (16 sites). 13 cases were injured in the spine involving a total of 14 vertebrae, 20 sites, of which, 10 cases were accompanied by injuries in the brain and spinal cord. A total of 17 cases were injured in the chest, of which 6 cases were accompanied by rib fracture, amounting to 27 sites. A total of 7 cases were accompanied by visceral injury, involving four sites of the abdomen. ConclusionMulti-site and multi-organ injuries are the most after the earthquake, of which, limb fracture is frequently-seen and abdominal injuries are rare. Imaging examination is very useful in screening injuries caused by the earthquake and in treatment based on categorization.