A cross-sectional community study of post-traumatic stress disorder and social support in Lao People's Democratic Republic.

Abstract:

OBJECTIVE:To estimate post-traumatic stress disorder (PTSD) symptoms in those injured and not injured by landmines or unexploded ordnance (UXO) in rural Lao People's Democratic Republic and to determine whether the perception of social support was associated with PTSD symptom severity. METHODS:A community survey was conducted among 190 people injured by landmines or UXO and 380 age-, sex- and neighbourhood-matched non-injured individuals in the Sepone district of Savannakhet Province, the part of the Lao People's Democratic Republic most heavily bombed during the Viet Nam War. Using the Harvard Trauma Questionnaire and the Medical Outcomes Study Social Support Survey, trained health-care workers conducted face-to-face interviews to assess PTSD symptoms and level of perceived social support. Multiple linear regression was performed to explore the association between social support and other factors and PTSD. FINDINGS:The prevalence of PTSD was higher among the injured (10%) than among the non-injured (4%), but the level of perceived social support was not significantly different between the two groups. A higher level of perceived social support was associated with milder symptoms of PTSD. Women, older people and those with a formal education were more often and more severely affected by PTSD. CONCLUSION:The perception of strong social support might help to alleviate the symptoms of PTSD among people injured by landmines or UXO in rural parts of the Lao People's Democratic Republic. Psychosocial interventions should be incorporated in assistance for the injured because they have more severe and longer-lasting symptoms of PTSD than the non-injured. OBJECTIF:Estimer les symptômes de stress post-traumatiques (PTSD) chez les blessés et non blessés par des mines ou des munitions non explosées en milieu rural en République Démocratique Populaire Lao et déterminer si la perception de l'aide sociale a été associée avec la sévérité des symptômes du stress post-traumatique. MÉTHODES:Une enquête communautaire a été menée auprès de 190 personnes blessées par des mines ou des munitions non explosées et de 380 individus non blessés appariés selon l'âge, le sexe et le quartier dans le district de Sepone de la Province de Savannakhet, la partie de la République Démocratique Populaire Lao la plus lourdement bombardée pendant la Guerre du Viet Nam. En utilisant le Questionnaire de Harvard relatif aux Traumatismes vécus et l'Enquête sur l'Aide Sociale de l’Étude des Conséquences Médicales, des travailleurs de la santé qualifiés ont mené des entretiens en face-à-face pour évaluer les symptômes du stress post-traumatique et le niveau de l'aide sociale reçue. Une régression linéaire multiple a été effectuée afin d'étudier l'association entre l'aide sociale et d'autres facteurs et le stress post-traumatique. RÉSULTATS:La prévalence du stress post-traumatique est plus élevée chez les blessés (10%) que chez les non-blessés (4%), mais le niveau de l'aide sociale reçue n'était pas significativement différente entre les deux groupes. Un niveau plus élevé d'aide sociale reçue a été associé à des symptômes plus légers de stress post-traumatique. Les femmes, les personnes âgées et les personnes ayant bénéficié d'un enseignement scolaire sont plus souvent et plus durement touchées par le stress post-traumatique. CONCLUSION:La perception d'une aide sociale élevée pourrait aider à soulager les symptômes de stress post-traumatique chez les personnes blessées par des mines ou des munitions non explosées dans les régions rurales de la République Démocratique Populaire Lao. Les interventions psychosociales devraient être incorporées à l'assistance aux blessés car ils ont des symptômes plus graves et plus durables de stress post-traumatique que les non-blessés. OBJETIVO:Calcular los síntomas del trastorno de estrés postraumático en personas heridas y no heridas por minas antipersona o artefactos sin detonar (UXO) en las zonas rurales de la República Democrática Popular Lao y determinar si la percepción del apoyo social estuvo asociada con la gravedad de los síntomas del TEPT. MÉTODOS:Se llevó a cabo una encuesta comunitaria entre 190 heridos por minas antipersona o UXO y 380 personas no heridas emparejadas por edad, sexo y vecindario del distrito de Sepone en la provincia de Savannakhet, la zona de la República Democrática Popular Lao que sufrió el bombardeo más intenso durante la Guerra de Viet Nam. Por medio del cuestionario para evaluar el estrés traumático de Harvard y la encuesta Medical Outcomes Study Social Support Survey, un equipo de personal sanitario formado realizó entrevistas presenciales para evaluar los síntomas del TEPT y el nivel de apoyo social percibido. Se realizó una regresión lineal múltiple para examinar la asociación entre el apoyo social y otros factores con el TEPT. RESULTADOS:La prevalencia del TEPT fue más alta entre los heridos (10 %) que entre las personas que no sufrieron heridas (4 %), sin embargo, el nivel de apoyo social percibido no varió significativamente entre ambos grupos. Un mayor apoyo social percibido estuvo asociado con unos síntomas menos graves del TEPT. Las mujeres y las personas mayores o con una buena educación se vieron afectadas con mayor frecuencia y gravedad por el TEPT. CONCLUSIÓN:La percepción de un apoyo social fuerte podría ayudar a aliviar los síntomas del TEPT entre los heridos por minas antipersona o UXO en las zonas rurales de la República Democrática Popular Lao. Deberían integrarse intervenciones psicosociales como asistencia a los heridos, ya que sus síntomas de TEPT se manifiestan con más gravedad y duración que los de las personas que no han sufrido heridas. الغرض:تقييم أعراض اضطراب إجهاد ما بعد الصدمة (PTSD) لدى المصابين وغير المصابين بفعل الألغام الأرضية أو الذخائر غير المتفجرة في ريف جمهورية لاو الديمقراطية الشعبية وكذلك تحديد ما إذا كان تصور الدعم الاجتماعي له صلة بدرجة وخامة أعراض اضطراب إجهاد ما بعد الصدمة. الطريقة:تم إجراء دراسة مجتمعية على 190 مصاباً بفعل الألغام الأرضية أو الذخائر غير المتفجرة و380 شخصاً غير مصاب يتطابقون معهم من حيث العمر والجنس والجوار في منطقة سيبون بمقاطعة سافاناكيت ، ذلك الجزء من جمهورية لاو الديمقراطية الشعبية الذي تعرض للقصف الشديد أثناء حرب فيتنام. أجرى مقدمو الرعاية الصحية المدربون مقابلات وجهاً لوجه لتقييم أعراض اضطراب إجهاد ما بعد الصدمة ومستوى الدعم الاجتماعي المتصور باستخدام استبيان للصدمة ومسح الدعم الاجتماعي لدراسة النتائج الطبية. وتم إجراء الارتداد الخطي المتعدد لاستكشاف العلاقة بين الدعم الاجتماعي وغيره من العوامل واضطراب إجهاد ما بعد الصدمة. النتائج:كانت نسبة انتشار اضطراب إجهاد ما بعد الصدمة أكبر بين المصابين (10 %) عن غير المصابين (4 %)، ولكن مستوى الدعم الاجتماعي المتصور لم يختلف كثيراً بين المجموعتين. وكان هناك مستوى أعلى من الدعم الاجتماعي المتصور يرتبط بالأعراض الأخف لاضطراب إجهاد ما بعد الصدمة. وكانت النساء والأشخاص الأكبر والحاصلون على تعليم رسمي هم من يتأثرون في الغالب باضطراب إجهاد ما بعد الصدمة وأشد المتضررين منه. الاستنتاج:ربما يساعد تصور الدعم الاجتماعي القوي في تخفيف أعراض اضطراب إجهاد ما بعد الصدمة بين المصابين بفعل الألغام الأرضية أو الذخائر غير المتفجرة في المناطق الريفية من جمهورية لاو الديمقراطية الشعبية. وينبغي إدراج التدخلات النفسية الاجتماعية في المساعدة المقدمة للمصابين لأنهم يعانون من أعراض أكثر حدة وأطول أمداً لاضطراب إجهاد ما بعد الصدمة عن غير المصابين. 目的:预估老挝人民民主共和国农村地区受地雷和未爆弹药(UXO)伤害和未受伤人群中的创伤后应激障碍(PTSD)征候,并确定社会支持的觉知是否与PTSD症状严重程度有关。 方法:在沙湾拿吉省车邦区 190 名受地雷或UXO伤害的个人以及 380 名年龄、性别和毗邻关系与之匹配的未受伤害个体中进行社区调查,该地区是越南战争期间老挝受到最猛烈轰炸的地区之一。经过培训的医护工作者使用哈佛创伤问卷和医疗成果研究社会支持调查对被调查者进行面对面的访谈,评估PTSD症候和觉知社会支持的等级。执行多元线性回归,以探索社会支持和其他因素与PTSD之间的关联。 结果:受伤者中的PTSD发病率(10%)高于未受伤者(4%),但是两个群体之间觉知社会支持的水平没有显著差异。更高水平的觉知社会支持与更缓和的PTSD症状相关。妇女、老年人和接受过正规教育的人更经常和更严重地受到PTSD的影响。 结论:对强大社会支持的觉知可能有助于缓解老挝人民民主共和国农村地区受地雷或UXO伤害群体的者PTSD症状。在对受伤者的救助中应纳入心理社会干预,因为他们的PTSD症状比未受伤害的人更严重,更持久。 Цель:Провести количественный анализ симптомов посттравматических стрессовых расстройств (ПТСР) у пострадавших и не пострадавших от взрывов мин и неразорвавшихся боеприпасов (НРБ) жителей сельских районов Лаосской Народно-Демократической Республики и установить, зависит ли восприятие общественной поддержки от тяжести симптомов ПТСР. Методы:В районе Сепоне провинции Саваннакет— территории Лаосской Народно-Демократической Республики, подвергшейся наиболее интенсивным бомбардировкам во время войны во Вьетнаме, — был проведен опрос местных жителей, в котором участвовали 190 человек, подорвавшихся на минах или неразорвавшихся боеприпасах, и 380 человек, не получивших физических травм и подобранных с учетом сопоставимости пола, возраста и места жительства. Пользуясь Гарвардским опросным листом для оценки травм и анкетой исследования медицинских результатов в части мер социальной поддержки, квалифицированные медработники проводили личные интервью и оценивали симптомы ПТСР и восприятие общественной поддержки. Для изучения связи общественной поддержки с другими факторами и с ПТСР применялись методы множественной линейной регрессии. Результаты:У пострадавших симптомы ПТСР проявлялись чаще (10%), чем у непострадавших (4%), однако восприятие общественной поддержки в обеих группах было примерно одинаковым. Более высокий уровень восприятия общественной поддержки наблюдался у лиц с более легкими симптомами ПТСР. Более частые и тяжелые проявления ПТСР наблюдались у женщин, лиц пожилого возраста и лиц, получивших формальное образование. Вывод:Убежденность в наличии сильной общественной поддержки способна облегчить остроту симптомов ПТСР у жителей сельских районов Лаосской Народно-Демократической Республики, подорвавшихся на минах и НРБ. В программу помощи пострадавшим необходимо включать меры психосоциального характера, поскольку у них симптомы ПТСР протекают тяжелее и дольше, чем у непострадавших.

authors

Southivong B,Ichikawa M,Nakahara S,Southivong C

doi

10.2471/BLT.12.115311

subject

Has Abstract

pub_date

2013-10-01 00:00:00

pages

765-72

issue

10

eissn

0042-9686

issn

1564-0604

pii

BLT.12.115311

journal_volume

91

pub_type

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  • Neutralizing and haemagglutination-inhibiting antibodies to yellow fever 17 years after vaccination with 17D vaccine.

    abstract::The duration of immunity conferred by yellow fever vaccine is as yet undetermined. In this study the neutralizing and haemagglutination-inhibiting antibodies to yellow fever were investigated in 108 persons living in Pouso Alegre, Brazil, where yellow fever has never been reported. These persons had been vaccinated wi...

    journal_title:Bulletin of the World Health Organization

    pub_type: 杂志文章

    doi:

    authors: GROOT H,RIBERIRO RB

    更新日期:1962-01-01 00:00:00

  • Griseofulvin in the mass treatment of tinea capitis.

    abstract::The prevalence of ringworm of the scalp in many countries, and the fact that many of the current measures to control it are inconvenient for mass use, lend particular interest to the account given in this paper of mass treatment of tinea capitis in an Arab village in Israel. A total of 446 cases were treated, on an am...

    journal_title:Bulletin of the World Health Organization

    pub_type: 杂志文章

    doi:

    authors: ZIPRKOWSKI L,KRAKOWSKI A,SCHEWACH-MILLET M,BTESH S

    更新日期:1960-01-01 00:00:00

  • Prevention of blindness and priorities for the future.

    abstract::The impact of visual loss has profound implications for the person affected and society as a whole. The majority of blind people live in developing countries, and generally, their blindness could have been avoided or cured. Given the current predictions that the number of blind people worldwide will roughly double by ...

    journal_title:Bulletin of the World Health Organization

    pub_type: 杂志文章,评审

    doi:

    authors: West S,Sommer A

    更新日期:2001-01-01 00:00:00

  • A specific ELISA method for determining chloroquine in urine or dried blood spots.

    abstract::Reported is an enzyme-linked immunosorbent assay (ELISA) that has been optimized and validated for the determination of chloroquine in urine or dried blood spots. The assay employs antisera raised in sheep to a chloroquine derivative conjugated to keyhole limpet haemocyanin and chloroquine conjugated to porcine thyrog...

    journal_title:Bulletin of the World Health Organization

    pub_type: 杂志文章

    doi:

    authors: Rowell V,Rowell FJ,Baker A,Laurie D,Sidki AM

    更新日期:1988-01-01 00:00:00

  • Employment and health after retirement in Japanese men.

    abstract:Objective:To estimate the average treatment effect of working past the current retirement age on the health of Japanese men. Methods:We used publicly available data from the National Survey of Japanese Elderly, extracting a sample of 1288 men who were 60 years or older. Survey respondents were followed-up for at most ...

    journal_title:Bulletin of the World Health Organization

    pub_type: 杂志文章

    doi:10.2471/BLT.18.215764

    authors: Okamoto S,Okamura T,Komamura K

    更新日期:2018-12-01 00:00:00

  • The arenaviruses: some priorities for future research.

    abstract::In this paper Lassa virus is used as a model in pinpointing priorities for future research on the arenaviruses. Suggestions for specific investigations and public health measures cover the detection of Lassa virus infection, the pathology and therapy of the disease, and its prevention and control. ...

    journal_title:Bulletin of the World Health Organization

    pub_type: 杂志文章

    doi:

    authors: Johnson KM

    更新日期:1975-01-01 00:00:00

  • An estimate of the frequency of diagnostic X-ray examinations in Kenya in 1986.

    abstract::The frequency of radiological examinations in a country is an important indicator of the general scope of such services in that setting. Frequency data obtained from surveys provide health planners with valuable information that can form an objective basis for resource allocation. Also, from the point of view of radia...

    journal_title:Bulletin of the World Health Organization

    pub_type: 杂志文章

    doi:

    authors: Tole NM

    更新日期:1989-01-01 00:00:00

  • Use of ELISA to reveal rodent infections in plague surveillance and control programmes.

    abstract::To assess its potential applications in plague surveillance and control programmes, an enzyme-linked immunosorbent assay (ELISA) that captures the specific Yersinia pestis F1 antigen was used to determine the amounts of this antigen present in samples of blood and spleens from laboratory rats with acute plague, in the...

    journal_title:Bulletin of the World Health Organization

    pub_type: 杂志文章

    doi:

    authors: Williams JE

    更新日期:1990-01-01 00:00:00