| 摘要: | 一九九九年九月二十一日凌晨一時四十七分在南投發生了芮氏規模7.3級之集集大地震，共造成2347人死亡。地震翻轉了災區整體的健康生活環境，也導致居民生理、心理、社會的障礙。本研究採用中文版戴氏創傷量表（DTS-C）及中國人健康量表（CHQ-12）自填式問卷對台中縣災區大里市、新社鄉、石岡鄉、東勢鎮等組合屋災民272位施以問卷調查。主要目的是要探討組合屋居民創傷後反應(PTSD)及CHQ狀況及相關影響因素與生活需求，並對台中縣、南投縣，彰化縣等三縣進行民國八十七、八十八年年齡標準化死亡率及死因別死亡率之分析及比較。以SAS套裝軟體及SPSS/PC作檢定。PTSD與年齡、教育程度、自己受傷有統計相關性。CHQ之身體、精神症狀與年齡、自己受傷有統計上的差異。目前災民的生活需要協助項目以經濟生活、環境生活、就業輔導為主。三縣標準化死亡率男、女88年都比87年高，男性高於女性，災區88年事故傷害死亡率均比87年高，男女性均以88年9 月的事故傷害死亡率為最高，災區男性心血管疾病死亡率在地震後一個月為最高，女性心血管疾病死亡率在88年9 月時最高，三縣市男性災區自殺死亡率在88年10月、11月均比87年同時間高，災區女性88年10月自殺死亡率比88年9月高亦比87年同時間高。建議在災區應以社區服務為導向，結合產、官、學界力量，協助社區災民能自治、自主、自決以重建健康的社區。公共衛生除應提供緊急醫療救護外、更應重視慢性病防治、社區心理衛生之工作，尤其要關懷社區之高齡者或高危險群，平時更應加強災變之應變及安全教育，以減少傷亡及病情惡化。; On September 21, 1999 at 1.47 am, an earthquake of magnitude 7.3 on the Richter scale occurred in Chi-Chi, Nantou county in central Taiwan. 2347 people were killed and an even larger number of people were affected physically, socially and psychologically. The objective of this study was to assess the physical and psychological effects of the quake among survivors living in temporary housing and to compare mortality rates of 1998 and 1999. Four districts in Taichung county were included in the study: Dali, Hsin-shr, Shr-kang, Tong-shr. 272 survivors were interviewed by questionnaire and included demographic data and items related to the effects of the earthquake on the survivors. The Davidson Trauma Scale (DTS-C) and the Chinese Health Questionnaire (CHQ-12) were used to evaluate the psychological and physical effects of the quake. Age-adjusted mortality rates and causes-specific mortality rates were calculated for 1998 and 1999. The data were analyzed using SAS and SPSS software. Prevalence rates of post-traumatic stress disorder (PTSD) and CHQ among females were 22.2% and 64%, but were significantly lower among males (9.2% and 47.9%). Using multiple linear and logistic regression models, the results showed that prevalence of PTSD was significantly correlated with age, education level and physical injury. The results of the CHQ showed that psychological and physical effects of the quake were significantly related to age and physical injury. The most frequently reported needs items was economic, followed by environmental and psychological. Standardized mortality rates were consistently higher in 1999 compared to 1998 for both males and females. Mortality rate due to injury peaked in September 1999. Cardiovascular disease among males and females peaked in October and September, 1999, respectively. In central Taiwan, mortality due to suicide among males was significantly higher from October to November, 1999 compared to the same period in 1998. For females, suicide rate was significantly higher in October 1999 compared to the same month in the previous year. The results of our study were consistent with other previous studies in that the earthquake had a considerable physical and psychological effect on survivors living in temporary housing units. The authors recommend that government agencies, private corporations and academics cooperate to help quake survivors rebuild their lives by becoming more independent. Also, for elderly and high risk individuals, there needs to be greater provision of emergency medical care and chronic disease control as well as psychological counseling. |
