RESUMEN
BACKGROUND: An understudied area of interest in post-disaster public health is individuals' use of social networks as a potential determinant of quality of life (QOL) and mental health outcomes. A population-based cross-sectional study was carried out to examine whether continual use of online social networking (Facebook) in an adult population following a massive earthquake was correlated with prevalence of depression and post-traumatic stress disorders (PTSD) and QOL outcomes. METHODS: Participants were a sample of 890 adults aged 25-54 who had been exposed to the L'Aquila earthquake of 2009. Definition of "user" required a daily connection to the Facebook online social network for more than 1 h per day from at least 2 years. Depression and PTSD were assessed using the Screening Questionnaire for Disaster Mental Health. QOL outcomes were measured using the World Health Organisation Quality of Life BREF (WHOQOL-BREF) instrument. Logistic regression was carried out to calculate the prevalence odds ratios (POR) for social network use and other covariates. RESULTS: Two hundred and twenty one of 423 (52.2%) men, and 195 of 383 (50.9%) women, had been using Facebook as social network for at least 2 years prior to our assessment. Social network use correlated with both depression and PTSD, after adjusting for gender. A halved risk of depression was found in users vs. non-users (POR 0.50 ± 0.16). Similarly, a halved risk of PTSD in users vs. non-users (POR 0.47 ± 0.14) was found. Both men and women using online social networks had significantly higher QOL scores in the psychological and social domains of the WHOQOL-BREF. CONCLUSION: Social network use among adults 25-54 years old has a positive impact on mental health and QOL outcomes in the years following a disaster. The use of social networks may be an important tool for coping with the mental health outcomes of disruptive natural disasters, helping to maintain, if not improve, QOL in terms of social relationships and psychological distress.
RESUMEN
BACKGROUND: People's well-being after loss resulting from an earthquake is a concern in countries prone to natural disasters. Most studies on post-earthquake subjective quality of life (QOL) have focused on the effects of psychological impairment and post-traumatic stress disorder (PTSD) on the psychological dimension of QOL. However, there is a need for studies focusing on QOL in populations not affected by PTSD or psychological impairment. The aim of this study was to estimate QOL changes over an 18-month period in an adult population sample after the L'Aquila 2009 earthquake. METHODS: The study was designed as a longitudinal survey with four repeated measurements performed at six monthly intervals. The setting was the general population of an urban environment after a disruptive earthquake. Participants included 397 healthy adult subjects. Exclusion criteria were comorbidities such as physical, psychological, psychiatric or neurodegenerative diseases at the beginning of the study. The primary outcome measure was QOL, as assessed by the WHOQOL-BREF instrument. A generalised estimating equation model was run for each WHOQOL-BREF domain. RESULTS: Overall, QOL scores were observed to be significantly higher 18 months after the earthquake in all WHOQOL-BREF domains. The model detected an average increase in the physical QOL scores (from 66.6 ± 5.2 to 69.3 ± 4.7), indicating a better overall physical QOL for men. Psychological domain scores (from 64.9 ± 5.1 to 71.5 ± 6.5) were observed to be worse in men than in women. Levels at the WHOQOL domain for psychological health increased from the second assessment onwards in women, indicating higher resiliency. Men averaged higher scores than women in terms of social relationships and the environmental domain. Regarding the physical, psychological and social domains of QOL, scores in the elderly group (age > 60) were observed to be similar to each other regardless of the significant covariates used. CONCLUSIONS: WHOQOL-BREF scores of the psychological domain displayed trends conditioned by age and education: older subjects experienced less satisfaction with psychological health on average. Less-educated subjects always demonstrated the worst QOL scores. Gender, age and education impacted the variability of QOL in the environmental dimension in the elderly.
