| 英文摘要 |
In the early morning of September 21, 1999, Chichi Earthquake, the most severe disaster in the last century, shook Taiwan. According to statistics, the earthquake resulted in 2,494 deaths and at least ten thousand injuries. An unprecedented amount of emergency medical services as well as continued medical care were dispatched and rendered, The existing studies focused on what kinds of services were rendered and whether the medical care was adequate. However, little is known about the impact of the Chichi Earthquake on the family physicians who provided medical services and care during and after the disaster. Whether family physicians, have the proper training for coping with disaster is another main issue that has been left unexplored hy previous studies. To address these two important issues, this study aims to assess the scope and magnitude of the impact the earthquake had on the physicians involved in coping with it and the appropriateness of the medical training. Questionnaires were the main instrument for data collection. Questionnaires were sent out to all 4,778 members in the Taiwan Association of Family Medicine in January 2000 (4 months after 921 Earthquake). Among those questionnaires returned (7.6 percent return rate), 360 are valid for analysis. The final results are five-fold. First, the earthquake affected the regular practices of 9.1 percent of family physicians who completed and returned the questionnaire. As expected, those who lived in the disaster area experienced more impact than those who did not. The odds ratio for those who lived in the disaster area to those who did not was 4.8 (95% confidence interval: 2.13-10.55). This difference in impact felt between two groups is statistically significant (p=0.001). Second, 73.4 percent of the physicians indicated at least some extent of psychological impact, while 35.9 percent of physicians themselves or their family members had been hurt physically. Third, the earthquake inflicted property damage on 25.4% of the physicians. Again as expected, those who were within the disaster area had more property damage than those who lived outside the disaster area, which is statistically significant (p=0.001). The odds ratio for those who lived within the disaster area to those who did not was 5.00 (95% confidence interval: 2.75-9.35). Fourth, the days between the earthquake and the resumption of regular clinic schedules average 36.9 days for all physicians. For respondents in the disaster area, this period lasted 65.6 days, while 15.1 days were needed for non-disaster areas. The cost for recovery was an average of 328 thousand NT dollars. For the disaster area the cost was 477 thousand NT dollars and for non-disaster areas the cost was 19.1 thousand NT dollars (p=0.0769). Fifth, primary care units and local hospitals were thought to be the appropriate care units to provide emergency disaster medical service by 67.8 percent and 53.6 percent of the respondents, respectively. Among those who responded, 34.1 percent of Physicians thought they did not possess sufficient capability in provision of emergency disaster medical services and 48,7 percent felt that they lacked the ability or training to in provision of psychological services. The results of this study suggest the importance of enhancing medical training in dealing with the injuries and psychological problems associated with disasters. In addition, government should provide special assistance to these family physicians in recovering from property damage and bodily injuries since they play an essential role in providing medical care to a large number of victims and their families. |
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