汶川地震一年後重災區喪親者家庭功能和憂鬱的調查研究

Family Function and Depression in Relatives of Earthquake Victims: A Survey Conducted One Year after China's Wenchuan Earthquake

背景：汶川大地震，不僅造成了巨大的人員傷亡和經濟損失，而且給倖存者帶來了創傷性的心理打擊，尤其遇難者的親屬遭受的打擊更大。地震後，喪親者除了需要物質幫助外，還需要家庭和精神重建。目的：瞭解汶川地震一年後重災區喪親者憂鬱和家庭功能的現狀，並探討其憂鬱與家庭功能的相關性，為喪親家庭心理重建提供依據。方法：採用橫斷面調查法，運用家庭功能評估表和漢密爾頓憂鬱量表於汶川地震一年後對重災區的264名喪親者進行調查。結果：喪親者家庭功能總分平均為6.52 ± 2.65分，50%的喪親者家庭功能良好。喪親者的家庭功能在婚姻狀況、家庭結構及生育狀況等變項不同組別間具有顯著差異。喪親者憂鬱均分為40.41 ± 9.35分，本研究樣本均有不同程度的憂鬱症狀。得分最高的五項表現分別為：憂鬱情緒、工作興趣下降、精神性焦慮、能力減退以及激動（agitation）行為。喪親者的憂鬱症狀在婚姻、休閒娛樂頻率、震後經濟狀況和再生育狀態等變項不同組別間具有顯著差異。喪親者的家庭功能與憂鬱情緒兩變項間不具顯著之相關性。結論：汶川地震喪親者家庭功能受到不同程度損害，憂鬱症狀是喪親者普遍存在的心理問題，喪親者家庭功能與憂鬱之間的相關性未具顯著意義。本研究建議宜針對有顯著憂鬱症狀之喪親者，提供介入措施，以協助改善和提高家庭功能的有效因應技巧，從而，有效地降低個體不良心理和情緒反應，促進個體身心健康。

Background: The Wenchuan Earthquake that hit Sichuan, China in 2008 not only caused huge losses in terms of human life and economic damage. It also caused psychological trauma in survivors, especially those who had lost relatives and close friends (bereaved). In the aftermath of earthquakes, bereaved individuals require family and spiritual renewal in addition to material assistance.Purpose: This study investigated the status of and relationship between family function and depression in bereaved individuals living in areas devastated by the Wenchuan Earthquake. Results provide baseline information for postdisaster family reconstruction.Methods: This cross-sectional study surveyed 264 qualified bereaved individuals who lived in an area hard hit by the Wenchuan Earthquake. Face-to-face interviews were administered based on the family APGAR (adaptation, partnership, growth, affection, resolve) index and Hamilton depression (HAMD) scale.Results: The mean family function score for participants was 6.52 ± 2.65. Results for half (50.0%) of participants indicated ”good” family function. Results indicated marital status, family structure and status of having another baby as factors that significantly influence family function (p ＜ .05). Participants' mean depression score was 40.41 ± 9.35, with all (100%) of participants demonstrating symptoms of depression. The 5 most prevalent depressive symptoms were: depressed mood, decreased interest in work, mental anxiety, diminished capacity and agitation. Results showed marital status, leisure frequency, economic status, and having another baby as factors that significantly influenced family function (p ＜ .05). A Pearson's correlation analysis indicated no significant relationship between level of depression and family function (p ＞ .05).Conclusion: Family functions of the bereaved living in areas hard hit by the Wenchuan Earthquake were all undermined to varying degrees. Although participants all exhibited depressive symptoms, this study found no affect of such symptoms on family functions. Interventions delivered in the months and years after an earthquake should be tailored to address each individual's depression status. Interventions should also help these individuals learn to improve and enhance family functions to effectively reduce negative behaviors and reactions in order to better promote physical and mental health.