Unlike many other natural disasters, earthquakes come without warning, and their impact
is often widespread and their effects ongoing 20]. In the face of earthquakes and corresponding harsh environments, rescuers may become
fragile both physically and mentally 21]. Research into the HRQoL of medical rescuers could prove valuable data for future
rescue work and enhance the overall effectiveness of rescue efforts after a major
earthquake 22].
Using the SF-12 as an instrument to assess the impact of the Ludian earthquake rescue
experience on the overall HRQoL of medical rescuers, we found that the rescuers had
a similar PCS score compared to the normal population (49.86 vs 50); however, they had an obviously lower MCS score than the normal population (35.85
vs 50). This result confirmed that the HRQoL of rescuers, especially for mental health
status, had been impaired by the Ludian earthquake. Interestingly, when we compare
the health status of the rescuers with the survivors after Wenchuan earthquake, we
found the rescuers had an obvious higher PCS score (49.86 vs 37.6) but a relatively low MCS score (35.85 vs 36.8) 23]. Medical rescuers’ duty is to provide professional medical care to the wounded as
soon as possible. In executing their responsibilities, they may confront dead bodies,
seriously injured victims, and negative reactions and even violence on the part of
victims 24], 25]. All of these factors may contribute to the impairment of rescuers’ psychological
health status.
With respect to risk factors of HRQoL among rescuers, we found that military medical
rescuers had both higher PCS and MCS scores. As military service members, these medical
personnel go to the nearest encampment and participate in a series of military skills
training sessions every year. By training, they build good physical fitness and learn
coping skills in the face of harsh conditions.
Being trapped/in danger is one factor that not only worsens rescuers’ physical health
status (PCS: 48.72 vs. 50.18) but also puts them at greater risk for bad mental health status (MSC: 34.63
vs. 36.21). The government should pay more attention to rescuers placed in danger and
ensure that when the rescuers get hurt, they receive medical and psychological services
in a timely fashion. Age is another predictor that has significant impact on rescuers’
physical health status. This result is easy to understand since physical strength
declined with age. However, the same trend didn’t occur for psychological aspects,
which is inconsistent with previous studies 6], 9], 26].
As for risk factors for rescuers’ mental state, we found gender and education level
were two important factors. Previous studies have indicated that women are more sensitive
to threats, less likely to use effective coping strategies, and tend to interpret
disasters more negatively than men do 27]. In addition, women are thought to be more sensitive to stress hormones, so their
ability to manage stressful situations may be relatively poorer than men’s ability
28]. This finding suggests the need to pay more attention to women and create targeted
interventions for female rescuers who respond to large disasters to reduce their psychological
burden. Coping skills training (e.g. anger/hostility management and self-efficacy training) could be helpful for primary
and secondary prevention in female rescuers 29]. Educational level indirectly influences economic resources, social status, social
networks, health behaviour, and so on 30]. Medical rescuers with higher education levels might employ better coping methods
because they have greater social resources, thus reducing the incidence of mental
health problems.
Inconsistent with previous studies, we found that rescue training was not a significant
predictor in our study 31]. This phenomenon may remind relevant policy makers to pay more attention to the content
and quality of rescue training that medical personnel received before starting work.
A series of comprehensive and systematic disaster relief training should be popularized
among medical staff.
Certain limitations of this study should be recognized. First, this study is based
on questionnaires; as such, it allows for the possibility of response bias. Another
limitation is the study’s cross-sectional design. Longitudinal studies are needed
preferably with an assessment prior to severe events. Besides, as an observational
study, we took many factors into account, but might ignore some important confounders
such as lifestyle, mental state, emotional component, co-existing stressors, mental
state, coping strategies and so on. Despite these limitations, the present study is
the first cross-sectional study focusing on health-related quality of life and its
risk factors in medical rescue populations following an earthquake. In our study,
significant associations between demographic, trauma-related, and rescue-related experiences
variables and overall physical and mental health of medical rescuers were presented.