The prevalence of post traumatic stress disorder (ptsd) among flood affected school
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The prevalence of post traumatic stress disorder (ptsd) among flood affected school

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The prevalence of post traumatic stress disorder (ptsd) among flood affected school The prevalence of post traumatic stress disorder (ptsd) among flood affected school Document Transcript

  • ijcrb.webs.com JUNE 2011 INTERDISCIPLINARY JOURNAL OF CONTEMPORARY RESEARCH IN BUSINESS VOL 3, NO 2 The Prevalence of Post Traumatic Stress Disorder (PTSD) among Flood Affected School Children in Pakistan Nasir Ahmad PhD scholar (Education) Foundation University Islamabad, Pakistan Dr.Tayyab Alam Bukhari Chairman Department of Education, Foundation University Islamabad, Pakistan Nargis Munir M.Sc (Clinical Psychology) FFH Rawalpindi, Pakistan ols ToAbstract d anThe present study was designed to determine the prevalence of Post traumatic stress disorder er(PTSD) among flood affected school children in Pakistan. The sample of the study was ritcomprised of 522 randomly selected students aged 10-16 years from five flood affected districts Wof Khyber Pukhtunkhwa. The instrument used in the study was The Impact of Event Scale- ee FrRevised (IES-R) to measure Post traumatic stress disorder (PTSD) among flood affected school ithchildren in Pakistan.. The main findings of the study were; secondary school students were rwhighly affected by Post traumatic stress disorder (PTSD); Female secondary school students werehighly affected by Post traumatic stress disorder (PTSD; Displaced secondary school students itowere highly affected by Post traumatic stress disorder (PTSD); female students developed more EdPTSD as compared to male students; and displaced students developed more PTSD as compared DFto non-displaced students. ll PKey words: Post traumatic stress disorder (PTSD), Flood, The Impact of Event Scale-Revised Fi(IES-R) PDINTRODUCTIONNatural disaster affected the lives of many people all over the world. The affectess of suchdisasters faces different calamities in term of deaths, physical injuries, property lose andpsychological injuries. Post traumatic stress disorder (PTSD) is one of the most commonpsychological injuries that the victims of natural disasters faced. Post traumatic stress disorder(PTSD) may be described as characteristic set of symptoms resulting from exposure to traumaticstressors. DSM-IV described Post traumatic stress disorder (PTSD) as exposure to a traumaticevent in which person has responded with intense fear, helplessness or horror. (Clark, 1999) Walsh (1994) observed that “Post traumatic stress disorder (PTSD) is usually provokedby a traumatic events that is outside the rang of usual human experiences such as bereavement,chronic illness, business losses or marital conflicts.” The events that caused Post traumatic stress disorder (PTSD) are war, see or experiencephysical violence and natural disaster like earth quick, hurricane and flood. Smith (2003)COPY RIGHT © 2011 Institute of Interdisciplinary Business Research 445
  • ijcrb.webs.com JUNE 2011 INTERDISCIPLINARY JOURNAL OF CONTEMPORARY RESEARCH IN BUSINESS VOL 3, NO 2observed that Post traumatic stress disorder (PTSD) may develop immediately after the traumaor it may be brought on by a minor stress experience week, month or even year later. Flood is one of the most sever natural disaster and it “can result in direct economic andproperty lose, physical injuries, death and psychological injuries” (Huang, 2010). Post traumaticstress disorder (PTSD) is one of the most common psychological injuries that the flood survivorsfaced. Green (1992) examined the survivors of Buffalo creek dam collapse in 1972 and foundthat 63% of the survivors were suffering From Post traumatic stress disorder (PTSD). Natural disasters also caused Post traumatic stress disorder (PTSD) among schoolstudents as ziaddini (2009) observed that the prevalence of Post traumatic stress disorder (PTSD)was 66.7% among high school students after the earth quick disaster in the city of Bam, Iran. The people of Pakistan faced a devastating flood in late July 2010 following by monsoonrain in Punjab, Sindh, Khyber Pukhtunkhwa and Balochistan regions. It destroyed the propertyand infrastructure and affected about 20 million people, with a death toll close to 2000. Thepeople had horrifying experiences accompanying death of families and property loses resulted in lssevere traumatic responses in surviving people including school children. o To The present study was designed to determine the prevalence of Post traumatic stress ddisorder (PTSD) among flood affected school children in Pakistan. anMETHOD er rit The sample of the study was comprised of 522 randomly selected students aged 10-16 Wyears from five flood affected districts of Khyber Pukhtunkhwa. These districts include ee FrCharssada, Lower Dir, Upper Dir, Noshehra and Swat. The instrument used in the study was The ithImpact of Event Scale-Revised (IES-R) to measure Post traumatic stress disorder (PTSD) among rwflood affected school children in Pakistan. The Impact of Event Scale (IES) is a short set of 15 questions evaluating experiences of itoavoidance and intrusion which attempts to reflect the intensity of the post traumatic phenomena. EdDeveloped in 1979 by Mardi Horowitz, Nancy Wilner, and William Alvarez DFDaniel S. Weiss and Charles R. Marmar (1997) chose to revise the scale by adding seven ll Padditional questions to measure another dimension of intense stress events. Both versions have Fibeen found to be valid and reliable. The revised version of the Impact of Event Scale (IES-r) has PDseven additional questions and a scoring range of 0 to 88.On this test, scores that exceed 24 can be quite meaningful. High scores have the followingassociations. 24 Those with scores this high have partial PTSD or at least some of the symptoms. or more 33 This represents a probable diagnosis of PTSD.and above 37 This is high enough to suppress your immune systems functioning. or moreCOPY RIGHT © 2011 Institute of Interdisciplinary Business Research 446
  • ijcrb.webs.com JUNE 2011 INTERDISCIPLINARY JOURNAL OF CONTEMPORARY RESEARCH IN BUSINESS VOL 3, NO 2The data was collected four month after the event.RESULTSTable 1Descriptive statistics Mean and standard deviation of age and PTSD of flood affected school childrenVariables N Mean S.DAge 522 12.87 1.79PTSD 522 42.48 9.35 ls o dTo an Table 1 shows that the numbers of respondents are 522.The mean and standard deviation erof age are 12.87 and 1.79 respectively. The mean and standard deviation on PTSD scale are rit42.48 and 9.35. W ee FrTable 2 ithTotal number and percentage (%) of secondary school students on the measure of the Impact of rwEvent Scale (IES-r) itoScoring rang of IES-r No. of students percentage (%) EdLess than 24 16 3.06 DF24 or more 74 14.17 ll P33 or more 46 8.81 Fi37 or more 386 73.94 PD Total 522 100Table 2 shows that the total no. of respondents is 522. Out of which (16) 3.06 % did not havePost traumatic stress disorder (PTSD), (74) 14.17% had partial Post traumatic stress disorder(PTSD), (46) 8.81 % had a probable diagnosis of PTSD and (386) 73% had high PTSD. Thisshows that secondary school students were highly affected by Post traumatic stress disorder(PTSD).COPY RIGHT © 2011 Institute of Interdisciplinary Business Research 447
  • ijcrb.webs.com JUNE 2011 INTERDISCIPLINARY JOURNAL OF CONTEMPORARY RESEARCH IN BUSINESS VOL 3, NO 2Table 3Total number and percentage (%) of male secondary school students on the measure of theImpact of Event Scale (IES-r)Scoring rang of IES-r No. of students percentage (%)Less than 24 16 5.8424 or more 62 22.6333 or more 42 15.3337 or more 154 56.20 Total 274 100Table 3 shows that the total no. of male respondents is 274. Out of which (16) 5.84 % did nothave Post traumatic stress disorder (PTSD), (62) 22.63% had partial Post traumatic stress lsdisorder (PTSD), (42) 15.33 % had a probable diagnosis of PTSD and (154) 56.20 had high o ToPTSD. This shows that male secondary school students were affected by Post traumatic stress ddisorder (PTSD). anTable 4 er rit WTotal number and percentage (%) of female secondary school students on the measure of the eeImpact of Event Scale (IES-r) FrScoring rang of IES-r No. of students percentage (%) ithLess than 24 0 0.0 rw24 or more 12 4.83 ito33 or more 4 1.61 Ed37 or more 232 93.54 DF Total 248 100 ll P Fi PDTable 4 shows that the total no. of female respondents is 248. Out of which (12) 4.83% hadpartial Post traumatic stress disorder (PTSD), (4) 1.61 % had a probable diagnosis of PTSD and(232) 93.54% had high PTSD. This shows that female secondary school students were highlyaffected by Post traumatic stress disorder (PTSD).Table 5 Total number and percentage (%) of displaced secondary school students on themeasure of the Impact of Event Scale (IES-r)Scoring rang of IES-r No. of students percentage (%)Less than 24 0 0.024 or more 0 0.033 or more 20 6.1337 or more 306 93.87 Total 326 100COPY RIGHT © 2011 Institute of Interdisciplinary Business Research 448
  • ijcrb.webs.com JUNE 2011 INTERDISCIPLINARY JOURNAL OF CONTEMPORARY RESEARCH IN BUSINESS VOL 3, NO 2Table 5 shows that the total no. of displaced respondents is 326. Out of which (20) 6.13 % had aprobable diagnosis of PTSD and (306) 93.87% had high PTSD. This shows that displacedsecondary school students were highly affected by Post traumatic stress disorder (PTSD).Table 6Total number and percentage (%) of non-displaced secondary school students on the measure ofthe Impact of Event Scale (IES-r)Scoring rang of IES-r No. of students percentage (%)Less than 24 16 8.1624 or more 66 33.6133 or more 30 15.3137 or more 84 42.86 Total 196 100 o ls To dTable 6 shows that the total no. of non-displaced respondents is 196. Out of which (16) 8.16 % andid not have Post traumatic stress disorder (PTSD), (66) 33.61% had partial Post traumatic stress erdisorder (PTSD), (30) 15.31 % had a probable diagnosis of PTSD and (84) 42.86% had high rit WPTSD. This shows that non-displaced secondary school students were also affected by Posttraumatic stress disorder (PTSD). ee Fr ithTABLE 7 rwMean, S.D, t and p value of flood affected female and male students on the measure of PTSD. ito EdVariables Female Male t p N=248 N=274 DF M S.D M S.D ll P FiPTSD 49.02 6.61 36.56 7.32 20.32 .007 PDdf=520 Table 7 reflects the numbers of female and male students are 248 and 274 respectively.The mean and standard deviation of female students on the measure of PTSD scale are 49.02 and6.61 and the mean and standard deviation of the male on the measure of PTSD scale are 36.56and 7.32 respectively. The t and p vale of both groups are 20.32 and .007. This indicates that the difference between the means of the two groups is significant at.01 levels. Inspection of means suggests that female students developed more PTSD as comparedto male students.COPY RIGHT © 2011 Institute of Interdisciplinary Business Research 449
  • ijcrb.webs.com JUNE 2011 INTERDISCIPLINARY JOURNAL OF CONTEMPORARY RESEARCH IN BUSINESS VOL 3, NO 2TABLE 8Mean, S.D, t and p value of flood affected displaced and Non-displaced students on the measureof PTSD.Variables Displaced Non-displaced t p N=326 N=196 M S.D M S.DPTSD 46.78 6.86 35.32 8.53 16.83 .000df=520 ls Table 8 reflects the numbers of displaced and non-displaced students are 326 and 196 o Torespectively. The mean and standard deviation of displaced students on the measure of PTSDscale are 46.78 and 6.86. The mean and standard deviation of non-displaced students on the d anmeasure of PTSD scale are 35.32 and 8.53 respectively. The t and p vale of both groups are16.83 and .000. er rit This indicates that the difference between the means of the two groups is significant at W.01 levels. Inspection of means suggests that displaced students developed more PTSD as eecompared to non-displaced students. Fr ithDISCUSSION rwThe present study was designed to determine the prevalence of Post traumatic stress disorder ito(PTSD) among flood affected school children in Pakistan. The main findings of the study were; Edsecondary school students were highly affected by Post traumatic stress disorder (PTSD); Female DFsecondary school students were highly affected by Post traumatic stress disorder (PTSD; ll PDisplaced secondary school students were highly affected by Post traumatic stress disorder Fi(PTSD); Female students developed more PTSD as compared to male students; and displaced PDstudents developed more PTSD as compared to non-displaced students. The main findings of the study that secondary school students were highly affected byPost traumatic stress disorder (PTSD) was supported by Piyasil et-al (2007) study on Posttraumatic stress disorder (PTSD) in children after Tsunami disaster in Thailand: 2 years follow-up. They found that 57.3% students were suffered from Post traumatic stress disorder (PTSD)among affected children. The finding of the study that female secondary school students were highly affected byPost traumatic stress disorder (PTSD) was supported by Stallard et-al (1998). They observed thatthere is 19% risk of Post traumatic stress disorder (PTSD) in boys and 55% in girls in childreninvolved in road traffic accidents. This finding was also supported by Breslau (1997) on hisstudy on Sex Differences in Posttraumatic Stress Disorder observed that Post traumatic stressdisorder (PTSD is more likely to develop in female than in male after exposure to traumaticevents.COPY RIGHT © 2011 Institute of Interdisciplinary Business Research 450
  • ijcrb.webs.com JUNE 2011 INTERDISCIPLINARY JOURNAL OF CONTEMPORARY RESEARCH IN BUSINESS VOL 3, NO 2ReferencesBreslau, Naomi. Glenn C., Davis., Patricia Andreski., Edward L. Peterson.., Lonni R.& Schultz. (1997). Sex Differences in Posttraumatic Stress Disorder. Arch Gen Psychiatry 54(11):1044-1048.Retrieved from http://archpsyc.ama- assn.org/cgi/content/abstract/54/11/1044Clark, Carolyn Chambers. (1997). Posttraumatic Stress Disorder: How to Support Healing. The American journal of Nursing 97 (18) : 26-33 Retrieved from http://www.jstor.org/stable/3465317Green B L.,indy J D.,race M C., & Leonard A C. (1992) Chronic posttraumatic stress disorder and diagnostic comorbidity in a disaster sample. The Journal of nervous and mental disease 180(12):760-766.Peng Huang., Hongzhuan Tan., Aizhong Liu.,Shuidong Feng., & Mengshi Chen.(2010). Prediction of posttraumatic stress disorder among adults in flood district. . Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2868002/ lsHorowitz, M. Wilner, N. & Alvarez, W. (1979). Impact of Event Scale: A measure of subjective o To stress. Psychosomatic Medicine, 41, 209-218. dPiyasil, Vinadda.,Panom Ketuman ., Ratnotai Plubrukarn., Vajiraporn Jotipanut ., Somsong an Tanprasert., Sumitra Aowjinda ., & Somchit Thaeeromanophap .(2007). Post Traumatic er Stress Disorder in Children after Tsunami Disaster in Thailand: 2 Years Follow-up. J rit Med Assoc Thai 2007; 90 (11): 2370-6. Retrieved from W http://www.medassocthai.org/journal eeSmith, H. (2003). Despair, resilience, and the meaning of family: Group therapy with French- Fr speaking survivors of torture from Africa. In R. Carter & B. Wallace (Eds.), ith Understanding and dealing with violence. Multicultural Perspectives rw Thousand Oaks, CA. pp. 291–319. itoStallard, Paul., Richard Velleman., & Sarah Baldwin .(1998). Prospective Study of Posttraumatic Ed Stress Disorder in children Invovled on road Traffic Accidents. British Medical Journal DF 317 (1173), 1619-1623 Retrieved from http://www.jstor.org/stable/25181287 ll PWalsh. Neol. (1994). A psychodynamic Model of Posttraumatic Stress Disorder. An Irish Quarterly Rewiew 83 (331) : 322-330 Retrieved from Fi PD http://www.jstor.org/stable/30091089Weiss, D.S., & Marmar, C.R. (1997). The Impact of Event Scale-Revised. In J.P. Wilson & T.M. Keane (Eds.), Assessing Psychological Trauma and PTSD (pp.399-411). New York. Guilford.Ziaaddini, Hassan., Nouzar Nakhaee., & Kolsoom Behzadi. (2009). Prevalence and Correlates of PTSD among High School Students After the Earthquake Disaster in the City of Bam, Iran. American Journal of Applied Sciences 6 (1): 130-132. Retrieved from http://www.scipub.org/fulltext/ajas/ajas61130-132.pdfCOPY RIGHT © 2011 Institute of Interdisciplinary Business Research 451
  • ijcrb.webs.com JUNE 2011 INTERDISCIPLINARY JOURNAL OF CONTEMPORARY RESEARCH IN BUSINESS VOL 3, NO 2 Survey Social Capital situation in Iranian Hospital Freyedon Ahmadi Public management Department, Payame Noor university, 19395-4697 Tehran, I.R. of IRAN Seyyed Ali Akbar Ahmadi Public management Department, Payame Noor university, 19395-4697 Tehran, I.R. of IRAN Arghavan Zandieh Public management Department, Payame Noor university, 19395-4697 Tehran, I.R. of IRANAbstractMuch of the literature on business development has focused on the role of community resources,especially financial and human capital, in organizational success and survival. Several studies ls oalso have examined the contributions of small and large businesses to the social and economic Towell-being of communities. There has been much less research on the relationships between d ansocial resources in communities and business development. This paper examines the importance erof social capital in Iranian hospital. For this aims were selected 90 people from three hospitals. ritThe results of this research indicated the level of structural and relational social capital is high, Wbut the level of cognitive social capital is below of average. ee FrKey words: ithSocial capital, relational capital, cognitive capital, structural capital rw itoIntroduction Ed Scholars such as Coleman (1990) and Putnam (1995) in an attempt to explain non-economic DFfactors in explaining success of certain economic processes drew on the concept of social capital.That is why at present, besides human, financial, and economical capitals, a new reality as social ll Pcapital is being extensively utilized in the literature of social and organization realms. Fukuyama Fi(1999) believes that a number of definitions had been given with respect to social capital but they PDrefer to its manifestation rather than to social capital itself. He says “social capital is aninstantiated informal norm that promotes co-operation between two or more individuals”(Fukuyama, 1999). Putnam (1995) also defines social capital as “The characteristics of the socialorganization such as networks, norms and social trust that facilitate coordination and cooperationfor mutual benefit”. Social capital as a theory view has been considered by behavioral science,economy, management and social science experts in recent two decades. Social capital issometimes viewed as the peoples property, so it is related to widespread social networks andaccessible resources. Therefore social capital is considered as the group property. Social capitalhas been the subject of many surveys in recent years and its relation to political and economicaldevelopment and personal effectiveness has been considered. Studies show that without socialcapital, it is hard to reach economical development by the means of other resources likefinancial, physical and natural resources.COPY RIGHT © 2011 Institute of Interdisciplinary Business Research 452