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Endo K.1, Kitajima T.1, Baral K.2
1Kyorin University, Graduate School of International Cooperation Studies, Mitaka, Japan, 2Patan Academy of Health Sciences, Lalitpur, Nepal
Background: Plentiful medical support had been provided immediately after the 2015 Nepal earthquake in Barpak, a mountainous area within the epicenter. Although consecutive medical support demand is obviously envisioned, previous research regarding the long-term impact of the injuries in the area to prove the necessity is sorely lacking.
Purpose: To identify the long-term impact of traumatic injuries due to the Nepal earthquake on Activities of Daily Living (ADL) and Quality of Life (QOL) in the epicentral area.
Methods: We conducted an interview survey in Barpak from 16 July to 17 August, 2016. We used a cluster-sampling which targeted 300 participants primarily, and Snowball-sampling adjunctively. We excluded communities too risky to visit, persons who were non-Nepali speakers, disabled prior to the earthquake, under 15 years old and/or difficult to communicate with for other reasons. We interviewed the participants to collect data about socio-demographic information, earthquake-related injuries and their treatment history, sequelae due to the injuries, ADL, QOL, and household information. Barthel Index (BI) and WHOQOL-BREF were used to assess ADL and QOL, respectively. We obtained the written informed consent from each participant and conducted the interviews with the help of a trained Nepalese interpreter. We divided the participants for analysis as follows; 1.Not-injured (Control) group, 2.Injured with inpatient care (Inpatient) group, 3.Injured without inpatient care (Non-inpatient) group. We statistically analyzed the data with a chi-square test, Mann-Whitney U test and Kruskal-Wallis test, and Bonferroni adjustment for multi comparison. The level of significance was set at α = 0.05.
Results: Two-hundred ninety-four people participated in the study: 240 in Control group, 21 in Inpatient, 33 in Non-inpatient. The average age of each group was 34.4 years(SD 15.6), 50.1(17.3), and 36.5(15.2), respectively. Each group had a mean BI score of 100(SD 1), 90(17), 100(0) after the earthquake. Of WHOQOL-BREF, the average score of each group for Domain 1 (Physical) were 55(SD 11), 33(17), 51(14), Domain 2 (Psychological) 52(11), 42(12), 50(12), Domain 3 (Social relationship) 6(14), 50(14), 60(12), and Domain 4 (Environment) 40(11), 29(10), 38(11), respectively. The Inpatient group had scores of BI and WHOQOL-BREF in each domain significantly lower than those of other 2 groups. The proportion of participants who became jobless or retired after the earthquake was significantly lower in Control group and significantly higher in the Inpatient group. The Inpatient group had participants who were still suffering from the sequelae of the earthquake-related injuries such as partial motor weakness, contracture, sensory impairment and pain significantly more than the Non-inpatient group. In Inpatient group, a mean admission period was 1.3 months(SD 1.3), 8 participants underwent some surgical operation and 7 participants received rehabilitation services. The mean number of days when rehabilitation services were provided in the hospitalization was 8.0 days(SD 17.6).
Conclusion(s): The earthquake victims who had been hospitalized were still suffering from the sequelae and job loss, and exhibit lower ADL and QOL in the epicenter area.
Implications: Our result suggests that it is possible to improve decreased ADL and QOL of the earthquake victims if a long-term rehabilitation support were provided seamlessly.
Funding acknowledgements: This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
Topic: Disaster management
Ethics approval: The Ethical Review Board of Kyorin University and the Nepal Health Research Council.
All authors, affiliations and abstracts have been published as submitted.
