TY - JOUR
T1 - Building resiliency
T2 - A cross-sectional study examining relationships among health-related quality of life, well-being, and disaster preparedness
AU - Gowan, Monica E.
AU - Kirk, Ray C.
AU - Sloan, Jeff A.
N1 - Funding Information:
This study was conducted in New Zealand at the University of Canterbury, Christchurch, and at GNS Science, Lower Hutt. This was made possible in part through the sponsorship and financial support of University of Canterbury College of Education and School of Health Sciences; GNS Science/Massey University Joint Centre for Disaster Research; New Zealand Earthquake Commission (EQC Research Grant No. 08/U544); New Zealand Ministry of Education; and Mayo Clinic (United States). The design and conduct of this study benefited from substantial expertise shared by the following individuals. Earthquake Commission (New Zealand): Hugh A. Cowan, PhD. GNS Science/Massey University Joint Centre for Disaster Research (New Zealand): David M. Johnston, PhD. Mayo Clinic (United States): Timothy J. Beebe, PhD; Victor M. Montori, MD; Jennifer St. Sauver, PhD; and Kristin S. Vickers Douglas, PhD, LP. Southern California Permanente Medical Group (United States): Steven J. Jacobsen, MD, PhD. Victoria University of Wellington (New Zealand): John McClure, PhD. We gratefully acknowledge L. Joseph Melton III, MD (Mayo Clinic), for his review and valuable comments during the preparation of this article. We extend our deep appreciation to the participants who generously gave their time and shared their experiences and insights for this research.
PY - 2014/6/9
Y1 - 2014/6/9
N2 - Background: Worldwide, disaster exposure and consequences are rising. Disaster risk in New Zealand is amplified by island geography, isolation, and ubiquitous natural hazards. Wellington, the capital city, has vital needs for evacuation preparedness and resilience to the devastating impacts and increasing uncertainties of earthquake and tsunami disasters. While poor quality of life (QoL) is widely-associated with low levels of engagement in many health-protective behaviors, the relationships among health-related quality of life (HrQoL), well-being, and preparedness are virtually unknown.Methods: We hypothesized that QoL and well-being affect household evacuation preparedness. We performed a quantitative epidemiologic survey (cross-sectional design) of Wellington adults. Our investigation assessed health-promoting attributes that build resiliency, conceptualized as health-protective attitudes and behaviors. Multidimensional QoL variables were measured using validated psychometric scales and analyzed for associations with evacuation preparedness, and we determined whether age and gender affected these relationships.Results: We received 695 survey responses (28.5% response rate; margin of error ±3.8%; 80% statistical power to detect true correlations of 0.11 or greater). Correlational analyses showed statistically significant positive associations with evacuation preparedness for spiritual well-being, emotional well-being, and life satisfaction. No associations were found for mental health, social well-being, or gender; physical health was weakly negatively associated. Evacuation preparedness increased with age. Regression analyses showed that overall health and well-being explained 4.6-6.8% of the variance in evacuation preparedness. Spiritual well-being was the only QoL variable that significantly and uniquely explained variance in preparedness.Conclusions: How well-being influences preparedness is complex and deeply personal. The data indicate that multidimensional readiness is essential, and meaningfulness is an important factor. Inadequate levels of tangible preparedness actions are accompanied by gaps in intangible readiness aspects, such as: 1) errors in perceived exposure to and salience of natural hazards, yielding circumscribed risk assessments; 2) unfamiliarity with the scope and span of preparedness; 3) underestimating disaster consequences; and 4) misinterpreting the personal resources required for self-managing disaster and uncertainty. Our results highlight that conceptualizing preparedness to include attitudes and behaviors of readiness, integrating well-being and meaningfulness into preparedness strategies, and prioritizing evacuation planning are critical for resiliency as a dynamic process and outcome.
AB - Background: Worldwide, disaster exposure and consequences are rising. Disaster risk in New Zealand is amplified by island geography, isolation, and ubiquitous natural hazards. Wellington, the capital city, has vital needs for evacuation preparedness and resilience to the devastating impacts and increasing uncertainties of earthquake and tsunami disasters. While poor quality of life (QoL) is widely-associated with low levels of engagement in many health-protective behaviors, the relationships among health-related quality of life (HrQoL), well-being, and preparedness are virtually unknown.Methods: We hypothesized that QoL and well-being affect household evacuation preparedness. We performed a quantitative epidemiologic survey (cross-sectional design) of Wellington adults. Our investigation assessed health-promoting attributes that build resiliency, conceptualized as health-protective attitudes and behaviors. Multidimensional QoL variables were measured using validated psychometric scales and analyzed for associations with evacuation preparedness, and we determined whether age and gender affected these relationships.Results: We received 695 survey responses (28.5% response rate; margin of error ±3.8%; 80% statistical power to detect true correlations of 0.11 or greater). Correlational analyses showed statistically significant positive associations with evacuation preparedness for spiritual well-being, emotional well-being, and life satisfaction. No associations were found for mental health, social well-being, or gender; physical health was weakly negatively associated. Evacuation preparedness increased with age. Regression analyses showed that overall health and well-being explained 4.6-6.8% of the variance in evacuation preparedness. Spiritual well-being was the only QoL variable that significantly and uniquely explained variance in preparedness.Conclusions: How well-being influences preparedness is complex and deeply personal. The data indicate that multidimensional readiness is essential, and meaningfulness is an important factor. Inadequate levels of tangible preparedness actions are accompanied by gaps in intangible readiness aspects, such as: 1) errors in perceived exposure to and salience of natural hazards, yielding circumscribed risk assessments; 2) unfamiliarity with the scope and span of preparedness; 3) underestimating disaster consequences; and 4) misinterpreting the personal resources required for self-managing disaster and uncertainty. Our results highlight that conceptualizing preparedness to include attitudes and behaviors of readiness, integrating well-being and meaningfulness into preparedness strategies, and prioritizing evacuation planning are critical for resiliency as a dynamic process and outcome.
KW - Earthquake
KW - Evacuation
KW - Hazards
KW - Health outcomes
KW - Health promotion
KW - Integrative disaster resilience
KW - Prevention
KW - Risk perception
KW - Self-management
KW - Tsunami
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U2 - 10.1186/1477-7525-12-85
DO - 10.1186/1477-7525-12-85
M3 - Article
C2 - 24909780
AN - SCOPUS:84902551184
SN - 1477-7525
VL - 12
JO - Health and Quality of Life Outcomes
JF - Health and Quality of Life Outcomes
IS - 1
M1 - 85
ER -