Professional Documents
Culture Documents
Key issues
Why research?
Descriptive study
Hypothesis testing
Association
Sampling
An example of cross-sectional study
Why research?
To guide health practice and policy
Because local research is often needed to guide
local health practice and policy
Because carrying out research strengthens
research capacity
What is a hypothesis
A statement which describes what you expect to
find in a specific manner
Clearly stated
Testable and refutable
Not a mere research question or objective
Backed by sample size calculation, and an
appropriate design and analysis
Example
Statement of the problem: mental health
problems are said to be common in the aftermath
of a disaster, and mental health problems are
believed to be associated with physical damage
Aim: to describe the association between physical
damage and mental health problems
Question: Are mental health problems associated
with physical damage in time of disaster?
Hypothesis: elderly people with poor mental
health are more likely to have severe housing
damage in time of disaster
Explain
o Analytical epidemiology
o Hypothesis-driven etiological research
o Risk factors and causes
Evaluate
o Quasi-experimental studies
o Randomized controlled trials
Association
Risk factor
Exposure
Disease
True association?
Independent
Outcome
Dependent
Chance
Bias
Confounding
Descriptive studies
Case series
Cross-sectional study
o Multi-center (geographic variance)
o Ecological correlation
o Repeated surveys (temporal variance)
Who to study?
Population
Sample
o Advantage:
time and cost
o Disadvantages:
sampling error,
bias if sample is not representative of population
Random sampling
Simple
Systematic
Stratified
Multi-stage and cluster
Prevalence study
Niigata
13
Earthquakes in Niigata
In 2004: The NiigataChuetsu earthquake
2004.10.23.5:56pm
Magnitude:6.8 in Richter scale
Seismic intensity:7 in Japanese scale
Damage:68 deaths 4805 injuries
Methods
4. Data collection
Trained health professionals administered the
questionnaires and the following structures
interviews;
5. Measurement
(2007.10.1-2008.1.11)
Results
2
Table 1. Characteristics of participants of the study of three year after the
Niigata-Chuetsu earthquake in 2004 (n=473)
n
Gender
Male
190
Age
65-74
209
75+
264
Average age
Marital status
Married
328
Divorced
3
Bereaved
140
Never married
2
Education
Elementary school
128
Koutouka
112
Chugakko
167
Koukou
20
Others
Numbers of year in education
Number of cohabitant
Previous psychiatric visit
19
Digit spam (3 digits)
Incorrect
29
Mean
95% CI
40.2
44.2
55.8
76.0
75.4-76.6
8.2
3.9
8.1-8.4
3.7-4.1
69.3
0.6
29.6
0.4
27.5
24.0
35.8
4.3
4.3
11.2
18
Results 3
I. Prevalence
study
Results Prevalence
4 of mental disorders in 2 weeks and past 3 years
Prevalence rate (%)
2w 3y
Major
depression
2w 3y
Major and Minor
depression
Current PTSD
Earthquake
Other events
Current
alcoholdependence, abuse
2w 3y
Suicidal
tendency
Results 5
The percentage of those who met criterion A and B of
PTSD in DSM-IV-TR by exposure of the earthquake and
the other events
Results 7
QOL mean
: male 3.54 (95%CI:3.47-3.60)
female 3.48 (95%CI:3.43-3.53)
Results Results
8 of regression analysis for quality of life and interviewees basic
characteristics (n=439)
Variables
Psychologica
l
Coef.
Social
-0.05
-0.07
0.07
-0.10
-0.01
0.00
0.00
0.00
0.00
0.03
0.01
-0.08
-0.04
0.00
0.02
0.03
Years in education
-0.03
0.00
0.00
-0.01
-0.01
-0.13
-0.03
-0.06
0.04
-0.03
-0.03
-0.04
-0.03
-0.04
-0.01
0.00
-0.15
**
3.6
0.015
3.9
0.034
Gender
(male=0, female=1)
Age
year
Marital status
Physical
Coef.
Coef.
Coef.
Coef.
*
-0.05
Number of cohabitants
0.02
0.03 **
0.03
(never=0, yes=1)
Severity of disaster damage -0.05
in 2004
Physical illness
-0.29 **
-0.17 **
Intercept
Adjusted R2
4.9
0.060
3.6
4.1
0.022 0.003
*:p<0.05, **:p<0.01
Discussion 1
Discussion 2
The risk factors for poor QOL were severity of disaster damage,
and physical illness in physical domain, fewer cohabitants and
physical illness in psychological domain, being female, and
fewer cohabitants in environmental domain.