Psychosocial Rehabilitation Among Older Earthquake Survivors: The Role of Community

Background and Purpose: Older survivors of natural disasters are at a great risk of psychosocial problems (e.g., post-traumatic distress) because their psychosocial distress is often exacerbated by their deteriorated health and declined capacity to adjust to new environment. Moreover, disaster such as an earthquake may damage older survivors' social network by separating families and friends. Thus, it is critical to explore and cultivate resources from their new environment to assist their psychosocial rehabilitation. This study examined the role of community as a buffer for psychosocial distress and explored how the sense of community would compensate for their losses and thereby reduce their distress. This study examined psychosocial distress among a sample of 299 older Chinese adults who survived the May 12th earthquake in 2008. In addition, the study also explored the mechanisms of community effects on psychosocial well-being using follow-up focus groups.

Methods: This study used a mixed method approach to study the role of community in buffering the psychosocial distress among older earthquake survivors. First a survey was conducted two months after the earthquake. Psychosocial distress as a result of earthquake was measured by a revised 15-item Impact of Event Scale (Horowitz, Wilner, & Alvarez, 1979). The sense of community scale developed by Peterson, Speer and McMillan (2008) was used to capture the older residents' emotional connection, membership, and needs fulfillment in the community. Eighteen months later, four focus groups were conducted among older earthquake survivors. Using the format outlined by Morgan (1997), the focus groups were highly structured. Moderators led the discussion by asking questions to explore the mechanisms on how temporary and rebuilt-communities affect their psychological well-being. The sessions were audio taped and professionally transcribed. Data were analyzed using NUD*ISTŪ qualitative analysis program.

Results: The hierarchical regression model using the survey data found that those who reported a stronger sense of community were found to have lower levels of earthquake distress (p < .05). The total variance explained by the model was 14%. Such a relationship between the sense of community and lower psychosocial distress was re-affirmed by the qualitative data from focus groups. Participants indicated that their psychosocial rehabilitation benefited from mutual support among community members, the shared experience of the disaster, and active participation in community affairs. Results indicate the importance of engaging older earthquake survivors in community life as an important method to facilitate their psychosocial rehabilitation.

Implications: Our findings highlighted the role of individuals' sense of community as a protective factor against psychosocial distress. In addition, this study also identified three pathways through which community affects their psychosocial well-being. Such findings have important practice implications for social workers and other helping professionals working with natural disaster victims. Attempts to engage older survivors in the process of community rehabilitation and therefore cultivating a sense of community in the process would help reduce their distress and facilitate a better recovery.