Factors Associated with Psychological Impacts of

Junior High School Students after Earthquake in

Padang, est Sumatra, Indonesia
!ilya "o#era
$
, %anokwan etasin
&
, and ilaiporn %hamwong
'
$
%asetsart (ni#ersity, )angkok $*+**, ,hailand
Email- milya.no#era/01yahoo2co2id
&
)oromara3onani 4ollege of "ursing "opparat 5a3ira, )angkok $*&'*, ,hailand
Email- %wetasin1yahoo2com
'
)oromara3onani 4ollege of "ursing 4hangwat "ontha6uri, $$***, ,hailand
Email- wionwanna1yahoo2com
Abstract7 Objectives: to examine factors associated with
psychological impacts of junior high school students after
earthquake in Padang, West umatera, !ndonesia"
#ethod: $his was a cross%sectional study, purposive random
sampling was used to recruite &'( students from three )unior
*igh chools including +$P ', +$P ,- and +$P &. from #ay
% )une &(,-" $he psychological impacts were assessed using the
/epression 0nxiety and tress cales%&, 1/0%&,2 and Ways of
3oping 4uestionnaire was used to measure the coping strategies"
$he results showed that &5"56 of participants had symptoms of
depression, .7",6 and &&"86 suffered from anxiety and stress,
rescpectively" $here were significant associations between age,
gender, socio%economic status, living arrangement, loss family
members, coping strategies and psychological impacts with p%
value 9 ("(.: except the associations between gender and anxiety,
socio%economic status and depression and anxiety, living
arrangement and depression and anxiety"
3onclusion: $his study provided useful information about
factors associated with psychological impacts after earthquake"
*owever, additional research was needed to investigate the long%
term, earthquake%related psychopathology" ;urses should receive
more education about disaster%related psychological health skills
to provide adequate psychological counseling and intervene
successfully to assist students who survived from the tragedy to
optimi<e their psychological health status after earthquake"
Keywords Psychological Impact; coping strategies; adolescent;
disasters; earthquake
I2 PE"8AH(9(A"
8isasters are 6ecoming more frequent, especially in the
Asia:Pacific region2 In &**/, ;*< of all reported natural
disasters occurred in Asia and more than /*< of the reported
#ictims li#ed in that area =$>2 )ase on pre#ious studies, natural
disaster 6ring physical and psychological stresses to the
sur#i#ors =&>2 Indonesia has recently struck 6y a series of
ma3or earthquakes and su6sequent tsunamis that ha#e largely
affected cities2 For e?ample, in &**; tsunami and earthquakes
destroyed )anda Aceh and !eula6oh2 In addition, in &**@,
central Ja#a was damaged 6y earthquake ='>2 After two years,
an earthquake occurred in the est Sumatra Island, especially
in Padang, a magnitude force of 02@ on the Aichter scale had
struck on Septem6er &**+2 ,his earthquake caused
significant damage to hundreds of 6uildings and the death of
$$$0 indi#iduals =;>2 Padang is the capital city of est
Sumatra Pro#ince in Indonesia2 Beographically, Padang has
potential haCards of earthquakes, it is important to note that
the city is located on the Eurasian plate and quite near to the
inter:plate 6oundary 6etween the Eurasian Plates and Indo:
Australian Plates2 ,his inter:plate 6oundary is reported to 6e
the most seismically acti#e in the region =;>2 !usa and his
colleagues D&*$&E reported that people affected 6y natural
disasters like tsunami in Aceh, earthquake and landslide in
est Sumatra were at risk to de#elop psychological impact
such as depression, an?iety and stress=F>2 ,he psychological
impacts often persists for a #ery long time after the disaster
and represents a further 6urden to indi#iduals whose physical
and emotional resources ha#e already 6een depleted 6y their
own and their 6elo#ed ones losses2 In post:disaster studies,
researchers had found that coping was an important predictor
of psychological symptoms2 In addition to directly
ameliorating or deteriorating psychological distress, coping
had 6een found to moderate the relationships 6etween
stressors and mental health outcomes in a few of empirical
researches =@>2 Adolescence is a de#elopmental period where
teens are particularly #ulnera6le to traumatic e#ents2 ,his is a
particularly challenging period for this population 6ecause
they must simultaneously cope with significant changes in
physical and psychosocial de#elopment =0>2 Se#eral studies
suggested that teenagers also showed depression, 6elligerence,
and an?iety following a disaster2 Incidence caused 6y the
earthquake that occurred in est Sumatra Island had
psychological impacts on mental health pro6lem in
adolescents2 ,his study concentrated on 3unior high school
students who as discussed a6o#e, are amongst the most
#ulnera6le to psychological impacts2 Gouth are the future
generation of the nation2 ,he condition of teenagers today can
predict future de#elopment of the nation2 ,herefore, it is #ery
important to pay attention to these teenagers in all aspects of
their li#es2 Hne of the most important aspects is mental health2
,he main o63ecti#e of the present study was to e?amine
factors associated with psychological impact of 3unior high
school students after earthquake in Padang2 ,herefore
identifying the risk factors would assist in the future
management of sur#i#ors of natural disasters to help them
cope up 6etter with their pro6lem2
II2 !E,H8A PE"E9I,IA"
,his cross:sectional study was conducted on Junior high
school students in est Sumatra, Indonesia2 A total of &0*
respondents were recruited 6y using purposi#e random
sampling to choose the Junior high schools2 Further, to select
the sample in each Junior high school used simple random
sampling2 ,he inclusion criteria wereI adolescents in Junior
high schools from first to third grades, students who aged of
$$ to $@ years old and also had 6een permitted 6y the parents
or guardian2 Participation of young students who had
e?perienced 6y earthquake and also had resided in Padang at
the time of the earthquake, could use effecti#e #er6al
communication and willing to participate cooperati#ely2 For
students who had pre#ious mental disorders, mo#ed out from
Padang city and re3ected to gi#e a consent and had
communication 6arriers were e?cluded from this study2
Ethical clearance was o6tained from the Ethical Aesearch
4ommittee of )oromara3onani 4ollege of "ursing "opparat
5a33ira and legal study permits were o6tained from rele#ant
authorities in Padang city2 ,he respondentsJ le#els of stress,
depression and an?iety were measured using the Indonesian
#ersion of 8epression, An?iety and Stress Scale &$ D8ASS:
&$E2 ,he 8ASS had 6een shown to ha#e high internal
consistency and discriminations in a #ariety of settings =/>2
,he ays of 4oping Kuestionnaire DH4E was a #alidated
measure that identified the thoughts and actions of an
indi#idual had used to cope with specific stressful encounters
=+>2 For relia6ility, the cron6achJs alpha coefficients for the
ays of 4oping Kuestionnaire were L M *2@F:*2//2 8ata was
entered, cleaned and analysed using descripti#e statistics 4hi:
Square 6y Phi: and 4ramerJs 52
III2 HASI9
According to ,a6le $, the results showed that studentJs ages
ranged from $$ to $@ years old and female students were
slightly o#er than male students2 Family income of the
participants was in the highest socio:economic status, with
monthly income o#er than $,***, *** rupiah 2 ith regarding
to li#ing arrangement, it was found that most respondents
li#ed with 6oth 6iological parents, and more than half D/@20<E
of the participants had no loss relati#es2 In addition, coping
strategies consisted of Pro6lem focused:coping and Emotion
focused coping2 !a3ority of the participants D@'<E had often
used pro6lem focused coping and then @&2& < emotion
focused coping2 ,he result also showed that &&<NF/< of
respondents were either stressed, depressed or an?ious2
,a6le & showed that there were statistical association
6etween age, gender, socio economic status, li#ing
arrangement, loss family mem6ers, coping strategies
DPro6lem:focused coping and Emotion:focused copingE and
psychological impacts with p:#alue O *2*F, 6ut not
significantly associated 6etween gender and an?iety2 ,he
other #aria6les such as socio:economic status, li#ing
arrangement also were not significantly associated with
depression and an?iety2 4ramerJs 5 was used to determine the
strenght or the weakness of the association 6etween
independent #aria6les and dependent #aria6les2 !a3ority of
the associations was weak, only associations 6etween gender,
coping strategies DPro6lem:focused coping and Emotion:
focused copingE and stress with moderate associations2
I52 PE!)AHASA"
,he purpose of the study was to e?amine factors associated
with psychological impacts of 3unior high school students
after earthquake2 Among the demographic #aria6les of
interest, age had statistically significant associations with
depression, an?iety and stress, the result of this study
suggested that #ictims of younger age groups were more
#ulnera6le to depression, an?iety and stress following a
natural disaster2 It implied that younger age group especially
the school:going children, were a #ulnera6le group for
ad#erse psychological implication in post:disaster areas2 ,his
result was consistent with the pre#ious study which also used
same questionnaire for psychological impacts in Aceh aceh
and est Sumatea, was found that young age was
significantly associated with depression, an?iety and stress
=F>2 Actually, the de#elopmental psychopathology in relation
to depression, an?iety and stress had 6een found to 6e
associated with age =$*>2 Similarly Sopacua D&**0E reported
the younger age who e?perienced with a disaster had higher
psychological impacts than olders2
In regard to gender, 6oth genders were well presented in
the study, and consisted of mostly equal 6etween male and
female2 ,here were significant associations 6etween gender
and psychological impact i2e2 depression, and stress2 ,his
study result was similar to the pre#ious findings e?plained that
the female gender had more predictors of mental issues such
as depression and traumatic stress responses than male =$&>2
Aegarding to income, there was a higher income, 6ut had
negati#e significant association 6etween socio:economic
status and psychological impact Di2e2 depression and an?ietyE2
,his result was contrast with Asgary and illis D$++0E stated
that the socio economic status of indi#iduals may also affect
their psychological response to the disaster2 9ower income or
wealth can place indi#iduals or their households at greater
risks of damage from disastersI 6ecause, for e?amples, of poor
housing quality, inferior residential location or inadequate
safety features2 Additionally, it was found that the lower the
income amongst the sample, the higher the likelihood of
se#ere mental illness =$;>2
In this study, mostly of the participants li#ed with 6oth
parents2 Furthermore, statistical analysis showed that there
was positi#ely significant association 6etween li#ing
arrangement and stress2 Percei#ed support from parents,
classmates and teachers seemed to associate with a lower risk
of stress2 Studies including natural disasters, community
#iolence, se?ual and psychal a6use, parental homicide and
serious illness had documented the importance of parental
support and parentJs capa6ility to cope with the trauma
regardless of their own emotional reaction in pre#enting post
trauma stress disorder symptoms of children and adolescents
=$F>2 9oss family mem6ers were statistically significant with
depression, an?iety and stress2 ,his result considered that
factors related to the stressor it self may also increase
#ulnera6ility, such as the loss of a lo#ed one, home, or 3o6, or
the e?perience of in3ury as a consequence of the e#ent
=$',$;,$F,$@,$0> ,his recent findings was consistent with
other research findings found that people who lost family
mem6ers reported significant se#ere psychological impacts
compared to those who did not =$/>2
According to 9aCarus and Folkman D$+/;E define coping
as Pconstantly changing cogniti#e and 6eha#ioural efforts to
manage specific internalQe?ternal demands that appraised as
e?ceeding the resources of the person2 ,he type of coping
strategies were di#ided 6y 9aCarus and Folkman D$+/;E
including pro6lem focused coping strategy and emotional
focused coping strategy2 ,his study re#ealed that, there were
two coping strategies used in the study area, @'< of
respondents confessed that they often used pro6lem focused
coping and @&2&< of the respondents claimed often used
emotional focused coping2 In addition, the present study
re#ealed that there were significant associations 6etween
coping strategies and psychological impacts2 In this study
re#ealed that coping strategies were one of the factors that
associated with psychological impact i2e depression, an?iety
and stress2 Similarly, 4hung and his colleagues D&**;E studied
community residents e?posed to two technological disasters
and found that often used of 6oth emotion:focused and
pro6lem:focused coping strategies was associated with post:
traumatic stress symptoms and general health pro6lems2
Similarly, Spurell R !cFarlane D$++'E e?amined the
associations 6etween coping strategies and the presence of
post traumatic stress2 ,he results indicated that the often used
coping strategies was associated with the presence of a
diagnosed disorder such as post traumatic stress, ma3or
depression, affecti#e disorder or an?iety disorder2 According
to the pre#ious study pro6lem:focused coping appeareds to 6e
associated with reduced depressi#e symptoms as this style
acti#ely remo#eds or resol#eds stressors =&$>2 As stressors are
remo#ed 6efore they de#elop into functionally inhi6iting
stressors, this may reduce stress le#els and pre#ent indi#iduals
from e?periencing more se#ere psychological distress2
Aesearch had also shown that pro6lem:focused coping was
adapti#e in uncontrolla6le situations as it pro#ideds
indi#iduals with a sense of mastery and gain =+>2 Emotion
focused coping strategies were employed to regulate
emotional reactions or to make one feel 6etter without actually
sol#ing the pro6lem2 According to the pre#ious study emotion
focused coping could 6e adapti#e in dealing with in capa6ility
feeling in an unclear situation =&*>2 9aCarus D$+/;E mentioned
that distancing, as one of the emotional coping strategies had
6een reported to 6e significantly helpful in situations that are
e?tremely stressfull, emotially distressing and appraised as
unchangea6le2 ,hey 6elie#ed that our emotions were results of
our recei#ing information2 It was o6#ious that a personJs
6eliefs a6out stress and their a6ility could widely change the
way of person responded, that was, hisQher 6eha#ioural
component of their coping responses2 Indi#iduals only used
emotion focused coping strategies if they were sure that there
was a chance to manage or alter the stress sources or demands
from the situation2
4oping strategies of indi#iduals had 6een found to 6e
related to the symptoms and the course of the disorder2 hen
a traumatic e#ent happeneds, pre:e#ent coping strategies of
indi#iduals might no longer 6e adequate and new skills need
to 6e gained2 ,hat was why it was important to help
indi#iduals to cope with the disorder and en#ironmental
ad#ersity2 the factors affecting coping strategies also affected
post trauma stress symptomatology =&*>2 Psychological stress
that trauma sur#i#ors e?perienced could 6e e?plained 6y the
cogniti#e theory of stress and coping =+>2 ,he model
suggesteds that what determineds the stress le#el that an
indi#idual e?periences was the cogniti#e e#aluation of the
e#ent and a#aila6le coping resources2 In other words, how the
indi#idual percei#eds the stressor and gi#eds response to it
was #ery important for his or her psychological well 6eing
=$+>2 Finally, the limitations of the study needed to 6e
acknowledgement2 Firstly, this research was a cross:sectional
descripti#e study that could not con#inces the real time of its
episode so prospecti#e study was recommended2 Secondly, it
could not e?plain continous sequences of deprression, an?iety
and stress through all stage of mental health pro6lem2
Psychological impact among earthquake sur#i#ors along side
e?perience of other pro6lems could 6e considered a serious
issue for peopleJs health status li#ing in such difficult
conditions2 E#idence suggesteds that se#ere earthquakes e#en
could cause long standing mor6idity =&*>2 Howe#er, past
psychiatric illness also might contri6ute to this situation =&>2
(nfortunately one of the shortcomings of the present study
was did not measure pre#ious psychiatric conditions among
sur#i#ors and thus it was not possi6le to comment on this
further2 ,hirdly, no information was o6tained on important
trauma:e?posure #aria6les such as e?tent of fear or percei#ed
life:threat during the earthquake, ru66le e?perience,
dissa6ility or in3ury, et cetera2 )esides, the last point
highlighted for a potential limitation of this study was no
measure P,S8 symptom2 Since post traumatic stress disorder
was also common in earthquake sur#i#ors, this study was
limited for not including a #alidated diagnostic measure of
P,S82
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52 %ESI!P(9A"
In conclusion, negati#e psychological impacts from natural
disasters remained pre#alent and su6stantial in up to F*< of
the sur#i#ors, e#en after many years following the disasters2
,his result indicated that inter#entions focusing on the
psychological impacts of such traumatic e#ents should gi#e
special attention to those who had loss their family mem6er
and li#ing alone2 Particularly, younger age groups may also 6e
psychologically #ulnera6le in the aftermath of an earthquake
and knowing the factors could 6e assisted healthcare pro#iders
to reduce negati#e health impacts of the earthquake2 In
addition, adequate psychological counseling was needed for
those who sur#i#ed from the tragedy2
A4%"H9E8B!E",
e would like to thank to the 8irectorate Beneral of
Higher Education, !inistry of 4ulture and Education of the
Aepu6lic of Indonesia for gi#ing financial support2 e also
thank to Head !aster and personal staff of S9,P 0, S9,P $'
and S9,P &F in Padang, est Sumatera Indonesia2 9astly,
special thank for the participants in this study2
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