Objectives: Disaster mental health research has largely focused on personal losses, while workplace-related losses remain underexplored. The Great East Japan Earthquake of 2011 caused widespread devastation, including hospital destruction. This study examined the association between workplace destruction, posttraumatic stress disorder (PTSD), and depression among local nurses 13 months after the disaster. Methods: A cross-sectional survey was conducted with 414 nurses working in coastal Miyagi Prefecture at the time of the earthquake (response rate: 87.5%). PTSD and depression were assessed using the PTSD Checklist–Specific Version (PCL-S) and the Patient Health Questionnaire-9 (PHQ-9). Group differences were analyzed using the chi-square and t-tests. Logistic regression models estimated odds ratios (ORs) for workplace destruction after adjusting for age, work role, and disaster-related personal factors. Results: The prevalence of probable PTSD and depression were 11.7% and 24.6%, respectively. Nurses from tsunami-destroyed hospitals showed higher crude prevalence of severe symptoms. Workplace destruction demonstrated elevated odds in the baseline models; however, after full adjustment for personal and reconstruction-related burdens, the magnitude of the association was attenuated, and confidence intervals indicated statistical uncertainty. Family member death or missing status remained the strongest independent correlate of severe PTSD (adjusted OR 5.4; p<0.001). Conclusions: Workplace destruction was associated with adverse mental health outcomes in the crude analyses, but its independent contribution diminished after accounting for cumulative personal and disaster-related burdens. These findings suggest that long-term mental health vulnerability among disaster-exposed nurses reflects complex interactions between occupational disruption and personal loss rather than structural workplace damage alone.
Takahashi et al. (Thu,) studied this question.