Evidence Based Public Health Policy and Practice

Study objectives: The study investigated the prevalence and associated factors (media coverage in particular) of stress related responses to the December 2004 tsunami. Design: An anonymous population based cross sectional telephone survey was conducted. Post-traumatic stress symptom was measured by the locally validated Chinese impact of event scale (CIES) and whether the respondent felt disturbed, apprehensive, or horrified because of the tsunami. Items related to media coverage included measures on frequency of exposure, level of distress caused by different types of images, and contents of the news messages were measured. Two summative scores, the weighted image unrest score (WIUS) and weighted content unrest score (WCUS) were formed. Setting: Hong Kong, China. Participants: A total of 604 adult Chinese respondents were interviewed. Main results: Of the respondents, 33.8% were exposed to tsunami related mass media news reports .10 times per day; 56.5% to 64.7% felt severely or very severely disturbed by the six studied types of distressful messages; 52.6% to 71.4% felt similarly because of the eight studied types of distressful contents. Of the male respondents, 30% and 5.9% respectively showed signs of mild or moderate/severe post-traumatic stress symptoms (39% and 8.7%, respectively for women). Higher WIUS and higher WCUS were associated with mild or moderate/severe post-traumatic stress symptoms (multivariate OR = 1.72 to 14.67, p,0.05). These media exposure indicators, together with some other perception variables, were significantly associated with other stress indicators. Conclusions: The intensive media coverage of the tsunami was consistently associated with different types of tsunami related stress indicators.