The shared decision-making system appeared to partly improve patients' perceptions of communication and relationships with doctors but did not have a significant effect on other patient-level outcomes.
After the Great East Japan Earthquake in March 2011, residents of the area affected by the Fukushima nuclear accident were forced to seek long-term shelter. International attention to mental health needs has increased along with reconstruction of life throughout the region. Mental health, suicidal thoughts and related factors in the 18 months after the Great East Japan Earthquake and Fukushima Daiichi Nuclear Disaster were examined in a community-based, cross-sectional study of 1,595 adults living in Fukushima. To determine mental status, we used the Japanese version of K6, which was developed to screen mood and anxiety disorders. Using a cut-off of 13 points, the frequency of poor mental health was 12.1% among all subjects. Thus, the frequencies of mental health problems and suicidal thoughts were high among residents forced to live in long-term shelters following a disaster. To improve the mental well-being of community-dwelling adults living for extended periods in shelters following a disaster, there is a need to focus on issues of unemployment, stress on the health of shelter dwellers and their families, stress on human relationships, social support, social capital, and suicidal thoughts.
While motivation and hope of livelihood reconstruction have gradually risen in the three years since the disaster, anxieties about an uncertain future, loss of purpose in life, and disruption of social networks continue adversely to affect the mental health of survivors.
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