Project Summary

Project Name: Development of a Clinical Decision Support System Based on a New Scale for Post-Disaster Psychological Triage

Project Summary

Natural disasters are one of the leading problems that negatively affect public mental health. There are studies conducted on public mental health after almost every disaster. When the studies are examined in general, the difficulties encountered in the studies can be shown as the high number of questions in the scales used, the need to use more than one scale, and the high number of individuals affected by the disaster. Due to these difficulties, it has been observed that researchers generally focus only on Post-Traumatic Stress Disorder (PTSD) and do not screen for some other mental problems that may threaten public mental health in the long term. For this reason, a new scale that can evaluate the symptoms of other mental illnesses in addition to PTSD, enlighten the physician about the loss of functionality, and also set a standard inpatient follow-up; a smart system that can perform psychological triage to facilitate the work of field workers is needed. In this project, the main research topic is the development of a new, more comprehensive Post-Disaster Symptom Screening Scale that addresses the unique nature of post-disaster traumatic stress and the development of a Disaster Psychiatry Clinical Decision Support System based on this scale.

As is the case worldwide, there is an increase in natural disasters in our country due to climate change and global warming. In addition, our country is an earthquake country and geologists say that earthquakes of minimum magnitude 7 are expected on more than one fault. In light of this reality, the Post-Disaster Symptom Screening Scale and Disaster Psychiatry Clinical Decision Support System to be obtained from this project are aimed to play an important role in the rapid detection of individuals whose mental health is affected after possible disasters and to facilitate the work of field workers. In the first phase of the proposed project, the Post-Disaster Symptom Screening Scale is planned to be developed. The scale aims to screen the vegetative symptoms that occur most frequently in individuals after disasters and the symptoms of some mental illnesses that are on the rise in society. The scale, consisting of five-point Likert-type questions, will be subject to content validity, reliability, and structural validity studies. In addition, a disaster demographic information form will be prepared to determine the demographic characteristics of the disaster victim as well as the material and moral losses related to the disaster.

In the study, each disaster victim to whom the scale is applied will undergo a psychiatric evaluation and will be diagnosed, and a psychological triage group will be determined. The data from the scale and the disaster demographic information form will form the input set of the Disaster Psychiatry Decision Support System, and the psychological triage result will be given as the output set, and supervised learning will be provided. The data will be preprocessed for noise removal and standardization. Feature vectors will be created with appropriate statistical features for the relevant data. To estimate the output values, artificial neural networks, linear discrimination classifiers, k-nearest neighbor classifier, support vector machines, extreme learning machines, etc. methods will be used. In the performance evaluation of the methods, k-fold cross-validation will be applied and the most robust decision support system will be selected according to the successes obtained as a result of the application of machine learning methods. The decision support system will be provided to perform psychological triage in a shorter time by dynamically reducing the questions according to the answers given by the individuals and to provide a preliminary assessment to the field workers. The project will be completed according to 6 work packages within 24 months. Thanks to the scale and clinical decision support system to be obtained from the project, it is expected that early diagnosis and treatment for individuals referred to health institutions on time will contribute to the protection of community mental health, reduction of workforce losses and reduction of their economic effects. It aims to make 3 international publications, at least 2 of which will be in SCIE-indexed journals, to present them at 4 international/national congresses and to prepare a thesis study of a doctoral student from the project. It is thought that the clinical decision support system to be obtained as a result of the project will be a patentable product with high commercialization potential.

 

Keywords: Disaster Psychiatry, Psychological Triage, Mental Health, Scale, Clinical Decision Support System

 

Project Name: The Effect of Laughter Therapy Applied to Earthquake Victim Mothers on Hope and Well-Being Levels

Project Summary

On February 6, 2023, an earthquake measuring 7.7 in magnitude centered in the Pazarcık district of Kahramanmaraş Province in Turkey, followed by a second earthquake measuring 7.6 in magnitude centered in Elbistan, caused the deaths of 50,783 people in the provinces of Kahramanmaraş, Gaziantep, Şanlıurfa, Diyarbakır, Adana, Adıyaman, Osmaniye, Hatay, Kilis, Malatya and Elazığ. The magnitude of the cost impact of the 2023 Kahramanmaraş earthquake, which is described as the “disaster of the century” and calculated as 103.6 billion dollars, is as disturbing as the devastating effect of the disaster on the hope and well-being levels of individuals.

According to previous studies, the high probability that socio-psychological effects will continue long after the February 6, 2023 earthquakes necessitates physical and mental self-care activities to support the health and well-being of those affected by the disaster.

Since the mother is the first teacher and guide of the child, and for the widespread impact of our project to reach a wider audience directly and indirectly, the suitability of laughter therapy as a relaxing application that will benefit earthquake-stricken mothers living in the provinces of Elazığ and Malatya, which were affected by the 2023 Kahramanmaraş Earthquakes, will be discussed in the project.

Laughter therapy, which has become increasingly popular worldwide and has recently been recognized as a low-cost, risk-free and less time-consuming application to improve mental health, is a group-based laughter exercise that includes laughter, light movement, stretching, rhythmic breathing, and meditation performed as if it were real. When articles evaluating the psychological and physiological effects of laughter therapy on individuals are examined, it is observed that promising results are obtained. A recent meta-analysis of 45 interventions that encourage laughter, conducted with 2,500 randomized participants, found significant positive mental and physical health effects. Although challenging, laughing when you are sad can be a “great way to balance sadness.”

Hope is considered to be a state that includes a person’s high positive expectations about the future, their belief in the world, and their belief that life is worth living. High hope also has a positive effect on coping with traumatic experiences. It is known that individuals’ well-being decreases as a result of traumatic life events and they have difficulty coping with the current situation. A study conducted on 188 adults who experienced the earthquake that occurred in the Pazarcık and Elbistan districts of Kahramanmaraş on February 6, 2023, indicated the importance of having positive resources such as hope and well-being in individuals’ ability to cope with post-traumatic symptoms.

Although laughter therapy is expected to promote hope and well-being, no study has demonstrated this relationship after a disaster. Therefore, there is a need for evidence-based studies evaluating the effects of laughter therapy on hope and well-being in mothers, who are important building blocks of society, after the earthquake. This study aims to clarify the relationship between hope and well-being and laughter therapy after the Kahramanmaraş earthquakes.

The project was designed to be carried out in three stages. In the first stage, data will be collected from the schools we have determined on a provincial basis to determine the mother earthquake victims' psychological well-being, hope and post-earthquake trauma levels. While the data is being collected at this stage, the desire of the mother earthquake victims to participate in the laughter yoga program will also be questioned. In this way, a new sample will be determined for the implementation of the second stage. The second stage will be carried out on the sample determined at the first stage. In this stage, a pilot randomized controlled experimental design will be used to evaluate the effects of laughter therapy applied on post-earthquake trauma symptoms, continuous hope and psychological well-being levels.

The laughter therapy application study sample, which was conducted using a control group with a pre-test/post-test design, consists of volunteer earthquake victim mothers who meet the inclusion criteria according to the provinces where the study will be conducted. In the third stage, laughter therapy will be made widespread.

 

Keywords: Laughter Therapy, Post-Earthquake Trauma Symptoms Scale, Continuous Hope Scale, Psychological Well-Being Scale