Psychosocial difficulties of Amoy Gardens residents After the SARS outbreak
¡@¡@After 2 focus group meetings in mid June 2003 as well as literature & news review on SARS, a self-report questionnaire was finalized. 4,896 questionnaires were distributed to all the individual households of the Amoy Gardens, 903 were validly analyzed (response rate 18.5%). The respondents were aged 15 to 80 (41% males, 59% females). Nearly 90% of the respondents were employed.
¡@¡@The survey showed that the daily lives of nearly 90% of the respondents were deeply affected, including the domains of social relationship, work and family lives. 40.6% recalled that they were rejected for dining with friends during April 2003. 25.4% reported that they had distanced neighbors who (or their family members) were infected. More than 30% were turned down when they requested household maintenance services or home delivery, more than 20% were rejected for hotel service or received unfair treatment at clinics. In order not to be treated differently, nearly 40% of the respondents had concealed their Amoy Gardens identity when eating out in the public or visiting a doctor.
¡@¡@In the workplace, nearly half of those who were at work in April perceived unfair treatment or unpleasant experiences. The unfair treatment by bosses included being requested to work at home (38.3%) and to produce clear health bill in order to resume work (26.8%). The unpleasant experiences with colleagues or clients included being requested to wear masks (65.3%), being avoided (47.2%) and receiving impersonal communication (44.6%). Almost 40% of the respondents had concealed their identity as Amoy Gardens residents when seeking jobs during the outbreak whilst nearly 20% would do so when necessary in future employment.
¡@¡@Ex-SARS patients in the Amoy Gardens also experienced difficulties in workplace or schools. For example, respondents who were acquainted with ex-SARS patients there said that the latter were requested: to take prolonged leave before resuming work or schooling (68.0%) and to continue to wear masks at work or in school (57.8%).
¡@¡@Regarding the experiences of residents of block E, 37.3% of these respondents had felt being shunned by residents of other blocks. At the same time, the non-block E respondents also expressed their fear against block E. They avoided walking near block E (76.0%), emphasized to others that they were not block E residents (61.2%), and admitted avoiding block E residents (12.1%).
¡@¡@Nearly 40% of the respondents who were employed during April reported that they were treated differently from colleagues residing in other infected buildings in Hong Kong. Nearly 60% complained that they were treated irrationally. Most of the respondents (88.4%) thought that the public saw Amoy Gardens differently from other infected buildings. The most common reasons for such perception were: the SARS viruses in the Amoy Gardens were extraordinarily infectious (89.2%), the spreading of SARS there was mysterious (75.3%), and many blocks there were infected (74.9%), the government's unsatisfactory ways of disseminating information on death and infected cases (64.7%), and the negative portrayal of the Amoy Gardens in the media (57.1%).
¡@¡@Nearly 90% of the respondents reported having been distressed and anxious since the outbreak of SARS. Among these distressed residents, persistent (more than 2 weeks) symptoms of low mood, irritability, insomnia, headache and chest discomfort were common (73.1%, 56.7%, 34.2% 17.4% and 17.1% respectively). They attributed the occurrence of such symptoms to the infectiousness of SARS, the mysterious mode of spreading, and the effect of stigmatization. Nearly 60% of the anxious respondents may have suffered from the symptoms of mood disorders because of the SARS outbreak. 40% of the respondents had moved out of Amoy Gardens during the outbreak while nearly 40% of those who had not moved out had thought about leaving there. In the future, about 20% of the respondents had a plan of moving out.
¡@¡@Physical proximity was a causal factor of distress. Block E residents reported a higher percentage of chest discomfort compared to non-block E residents. The residents in Phase I also reported a higher percentage of irritability. For those who contracted SARS and those had members infected in their flat, they had more complaints of insomnia, chest discomfort and irritability.
¡@¡@When asked about the causes of high mortality and infection rate, respondents reported that they were due to unsatisfactory management and policy by the government (88.0%), insufficient knowledge of a highly infectious virus (71.6%) and the infra-structural problems in the Amoy Gardens (45.4%).
¡@¡@SARS related suffering and unfair treatment were common among Amoy Gardens residents. It is recommended that the government should pay more attention to the psychological health of the public and adopt a proactive mode of intervention to individuals who are affected or will be affected in future SARS outbreaks. An accurate mode of communicating risks is also important for reducing panic and socioeconomic losses.