title: Living status, economic hardship and sleep disturbance were associated with subjective shoulder pain in survivors of the Great East Japan Earthquake: A cross sectional study.
abstract: BACKGROUND
  The Great East Japan Earthquake and devastating Tsunami hit hard everything on the northeastern coast of Japan. This study aimed to determine socio-psychological factors for "subjective shoulder pain" of the survivors at 2 years evaluated by a self-report questionnaire.
  
  
  METHODS
  Between November 2012 to February 2013, survivors replied to the self-report questionnaire, and 2275 people consented to join this study. Living status was divided into 5 categories (1. same house as before the earthquake (reference group), 2. temporary small house, 3. apartment, 4. house of relatives or acquaintance, 5. new house) and economic hardship was divided into 4 categories (1. normal (reference group), 2. a little bit hard, 3. hard, 4. very hard). Gender, age, body mass index, living areas, smoking and drinking habits, complications of diabetes mellitus and cerebral stroke, working status, and walking time were considered as the confounding factors. Kessler Psychological Distress Scale of ≥10/24 and Athens Insomnia Scale of ≥6/24 points were defined as a presence of psychological distress and sleep disturbance, respectively. We used multiple logistic regression analysis to examine the association of shoulder pain with living environment, economic hardship, psychological distress, and sleep disturbance at 2 years after the earthquake.
  
  
  RESULTS
  There were significant differences in the risk of having shoulder pain in those with "apartment" (OR = 1.74, 95% CI = 1.03-2.96), "house of relatives or acquaintance" (OR = 2.98, 95% CI = 1.42-6.25), economic hardship of "hard" (OR = 1.71, 95% CI = 1.08-2.7) and "very hard" (OR = 2.51, 95% CI = 1.47-4.29), and sleep disturbance (OR = 2.96, 95% CI = 2.05-4.27).
  
  
  CONCLUSIONS
  Living status of "apartment" and "house of relatives or acquaintance", economic hardship of "hard" and "very hard", and "sleep disturbance" were significantly associated with shoulder pain.
authors.affiliation: Department of Orthopaedic Surgery, Tohoku University School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan. Electronic address: hagi@med.tohoku.ac.jp.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Hagiwara
authors.affiliation: Department of Orthopaedic Surgery, Tohoku University School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Sekiguchi
authors.affiliation: Department of Orthopaedic Surgery, Tohoku University School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Yabe
authors.affiliation: Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan.
authors.forename: Yumi
authors.initials: Y
authors.lastname: Sugawara
authors.affiliation: Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Watanabe
authors.affiliation: Department of Orthopaedic Surgery, Tohoku University School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Kanazawa
authors.affiliation: Department of Orthopaedic Surgery, Tohoku University School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Koide
authors.affiliation: Department of Orthopaedic Surgery, Tohoku University School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Itaya
authors.affiliation: Tohoku Fukushi University, 6-149-1, Kunimigaoka, Sendai, Miyagi 989-3201, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Tsuchiya
authors.affiliation: Division of Epidemiology, Department of Health Informatics and Public Health, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Tsuji
authors.affiliation: Department of Orthopaedic Surgery, Tohoku University School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Itoi
mesh_terms: D000368:Aged; D003365:Costs and Cost Analysis; D003430:Cross-Sectional Studies; D004190:Disasters; D055866:Earthquakes; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000150:complications / Q000191:economics / Q000453:epidemiology; D011203:Poverty; D012189:Retrospective Studies; D057566:Self Report; D020069:Shoulder Pain / Q000150:complications / Q000191:economics / Q000453:epidemiology*; D012893:Sleep Wake Disorders / Q000191:economics / Q000453:epidemiology* / Q000209:etiology; D013315:Stress, Psychological / Q000191:economics / Q000453:epidemiology* / Q000209:etiology; D011795:Surveys and Questionnaires; D017741:Survivors / Q000706:statistics & numerical data*; D057192:Tsunamis