Erciyes Üniversitesi Tıp Fakültesi Son Sınıf Öğrencilerinin Kahramanmaraş Depremi Sonrasında Yaşadıkları İkincil Travma Durumlarının Değerlendirilmesi

Assessment of Secondary Trauma Among Final-Year Medical Students at Erciyes University Following the Kahramanmaraş Earthquake

Zeynep Aydın, Elçin Balcı

Department of Public Health, Erciyes University Faculty of Medicine, Kayseri, Türkiye

Traumatic events are defined as situations involving actual or threatened death, serious injury, or physical harm that a person experiences or witnesses. Individuals may develop secondary trauma when they are held responsible for, or personally assume responsibility for, such catastrophic events. This study aims to evaluate the secondary trauma levels associated with social media use among final-year (intern) medical students at a medical faculty located in Kayseri—a province that felt intense shaking due to its proximity to the earthquake zone and maintained continuous contact with the affected region through migration and aid activities—after the 2023 Kahramanmaraş earthquakes.

This descriptive, cross-sectional study was conducted among final-year students of Erciyes University Faculty of Medicine between May 1 and June 1, 2023. The sample size was calculated using G*Power 3.1.9.7, assuming that 50% of participants were affected by the earthquake, with a difference-from-constant test, small effect size (0.1), and β = 80%, resulting in a minimum required sample of 199. To account for potential missing or incorrect data, 10% more were added, and 220 individuals were included. Nine participants were excluded due to incomplete data and six for not using social media, yielding a final sample of 205. Ethical approval was obtained from the Erciyes University Social and Human Sciences Ethics Committee (application no: 394).

The data collection tool consisted of a questionnaire including sociodemographic characteristics, questions related to earthquake exposure, and the “Secondary Traumatic Stress Scale for Social Media Users” (Mancini, 2019; Balcı Çelik & Altınışık, 2021). Higher scores indicate higher levels of secondary traumatic stress originating from social media exposure. Independent variables consisted of sociodemographic characteristics, and the dependent variable was the secondary traumatic stress scale score. Normality was assessed using the Kolmogorov–Smirnov test. For comparisons of median scores, the Mann–Whitney U test was used for two-group comparisons and the Kruskal–Wallis test for comparisons involving more than two groups. A p-value <0.05 was considered statistically significant.

Of the participants, 57.6% were female, 96.6% were single, and 61.0% reported moderate economic status. The mean age was 24.4±1.38 years, and 47.8% lived with their families. A total of 82.9% reported having no chronic disease, 87.3% used no regular medication, 76.6% were non-smokers, and 7.3% reported a diagnosed mental disorder. Among smokers (23.4%), 17.1% stated that their cigarette consumption increased after the earthquake. In total, 96.1% were in Kayseri during the earthquake, and 2.5% were in other affected regions.

Among those whose buildings were damaged (19.5%), 80.0% described the damage as minor. Additionally, 98.5% did not have a first-degree relative injured in the earthquake, and 99.0% did not experience a first-degree relative’s death. Regarding contact with or assistance to earthquake victims (54.1%), 31.2% provided in-kind or monetary aid, 19.0% provided healthcare services, 12.7% offered social support, and 2.9% participated in search-and-rescue efforts.

In terms of social media use, 93.2% used WhatsApp and 85.4% used Instagram. More than half (56.1%) spent 2–3 hours daily on social media. Daily screen time was 4–5 hours for 39.5% of participants, with a median of 5.00 hours (Q1: 3.00 – Q3: 6.00). After the earthquake, screen time did not change for 68.3% of participants.

Secondary traumatic stress scores were higher among females compared to males, among participants with chronic diseases compared to those without, and among those whose screen time increased after the earthquake compared to those whose screen time did not change. Marital status, presence of a mental disorder, smoking status, contact/assistance to earthquake victims, and economic status were not statistically significant.

This study demonstrated that increased screen time after the earthquake was associated with higher levels of secondary traumatic stress. Further studies with larger sample sizes are needed to evaluate whether reducing screen time after traumatic events such as disasters may help mitigate secondary traumatic stress. Increased screen time can also be transformed into an opportunity: through social media, programs aimed at reducing post-traumatic anxiety, accelerating mental health recovery, and promoting accurate information can be disseminated to help combat infodemics and support affected populations.

Keywords: earthquake, secondary trauma, secondary traumatic stress scale, social media