BackgroundIn this study, exposure refers to survivors who suffered from life-changing situations, such as personal injuries, the deaths or injury of family members, relatives or friends or the loss of or damage to personal or family property, as a result of the earthquake. The mediating effect of risk perception on the exposure and psychological health in survivors from the Longmen Shan Fault area and the moderating effect of social support on the relationship between risk perception and psychological health were both examined.MethodA cross-sectional survey was conducted in a local Longmen Shan Fault area near the epicenter of the 2008 Wenchuan earthquake. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), the standard Chinese 12-item Short Form (SF-12v2), and the Social Support Rating Scale (SSRS) were used to interview 2,080 earthquake survivors in the period one-year after the earthquake. Based on the environment and the characteristics of the Longmen Shan Fault area, a risk perception questionnaire was developed to evaluate survivor risk perception. Factor and regression analyses were conducted to determine the hypothetical relations.ResultsThe analyses provided effective support for the hypothesized model. Survivor risk perception was classified into direct risk perception and indirect risk perception. Survivor direct risk perception was found to play a partial mediating role in the relationship between exposure and the two domains (Physical component summary (PCS) and the Mental component summary (MCS)) of psychological health. Survivor indirect risk perception was found to have a only partial mediating effect on the association between exposure and MCS. Social support was found to moderate the influence of risk perception on psychological health.ConclusionRisk communication should be considered in future post-earthquake psychological assistance programs and social support strategies could also be useful in improving psychological health.

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The Longmen Shan Fault area is one of the most active seismic zones in the world, has a relatively dense population and a low economic development level. Therefore, the provision of effective post-earthquake relief is very important for saving lives and restricting financial losses. However, providing urgent relief is a complex problem that requires efficient coordination between the organizations, and departments involved, and the specific environments, for the supply of urgent materials, energy and information. In practice, although there are sufficient relief supplies, because of the lack of systemic thinking, relief activities are often chaotic leading to inefficiencies and even increases in the damage and loss of life. In this study, a critical systems thinking approach is used to reflect on the system contexts, boundaries, structures and functions of the emergency relief systems. Using systems modeling we constructed simulations for different relief plans and their consequences, and a work shop of metasynthetic engineering was constructed to integrate the different views, knowledge and contexts. At the practical stage, after the model's validity was verified from the 2008 Wenchuan earthquake data, based on the 2013 Lushan earthquake simulation results, some recommendations are made to improve future post-disaster relief operations. Finally, the significance of critical systems thinking is demonstrated to ensure effective and efficient of post-earthquake relief. Some limitations and future research also have been presented in conclusion.

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