{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:28:55Z","timestamp":1753892935023,"version":"3.41.2"},"reference-count":46,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,3,9]],"date-time":"2022-03-09T00:00:00Z","timestamp":1646784000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Social unrest affects people's health and well-being. People's health-related needs during social unrest are concerns in both research and clinical practice. This study aimed to build and test a framework to describe and understand the health status and needs of people with post-traumatic stress disorder (PTSD) during social unrest.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study was a cross-sectional survey. A total of 460 people who had experienced post-traumatic distress as a result of the social unrest in 2019 and 2020 were included. A conceptual model comprised four essential areas, namely posttraumatic distress symptoms, participation restrictions, perceived stigma and functional disability, was built from literature. Part 1 validated four instruments that evaluate and define the factor structure of these four areas, In Part II, structural equation modeling was used to test and validate a combined model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Factors underlying the four areas were defined. Analysis using structural equation modeling confirmed a best fit of the model. PTSD symptoms, perceived stigma and participation restriction during social unrest contributed significantly to functional disability; PTSD symptoms exerted a direct effect on participation restriction and perceived stigma; and the effect of PTSD symptoms on functional disability was mediated through its influence on perceived stigma during social unrest.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A community-based inclusive approach is essential to understand the holistic needs of people with PTSD during social unrest. To improve health and well-being in addition to evaluating mental health impacts, considering interactions with the rapid change and stressful social environment is essential.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2022.838606","type":"journal-article","created":{"date-parts":[[2022,3,9]],"date-time":"2022-03-09T14:25:44Z","timestamp":1646835944000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Building and Testing of a Conceptual Model to Describe and Measure the Health of People as Affected by Post-traumatic Stress Disorder During Social Unrest: A Confirmatory Factor Analysis and Structural Equation Modeling"],"prefix":"10.3389","volume":"10","author":[{"given":"Eva Yin-han","family":"Chung","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,3,9]]},"reference":[{"journal-title":"Constitution of the World Health Organization","year":"1995","key":"B1"},{"key":"B2","doi-asserted-by":"publisher","first-page":"77","DOI":"10.2307\/3527467","article-title":"The WHO definition of 'health'","volume":"1","author":"Callahan","year":"1973","journal-title":"Stud Hastings Cent"},{"key":"B3","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1016\/S0140-6736(19)33160-5","article-title":"Depression and post-traumatic stress during major social unrest in Hong Kong: a 10-year prospective cohort study","volume":"395","author":"Ni","year":"2020","journal-title":"Lancet."},{"volume-title":"Diagnostic and Statistical Manual of Mental Disorders (DSM-5\u00ae)","year":"2013","key":"B4"},{"key":"B5","doi-asserted-by":"publisher","first-page":"982","DOI":"10.1016\/S2215-0366(19)30382-7","article-title":"The mental health impact of the pro-democracy movement in Hong Kong","volume":"6","author":"Hou","year":"2019","journal-title":"Lancet Psychiatry."},{"key":"B6","doi-asserted-by":"publisher","first-page":"232","DOI":"10.1177\/0004867419899165","article-title":"Mental health during and after protests, riots and revolutions: a systematic review","volume":"54","author":"Ni","year":"2020","journal-title":"Aust N Z J Psychiatry."},{"key":"B7","doi-asserted-by":"publisher","first-page":"1579","DOI":"10.1007\/s11136-013-0585-4","article-title":"The association of PTSD with physical and mental health functioning and disability (VA Cooperative Study# 569: the course and consequences of posttraumatic stress disorder in Vietnam-era veteran twins)","volume":"23","author":"Goldberg","year":"2014","journal-title":"Qual Life Res"},{"key":"B8","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1080\/00336297.2016.1143849","article-title":"Disability discourse: overview and critiques of the medical and social models","volume":"68","author":"Haegele","year":"2016","journal-title":"Quest."},{"key":"B9","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1207\/S15327949PAC0602_1","article-title":"Political trauma and recovery in a protracted conflict: understanding contextual effects","volume":"6","author":"Montiel","year":"2000","journal-title":"Peace Confl."},{"volume-title":"International Classification of Functioning. 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