The relationship between earthquake preparedness, perceived earthquake risk, and anxiety among adults

www.5n1quality.com The relationship between earthquake preparedness, perceived earthquake risk, and anxiety among adults Yetişkinlerde deprem hazırlığı, algılanan deprem riski ve kaygı arasındaki ilişki Merve Kolcu1, Aydan Yılmaz2, Seda Ayyıldız3, Zeynep Düz4, Yüsranur Dirikolu5, Feride Güzel6, Sümeyya Ay7, Fatma Aslan8, Haıbıer Rexıdaı9, İrem Büyükakça10 1 Associate Prof., PhD, RN , Department of Public Health Nursing, Hamidiye Faculty of Nursing, University of Health Sciences, Istanbul,/Turkey, [email protected], 0000-0002-8187-4767 ² MSc, RN, Department of Public Health Nursing, Hamidiye Faculty of Nursing, University of Health Sciences, Istanbul, Turkey, [email protected] , 0000-0001-7494-976X 3 Dr. Hem., SBÜ Zeynep Kamil Kadın ve Çocuk Hastalıkları Eğitim ve Araştırma Hastanesi, Enfeksiyon Kontrol Komitesi, İstanbul/ Türkiye, [email protected], 0000-0003-2664-0615 4 Nursing Student, Hamidiye Faculty of Nursing, University of Health Sciences, Istanbul, Turkey, [email protected], 0009-0003-9845-3824 5 Nursing Student, Hamidiye Faculty of Nursing, University of Health Sciences, Istanbul, Turkey, [email protected], 0009-0005-3393-463X 6 Nursing Student, Hamidiye Faculty of Nursing, University of Health Sciences, Istanbul, Turkey, [email protected], 0009-0001-8535-5147 7 Nursing Student, Hamidiye Faculty of Nursing, University of Health Sciences, Istanbul, Turkey, [email protected], 0009-0005-8472-7921 8 Nursing Student, Hamidiye Faculty of Nursing, University of Health Sciences, Istanbul, Turkey, [email protected], 0009-0007-3575-2228 9 Nursing Student, Hamidiye Faculty of Nursing, University of Health Sciences, Istanbul, Turkey, [email protected], 0009-0007-6826-7616 10 Nursing Student, Hamidiye Faculty of Nursing, University of Health Sciences, Istanbul, Turkey, [email protected], 0009-0007-4032-4156 Research Article / Araştırma Makalesi Corresponding Author/Sorumlu Yazar: Doç. Dr. Merve KOLCU, Sağlık Bilimleri Üniversitesi Hamidiye Hemşirelik Fakültesi İstanbul/Türkiye, [email protected], 0000-0002-8187-4767 DOI: 10.5281/zenodo.18054181 Received Date/Gönderme Tarihi: 09.10.2025 Accepted Date/Kabul Tarihi: 11.12.2025 Published Online/Yayımlanma Tarihi 31.12.2025 ABSTRACT This study aims to determine the relationship between earthquake preparedness, perceived earthquake risk, and anxiety among adults. This descriptive study was conducted with 286 individuals who participated in an online survey between May and August 2025. Data were collected using a questionnaire, which included the Earthquake Preparedness Behavior Scale, the Earthquake Risk Perception Scale, and the Earthquake Anxiety Scale. Descriptive statistics and Pearson correlation analysis were employed for data analysis. The mean total score of the Earthquake Preparedness Behavior Scale was 9.75±3.50, the mean total score of the Earthquake Risk Perception Scale was 27.60±3.38, and the mean total score of the Earthquake Anxiety Scale was 27.60±3.38. A statistically significant positive correlation was found between the total score of the Earthquake Preparedness Behavior Scale and the total scores of both the Earthquake Risk Perception Scale and the Earthquake Anxiety Scale (p<0.001). The findings of this study indicate a significant positive relationship between earthquake preparedness behavior, risk perception, and earthquake anxiety levels. This suggests that risk perception and anxiety are important factors influencing individuals’ level of earthquake preparedness. Anahtar Kelimeler: Earthquake Preparedness, Earthquake Risk Perception, Earthquake Anxiety ÖZ Bu araştırmada, yetişkin bireylerde depreme hazırlıklı olma durumu, deprem risk algısı ve anksiyete ilişkinin belirlenmesi amaçlanmıştır. Tanımlayıcı tipte olan bu araştırma Mayıs-Ağustos 2025 tarihleri arasında çevrim içi ankete katılan 286 birey ile yürütülmüştür. Verilerin toplanmasında; anket formu, Depreme Hazırlıklı Olma Davranışı Ölçeği, Deprem Risk Algısı Ölçeği ve Deprem Anksiyetesi Ölçeği kullanılmıştır. Verilerin analizinde; tanımlayıcı istatistikler ve pearson korelasyon analizi kullanılmıştır. Depreme Hazırlıklı Olma Davranışı Ölçeği toplam puan ortalaması 9.75±3.50, Bireylerin Deprem Risk Algısı Ölçeği toplam puan ortalaması 27.60±3.38, Deprem Anksiyetesi Ölçeği toplam puan ortalaması ise 27.60±3.38 olarak bulunmuştur. Depreme Hazırlıklı Olma Davranışı Ölçeği toplam puanı ile Deprem Risk Algısı Ölçeği toplam puanı ve Deprem Anksiyetesi Ölçeği toplam puanı arasında istatistiksel olarak pozitif yönde anlamlı ilişki olduğu görülmüştür (p<0.001). Araştırma sonuçları, depreme hazırlıklı olma davranışı, bireylerin deprem risk algısı ve deprem anksiyetesi düzeyleri ile pozitif yönde anlamlı bir ilişki göstermektedir. Bu durum, risk algısı ve anksiyetenin, bireylerin deprem hazırlık düzeylerini etkileyen önemli faktörler olduğunu ortaya koymaktadır. Key Words: Depreme Hazırlık, Deprem Risk Algısı, Deprem Kaygısı Reference | Atıf : Kolcu, M., Yılmaz, A., Ayyıldız, S., Düz, Z., Dirikolu, Y., Güzel, F., Ay, S., Aslan, F., Rexıdaı, H. & Büyükakça, İ. (2025). The relationship between earthquake preparedness, perceived earthquake risk, and anxiety among adults. Journal of 5N1Quality, 3(3), 101-109 J 5N1 Quality, 2025, 3(3): 101-109 J 5n1quality ● 2025 ● Vol 3 ● Issue 3 97 Kolcu et al.: Earthquake preparedness, risk perception, and anxiety among adults INTRODUCTION Earthquakes, as in many parts of the world, are natural disasters in Turkey that cause significant loss of life and property and are difficult to predict (Topal, Başpınar & Güntürkün, 2024; Mızrak, Özdemir & Aslan, 2021). A large proportion of disaster-related deaths and economic losses worldwide result from earthquakes; therefore, earthquakes represent not only physical destruction but also social, economic, and psychological consequences at both individual and societal levels (Wang et al., 2021). The geological structure of Turkey and its location on active fault lines make the country one of the regions with the highest earthquake risk. Indeed, large-scale earthquakes experienced in recent years have brought issues such as disaster management, community resilience, and individual preparedness to the forefront of the agenda (Topal, Başpınar & Güntürkün, 2024). Preparedness for earthquakes is one of the fundamental determinants in reducing disasterrelated losses. This encompasses not only physical preparations (e.g., preparing an emergency kit, identifying safe areas, developing an evacuation plan) but also individuals’ level of knowledge, awareness, risk perception, and psychological resilience. The literature indicates that risk perception regarding disasters is a factor that directly influences individuals’ preparedness behaviors. A high level of risk perception may encourage individuals to take protective and preventive measures, whereas a low level of risk perception may lead to insufficient levels of preparedness. However, excessively high-risk perception may also result in persistent anxiety, fear, and feelings of helplessness, thereby adversely affecting functionality (Trumbo et al., 2016; Gül, 2024). One of the most observed psychological responses to disasters is anxiety. The destructive effects of earthquakes cause individuals to experience prolonged anxiety not only during the event itself but also in its aftermath. It has been reported that individuals with prior earthquake experience tend to exhibit higher levels of anxiety, which adversely affects both their daily life activities and future planning (Kahraman & Çubukcu, 2025; Uğur, Kartal & Mete, 2021). While anxiety may stimulate preparedness behaviors in some individuals, in others it can lead to dysfunctional coping strategies such as avoidance, denial, or catastrophizing. Therefore, understanding the relationship between anxiety and earthquake preparedness is crucial in planning preand post-disaster interventions (TUIK, 2022). Adults occupy a key position in disaster preparedness due to their decisive roles within their families and immediate social environments. The risk perception, preparedness levels, and anxiety status of adults directly affect not only their own safety but also the safety of those under their care. Accordingly, an analysis of the relationship between adults’ earthquake preparedness, risk perception, and anxiety levels is essential for the formulation of effective community-based disaster management strategies (TUIK, 2022; Zhou et al., 2017). This study aims to examine the relationship between earthquake preparedness, earthquake risk perception, and anxiety among adults. The findings obtained are expected to contribute to the development of disaster preparedness programs, the strengthening of risk communication processes, and the planning of psychosocial support interventions before disasters. In this way, it may be possible to enhance resilience against disasters at both individual and societal levels. 98 J 5n1quality ● 2025 ● Cilt 3 ● Sayı 3 Kolcu vd.: Yetişkinlerde deprem hazırlığı, risk algısı ve kaygı METHODS Study Design and Participants The population of this descriptive study consists of 56.592,570 individuals aged 18-65 residing in Turkey, according to the results of the Address-Based Population Registration System (TUIK, 2022). Based on the sample size calculation formula for a known population, it was determined that at least 286 adult individuals should be included in the study. Data were collected between May and August 2025 through an online survey using the snowball sampling method, from adults aged 18–65 who agreed to participate in the study and completed the questionnaire in full. The sample included 286 literate adults without communication impairments who were able to complete the online survey. Measurements Data for the study were collected using a structured questionnaire, which included the Earthquake Preparedness Behavior Scale, the Earthquake Risk Perception Scale, and the Earthquake Anxiety Scale. Questionnaire form The questionnaire collected information on adults’ demographic characteristics (age, gender, marital status, educational level, occupation, and monthly income), knowledge of the earthquake risk in their residential area, and concerns about potential earthquake risk in their region. The form consisted of a total of 10 items. Earthquake preparedness behavior scale The Earthquake Preparedness Behavior Scale, developed by Wang et al. (2021) and adapted into Turkish by Topal et al. (2024), comprises 13 items across three subscales: material preparedness, behavioral preparedness, and awareness-based preparedness. None of the items require reverse scoring. In accordance with the original version of the scale, responses are collected. The same scoring method is applied to the overall scale and its subscales, with the total score representing the participant’s level of preparedness. The scale demonstrated acceptable internal consistency, with a Cronbach’s alpha of 0.70 (Topal, Başpınar & Güntürkün, 2024; Wang, Han & Liu, 2021). Earthquake risk perception scale This scale is used to assess earthquake risk perception and was originally developed by Trumbo et al. (2016) to measure sensory and cognitive risk perceptions related to hurricanes (Trumbo et al., 2016). It has been indicated that the scale can be generalized to all natural disasters, and when applied to a disaster other than hurricanes, only the name of the disaster needs to be replaced. Mızrak et al. adapted the scale for earthquakes and conducted its Turkish validity and reliability study. The scale consists of eight items rated on a five-point Likert-type scale, with no reverse-scored items. It includes two subscales: sensory risk perception and cognitive risk perception. Participants are asked to select J 5n1quality ● 2025 ● Vol 3 ● Issue 3 99 Kolcu et al.: Earthquake preparedness, risk perception, and anxiety among adults the option that best reflects their perception of earthquake-related risk. Higher mean or total scores indicate higher levels of risk perception. The Cronbach’s alpha coefficient of the scale was reported as 0.85, demonstrating good internal consistency (Mızrak, Özdemir & Aslan, 2021). Earthquake anxiety scale Developed by Gül (2024), this scale uses a five-point Likert-type format. Scores on the scale range from 9 to 45, with no reverse-scored items. In the scale interpretation, scores of 9-21 indicate low anxiety, 22–33 indicate moderate anxiety, and 3445 indicate high anxiety (Gül, 2024). Statistical Analysis The data obtained from the study were analyzed using SPSS 25.0 (IBM, Armonk, NY, USA). Descriptive statistics and Pearson correlation tests were used for data analysis. Results were evaluated at a 95% confidence interval, with the significance level set at p < 0.05. Ethical Consideration The study was conducted in accordance with the Helsinki Declaration after obtaining ethical approval (dated May 29, 2025; number 12/8). The purpose and procedures of the study were explained in writing to all participants included in the research. Data were collected only after each participant provided written informed consent. RESULTS Among the participants, 75.9% were female, 73.1% were single, 71.7% were university graduates, 53.8% were students, and 55.6% reported that their income met their expenses. Regarding earthquakerelated perceptions, 80.4% considered the province they live in as risky, 79.7% had experienced an earthquake in the past year, 64.7% did not feel prepared for an earthquake, and 81.2% reported being concerned about earthquake risk. The mean age of the participants was 26.89 ± 10.57 years (Table 1). Table 1. Descriptive characteristics of the participants (n = 286) Characteristics n % Gender Female 217 75.9 Male 69 24.1 Marital Status Married 77 26.9 Single 209 73.1 Education Primary school 18 6.3 Middle school 12 4.2 High school 41 14.3 University 205 71.7 Graduate school 10 3.5 100 J 5n1quality ● 2025 ● Cilt 3 ● Sayı 3 Kolcu vd.: Yetişkinlerde deprem hazırlığı, risk algısı ve kaygı Table 1. (Devam) Descriptive characteristics of the participants (n = 286) Characteristics n % Occupation Self-employed 44 15.4 Student 154 53.8 Worker / employee 26 9.1 Homemaker 40 14.0 Unemployed 22 7.7 Monthly income Income does not meet expenses 107 37.4 Income meets expenses 159 55.6 Income exceeds expenses 20 7.0 Perception of living in a risky province Yes 230 80.4 No 9 3.1 Partially 47 16.5 Experienced an earthquake in the past year Yes 228 79.7 No 58 20.3 Perceived earthquake preparedness Yes 18 6.3 No 185 64.7 Partially 83 29.0 Concern about earthquake risk Yes 232 81.2 No 15 5.2 Partially 39 13.6 Mean ± SD. Min.- Max. Age 26.89±10.57 18-63 SS.: Standard Deviation; Min.-Max.: Minimum-Maximum The score distributions for the Earthquake Preparedness Behavior Scale, Earthquake Risk Perception Scale, and Earthquake Anxiety Scale are presented in Table 2. For the Earthquake Preparedness Behavior Scale, the mean score for the material preparedness subscale was 3.56 ± 1.91 (range: 0–7), for the behavioral preparedness subscale 3.13 ± 1.45 (range: 0–5), for the awarenessbased preparedness subscale 3.04 ± 1.20 (range: 0–4), and the total score was 9.75 ± 3.50 (range: 0–16). The mean score for the sensory risk perception subscale of the Earthquake Risk Perception Scale was 14.57 ± 2.15 (range: 8–19), for the cognitive risk perception subscale 16.31 ± 1.94 (range: J 5n1quality ● 2025 ● Vol 3 ● Issue 3 101 Kolcu et al.: Earthquake preparedness, risk perception, and anxiety among adults 8–20), and the total score was 30.88 ± 2.94 (range: 23–38). The mean total score of the Earthquake Anxiety Scale was 27.60 ± 3.38 (range: 19–37) (Table 2). Table 2. Score distributions of the Earthquake Preparedness Behavior Scale, Earthquake Risk Perception Scale, and Earthquake Anxiety Scale Scales Mean±SD. Min.-Max. Earthquake Preparedness Behavior Scale Material Preparedness 3.56±1.91 0-7 Behavioral Preparedness 3.13±1.45 0-5 Awareness-Based Preparedness 3.04±1.20 0-4 Total Score 9.75±3.50 0-16 Earthquake Risk Perception Scale Sensory Risk Perception 14.57±2.15 8-19 Cognitive Risk Perception 16.31±1.94 8-20 Total Score 30.88±2.94 23-38 Earthquake Anxiety Scale Total Score 27.60±3.38 19-37 SD.: Standart Deviation; Min.-Max.: Minimum-Maximum The relationships among the Earthquake Preparedness Behavior Scale, Earthquake Risk Perception Scale, and Earthquake Anxiety Scale were examined. A statistically significant positive correlation was observed between the total score of the Earthquake Preparedness Behavior Scale and the total scores of both the Earthquake Risk Perception Scale and the Earthquake Anxiety Scale (p < 0.001) (Table 3). Table 3. Relationships among the Earthquake Preparedness Behavior Scale, Earthquake Risk Perception Scale, and Earthquake Anxiety Scale Scales Earthquake Preparedness Behaviour Scale Earthquake Risk Perception Scale Earthquake Anxiety Scale Earthquake Preparedness Behaviour Scale 10.076* 0.018* * Pearson correlation p<0.01 DISCUSSION The findings of this study provide important insights into adults’ preparedness, risk perception, and anxiety levels related to earthquakes. The majority of participants were female (75.9%), single (73.1%), university graduates (71.7%), and students (53.8%). This demographic distribution represents a significant sample for evaluating earthquake preparedness and risk perception among young and educated individuals. The predominance of students highlights the need to focus on disaster awareness and preparedness behaviors in the younger population. Previous literature also indicates that, although 102 J 5n1quality ● 2025 ● Cilt 3 ● Sayı 3 Kolcu vd.: Yetişkinlerde deprem hazırlığı, risk algısı ve kaygı young adults tend to have relatively high awareness of disasters, their actual preparedness behaviors remain limited (Topal, Başpınar, & Güntürkün, 2024; Mızrak, Özdemir & Aslan, 2021; Trumbo et al., 2016). In the study, 80.4% of participants considered their province to be at risk for earthquakes, and 79.7% had experienced an earthquake in the past year, indicating that individuals are aware of the likelihood of earthquakes in their environment. Nevertheless, 64.7% reported not feeling prepared for an earthquake, and 81.2% expressed concern about earthquake risk. These findings confirm the frequently emphasized “risk perception–preparedness gap” in the literature, where individuals are aware of earthquake hazards, but this awareness does not always translate into behavioral preparedness.9 Possible reasons for this gap include lack of knowledge, economic constraints, fatalistic beliefs, and psychological barriers related to disasters. In this context, nurses—particularly in the field of public health—can play a critical role (Agarwalla et al., 2020). Public health nurses can organize educational programs, counselling, and awareness initiatives to enhance individuals’ earthquake awareness, support their behavioral preparedness, and address their psychosocial needs (Yan et al., 2015). Analysis of the Earthquake Preparedness Behavior Scale revealed that the material preparedness subscale (3.56 ± 1.91) scored higher than the behavioral (3.13 ± 1.45) and awareness (3.04 ± 1.20) subscales. This finding indicates that individuals tend to focus more on tangible and visible preparedness measures (e.g., preparing an emergency kit, storing food and water) while remaining insufficient in behavioral preparedness (e.g., developing an evacuation plan, identifying safe areas) and cognitive/awareness aspects. However, behavioral preparedness is one of the most critical components in disaster management. A lack of knowledge about appropriate actions during an earthquake or low awareness can limit the effectiveness of material preparations (Rezabeigi Davarani et al., 2023; Vrselja, Pandžić & Glavaš, 2023). Therefore, individuals should be encouraged to move beyond material-based preparedness and strengthen their preparedness at the behavioral level. According to the Earthquake Risk Perception Scale findings, participants exhibited high sensory (14.57 ± 2.15) and cognitive (16.31 ± 1.94) risk perceptions. This high level of risk perception indicates that individuals are aware of the destructive potential of earthquakes. The literature suggests that risk perception is one of the strongest predictors of preparedness behaviors (Aksa et al., 2020; Ma et al., 2023). However, in this study, despite high-risk perception, preparedness levels remained moderate, suggesting a perception–behavior inconsistency among individuals. One possible explanation is that high risk perception may induce excessive anxiety and feelings of helplessness, preventing translation into actionable behaviors. Indeed, some studies have reported that excessively high-risk perception can lead to catastrophizing and avoidance responses rather than promoting preparedness behaviors (Thapa et al., 2018). Analysis of the Earthquake Anxiety Scale revealed a high mean score (27.60 ± 3.38), indicating that anxiety related to earthquakes is a common psychological response in the population. Earthquakerelated anxiety can have both facilitating and inhibiting effects on individuals’ preparedness behaviors (Thapa et al., 2018; Uğur et al., 2021). The study found a significant positive correlation between the Earthquake Anxiety Scale and the Earthquake Preparedness Behavior Scale, suggesting that anxiety may motivate preparedness behaviors up to a certain level. Similarly, Thapa et al. (2018) and Kahraman et al. (2025) emphasized J 5n1quality ● 2025 ● Vol 3 ● Issue 3 103 Kolcu et al.: Earthquake preparedness, risk perception, and anxiety among adults that disaster-related anxiety can enhance preparedness behaviors, whereas excessive anxiety may impair functionality. This finding indicates that earthquake-related anxiety should not be considered entirely negative, although excessive levels may pose a risk to mental health (Zhou et al., 2017; Thapa et al., 2018). One of the key contributions of this study is the demonstration of a positive relationship among earthquake preparedness, risk perception, and anxiety. The findings indicate that psychological factors play a critical role in disaster preparedness, and that individuals should be supported not only in physical preparedness but also in cognitive and emotional domains. The predominance of young and student populations highlights the need to strengthen disaster education, psychosocial resilience programs, and risk communication strategies for this group. Nurses, particularly in the field of public health, can play a vital role by organizing educational programs to enhance earthquake awareness, supporting behavioral preparedness, and implementing interventions to promote psychosocial resilience. This study has several limitations. First, the data were collected via an online survey, which excluded individuals without internet access, those with limited technological skills, or those unwilling to participate in online research. Additionally, the data were obtained from a specific sample during a defined period, which limits the generalizability of the findings to the broader adult population. CONCLUSION In conclusion, this study provides important contributions to the disaster management literature by revealing the interrelationships among earthquake preparedness, risk perception, and anxiety. The findings indicate that disaster preparedness programs should not be limited to the provision of material resources, but should also focus on enhancing individuals’ behavioral skills and psychological resilience. In this context, it is essential to develop holistic and multidimensional approaches in communitybased disaster management strategies that take into account both risk perception and anxiety. Nurses play a critical role in preand post-disaster processes; public health nurses can directly contribute to disaster preparedness and response at both individual and community levels by increasing earthquake awareness, supporting behavioral preparedness, and addressing psychosocial needs. The findings of this study offer significant implications for nursing practice and public health. Nurses play a critical role in enhancing individuals’ disaster preparedness, strengthening risk perception, and supporting coping with anxiety. The results highlight the need for nurses to take an active role, particularly given that a substantial proportion of individuals do not feel prepared for earthquakes and exhibit only moderate preparedness behaviors. Public health nurses can implement educational, counseling, and informational interventions to increase awareness of earthquake risk. 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