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Exploring Injury Panorama, Consequences, and Recovery among Bus Crash Survivors: A Mixed-Methods Research Study
Umea Univ, Ctr Res & Dev Disaster Med, Dept Surg & Perioperat Sci, Sect Surg, Umea, Sweden.;Umea Univ, Dept Nursing, Umea, Sweden.;Umea Univ, Artic Res Ctr, Umea, Sweden..
Umea Univ, Ctr Res & Dev Disaster Med, Dept Surg & Perioperat Sci, Sect Surg, Umea, Sweden..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Research and Development, Gävleborg. Linnaeus Univ, Ctr Collaborat Palliat Care, Kalmar Vaxjo, Sweden..
Umea Univ, Dept Nursing, Umea, Sweden.;Umea Univ, Artic Res Ctr, Umea, Sweden..
2017 (English)In: Prehospital and Disaster Medicine, ISSN 1049-023X, E-ISSN 1945-1938, Vol. 32, no 2, 165-174 p.Article in journal (Refereed) Published
Abstract [en]

Objective The aim of this study was to explore physical and mental consequences and injury mechanisms among bus crash survivors to identify aspects that influence recovery. Methods The study participants were the total population of survivors (N=56) from a bus crash in Sweden. The study had a mixed-methods design that provided quantitative and qualitative data on injuries, mental well-being, and experiences. Results from descriptive statistics and qualitative thematic analysis were interpreted and integrated in a mixed-methods analysis. Results Among the survivors, 11 passengers (20%) sustained moderate to severe injuries, and the remaining 45 (80%) had minor or no physical injuries. Two-thirds of the survivors screened for posttraumatic stress disorder (PTSD) risk were assessed, during the period of one to three months after the bus crash, as not being at-risk, and the remaining one-third were at-risk. The thematic analysis resulted in themes covering the consequences and varying aspects that affected the survivors' recoveries. The integrated findings are in the form of four core cases of survivors who represent a combination of characteristics: injury severity, mental well-being, social context, and other aspects hindering and facilitating recovery. Core case Avery represents a survivor who had minor or no injuries and who demonstrated a successful mental recovery. Core case Blair represents a survivor with moderate to severe injuries who experienced a successful mental recovery. Core case Casey represents a survivor who sustained minor injuries or no injuries in the crash but who was at-risk of developing PTSD. Core case Daryl represents a survivor who was at-risk of developing PTSD and who also sustained moderate to severe injuries in the crash. Conclusion The present study provides a multi-faceted understanding of mass-casualty incident (MCI) survivors (ie, having minor injuries does not always correspond to minimal risk for PTSD and moderate to severe injuries do not always correspond to increased risk for PTSD). Injury mitigation measures (eg, safer roadside material and anti-lacerative windows) would reduce the consequences of bus crashes. A well-educated rescue team and a compassionate and competent social environment will facilitate recovery.

Place, publisher, year, edition, pages
Cambridge University Press, 2017. Vol. 32, no 2, 165-174 p.
Keyword [en]
Emergency Medical Services, injuries, mass-casualty incident, survivors
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-321139DOI: 10.1017/S1049023X16001485ISI: 000398228600007PubMedID: 28132665OAI: oai:DiVA.org:uu-321139DiVA: diva2:1094964
Available from: 2017-05-11 Created: 2017-05-11 Last updated: 2017-05-11Bibliographically approved

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