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Exploring Injury Panorama, Consequences, and Recovery among Bus Crash Survivors: A Mixed-Methods Research Study

Published online by Cambridge University Press:  30 January 2017

Isabelle Doohan Open the ORCID record for Isabelle Doohan [Opens in a new window] ,
Ulf Björnstig Open the ORCID record for Ulf Björnstig [Opens in a new window] ,
Ulrika Östlund  and
Britt-Inger Saveman Open the ORCID record for Britt-Inger Saveman [Opens in a new window]
Isabelle Doohan*
Affiliation:
Department of Surgical and Perioperative Sciences, Section of Surgery - Centre for Research and Development in Disaster Medicine, Umeå University, Umeå, Sweden Department of Nursing, Umeå University, Umeå, Sweden Affiliated to Artic Research Centre at Umeå University, Umeå, Sweden
Ulf Björnstig
Affiliation:
Department of Surgical and Perioperative Sciences, Section of Surgery - Centre for Research and Development in Disaster Medicine, Umeå University, Umeå, Sweden
Ulrika Östlund
Affiliation:
Center for Collaborative Palliative Care, Linnaeus University, Kalmar/Växjö, Sweden Center for Research & Development, Uppsala University/Region Gävleborg, Sweden
Britt-Inger Saveman
Affiliation:
Department of Nursing, Umeå University, Umeå, Sweden Affiliated to Artic Research Centre at Umeå University, Umeå, Sweden
*
Correspondence: Isabelle Doohan, MSc Department of Surgical and Perioperative Sciences Section of Surgery Umeå University, SE-901 87 Umeå, Sweden E-mail: isabelle.doohan@umu.se
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Abstract

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.

DoohanI, BjörnstigU, ÖstlundU, SavemanBI. Exploring Injury Panorama, Consequences, and Recovery among Bus Crash Survivors: A Mixed-Methods Research Study. Prehosp Disaster Med. 2017;32(2):165–174.

Keywords

Emergency Medical Servicesinjuriesmass-casualty incidentsurvivors
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 32 , Issue 2 , April 2017 , pp. 165 - 174
Copyright
© World Association for Disaster and Emergency Medicine 2017 

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Footnotes

Conflicts of interest: none

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