Health service utilization after terrorism: a longitudinal study of survivors of the 2011 Utøya attack in Norway

Stene, Lise Eilin; Dyb, Grete

doi:10.1186/s12913-015-0811-6

Cited by 30 publications

(37 citation statements)

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“…Our results underscore the importance of addressing the survivors' physical health in the aftermath of disasters, even in the absence of injuries. Previous studies have found somatic symptoms to be associated with higher levels of posttraumatic stress (Gupta, 2013) and the utilization of mental health services (Stene and Dyb, 2015) after disasters. Furthermore, somatic symptoms are associated with adverse psychosocial consequences and functional impairment (Campo et al, 1999).…”

Section: Discussionmentioning

confidence: 94%

“…The contact person was to ensure continuity in the follow-up throughout the first year, and set up standardized screening assessments at 5–6 weeks, 3, and 12 months after the attack (Norwegian Directorate of Health, 2012). Prior research has shown that all survivors received some type of healthcare in the aftermath of the Utøya attack, though an important minority was not proactively followed-up as recommended (Dyb et al, 2011; Stene and Dyb, 2015). The survivors' perceived needs, experiences and satisfaction with post-terror healthcare provision have not yet been investigated.…”

Section: Introductionmentioning

confidence: 99%

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Healthcare Needs, Experiences and Satisfaction after Terrorism: A Longitudinal Study of Survivors from the Utøya Attack

2016

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Background: Public health outreach programs have been developed in order to ensure that needs are met after disasters. However, little is known about survivors' experiences with post-terror healthcare. In the present study, our objectives were to (1) describe survivors' experiences with post-terror healthcare, (2) identify factors associated with reports of unmet healthcare needs, and (3) examine the relationship between socio-demographic characteristics, healthcare experiences and satisfaction.Methods: Our study comprised three waves of semi-structured interviews with 261/490 (53%) survivors of the Utøya mass shooting. We applied Pearson's chi-squared tests (categorical variables) and independent t-tests (continuous variables) to compare survivors by whether or not they reported higher perceived needs than received help for psychological reactions and physical health problems, respectively. Ordinal regression analyses were applied to examine whether socio-demographic characteristics and healthcare experiences were associated with dissatisfaction.Results: Altogether 127 (49%) survivors reported very high/high help needs for psychological reactions, and 43 (17%) for attack-related physical health problems. Unmet healthcare needs were associated with higher levels of posttraumatic stress, psychological distress, somatic symptoms and less social support. Survivors with immigrant backgrounds and injured survivors who were not admitted to hospital reported unmet needs for physical health problems more often. After adjustments for socio-demographic characteristics, immigrant origin was associated with dissatisfaction with post-terror healthcare. After additionally adjusting for healthcare experiences, poor rating of the overall organization and accessibility of healthcare remained significantly associated with dissatisfaction.Conclusions: Most survivors were satisfied with the post-terror healthcare they received, yet our findings indicate that increased attention to the physical health of non-hospitalized terrorism survivors is required. Furthermore, in future outreach, particular attention should be paid to the healthcare needs of survivors with immigrant background.

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Section: Discussionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Healthcare Needs, Experiences and Satisfaction after Terrorism: A Longitudinal Study of Survivors from the Utøya Attack

2016

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“…[10][11][12][13]. These authors found that only somatic symptoms were associated with mental health service utilization when adjusting for psychological symptom level (10), proposing that the somatic symptoms result from somatization. Stene et al investigated the Utøya attack survivors' healthcare needs, experiences, and satisfaction with post-terror healthcare 2.5 years after the attack (11).…”

mentioning

confidence: 98%

“…T error attacks can result in loss of life and large numbers of severely injured persons (1)(2)(3)(4)(5)(6). Prior research after terrorist attacks has focused primarily on post-traumatic stress disorder (PTSD) and other mental health issues and, correspondingly, the need for mental health services (7)(8)(9)(10). To our knowledge, few studies have addressed long-term somatic health characteristics and physical functioning in physically injured terror victims.…”

mentioning

confidence: 99%

“…The Norwegian Centre for Violence and Traumatic Stress has conducted a longitudinal survey investigating health problems and healthcare needs of the terror victims (e.g. [10][11][12][13]. These authors found that only somatic symptoms were associated with mental health service utilization when adjusting for psychological symptom level (10), proposing that the somatic symptoms result from somatization.…”

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confidence: 99%

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Clinical characteristics and physical functioning in persons hospitalized following the Norwegian terror attacks in July 2011: A follow up study

Månum¹,

Løvstad²,

Wisløff-Aase³

et al. 2019

J Rehabil Med

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Victims of terror are at major risk of long-term posttraumatic stress disorder (PTSD) and physical sequelae. Prior research after terrorist attacks has focused primarily on PTSD and the need for mental health services, where being injured has been seen as an indicator of high exposure to the traumatic event and a predictor of the level of psychological distress, rather than as a risk factor for function and healthcare needs. Similar to survivors of natural disasters, the impairments after terror attacks vary in severity, and might include spinal cord injuries, traumatic brain injury, limb amputation, fractures, soft-tissue injuries, and psychological sequelae. This study investigated the medical characteristics, physical functioning, and life satisfaction of people hospitalized with physical injuries due to the 2011 Norway terror events approximately 3 years after the attacks. The assessments revealed a broad spectrum of somatic and psychological problems, reduced physical functioning, and a continuous need for healthcare. Objective: To describe the clinical characteristics and physical functioning in persons hospitalized after 2 terror attacks in Norway in 2011. Design: Cross-sectional study with retrospective acute medical data. Subjects: Surviving persons hospitalized with physical injuries. Methods: Medical and psychological assessments 3-4 years after injury, with data on injury type and severity collected from medical records. Results: A total of 30 out of 43 potential subjects participated (19 women, 11 men; age range 17-71 years (median 23 years)). Eighteen participants had suffered a severe injury, with New Injury Severity Scale (NISS) scores > 15. All body parts were affected. The number of surgical procedures ranged from 0 to 22 (median 3), and days in intensive care ranged from 0 to 59 (median 2.5), of which 16 had more than 24 h intensive care. Three to 4 years later, a majority of the participants had a broad spectrum of somatic and psychological problems and reduced physical functioning. Two-thirds of the participants reported their physical health to be unsatisfactory, and continuous need for healthcare and unmet needs were identified for all except 4 of the participants. Conclusion: Persons hospitalized following a terror attack experience a broad spectrum of somatic and psychological problems and need long-term physical and psychological follow-up. This study indicates specific needs for rehabilitation after injuries acquired under psychological traumatic circumstances.

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Gun Violence Epidemiology

Rowhani‐Rahbar

Schleimer

2022

Handbook of Epidemiology

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Health service utilization after terrorism: a longitudinal study of survivors of the 2011 Utøya attack in Norway

Cited by 30 publications

References 30 publications

Healthcare Needs, Experiences and Satisfaction after Terrorism: A Longitudinal Study of Survivors from the Utøya Attack

Healthcare Needs, Experiences and Satisfaction after Terrorism: A Longitudinal Study of Survivors from the Utøya Attack

Clinical characteristics and physical functioning in persons hospitalized following the Norwegian terror attacks in July 2011: A follow up study

Gun Violence Epidemiology

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