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Survivors' experiences from a train crash
Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Kirurgi.
Umeå universitet, Medicinska fakulteten, Institutionen för omvårdnad.
2011 (engelsk)Inngår i: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 6, nr 4, s. 8401-Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Rarely described are people's lived experiences from severe injury events such as train crashes. The number of train crashes named disasters with ≥10 killed and/or ≥100 nonfatally injured grows globally and the trend shows that more people survive these disasters today than did so in the past. This results in an increased number of survivors needing care. The aim of the study was to explore survivors' experiences from a train crash. Narrative interviews were performed with 14 passengers 4 years after a train crash event. Qualitative content analysis was used to analyse the interviews. Experiences were captured in three main themes: (1) Living in the mode of existential threat describes how the survivors first lost control, then were thrown into a state of unimaginable chaos as they faced death. (2) Dealing with the unthinkable described how survivors restored control, the central role of others, and the importance of reconstructing the event to move forward in their processing. (3) Having cheated death shows how some became shackled by their history, whereas others overcame the haunting of unforgettable memories. Furthermore, the result shows how all experienced a second chance in life. Experiencing a train crash meant that the passengers experienced severe vulnerability and a threat to life and interdependence turned out to play a crucial role. Focusing on helping other passengers on site was one way to regain the loss of control and kept the chaos at bay. Family, friends, and fellow passengers turned out to be extremely important during the recovery process why such closeness should be promoted and facilitated.

sted, utgiver, år, opplag, sider
Stockholm: Co-Action Publishing , 2011. Vol. 6, nr 4, s. 8401-
Emneord [en]
Content analysis, experiences, interviews, nursing, train accident
HSV kategori
Identifikatorer
URN: urn:nbn:se:umu:diva-50279DOI: 10.3402/qhw.v6i4.8401PubMedID: 22125573OAI: oai:DiVA.org:umu-50279DiVA, id: diva2:461127
Tilgjengelig fra: 2011-12-02 Laget: 2011-12-02 Sist oppdatert: 2018-06-08bibliografisk kontrollert
Inngår i avhandling
1. Train crashes: consequences for passengers
Åpne denne publikasjonen i ny fane eller vindu >>Train crashes: consequences for passengers
2012 (engelsk)Doktoravhandling, med artikler (Annet vitenskapelig)
Abstract [en]

Background: Globally, and in Sweden, passenger railway transport is steadily increasing. Sweden has been relatively free from severe train crashes in the last decades, but the railway infrastructure is alarmingly worn and overburdened, which may be one reason for an increasing number of reported mishaps. Worldwide, major train crashes/disasters are a frequent cause of mass casualty incidents. Several shortcomings, especially within the crash and post-crash phases cause severe consequences for the passengers.

Aim: To investigate the consequences of train crashes on passengers, focusing on factors of importance in the crash and post-crash phases. The specific aims are: (I) to identify the historical development and magnitude of passenger train disasters globally on various continents and countries, (II, III) to identify injury panorama and injury objects in two train crashes, (IV) to explore survivor´s experiences from a train crash, and (V) to explore their experiences of journalists and media coverage.

Methods: Study I is a register study based on 529 railway disasters worldwide, whereas studies II-V are case studies from the two latest severe train crashes in Sweden (Nosaby and Kimstad). These studies are based on 73 and 21 passengers respectively. Studies I-III is essentially quantitative where descriptive statistics (I, III), multivariate analysis (III), and content analysis (II, III) are used. Studies II and III are also supplemented by semi-structured interviews. Studies IV and V are qualitative and the interviews (n=14, n=30) have been analyzed with qualitative content analysis. Study IV is also supplemented with quantitative data.

Results: The number of railway disasters, fatalities, and non-fatally injured passengers has increased throughout the last hundred years - particularly during the last four decades (1970–2009) when 88% of all disasters occurred (I). Passengers in the first overturned carriage suffered most severe and lethal injuries (III). Internal structures such as tables, chairs, internal walls, as well as luggage, other passengers (II, III), glass (II), and wood pellets (III) induced many of the injuries. Those who traveled facing forward with a table in front of them, in carriages that did not overturn, were more likely to sustain injuries to their abdomen/pelvis than those without a table (III). Passengers who traveled rear facing had higher rates of whiplash injuries. Surviving a train crash was experienced as "living in a mode of existential threat". The long term consequences however were diverse for different persons (IV). All experienced that they had cheated death, but some became "shackled by history", whereas others overcame the "haunting of unforgettable memories." The centrality of others and the importance of reconstructing the turn of events were important when "dealing with the unthinkable". The media coverage were experienced as positive in the recovery process and the journalists were also perceived as helpful (V). By some the journalist’s nevertheless were also perceived as harmful or negligible, and the subsequent media coverage as either uncomfortable or insignificant.

Conclusion: Despite extensive crash avoidance systems severe railway crashes still occur. Improved interior safety, as has been implemented in the automobile and aviation industries, would have an important reduction in injuries and facilitate evacuation. Being surrounded by family, friends, fellow passengers and participating in crash investigations, and experiencing descriptive media coverage were some crucial factors when dealing with the traumatic event and should be promoted.

sted, utgiver, år, opplag, sider
Umeå: Umeå universitet, 2012. s. 56
Serie
Umeå University medical dissertations, ISSN 0346-6612 ; 1528
Emneord
Accident, crash, disaster, experiences, injuries, injury inducing objects, media coverage, railway, safety
HSV kategori
Identifikatorer
urn:nbn:se:umu:diva-61291 (URN)978-91-7459-505-5 (ISBN)
Disputas
2012-11-30, Sal B, 9 tr, Tandläkarhögskolan, Norrlands universitetssjukhus, Umeå, 13:00 (engelsk)
Opponent
Veileder
Tilgjengelig fra: 2012-11-09 Laget: 2012-11-08 Sist oppdatert: 2018-06-08bibliografisk kontrollert

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