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对年轻恐怖主义幸存者父母的医疗保健:挪威基于登记的研究。

Healthcare to parents of young terrorism survivors: a registry-based study in Norway.

机构信息

Norwegian Centre of Violence and Traumatic Stress Studies (NKVTS), Oslo, Norway.

Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.

出版信息

BMJ Open. 2017 Dec 21;7(12):e018358. doi: 10.1136/bmjopen-2017-018358.

Abstract

OBJECTIVES

To assess changes in parents' short-term and long-term primary and specialised healthcare consumption following a terrorist attack threatening the lives of their children.

DESIGN

Registry-based study comparing parental healthcare service consumption in the 3 years before and the 3 years after a terrorist attack.

SETTING

The aftermath of the Utøya terrorist attack. The regular, publicly funded, universal healthcare system in Norway.

INTERVENTION

Parents learning of a terrorist attack on their adolescent and young adult children.

PARTICIPANTS

Mothers (n=226) and fathers (n=141) of a total of 263 survivors of the Utøya terrorist attack (54.6% of all survivors 13-33 years, n=482).

MAIN OUTCOME MEASURES

We report primary and specialised somatic and mental healthcare service consumption in the early (0-6 months) and delayed (>6-36 months) aftermath of the attack, both in terms of frequency of services consumed (assessed by age-adjusted negative binomial hurdle regression) and proportions of mothers and fathers provided for (mean semiannual values). The predisaster and postdisaster rates were compared by rate ratios (RRs), and 95% CI were generated through bootstrap replications.

RESULTS

Frequency of primary healthcare service consumption increased significantly in both mothers and fathers in the early aftermath of the attack (mothers: RR=1.97, 95% CI 1.76 to 2.23; fathers: RR=1.73, 95% CI 1.36 to 2.29) and remained significantly elevated throughout the delayed aftermath. In the specialised mental healthcare services, a significant increase in the frequency of service consumption was observed in mothers only (early: RR=7.00, 95% CI 3.86 to 19.02; delayed: RR=3.20, 95% CI 1.49 to 9.49). In specialised somatic healthcare, no significant change was found.

CONCLUSION

Following terrorist attacks, healthcare providers must prepare for increased healthcare needs in survivors and their close family members, such as parents. Needs may present shortly after the attack and require long-term follow-up.

摘要

目的

评估父母在得知子女生命受到威胁的恐怖袭击后,短期和长期的初级和专科医疗保健消费的变化。

设计

在恐怖袭击后,通过登记处研究比较父母在恐怖袭击前 3 年和后 3 年的医疗保健服务消费。

地点

乌托亚恐怖袭击的余波。挪威常规的、公共资助的、全民医疗保健系统。

干预措施

父母得知针对其青少年和青年子女的恐怖袭击。

参与者

共有 263 名乌托亚恐怖袭击幸存者的父母(13-33 岁幸存者的总数为 482 名,占幸存者总数的 54.6%),包括母亲 226 名,父亲 141 名。

主要观察指标

我们报告了在袭击后的早期(0-6 个月)和延迟期(>6-36 个月),父母在初级和专科躯体和精神保健服务方面的消费情况,包括消费服务的频率(通过年龄调整的负二项式障碍回归评估)和父母的比例(半年度平均值)。通过率比(RR)比较受灾前和受灾后的比率,通过自举复制生成 95%置信区间。

结果

在袭击后的早期,父母双方的初级保健服务消费频率均显著增加(母亲:RR=1.97,95%CI 1.76-2.23;父亲:RR=1.73,95%CI 1.36-2.29),并且在延迟期内一直保持显著升高。在专科精神保健服务中,仅母亲的服务消费频率显著增加(早期:RR=7.00,95%CI 3.86-19.02;延迟:RR=3.20,95%CI 1.49-9.49)。在专科躯体保健方面,没有发现显著变化。

结论

恐怖袭击后,医疗保健提供者必须为幸存者及其直系亲属(如父母)增加的医疗保健需求做好准备。需求可能在袭击后不久出现,并需要长期随访。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23a1/5778306/2fe8a1dc42f0/bmjopen-2017-018358f01.jpg

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