Lina Gyllencreutz

Outdoor pedestrian fall-related injuries among Swedish senior citizens – injuries and preventive strategies

Senior citizens get around, to a large extent, as pedestrians, and safe walking is desirable for senior citizens allowing them to stay mobile, independent and healthy in old age. Senior citizens are over-represented in injury statistics, and fall-related injuries are common. The aim of this study was to investigate fall-related injuries including healthcare costs among senior citizen pedestrians injured when walking in public outdoor environments and to describe their self-reported causes and suggested preventive strategies. The data were based on a combination of information from injury data and a questionnaire. Three hundred senior citizens attended one emergency department after sustaining injuries from pedestrian falls; 60% suffered nonminor injuries, mostly fractures. One-fifth of the pedestrians were hospitalised for an average of 8 days with an indirect hospital cost of 6.2 million EUR (55 million SEK). Environmental factors such as ice were the most commonly described cause of the injury incident. Forty per cent of the respondents indicated that the municipality was responsible for the cause of the injury incident. Fewer respondents mentioned their own responsibility as a preventive strategy. Thirty per cent described a combination of improvements such as better road maintenance, changes in human behaviour and use of safety products as preventive strategies. It is of great importance to highlight general safety, products and preventive strategies to minimise injury risks, so that pedestrians can safely realise the known health benefits of walking and thereby limit healthcare costs.

Non-minor injuries among children sustained in an outdoor environment - a retrospective register study

The aim was to investigate non-minor injuries sustained during outdoor activities among 0–12 year old children and to explore self-reported circumstances surrounding these incidents. During 2007–2009, the Umeå University Hospital injury database (IDB) registered 795 children with moderate (n = 778) and serious (n = 17) injuries, such as fractures. The IDB includes data from a questionnaire completed in the emergency department by the injured child or a parent. The open-ended questions catch the injured childs description of what circumstances precede the injury incident. The most commonly reported activities contributing to injuries were play, sport, and transport. Surface impacts were also reported as contributing factors along with products such as trampolines, bicycles, and downhill skis. By achieving a deeper knowledge about the activities and circumstances that precede non-minor injury incidents, creating safer outdoor environments may be feasible.

Survivors' experiences of consequences and recovery five years after a major bus crash

RATIONALEnThere is a lack of long-term follow-up studies focused on injured and uninjured survivors experiences of the recovery process after major traffic crashes.nnnAIMnTo explore all survivors experiences of long-term physical and psychological consequences and recovery 5xa0years after a major bus crash.nnnMETHODOLOGICAL DESIGN AND JUSTIFICATIONnA qualitative design was used to explore experiences in a 5-year follow-up study.nnnRESEARCH METHODSnParticipants were 54 survivors of a bus crash with 56 survivors and six fatalities. Telephone interviews were analysed with qualitative content analysis.nnnRESULTSnThe first category, Being resilient or suffering in daily life, has four subcategories covering quick recovery, suffering in daily life, distress in traffic situations and long-term pain. Reasons for quick recovery among survivors were previous crisis experiences, travelling alone, being uninjured and not being exposed to traumatic impressions. For the other survivors, being reminded of the crash caused disturbing reactions, such as sweating, anxiety and flashbacks. Survivors avoided going by bus if they could. A group of the injured survivors was still suffering from limiting and painful injuries. The second category, Reassessing oneself andxa0social connections, has three subcategories covering self-awareness, impact on relationships and connectedness. Survivors either developed a stronger bond to their significant other or separated from their partner within the first couple of years. Friendships and a sense of connectedness among survivors were sources of long-lasting comfort and support. The theme overarching the categories is Visible and existential marks in everyday life, representing the various ways in which the crash influence the survivors lives.nnnCONCLUSIONnThere is a need for more information about disruptive long-lasting consequences, such as travel anxiety, and available treatments. Initially, health-promoting connectedness can be facilitated by treating survivors as a group of people who belong together, from the day of the crash and throughout the recovery process.

Validating a questionnaire - prehospital preparedness for pediatric trauma patients

In recent decades, prehospital emergency care has undergone extensive development. Today, prehospital emergency nurses (PENs) are well trained and provide advanced care to patients of all ages. Caring for pediatric trauma patients is considered to be particularly demanding. However, in Sweden and internationally, there is a lack of research regarding PENs preparedness for caring for pediatric trauma patients.nnnOBJECTIVEnThe development and testing of a questionnaire on self-reported preparedness among PENs caring for pediatric trauma patients in a prehospital emergency setting.nnnMETHODSnQuestionnaire development included face and content validity tests resulting in 38 questions. Eighteen of these questions were analyzed by test-retest. The content of the questionnaire was statistically analyzed.nnnRESULTSnFifteen questions were considered valid after reliability and validity tests. Three questions did not fulfill the stability criteria. The content analyses show a low degree of experience with pediatric trauma patients and half of the participants reported stress symptoms when responding to such alarms.nnnCONCLUSIONnThe questionnaire assessing PENs preparedness caring for pediatric trauma patients in Sweden is considered to be suitable for research and clinical practice to improve the care of pediatric trauma patients and the health of PENs, although further testing of the questionnaire is required.

Everyday outdoor mobility in old age: Focus group interviews with active senior citizens

Background: Senior citizens are over‐represented in injury statistics, and fall‐related injuries are globally recognized as a major threat to their health and wellbeing. Outdoor falls are likely to occur among those who are active and healthy when walking or cycling. The objective of this study was to explore active senior citizens experiences and perceptions of how their safety could be increased and their risk reduced in outdoor environments. Methods: Six focus‐group interviews with 31 healthy and active senior citizens were conducted in northern Sweden. Data were analyzed via a qualitative content analysis method. Results: Participants adjusted to age‐related changes in order to stay safe during outdoor mobility. Outdoor activities were facilitated by having confidence of safety within the environment, and by using safety devices. Fear of, for example, falling and dangerous environments, such as uneven surfaces, as well as the shortcomings of safety devices, were constraining elements for outdoor activity. Conclusions: It is of great importance to raise awareness of healthy aging and to illuminate directions for environmental changes. Asking old people about their experiences allows the researcher to identify with their perspective, and may give a more comprehensive understanding of the most appropriate recommendations for health and safety improvements.