Relationships between sequelae of injury, participation, and quality of life in survivors of terrorist attacks

This study described participation, health-related quality of life, and post-traumatic stress disorder (PTSD) in survivors of terrorist attacks and examined the relationships among these outcomes. Participants were 35 survivors of terrorist attacks, an average of 2 years after the injury, with a mean age of 32.1 (± 13.8) years. Most of the participants suffered multiple traumatic injuries. Forty percent to 60% of the sample reported restrictions in participation in the areas of employment, leisure, and homemaking. The patterns of time use indicated a relatively small amount of time devoted to work and more to rest. Survivors who resumed their participation in work and leisure reported high percentages of perceived competence and enjoyment from these occupations. The survivors scored below the norm on the Medical Outcome Study 36-Item Short-Form Health Survey (SF-36) scales, indicating low health-related quality of life. A significant moderate correlation in the expected direction was found between the Participation Index total score and the SF-36 total score (r = -.560, p < .01). PTSD was found in 39% of the survivors. No significant difference was found between the group with PTSD versus the group without PTSD on the Participation Index total score (Z = -.481, p = .650); however, subjects without PTSD achieved significantly higher mean scores on the SF-36 total score than those with PTSD (Z = -2.85, p = .003). Further research is required to examine the possible qualitative effect of PTSD on participation in work, leisure, and home management.