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

There is a lack of long-term follow-up studies focused on injured and uninjured survivors' experiences of the recovery process after major traffic crashes.

To explore all survivors' experiences of long-term physical and psychological consequences and recovery 5 years after a major bus crash.

A qualitative design was used to explore experiences in a 5-year follow-up study.

Participants were 54 survivors of a bus crash with 56 survivors and six fatalities. Telephone interviews were analysed with qualitative content analysis.

The 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 and social 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.

There 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.