Conducting in-depth interviews of people who survived the Indian Ocean tsunami or those who lost their loved ones in the disaster, nurse researchers found that such individuals went through a complex process of trauma and grief.
Research collaborators from Norway-based Haugesund University College and the Karolinska Institute in Stockholm have revealed that they talked to people about their emotions and attitudes to life following the tragedy.
They observed that the emotions expressed by the study participants ranged from the initial pleasure of being on a dream holiday, through to the trauma of the event, their grief and loss and the way that families pulled together to come to terms with what had happened.
The earthquake off the coast of Sumatra on 26 December 2004, and the resulting tsunami, are estimated to have killed somewhere in the region of a quarter of a million people. They included 543 Swedish tourists, including 140 children under the age of 18. A further 66 Swedish children lost at least one parent.
"We carried out one-to-one and group interviews with 19 people recruited in collaboration with the Swedish Red Cross to find out how the event had affected them. The paper just published in the Journal of Advanced Nursing looks at their initial reactions to being caught up in this international tragedy and we will be reporting our longer term findings in due course," says the study's lead author, Dr. Maj-Britt Raholm.
The team started the interviews with the 13 women and six men, aged from 24 to 67 years, 21 months after the tsunami. Interviews were undertaken a further five times, at eight-week intervals.
Twelve of the people interviews were on holiday when the tsunami struck, and included a man who lost his daughter and his mother and a couple who lost their child.
The other seven participants were at home in Sweden.
Some lost as many as four family members, including children, in the tragedy.
"The experiences of the tsunami survivors and their relatives revealed a comprehensive picture, which broke down into three distinct phases. These can be summarised as experiencing the core of existence, a changed understanding of life and the power of communion," says Dr. Raholm.
The researchers found that relatives at home felt desperately isolated, and that getting the news that a loved one had died was associated with pronounced physical and mental sensations, like a heavy body and amnesia.
"I threw myself on the floor and wanted to rip the skin from my body," said one woman.
"The papers wrote about them but it wasn't part of our reality," said another.
The study also revealed that common grief and loss united people, and brought together even broken relationships.
When the survivors returned, relatives became very protective.
"It is pretty strange that something good came out of this horrible experience," said one survivor who became closer to one's siblings.
Writing about their findings in the Journal of Advanced Nursing, the researchers said that feedback from disasters like the tsunami were essential as they could help shape future care.
"Healthcare professionals have an important role to play in caring for the victims of major disasters, as the effects can last for many years and in some cases people never recover from them," says Dr. Raholm.
"We believe that it is important that nurses and nursing students have the knowledge they need to care for patients who have gone through life-changing traumas. We hope that our research will provide insight into the complex experiences and needs of those directly involved in major disasters like the 2004 tsunami. The more we learn from disasters that have already happened, the better prepared we can be for those that will inevitably happen in the future," the researcher adds.