based measures of learning, memory, and attention. Subjective
perception of impaired memory and attention was reported
on 2 items from the Rivermead Post Concussion Symptoms
Questionnaire (27). The participants were asked to compare
with premorbid level (i.e. before the terror attacks) and rate the
extent of symptoms related to concentration and memory on a
scale from 0 to 4 (0 = no problem at all; 4 = severe problem),
where scores of ≥ 3 were considered clinically significant (28).
The Glasgow Outcome Scale-Extended (GOS-E) was used to
assess gross outcome in participants with radiologically verified
brain injury (29).
Physical function. The generic Short Form Health Survey (SF-
36) physical function scale (PF) was used to assess physical
abilities, mobility, and self-care (30). The PF consists of 10
items focused on the extent to which a respondent’s health has
limited performance of various physical activities over the past 4
weeks. Responses are provided on a 3-point scale; “yes, limited
a lot”, “yes, limited a little”, and “no, not limited at all”. Scores
on the individual items were converted into a 0–100 scale (31),
with PF total scores below 86.4 being considered to indicate
physical limitations (30).
The Barthel ADL index, with a score ranging from 0 to 20,
was used to assess independence in daily life (32). Total scores
below 4 were considered to indicate dependency in activities
of daily living (ADL) (32).
Health characteristics were assessed via a custom-made ques-
tionnaire addressing past (before 22 July 2011) and current
health problems. The questionnaire assessed the participants’
health status considering current and previous diagnosis and/
or treatments of eye/ear conditions, cardiovascular or lung
diseases, diabetes mellitus, skin conditions, cancer, rheumatolo-
gically or other musculoskeletal conditions (e.g. fibromyalgia),
and neurological conditions, including headache as well as
gastrointestinal and allergic conditions.
Life satisfaction. The Life Satisfaction Scale (LSS) measures
both global and domain-specific life satisfaction and has been
well-validated in Sweden, which has a comparable culture to
Norway (33, 34). Two items addressing the level of satisfaction
with physical and psychological health were included. Items
are scored on a 6-point scale, from 1 (very dissatisfied) to 6
(very satisfied). Total scores and dichotomized scores (1–4 (not
satisfied) vs 5–6 (satisfied)) are presented (33).
Healthcare. A questionnaire was developed based on that of
another research group studying the same terror attacks (10,
11), which included questions regarding previous and current
provision of health services (care or treatment), along with their
perceived usefulness.
Statistical analysis and data management
Descriptive statistics were used to describe the study sample.
Relations between continuous variables were examined using
Spearman’s two-tailed correlation coefficients. Differences
between participants above and below the clinical cut-off values
were investigated using Mann–Whitney non-parametric 2-sam-
ple tests and simple cross-tabulations with Fisher’s exact test.
Values of p < 0.05 were considered statistically significant. All
analyses were conducted using SPSS v.22 (IBM Corporation,
Armonk, NY, USA).
227
RESULTS
Participants
Forty-eight persons were identified as potential partici-
pants. As shown in the flow diagram (Fig. 1), 35 were
injured at Utøya Island, and 13 in the Governmental
Quarter. Of these, 3 persons triaged to local hospitals
in Oslo were not contacted (as we did not have ac-
cess to their identities and assumed their injuries to
be minimal, since they would otherwise have been
triaged to OUHU) and 2 persons were excluded. A
potential sample of 43 persons was thus established,
of which 31 were injured at Utøya Island and 10 in the
Governmental Quarter. A final sample of 30 persons
was included, corresponding to a 70% response rate.
The length of acute hospital stays ranged from 1 to
81 days with a median [Q1, Q3] of 15 days [1, 27]. Five
participants were transferred to local hospitals within
30 h, and we do not have access to their total length
of hospital stay. The median of 15 might therefore
be somewhat too low. If these 5 are not included, the
median [Q1, Q3] of 19 days [2, 28]. The participants
were discharged to their homes (n = 10), local hospitals
(n = 11) or specialized inpatient rehabilitation centres
(n = 9). Those transferred to rehabilitation had multiple
Hospitalized patients
n=48
(Govermental quarters, n=13)
(Utøya Island, n=35)
Govermental quarters (n=3)
Sent to local hospitals in Oslo ( n=3)
Utøya Island (n=2)
Died after admission to hospital (n=1)
Foreign resident without Norwegian address (n=1)
Eligible population
n=43
(Govermental quarters, n=10)
(Utøya Island, n=33)
Concented to participate
n=31
Drop out before assessment (n=1)
Final Sample
n=30
(Govermental quarters, n=7; Utøya Island, n=23)
Fig 1. Flow diagram of study participants.
Three-year clinical characteristics of hospitalized terror victims
J Rehabil Med 51, 2019