Psychometric evaluation of the Decision Support System (DSS) for municipal nurses encountering health deterioration among older adults.

BACKGROUND: A valid and reliable tool is crucial for municipal registered nurses (RNs) to make quick decisions in older adults who show rapid signs of health deterioration. The aim of this study was to investigate the psychometric properties of the Decision Support System (DSS) among older adults in the municipal healthcare system. METHODS: Firstly, we utilized the Rasch dichotomous model to analyze the DSS assessments (n=281) that were collected from municipal RNs working with older adults in the municipal healthcare system. We examined the properties of the DSS in terms of its unidimensionality, item fit, and separation indices. Secondly, to investigate inter-rater agreement in using the DSS, four experienced municipal RNs used the DSS to assess 60 health deterioration scenarios presented by one human patient simulators. The 60 DSS assessments were then analyzed using the ICC (2,1), percentage agreement, and Cohen κ statistics. RESULTS: The sample of older adults had a mean age of 82.8 (SD 11.7). The DSS met the criteria for unidimensionality, although two items did not meet the item fit statistics when all the DSS items were analyzed together. The person separation index was 0.47, indicating a limited level of separation among the sample. The item separation index was 11.43, suggesting that the DSS has good ability to discriminate between and separate the items. At the overall DSS level, inter-rater agreements were good according to the ICC. At the individual DSS item level, the percentage agreements were 75% or above, while the Cohen κ statistics ranged from 0.46 to 1.00. CONCLUSIONS: The Rasch analysis revealed that the psychometric properties of the instrument were acceptable, although further research with a larger sample size and more items is needed. The DSS has the potential to assist municipal RNs in making clinical decisions regarding health deterioration in older adults, thereby avoiding unnecessary emergency admistion and helping.

Mental Disorders in Peyronie's Disease: A Swedish Cohort Study of 3.5 Million Men.

PURPOSE: Studies have shown that men with Peyronie's disease often suffer from psychological problems, but the psychiatric burden of this disorder remains largely unknown. We assessed risks of a range of psychiatric outcomes in a population based Swedish cohort comprising 3.5 million men. MATERIALS AND METHODS: We conducted a longitudinal cohort study based on Swedish national registers. A total of 8,105 men diagnosed with Peyronie's disease and 3.5 million comparison subjects from the general Swedish population were selected, and followed up with for diagnosed psychiatric outcomes including substance use disorder, alcohol misuse, anxiety disorder, depression, and self-injurious behaviors. Risks of psychiatric outcomes were estimated with Cox regressions and additionally adjusted for birth year. RESULTS: Men with Peyronie's disease had increased risks of being diagnosed with substance use disorder (HR 1.4, 95% CI 1.1-1.9), no excess risk of alcohol misuse (HR 0.9, CI 0.8-1.1), but elevated risks of anxiety disorder (HR 1.9, CI 1.6-2.2), depression (HR 1.7, CI 1.5-2.0), self-injurious behaviors (HR 2.0, 95% CI 1.7-2.3) as well as any psychiatric outcomes (HR 1.4, 95% CI 1.2-1.5). The risk estimates were slightly decreased when adjusted for birth year. A limitation of the study was that we had no information about Peyronie's disease diagnoses assigned before year 1997. CONCLUSIONS: Men with Peyronie's disease are at increased risk of being diagnosed with adverse psychiatric outcomes. Health care providers should ensure that men with Peyronie's disease have a documented mental health status assessment.

Prevention of Chlamydia Infections With Theater in School Sex Education.

The aim of the study was to evaluate if an intervention including theater in school sex education affects students' knowledge, attitudes, and behavior regarding condom use in Sweden. The study was a cluster randomized controlled trial. The intervention group got a play, value exercises, chlamydia games, condom school, and interactive replay with professional actors and staff from a youth guidance center. The control group got standard sex education from school staff. Students in both groups answered web surveys on knowledge, attitudes, and behavior regarding condom use. Posteducation, knowledge on condom use, chlamydia, and protection had increased in both groups. However, students in the intervention group showed higher levels of knowledge, improved attitudes, and less risky behavior in regard to condom use compared to the control group. The intervention titled SAFETY seemed to be a beneficial supplement to standard sex education and more effective with regard to knowledge of condom use.

Web-Based Intervention for Women With Type 1 Diabetes in Pregnancy and Early Motherhood: Critical Analysis of Adherence to Technological Elements and Study Design.

BACKGROUND: Numerous Web-based interventions have been implemented to promote health and health-related behaviors in persons with chronic conditions. Using randomized controlled trials to evaluate such interventions creates a range of challenges, which in turn can influence the study outcome. Applying a critical perspective when evaluating Web-based health interventions is important. OBJECTIVE: The objective of this study was to critically analyze and discuss the challenges of conducting a Web-based health intervention as a randomized controlled trial. METHOD: The MODIAB-Web study was critically examined using an exploratory case study methodology and the framework for analysis offered through the Persuasive Systems Design model. Focus was on technology, study design, and Web-based support usage, with special focus on the forum for peer support. Descriptive statistics and qualitative content analysis were used. RESULTS: The persuasive content and technological elements in the design of the randomized controlled trial included all four categories of the Persuasive Systems Design model, but not all design principles were implemented. The study duration was extended to a period of four and a half years. Of 81 active participants in the intervention group, a maximum of 36 women were simultaneously active. User adherence varied greatly with a median of 91 individual log-ins. The forum for peer support was used by 63 participants. Although only about one-third of the participants interacted in the forum, there was a fairly rich exchange of experiences and advice between them. Thus, adherence in terms of social interactions was negatively affected by limited active participation due to prolonged recruitment process and randomization effects. Lessons learned from this critical analysis are that technology and study design matter and might mutually influence each other. In Web-based interventions, the use of design theories enables utilization of the full potential of technology and promotes adherence. The randomization element in a randomized controlled trial design can become a barrier to achieving a critical mass of user interactions in Web-based interventions, especially when social support is included. For extended study periods, the technology used may need to be adapted in line with newly available technical options to avoid the risk of becoming outdated in the user realm, which in turn might jeopardize study validity in terms of randomized controlled trial designs. CONCLUSIONS: On the basis of lessons learned in this randomized controlled trial, we give recommendations to consider when designing and evaluating Web-based health interventions.

A Decision support system (DSS) for municipal nurses encountering health deterioration among older people.

BACKGROUND: This study is part of a larger project called ViSam and includes testing of a decision support system developed and adapted for older people on the basis of M (R) ETTS (Rapid Emergency Triage and Treatment System). The system is designed to allow municipal nurses to determine the optimal level of care for older people whose health has deteriorated. This new system will allow more structured assessment, the patient should receive optimal care and improved data transmission to the next caregiver. METHODS: This study has an explanatory approach, commencing with quantitative data collection phase followed by qualitative data arising from focus group discussions over the RNs professional experience using the Decision Support system. Focus group discussions were performed to complement the quantitative data to get a more holistic view of the decision support system. RESULTS: Using elements of the decision support system (vital parameters for saturation, pain and affected general health) together with the nurses' decision showed that 94 % of the older persons referred to hospital were ultimately hospitalized. Nurses felt that they worked more systematically, communicated more effectively with others and felt more professional when using the decision support system. CONCLUSIONS: The results of this study showed that, with the help of a decision support system, the correct patients are sent to the Emergency Department from municipal home care. Unnecessary referrals of older patients that might lead to poorer health, decreased well-being and confusion can thus be avoided. Using the decision support system means that healthcare co-workers (nurses, ambulance/emergency department/district doctor/SOS alarm) begin to communicate more optimally. There is increased understanding leading to the risk of misinterpretation being reduced and the relationship between healthcare co-workers is improved. However, the decision support system requires more extensive testing in order to enhance the evidence base relating to the vital parameters among older people and the use of the decision support system.

Attending cervical cancer screening, opportunities and obstacles: a qualitative study on midwives' experiences telephoning non-attendees in Sweden.

AIM: As part of a research project aimed at increasing participation in the cervical cancer screening program (CCS), we explored midwives' unique experiences of telephoning non-attendees and offering Pap smear appointments. METHODS: Twenty midwives, in four focus groups, discussed their experiences of a study investigating ways to increase participation in the CCS. The group discussions were tape-recorded and transcribed verbatim and underwent qualitative content analysis. RESULTS: Speaking with more than 1000 non-attendees provided the midwives with new perspective on the CCS and they realised that improving it might address a number of reasons for not participating. These reasons were often related to logistics, such as scheduling flexibility and appointment booking. The telephone conversations revealed that some women required more individual attention, while it was discovered that others did not require screening. The midwives considered the CCS to be life-saving; participating in this screening activity gave them a sense of satisfaction and pride. CONCLUSIONS: This study shows that midwives can improve access and prevent non-attendance at the cervical cancer screening program when they are aware of women's varying requirements for attending screening.

Quality of life after adopting compared with childbirth with or without assisted reproduction.

OBJECTIVE: This study compares quality of life among couples who had adopted a child 4-5.5 years previously with couples whose conception was spontaneous, as well as with couples who had successful or unsuccessful in vitro fertilization (IVF) treatment. DESIGN: Cross-sectional study. SETTING: Tertiary level university hospital. SAMPLE: From the following groups, 979 responses were obtained: adoption; successful IVF; unsuccessful IVF-living with children; unsuccessful IVF-living without children; and childbirth after spontaneous conception (controls). METHODS: Quality of life was studied with the Psychological General Well Being (PGWB) and Sense of Coherence (SOC) instruments. Demographic, socio-economic and health data were obtained with additional questionnaires. Multiple variance analysis was applied. MAIN OUTCOME MEASURES: The PGWB and SOC scores. RESULTS: After adjustment for seven confounders, the adoption group had higher PGWB scores than the unsuccessful IVF-living without children and the controls and higher SOC scores than all other groups. The unsuccessful IVF-living without children had lower PGWB and SOC scores than all other groups. The PGWB and SOC scores among controls did not differ from those with successful IVF or unsuccessful IVF-living with children. CONCLUSIONS: Adjusted PGWB and SOC scores revealed a high quality of life in the adoption group. However, the group unsuccessful IVF-living without children had low quality of life scores. Quality of life appears to be independent of the outcome of IVF treatment as long as there are children in the family.

How women who have experienced one or more miscarriages manage their feelings and emotions when they become pregnant again - a qualitative interview study.

AIM: The aim of this study was to investigate how women who have experienced one or more miscarriages manage their feelings when they become pregnant again. METHOD: Individual qualitative interviews were conducted with 16 women who were pregnant again after experiencing one or more miscarriages. The interviews were analysed using qualitative content analysis with an inductive approach. RESULTS: The analysis of the material ended up in five categories: distancing herself from her pregnancy, focusing on her pregnancy symptoms, searching for confirming information, asking for ultrasound examination and asking for professional and social support. Because of their past experience with miscarriage, it could be painful to have another pregnancy terminate in disappointment. Therefore, the women manage their feelings by distancing themselves from their pregnancies. Simultaneously, they are managing their emotions by seeking affirmation that their current pregnancy is normal. CONCLUSION: Generally speaking, women manage their emotions by themselves. They feel isolated with their worries and concerns, and they are in need of the support provided from their intimate circle of friends and family as well as from the staff of the maternity health care ward. Unfortunately, the women do not feel that they get the support they need from the staff, instead they have to rely on their friends, family and partners to help them manage their emotions.

Decreased need for emergency services after changing management for suspected miscarriage.

We investigated the effect of a changed routine to identify women with a nonviable pregnancy, in order to utilize health care resources more efficiently during office hours rather than relying on emergency care services. From hospital register data about where and when women with miscarriages were treated, there was a significant trend during a nine-year period for miscarriages to be more rarely diagnosed (p-value<0.001) in the emergency ward after office hours. The proportion of miscarriages that were diagnosed and handled at the emergency ward decreased from 31% in 2001 to 17% in 2009. Furthermore, the number of women showing up with bleeding at the emergency ward, but who also had a normal viable pregnancy, declined during the same period (p-value<0.01). Women with suspected miscarriage benefit from structured information and standardized management and can effectively be scheduled for day-time assessment including ultrasound with a concomitant reduced need for emergency services.

Gender perspective on quality of life, comparisons between groups 4-5.5 years after unsuccessful or successful IVF treatment.

OBJECTIVE: To describe and compare quality of life in men and women who had in vitro fertilization (IVF) within the Swedish public health system 4-5.5 years previously, either unsuccessfully and were subsequently living without children, or successfully, having children aged 4-5.5 years. These groups were compared to a control group of men and women with children born at the same time as in the successful group. DESIGN: Cross-sectional study. SETTING: Reproductive Unit, Sahlgrenska University Hospital, Gothenburg, Sweden. SAMPLE: Twenty-six men and 37 women in the unsuccessful group, 135 men and 154 women in the successful group and 93 men and 118 women in the control group. METHODS: Questionnaire study. The respective gender differences were studied in the control and study groups. MAIN OUTCOME MEASURES: Psychological general well-being (PGWB), sense of coherence (SOC), experience of infertility, demographic-socio-economic, and health characteristics. RESULTS: Men in the unsuccessful IVF group scored lower in total PGWB and SOC indices than the successful group men. They reported more depression, lower PGWB and lower SOC than the control group men. Women in the unsuccessful IVF group reported more anxiety, depression, and lower SOC than the successful group women and more depression and lower SOC indices than control group women. Men and women in the unsuccessful IVF group did not differ in any of the parameters. Men in the successful IVF group had higher PGWB, less signs of depression and more self-confidence than women in that group. CONCLUSION: Quality of life in men seems more negatively affected by involuntary infertility than reported in earlier studies.

Five Challenges When Managing Mass Casualty or Disaster Situations: A Review Study.

Background: Managing mass casualty or disaster incidents is challenging to any person or organisation. Therefore, this paper identifies and describes common challenges to managing such situations, using case and lessons learned reports. It focuses on sudden onset, man-made or technologically caused mass casualty or disaster situations. Methods: A management review was conducted based on a structured search in the PubMed and Web of Science databases. Results: The review included 20 case-and lessons learned reports covering natural disasters, man-made events, and accidents across Europe, the United States of Amerika (USA), Asia and the Middle East. Five common challenges were identified: (1) to identify the situation and deal with uncertainty, (2) to balance the mismatch between the contingency plan and the reality, (3) to establish a functional crisis organization, (4) to adapt the medical response to the actual and overall situation and (5) to ensure a resilient response. Conclusions: The challenges when managing mass casualty or disaster events involved were mainly related to the ability to manage uncertainty and surprising situations, using structured processes to respond. The ability to change mind set, organization and procedures, both from an organizational- and individual perspective, was essential. Non-medical factors and internal factors influenced the medical management. In order to respond in an effective, timely and resilient way, all these factors should be taken into consideration.

Initial Validation of the Diabetes and Breastfeeding Management Questionnaire (DBM-Q).

Women with pre-gestational diabetes face additional challenges after birth as they struggle with breastfeeding and managing unpredictable blood glucose levels. The aim of this study is to validate the Diabetes and Breastfeeding Management Questionnaire (DBM-Q). In total, 142 mothers with type 1 diabetes mellitus answered the questionnaire, which initially consisted of 11 items. The response rate was 82.5% (n = 128) at two months, and 88.4% (n = 137) at six months postpartum. The measurement properties of the Diabetes and Breastfeeding Management Questionnaire were tested according to the Rasch measurement theory (RMT). One item showed both disordered thresholds and several model misfits and was removed. Two items showed disordered thresholds which were resolved by collapsing response categories. This resulted in a 10-item questionnaire with all the fit residuals within the range of +2.5, minor significant differential item functioning, well-targeted items and a person separation index of 0.73. Evaluating the DBM-Q according to the RMT is a strength, as it evaluates data against strict measurement criteria. This study provides an initial validation of the questionnaire. The DBM-Q shows good measurement properties for measuring diabetes and breastfeeding management postpartum in women with pre-gestational diabetes. Further studies are needed to identify cutoffs for when professional support is needed.

Quality of life for couples 4-5.5 years after unsuccessful IVF treatment.

OBJECTIVE: To describe quality of life in men and women who had terminated in vitro fertilization (IVF) within the public health system 4-5.5 years previously, and for whom treatment did not result in childbirth. DESIGN: Cross-sectional study. SETTING: Reproductive Unit, Sahlgrenska University Hospital, Gothenburg, Sweden. SAMPLE: Four hundred pairs were invited to participate, 71% accepted and 68% completed questionnaires. METHODS: Questionnaire study. Study subgroups were compared with a control group with children and with each other. MAIN OUTCOME MEASURE: Psychological General Well-Being (PGWB), Sense of Coherence (SOC), experience of infertility, demographic-socio-economic and health characteristics were measured. RESULTS: Surprisingly, 76.7% had or lived together with children; 39.6% had biological children, 34.8% had adopted and 3.7% were parents to both biological and adopted children. No differences were found between the study and the control groups, except in SOC which scored lower in the study group. The study group with children had a higher PGWB index than the 23.3% without children and the controls. SOC scored higher in the subgroup with than those without children. Infertility was still a central issue in the subgroup without children. CONCLUSION: Despite having undergone unsuccessful IVF within the public health system, more than 75% lived with children 4-5.5 years later. This subgroup had a better quality of life, compared to those without children. Additional IVF treatment may result in increased quality of life.

Well-being, diabetes management and breastfeeding in mothers with type 1 diabetes - An explorative analysis.

OBJECTIVES: The aim was to explore and investigate associations between well-being, diabetes management and breastfeeding in mothers with type 1 diabetes mellitus (T1DM) up to six months postpartum. METHODS: An explorative analysis of self-reported questionnaires measuring general well-being, sense of coherence, self-efficacy of diabetes management and experiences of diabetes management during breastfeeding, which were distributed to 155 mothers with T1DM at two months and at six months after childbirth. The questionnaires were answered by 128 (82.5%) at two months and 137 (88.4%) at six months after birth. Statistical analysis included; descriptive statistics, Wilcoxon sign-rank test, sign test and Spearman's correlation coefficient (rs). RESULTS: The majority of the mothers had fairly high levels of general well-being and diabetes management but a quarter had a low sense of coherence at both two and six months after birth. A weak association was found between more unstable blood glucose levels and lower general well-being at two months postpartum, but no other associations with erratic glycaemia was found. Those with lower grades of general well-being and sense of coherence had a higher need of professional support to manage their diabetes than they were offered, at both two and six months. CONCLUSION: To develop more optimal care routines for mothers with T1DM after childbirth, further studies are needed to identify those most in need of additional support.

Postgraduate nurses' self-assessment of clinical competence and need for further training. A European cross-sectional survey.

BACKGROUND: Nursing practice requires application of knowledge, skills and values in various combinations and has undergone substantial changes the last decades. An increased focus on inter-professional collaboration and possible new and more independent roles for nurses are described. A variety of programs have been developed in order to educate registered nurses (RN) to meet the changes and demands in health and nursing care throughout the world. AIM: The aims were to 1) describe nurses' self-assessment of clinical competence and need for further training, and 2) explore possible differences between nurses in specialist vs master's programs. METHODS: A cross-sectional survey design was applied. 97 nurses in postgraduate programs from five countries responded (response rate 45%). A revised version of the Professional Nurse Self-Assessment Scale of clinical core competencies (PROFFNurseSASII) was used for data collection. Independent student t-test and regression analyses were carried out. RESULTS: The respondents rated their competence highest in taking full responsibility, cooperation with other health professionals and in acting ethically. Items where they considered themselves needing further training most were competence on medications, interaction and side effects and differential diagnoses. For all items, nurses in master's programs rated their competence higher than nurses in the specialist programs. Nurses in specialist programs rated their need for more training for all items higher than nurses in master's degree programs, and for 47 out of the 50 items these differences were statistically significant. CONCLUSION: Even though the nurses rated their competence high for important competence aspects such as taking responsibility and cooperation with other health professionals, it is worrying that their need for further training was highest for effects and interaction of various types of medications. Further studies are needed to conclude if and how master's education improves patient outcome.

Midwives' and obstetricians' views on appropriate obstetric sonography in Norway.

INTRODUCTION: The primary aim of this study was to investigate midwives' and obstetricians' views on how many ultrasound examinations should be part of standard care during pregnancy in Norway. MATERIAL AND METHODS: This study is a part of a larger study, the CROss-Country Ultrasound Study (CROCUS), an international investigation of midwives' and obstetricians' experiences of and views on the use of ultrasound. We distributed 400 questionnaires to respondents in all five health regions in Norway: 40 to municipal midwives, 180 to midwives working in hospitals and 180 to obstetricians. The questionnaire included specific questions about the appropriate number of examinations during pregnancy, examinations without medical indication, non-medical ultrasound, commercialisation and safety. RESULTS: The response rate was 45%. Of the respondents, 58% reported satisfaction with the offer of one scheduled ultrasound examination during pregnancy, as recommended in the Norwegian guidelines. Health care professionals who used ultrasound themselves were significantly more likely to want to offer more ultrasound examinations: 52% of the ultrasound users wanted to offer two or more ultrasound examinations vs. 16% of the non-users (p < .01). The majority of obstetricians (80%) reported that pregnant women expect to undergo ultrasound examination, even in the absence of medical indication. CONCLUSION: The majority of Norwegian health care professionals participating in this study supported the national recommendation on ultrasound in pregnancy. Ultrasound users wanted to offer more ultrasound examinations during pregnancy, whereas non-users were generally content with the recommendation. The majority of respondents thought that commercialisation was not a problem at their institution, and reported that ultrasound is often performed without a medical indication. The ultrasound users thought that ultrasound is safe.

Socio-economic and demographic determinants affecting participation in the Swedish cervical screening program: A population-based case-control study.

BACKGROUND: Cervical screening programs are highly protective for cervical cancer, but only for women attending screening procedure. OBJECTIVE: Identify socio-economic and demographic determinants for non-attendance in cervical screening. METHODS: Design: Population-based case-control study. Setting: Sweden. Population: Source population was all women eligible for screening. Based on complete screening records, two groups of women aged 30-60 were compared. The case group, non-attending women, (N = 314,302) had no smear registered for 6-8 years. The control group (N = 266,706) attended within 90 days of invitation. Main outcome measures: Risk of non-attendance by 9 groups of socioeconomic and demographic variables. Analysis: Unadjusted odds ratios (OR) and OR after adjustment for all variables in logistic regression models were calculated. RESULTS: Women with low disposable family income (adjOR 2.06; 95% confidence interval (CI) 2.01-2.11), with low education (adjOR 1.77; CI 1.73-1.81) and not cohabiting (adjOR 1.47; CI 1.45-1.50) were more likely to not attend cervical screening. Other important factors for non-attendance were being outside the labour force and receiving welfare benefits. Swedish counties are responsible for running screening programs; adjusted OR for non-participation in counties ranged from OR 4.21 (CI 4.06-4.35) to OR 0.54 (CI 0.52-0.57), compared to the reference county. Being born outside Sweden was a risk factor for non-attendance in the unadjusted analysis but this disappeared in certain large groups after adjustment for socioeconomic factors. CONCLUSION: County of residence and socio-economic factors were strongly associated with lower attendance in cervical screening, while being born in another country was of less importance. This indicates considerable potential for improvement of cervical screening attendance in several areas if best practice of routines is adopted.

Being Both Helpers and Victims: Health Professionals' Experiences of Working During a Natural Disaster.

BACKGROUND: In November 2013, the Haiyan typhoon hit parts of the Philippines. The typhoon caused severe damage to the medical facilities and many injuries and deaths. Health professionals have a crucial role in the immediate disaster response system, but knowledge of their experiences of working during and in the immediate aftermath of a natural disaster is limited. Aim The aim of this study was to explore health professionals' experiences of working during and in the immediate aftermath of a natural disaster. METHOD: Eight health professionals were interviewed five months after the disaster. The interviews were analyzed using phenomenological hermeneutic methods. RESULTS: The main theme, being professional and survivor, described both positive and negative emotions and experiences from being both a helper, as part of the responding organization, and a victim, as part of the surviving but severely affected community. Sub-themes described feelings of strength and confidence, feelings of adjustment and acceptance, feelings of satisfaction, feelings of powerless and fear, feelings of guilt and shame, and feelings of loneliness. CONCLUSION: Being a health professional during a natural disaster was a multi-faceted, powerful, and ambiguous experience of being part of the response system at the same time as being a survivor of the disaster. Personal values and altruistic motives as well as social aspects and stress-coping strategies to reach a balance between acceptance and control were important elements of the experience. Based on these findings, implications for disaster training and response strategies are suggested. Hugelius K , Adolfsson A , Örtenwall P , Gifford M . Being both helpers and victims: health professionals' experiences of working during a natural disaster. Prehosp Disaster Med. 2017;32(2):117-123.

Health among disaster survivors and health professionals after the Haiyan Typhoon: a self-selected Internet-based web survey.

BACKGROUND: Natural disasters affected millions of people worldwide every year. Evaluation of disaster health and health response interventions is faced with several methodological challenges. This study aimed (1) to describe survivors' and health professionals' health, 30 months after a natural disaster using a web-based self-selected Internet sample survey designed and (2) to evaluate the health effects of disaster response interventions, in the present study with a focus on disaster radio. METHODS: A web-based survey was used to conduct a cross-sectional study approximately 30 months after typhoon Haiyan. The GHQ-12, EQ-5D-3L, and EQ-VAS instruments were used in addition to study-specific questions. A self-selected Internet sample was recruited via Facebook. RESULTS: In total, 443 survivors, from what 73 were health professionals, participated in the study. The Haiyan typhoon caused both physical and mental health problems as well as social consequences for the survivors. Mental health problems were more frequently reported than physical injuries. Health professionals reported worse overall health and a higher frequency of mental health problems compared to other survivors. CONCLUSIONS: There were short-term and long-term physical, psychological, and social consequences for the survivors as a result of the Haiyan typhoon. Mental health problems were more frequently reported and lasted longer than physical problems. Health professionals deployed during the disaster reported worse health, especially concerning mental health problems. The survey used was found useful to describe health after disasters.