War experiences: the emotional health and wellbeing of Polish elderly immigrants

Abstract

Background: Large numbers of Polish refugees arrived in Australia following the end of the Second World War as displaced people, unable to return to their homeland. All had experienced loss of their homeland and many lost loved ones, endured hardship and suffering. Now this group constitutes a significant proportion of the Polish-Australian aged community. The main aim of this thesis is to describe, from a life-span perspective, the relationship between major life events, including war experiences, and psychological and physical health now and in the past. Attention is focused on the factors associated with the longevity of the trauma response.

Method: A mixed methods approach was employed using quantitative and qualitative methods along with a detailed historical account of the war and resettlement contexts. The quantitative component involved the recruitment and interview of a convenience sample of 72 Polish elderly migrants from Polish Senior Citizen's clubs across the Melbourne Metropolitan area. Participants who gave informed consent completed a detailed questionnaire and interview about their current physical health, social networks, psychological health, quality of life, posttrauma growth, war-related experiences, traumatic events, migration, and post war life events. Categorical and continuous variables were analysed using a combination of parametric and nonparametric statistics. The qualitative component involved a narrative interview with a subset of 18 people about the war years and early life in Australia. In addition, detailed field notes were compiled from the quantitative questions with the remaining 54 people supplementing their responses with stories and accounts while filling out the questionnaires. This produced a rich source of data that was analysed thematically.

Results: Fifty-three per cent of participants were women. Most were aged 75 or older (71%). Just over half were married and a third were living alone. The majority had children (90%). Twenty-one per cent described their physical health and seven per cent their emotional health as poor. During the war, 42% were in Germany as forced labourers, 26% had been exiled to the former Soviet Union, 15% had participated in the Armed Forces, 11% were civilians in Poland and 5% were Concentration Camp Survivors. Every person interviewed had experienced at least two traumatic events during the war. The most commonly reported events were the loss of home and belongings (81%), lack of food and water (79%), bombardment (78%) and forced separation from family (74%). People who had survived the concentration camps and ex-service men experienced the highest number of traumatic events. Number of traumatic events during the war was correlated with life-time PTSD symptoms (r=0.46 p=0.01), current PTSD symptoms (r=0.36) and physical health conditions (r=0.37 p=0.01) but was not associated with current quality of life. Negative worldview was associated with PTSD (lifetime and current), physical health conditions and impact of illness. Trait anxiety and years of residency were associated with depression, anxiety, PTSD (lifetime and current) scores and physical health conditions. Negative worldview, Trait anxiety and years of residency were all independent predictors of psychological distress accounting for 51% of the variance in psychological distress.

During their-lifetime, 75% of people identified a period of fear, anxiety and panic, 47% of participants reported feeling depressed, while 7% met criteria for PTSD. In the last six months, 33% reported clinically significant anxiety symptoms, 3% had moderate-severe depressive symptoms and 3% met criteria for current PTSD. Coping strategies mentioned most frequently were use of religion (54%) talking to family and friends (32%) and avoiding any reminders (18%) although none of these strategies were associated with emotional or physical health.

Thematic analysis revealed that Polish elderly described their accounts of trauma and physical deprivation in the context of individual, familial and community suffering. Individuals described a range of emotional responses to trauma such as fear, grief and humiliation. These emotions were also experienced by family and community. Survival mechanisms such as acts of defiance, using one’s own skills and having hope were described at an individual level. Family was identified as an important survival resource - a central component to this theme was that of the ‘strong mother’ fending for her children. Community was another resource identified by study participants such as the ‘acts of kindness by strangers’ that often made the difference between life and death. The theme of community and family suffering meant that the individual was not alone in trauma but surrounded by others in a similar situation. Community structures were an important part of the recovery and healing that took place after the war. The cohesive nature of Polonia (Poles abroad) may explain why people who did not return to Poland and migrated to Australia in the late 1940’s and 1950’s had lower rates of psychological distress compared with those who returned to communist Poland and only arrived relatively recently.

Conclusions: More than 60 years on from the end of the Second World War Polish elderly people were still affected by these events in some way and that in a small number of cases these events were associated with current emotional and physical health. The main determinant of current emotional and physical health was the type of main experience people endured, the number of traumatic events experienced, having a negative world-view, fewer years of residency and higher Trait-Anxiety scores. The thematic analysis revealed that there is a complex relationship between individuals, families and communities in how they experienced trauma and its aftermath and the resources and mechanisms they used in order to survive.