Learning Objective #1: Identify the relatioship among selected risk factors, resilience, and psychological distress in the post 9/11 environment in older adults and older Holocaust survivors.

Learning Objective #2: Discuss the implications for nursing education, nursing practice, nursing social policy and future nursing research.

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Background and Purpose: Older adults lived through World War II and experienced or witnessed devastating events. In wake of the national trauma that occurred on September 11, 2001, (9/11) these individuals are once again confronted with a potential threat to their safety. The purpose of this study was to examine the relationship between selected risk factors, resilience, and psychological distress in the post 9/11 environment in two groups that are known to be at high risk for psychological distress; older adults and older Holocaust survivors.

Theoretical Framework: Theories of risk and resilience provide a framework for understanding the complex factors associated with the susceptibility of individuals with previous trauma to posttraumatic symptomatology.

Methodology and Study Sample: This comparative survey study included 120 community-dwelling women in Florida born prior to 1926 who self-identify as Holocaust survivors or non-Holocaust survivors. Participants completed five instruments: a) researcher designed demographic tool, b) Resilience Scale, c) Trait Anxiety Inventory, d) Sense of Safety Regarding Terrorism Scale, and d) Trauma Symptom Checklist (TSC-33).

Data Analysis Procedure and Findings: Data were analyzed using descriptive statistics, multivariate analysis of variance (MANOVA) and multiple regression. The findings indicated that older Holocaust survivors who had prior traumatic experiences, suffer more posttraumatic symptoms in the post 9/11 environment during the ongoing War on Terrorism than the comparison group without a Holocaust background.

Discussion: Posttraumatic symptomatology resulting from 9/11 may represent a significant public health issue. Programs of public education may play a role in symptom prevention and health promotion. Clinicians should anticipate that even people far from an attack site may experience posttraumatic symptomatology. Nurses need to develop assessment skills and appropriate interventions for use when caring for individuals exposed to traumatic events. Healthcare practice efforts should focus on issues related to older adults and their concerns about terrorism and disasters.