A grounded theory study of 'turning into a strong nurse': Earthquake experiences and perspectives on disaster nursing education

What Are the Best Practices for Nursing Care during an Earthquake? A Scoping Review

Among natural disasters, earthquakes have a considerable impact and are among the ten deadliest, with an extreme impact on the healthcare sector. This study aimed to analyze the best practices in nursing care for earthquake victims. An in-depth analysis was carried out by using a scoping review, a method used in accordance with the PRISMA-ScR recommendations, to identify best nursing practice in these circumstances based on searches of eight databases: MEDLINE via PubMed; Cochrane Library; Embase; VHL; PDQ-Evidence; Scopus; ProQuest; and Google Scholar. Twenty-one studies were selected. The nursing practices identified were grouped into two distinct dimensions, each subdivided into four subcategories: (i) care practices: (a) immediate care, (b) intermediate care, (c) psychosocial care, and (d) ethical care; (ii) care management and coordination practices, which cover (a) care coordination, (b) victim care network organization, (c) teamwork, and (d) training. By analyzing these nursing practices during care and relief operations for earthquake victims, this study identified the various actions carried out, the nursing skills to be developed, and the reinforcement of these advanced practices through the systematization of nurses' skills, in order to promote victims' rehabilitation, minimize their suffering, and improve their quality of life during and after an earthquake.

"Shouldn't Nobody Make a Woman do What they Don't Want to do with their Body": Black Women's Reactions to the Supreme Court's Overturn of Roe v. Wade

Black women, particularly those with low-income, are projected to be the most negatively impacted group following the Supreme Court's overturn of Roe v Wade. It is expected that the rate of increase in live births, as well as the rate of maternal mortality, will be steepest for Black women due to high rates of unmet needs for contraception, unintended pregnancies, poverty, barriers to legal abortion access, and systemic racism. Previous research has shown that the legalization of abortion in 1973 significantly improved educational and employment outcomes for Black women, in particular. The current study seeks to assess the perceptions of predominantly under-resourced Black women following the overturning of Roe v Wade. Eighteen Black women participated in one of five focus groups during the summer of 2022 and shared their reactions to the Supreme Court ruling. Using grounded theory, researchers generated the following themes: sexism via forced births, economic implications, and dangers of banned abortions. Based on participants' concerns resulting from the Roe v Wade overturn, policy implications are provided for improving the following systems: safety net, child welfare, and infant and perinatal mental health care.

Earthquake Experiences of Nursing Students Residing in Earthquake Zone, the Disaster of the Century: A Qualitative Study

This study was carried out to examine the experiences of nursing department students regarding earthquakes with a phenomenological approach. The type of research is phenomenological research, one of the qualitative research methods. The research was carried out with 22 nursing students who experienced the earthquake in the Turkey earthquake on February 6, 2023. The data were collected using the "Semi-Structured Interview Form". In this study, "earthquake experience" was discussed as a phenomenon, and the data obtained from the phenomenon after content analysis were evaluated in five themes as follows: Experiences during the earthquake, experiences after the earthquake, search-rescue operations, social support and daily life after the earthquake. It was seen that they acted with the instinct of protection during the earthquake and then tried to shelter and communicate. The study reveal that the disaster preparedness and competencies of nursing students should be increased.

The bricolage mode of emergency medical teams in China: deficient and in urgent need of transformation-A qualitative study

Introduction

Emergency medical rescue plays a vital role in alleviating the harm of all kinds of emergencies to people's physical and mental health and life safety. The current emergency medical teams (EMTs) formation model is not unified. We focused on the disadvantages of the bricolage mode of China EMTs and put forward empirical-based countermeasures to improve the emergency management ability of EMTs.

Methods

From March to September 2022, 23 leaders of EMTs in North China (Tianjin) were selected by objective sampling method to conduct one-to-half structured in-depth interviews. Nvivo12.0 software was used for three-level coding. The disadvantages of the bricolage model of EMT were analyzed.

Results

Based on the three-level coding, 150 initial concepts, 36 sub-coding, 17 main coding, six categories, and two core categories were sorted out. Management structure, internal stability, and support are recognized as the crucial elements armed with the EMTs.

Discussion

The bricolage EMTs have disadvantages such as a chaotic management structure, weak internal stability, and inadequate support. It is necessary to construct full-time EMTs that incorporate a standardized personnel admission mechanism, full-time training and exercise mechanism, diversified incentive mechanism, and multi-agent cooperation mechanism, etc.

Experiences of intensive care nurses providing care to the victims of Kahramanmaraş earthquakes

BACKGROUND

Two earthquakes of magnitude 7.7 and 7.6 occurred in the Turkish province of Kahramanmaraş in 2023. The earthquakes resulted in serious losses of life and property in 11 provinces, and the injured were transferred to other provinces for treatment and care. To date, no studies on the experiences of intensive care nurses providing care to earthquake victims after the Kahramanmaraş earthquake sequence have been identified.

AIM

The aim of the present study is to explore the experiences of intensive care nurses providing care to earthquake victims who were transferred to other provinces.

STUDY DESIGN

A qualitative descriptive research design with conventional content analysis was used. Snowball sampling was used in the selection of intensive care nurses. Data saturation was achieved with 20 nurses. In-depth interviews were conducted with the participants through phone between March 8 and March 15, 2023. MAXQDA 20 software was used for data analysis. The COREQ checklist was used to guide the reporting of the study.

RESULTS

Twenty nurses were recruited. Four themes emerged from the data: challenges in caregiving processes; psychological challenges; ethical situations; urgent need for training and support.

CONCLUSIONS

After the Kahramanmaraş earthquake sequence, described by some as the disaster of the century, nurses encountered patients with unique needs that they had never encountered before and tried to cope with the constantly changing health conditions. For this reason, they were affected psychologically and experienced challenges in caregiving processes.

RELEVANCE TO CLINICAL PRACTICE

Conducting comprehensive training for diseases common among earthquake victims, developing new protocols for providing care to earthquake victims, developing more action plans for nurses, and psychologically supporting intensive care nurses would facilitate the caregiving processes.

The Effects of Disaster Nursing Education Program on Beliefs in General Disaster Preparedness, Disaster Response Self-Efficacy, and Psychological Resilience in Nursing Students: A Single-Blind, Randomized Controlled Study

AIM

This study was conducted to evaluate the effects of a disaster nursing and management education program on beliefs in general disaster preparedness, disaster response self-efficacy, and psychological resilience in nursing students.

METHOD

The sample consisted of nursing students receiving undergraduate education in Istanbul, Turkey. Participants were randomly divided into the intervention ( n = 65) and control ( n = 66) groups. The intervention group was given an eight-module education program with theoretical and applied components. Data were collected using the Belief in General Disaster Preparedness Scale, the Disaster Response Self-Efficacy Scale, and the Brief Resilience Scale.

RESULTS

The mean Belief in General Disaster Preparedness Scale, Disaster Response Self-Efficacy Scale, and Brief Resilience Scale scores of the intervention group were higher than those of the control group.

CONCLUSION

The disaster nursing and management education program provided to nursing students was determined to increase beliefs in general disaster preparedness, disaster response self-efficacy, and psychological resilience.

Construction of the Evaluation Index System for Nurse Deployment Pertaining to the Disaster Rescue

Based on the Delphi method, the analytic hierarchy process, and the entropy method, this paper constructs the evaluation index system for nurse deployment pertaining to the disaster rescue in military hospitals to furnish the reference evidence for scientific deployment of nursing staff, thereby promoting the rescue supportability. This paper establishes the expert consultation form of the evaluation index system for nurse deployment pertaining to the disaster rescue in military hospitals through expert interviews, group discussions, and so on. The Delphi method is applied to enquire 20 military experts in different professional fields two times, and the evaluation index system is finally determined. The weights of evaluation indexes of disaster rescue nurses are determined by the analytic hierarchy process and entropy method. The construction of the evaluation index system for the deployment of disaster relief nurses in military hospitals through Delphi method, analytic hierarchy process, and entropy method provides a reference method for rational allocation of nurses and points out the key points of hospital training. In addition, this paper provides a reference for the assessment and selection of nurses related to disaster relief in military hospitals and lays a foundation for the construction of subsequent evaluation models, which is of great significance for improving the level of nursing teams.

Are nurses prepared to respond to next infectious disease outbreak: A narrative synthesis

Aim

The review aimed to present a synthesis of nurses' preparedness for infectious disease and the components of emergency preparedness.

Design

Narrative synthesis.

Methods

A systematic search and screening for relevant studies were conducted to locate the relevant articles. The included studies were examined for scientific quality using the Mixed Methods Appraisal Tool. The findings of included studies were synthesized by a narrative synthesis approach.

Results

Totally 15 studies were included, and 4 themes associated with nurses' preparedness for pandemic were identified: knowledge and skills, psychological preparation, external resources, and attitude and intention.

Conclusions

Most nurses express a positive willingness to respond to epidemics, although they do not believe they are adequately prepared. Some measures should be taken for improving nurses' emergency preparedness, including providing ongoing training, protective equipment, safe working environment and psychological intervention, improving nurses' resilience and accelerating the sharing of scientific information about epidemics.

Disaster preparedness and core competencies among emergency nurses: A cross-sectional study

Aim

With the rise in frequency and severity of disasters in recent decades, it is essentially important that nurses must be adequately prepared to handle them. This study was aimed to evaluate the levels of disaster core competencies and preparedness of nurses in the emergency department.

Design

A cross‐sectional survey design was used.

Methods

This cross‐sectional research was conducted from August 2020 to December 2020 among 271 nurses in the emergency departments of six hospitals in Qazvin, Iran. The participants completed the “Nurses Perceptions of Disaster Core Competencies Scale” (NPDCC) (45 items) and the disaster preparedness (a single‐item visual scale). Data were analysed by one‐way analysis of variance, independent t‐tests and multiple linear regression analysis.

Results

The mean scores of disaster preparedness and core competencies of nurses were 6.75 out of 10 (SD = 1.63) and 2.88 out of 5 (SD = 0.80), respectively. "Technical skills" (mean = 3.24, SD = 0.91) were the highest and "communication skills" (mean = 2.57, SD = 0.95) were the lowest across the subscales of the scale. A significant association was found between disaster core competencies and preparedness of nurses (p < .001). Regression analysis results indicated that nursing disaster core competencies were perceived betted by older nurses (B = −0.405) who had experience in the disaster stage (B = 0.228) and nurses with disaster response experience (B = 0.223) and lower professional experience (B = 0.309). Nurses with a postdiploma degree (B = −0.480) and bachelor's degree (B = −0.416) were perceived to have lower disaster core competency than nurses with a master's or PhD degree.

Conclusion

There are still gaps in disaster preparedness and core competencies for emergency nurses that need to be addressed. Nursing managers must support an improvement in nursing disaster core competencies. This may be done by conducting sessions for routine disaster scenarios and providing formal disaster preparedness training.

Ethical Challenges Experienced by Healthcare Workers Delivering Clinical Care during Health Emergencies and Disasters: A Rapid Review of Qualitative Studies and Thematic Synthesis

Background: The COVID-19 pandemic has posed several ethical challenges worldwide. Understanding care providers' experiences during health emergencies is key to develop comprehensive ethical guidelines for emergency and disaster circumstances.Objectives: To identify and synthetize available empirical data on ethical challenges experienced by health care workers (HCWs) providing direct patient care in health emergencies and disaster scenarios that occurred prior to COVID-19, considering there might be a significant body of evidence yet to be reported on the current pandemic.Methods: A rapid review of qualitative studies and thematic synthesis was conducted. Medline and Embase were searched from inception to December 2020 using "public health emergency" and "ethical challenges" related keywords. Empirical studies examining ethical challenges experienced by frontline HCWs during health emergencies or disasters were included. We considered that ethical challenges were present when participants and/or authors were uncertain regarding how one should behave, or when different values or ethical principles are compromised when making decisions.Outcome: After deduplication 10,160 titles/abstracts and 224 full texts were screened. Twenty-two articles were included, which were conducted in 15 countries and explored eight health emergency or disaster events. Overall, a total of 452 HCWs participants were included. Data were organized into five major themes with subthemes: HCWs' vulnerability, Duty to care, Quality of care, Management of healthcare system, and Sociocultural factors.Conclusion: HCWs experienced a great variety of clinical ethical challenges in health emergencies and disaster scenarios. Core themes identified provide evidence-base to inform the development of more comprehensive and supportive ethical guidelines and training programmes for future events, that are grounded on actual experiences of those providing care during emergency and disasters.

Clinical Nurse Specialist Expands to Crisis Management Role During COVID-19 Pandemic

PURPOSE

Emergence of the COVID-19 crisis into the healthcare system challenged existing roles and shifted organizational priorities and staff responsibilities. Operating within the spheres of impact, clinical nurse specialists (CNSs) adapted to the needs of the organization and expanded their responsibilities to provide crisis leadership.

DESCRIPTION OF PROJECT

The CNSs used advanced practice nursing skills and leadership to implement hospital rounds, identify issues, make decisions, collaborate with stakeholders, disseminate new and emerging information, and evaluate processes in an ongoing pandemic. Using the health crisis management framework, the CNSs demonstrated authentic leadership throughout the prevention, preparedness, response, recovery, and rehabilitation phases.

OUTCOME

Data analysis of CNS handoff and meeting communications generated these areas of focus involving the CNSs: (1) clinical practice, (2) supplies, (3) workflows, and (4) people.

CONCLUSION

The CNS played a vital role in the planning, training, and evaluation of crisis preparation. New and emerging infectious diseases may continue to confront the healthcare system. Thus, healthcare systems need to remain prepared for public health threats. In the crisis leadership role, the CNS helped the transition to learn and relearn practices. As authentic leaders, CNSs instilled calmness, confidence, trust, and resiliency to the staff during the COVID-19 pandemic.

The Healers Are Broken: A Call for Trauma-Informed Professional Development in Nursing

The COVID-19 pandemic has highlighted the fact that nurses are at risk for poor mental health, but there is evidence that this risk existed long before the pandemic started. Nurses in professional development have a unique opportunity to support nurses through trauma-informed professional development. Evidence-based interventions, such as peer support, attention to cultural differences, and empowerment, can enhance protective factors and also promote recovery from trauma-related poor mental health outcomes.

Reflecting on the challenges encountered by nurses at the great Kermanshah earthquake: a qualitative study

Background

Iran has experienced an increasing number of earthquake in the past three decades. Nurses are the largest group of healthcare providers that play an important role in responding to disasters. Based on previous studies, they experienced challenges providing care in the previous disasters. Therefore, this study aimed to explore the nursing challenges to provide care to the injured in the Kermanshah earthquake, Iran.

Methods

This is a qualitative study with conventional content analysis using Granheim and Landman approach. In this study, 16 nurses involved in providing care to the injured in the Kermanshah earthquake were selected by purposeful sampling method. Data were collected using in-depth semi-structured interviews. The criteria proposed by Guba and Lincoln were used to ensure the validity of the study.

Results

Data analysis led to the emergence of 453 primary codes, 14 subcategories, and 5 categories. The five categories were as follows: (a) organizational and managerial challenges; (b) human resources; (c) infrastructure; (d) educational preparations; (e) and ethical.

Conclusions

The results of this study showed that nurses faced several challenges in providing care to earthquake victims. Based on these findings, better educational management and planning, infrastructure reform, and establishment of a crisis nursing national team seem necessary.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-021-00605-3.

Identify the Disaster Nursing Training and Education Needs for Nurses in Taif City, Saudi Arabia

Introduction

Nursing is considered the healthcare profession with the most members. Emergency nurses constitute the first line of treatment in healthcare facilities when catastrophic events bring disaster victims in need of medical attention. Therefore, these nurses must be well educated and trained efficiently to be able to deal with disastrous situations properly. This study aimed to distinguish the most important elements of education and training for preparing emergency nurses to face disasters in the Kingdom of Saudi Arabia (KSA), specifically, the city of Taif.

Methods

This study employed a tool to measure nurses’ most important training and education needs that was created by the authors based on a literature review and was approved by an expert panel in disaster nursing. Questionnaires were distributed to emergency nurses in four hospitals run by the Ministry of Health in Taif city. Survey responses were received from 210 participants, and the data were analyzed using a principal component analysis (PCA). A one-way ANOVA was used to determine the differences between groups according to their experiences.

Results

The following three factors were extracted from the data after redundant items were loaded and excluded: incident management systems (IMSs), disaster triage, and disaster drills. Nurses with less than three years of experience have a significant need to learn about these elements in order to be able to cope with disasters.

Conclusion

Understanding different types of disasters and how to deal with these catastrophic events is crucial. Significant differences existed between ED nurses in their understanding of the basic elements of disaster management based on their level of experience in an ED. Therefore, disaster education must be included in nursing curricula, and more training courses, mock drills, and simulations must be conducted in hospitals for nurses, especially nurses with less experience, so they can learn to manage their responsibilities during disasters.

Psychometric Evaluation of the Disaster Preparedness Evaluation Tool© (DPET) on Emergency Nurses in Mainland China: Two Cross-Sectional Studies

BACKGROUND

Emergency nurses play a major role in disaster relief in mainland China, but there is no valid instrument to measure the extent of their disaster preparedness. The Disaster Preparedness Evaluation Tool© is a reliable instrument to assess the disaster preparedness of nurse practitioners. The tool has been translated and validated in Saudi Arabia, Taiwan, China and the United States of America.

OBJECTIVES

This study aimed at translating and adapting the Disaster Preparedness Evaluation Tool© (DPET) for emergency nurses in mainland China and determining its psychometric properties.

DESIGN, SETTINGS AND PARTICIPANTS

A total of 2 cross-sectional online surveys were conducted in the emergency departments of 26 public grade III-A hospitals in Guangdong, mainland China. In the first study, 633 emergency nurses were recruited from May to August, 2018. In the second study, 205 were recruited in April 2019.

METHODS

The instrument was adapted through rigorous forward-backward translation, face validity, and pre-test processes. Exploratory factor and parallel analyses were used in the first study. Confirmatory factor analysis, internal consistency and split-half reliability were used in the second study.

RESULTS

Exploratory factor and parallel analyses extracted a 5-factor solution comprising of 34 items that accounted for 64.06% of the total variance. The fit indices indicated a good model fit. The reliability was good, as indicated by a Cronbach's alpha of 0.97 and a split-half reliability coefficient of 0.97.

CONCLUSION

The mainland China version of the DPET (DPET-MC) was a reliable and valid instrument and can be used in practice.

The psychosocial impact on frontline nurses of caring for patients with COVID-19 during the first wave of the pandemic in New York City

Background

Infectious disease pandemics, such as COVID-19, have dramatically increased in the last several decades.

Purpose

To investigate the personal and contextual factors associated with the psychological functioning of nurses responding to COVID in the New York City area.

Method

Cross sectional data collected via a 95-item internet-based survey sent to an email list of the 7,219 nurses employed at four hospitals.

Findings

2,495 nurses responded (RR 35%). The more that nurses cared for COVID patients as well as experienced home-work conflict and work-home conflict the higher the nurses' depression and anxiety. When asked what has helped the nurses to carry out their care of patients the most common responses were support from and to co-workers, training in proper PPE, and support from family/friends.

Discussion

Understanding the potential triggers and vulnerability factors can inform the development of institutional resources that would help minimize their impact, reducing the risk of psychological morbidity.

Hospital Nurses' Willingness to Respond in a Disaster

OBJECTIVE

This study examined the factors associated with nurses' willingness to respond in a disaster.

BACKGROUND

Nurses are key personnel in case of disasters, and therefore, understanding factors associated with willingness to respond is important.

METHODS

Questionnaires were distributed to 200 nurses recruited from 2 public hospitals in Seoul, Korea. Data were collected in January and February 2018 and 181 responses were analyzed.

RESULTS

Factors predicting willingness to respond in a disaster among public hospital nurses were level of education, self-efficacy, and disaster management competency.

CONCLUSIONS

Providing well-organized disaster preparedness and response training programs would enhance nurses' level of knowledge about disasters. In addition, training could improve nurses' self-efficacy and disaster management competency, which should enhance willingness to respond in a disaster.

Nurses' perception about posttraumatic growth (PTG) after natural disasters

Background

Natural disasters have become the most common, profound, and universal type of catastrophes over decades. Natural disasters can lead to both negative and positive impacts on survivors. Nurses have an important role in fostering posttraumatic growth (PTG) as a positive psychological adjustment amongst the survivors. However, nurses may have different perceptions of their roles in PTG. Such differences may result in various approaches in supporting PTG as best as possible. Therefore, nurses’ perception regarding PTG needs to be explored.

Method

This study used a descriptive qualitative approach. A total of fourteen nurse participants were included across five different cities in Indonesia, including Jakarta, Bogor, Depok, Tangerang, and Bekasi. Data were collected through in-depth interviews and analyzed with a thematic method.

Results

The study revealed three themes, as follows (1) PTG is a new concept for nurses, (2) PTG is a condition that needs to be sought by volunteers, and (3) PTG means human-God and human-human positive relationships.

Conclusion

The study highlights the importance of improving nurses’ understanding regarding PTG so that they can deliver appropriate strategies or interventions to support survivors in gaining positive changes after experiencing a natural disaster. The study recommends that knowledge and skills related to PTG should be introduced in undergraduate nursing program.

Educational needs and disaster response readiness: A cross-sectional study of clinical nurses

AIM

To analyse clinical nurses' educational needs and disaster response readiness and the factors influencing their disaster response readiness.

DESIGN

This was a cross-sectional study.

METHODS

A convenience sample comprising 260 nurses with more than a year of working experience at a hospital in Korea was selected from 1-31 August 2019. Data on nurses' educational needs and disaster response readiness were collected from participants. A multiple regression model was used to examine the factors influencing disaster response readiness among nurses.

RESULTS

Factors influencing personal readiness were number of years of clinical experience, being female, working in a medical ward, and educational needs for disaster response. Factors influencing self-protection were working in a medical ward and working in the emergency room. Factors influencing the emergency response were working in a medical ward and working in the emergency room. Factors influencing clinical management were a graduate-level education or higher, working in a medical ward, working in the emergency room, working in the paediatric ward, experience receiving disaster-related education, and educational needs for disaster response.

CONCLUSION

It is essential to be aware of the educational needs and disaster readiness of hospital clinical nurses, to develop their capacity to respond such situations. In addition, to improve the disaster competency of nurses, it is necessary to develop an education programme that considers the factors influencing disaster response readiness in this study.

IMPACT

Nurses must have the knowledge and skills to respond to a disaster. Nurse educators should help nurses strengthen their disaster-related knowledge, skills, and judgment. Hospital administrators should encourage nurse educators to provide disaster-related training and simulation-based education to increase nurses' disaster competency to act during disasters.

Relationships between disaster nursing competence, anticipatory disaster stress and motivation for disaster engagement

Nurses are the largest group of healthcare providers and are often the first line responders to a disaster event. Nurses' disaster competence, motivation for disaster engagement, and factors that impact their motivation to respond to disaster events need to be understood. The purposes of the study were to determine the predictive relationships between Taiwanese nurses' disaster competence, anticipatory disaster stress, and motivation for disaster engagement. A cross-sectional design was used to analyze data collected between August 2017 and December 2017 from eight hospitals in southern Taiwan. Ninety participants who met the recruitment criteria completed and returned questionnaires with an 88.24% response rate. Data collection involved administering the Disaster Nursing Competence Questionnaire, Anticipatory Disaster Stress Questionnaire, and the Motivation of Disaster Engagement Questionnaire. The results indicated that anticipatory disaster stress was positively correlated with disaster competence and motivation for disaster engagement. Disaster competence and willingness to join a hospital disaster rescue predicts an individuals' motivation for disaster engagement. The results of the study add to the understanding of factors that correlate with nurses' motivation to participate in disaster events. By understanding these factors, the government and healthcare administrators can design disaster education plans and other strategies to improve Taiwanese nurses' motivation to engage in disaster events.

Research on Disaster Literacy and Affecting Factors of College Students in Central China

OBJECTIVES

Disaster literacy, which is a concept involved in moral quality, knowledge, and ability, impacts the disaster response. This study aimed to evaluate disaster education needs and to determine the affecting factors of disaster literacy among college students.

METHODS

A cross-sectional study was conducted through questionnaires. A total of 7200 college students from 10 colleges and universities in 5 provinces and cities in China were investigated.

RESULTS

Disaster education needs were urgently. For the participants, 79.43% stated that their families were not prepared for disaster prevention items, 96.36% suggested a campus emergency rescue team, and 88.64% obtained disaster knowledge through TV or Internet, and only 12.89% had offered relevant courses in their disciplines. The total scores of college students' disaster literacy were 87.85 ± 19.86, which was at a low level. Multiple linear regression analysis showed that age, major, grade, place of residence, parental education, mother's occupation, disaster experience, disaster training experience, and family disaster preparedness significantly affected college students' disaster literacy, especially grade, family disaster preparedness, and place of residence.

CONCLUSIONS

College students' disaster literacy education is urgently needed. Families, communities, colleges and the government should attach importance to disaster literacy education for college students.

Psychometric evaluation of undergraduate student nurses' learning perceived needs in disaster nursing: Two cross-sectional studies

BACKGROUND

Disaster nursing education is a necessity for nurses and students to improve their disaster relief competencies. Determining undergraduate student nurses' learning perceived needs for disaster nursing can help improve curricula construction. In China there is currently no valid instrument available for the evaluation of influencing factors. A disaster nursing course content system was developed using the Delphi method in 2011. However, this system was unformed and lacked psychometric evaluation.

OBJECTIVES

To adapt the disaster nursing course content system into an instrument, to evaluate its psychometric properties, and to investigate undergraduate student nurses' learning perceived needs for disaster nursing.

DESIGN, SETTINGS AND PARTICIPANTS

Two cross-sectional studies were conducted in public higher education institutions in China. In the first study, a total of 1714 undergraduate student nurses were recruited in May to October 2016; in the second study, 68 were recruited in May 2019.

METHODS

The instrument was adapted through literature review, face validity and pilot testing in preliminary studies. The construct validity and reliability of the instrument were tested using exploratory factor analysis, parallel analysis, confirmatory factor analysis, internal consistency reliability and test-retest reliability.

RESULTS

The exploratory factor analysis and parallel analysis extracted a three-factor solution comprising 19 items that accounted for 71.69% of the total variance, including discipline introduction, skills and knowledge in disaster relief, and disaster management. The fit indices indicated a good fit. The internal consistency and test-retest reliability was good, as indicated by a Cronbach's alpha of 0.89 and an intraclass correlation coefficient of 0.87.

CONCLUSION

The Learning Needs for Disaster Nursing questionnaire exhibited good psychometric properties, thereby proving itself a valuable instrument for evaluating learning perceived needs in undergraduate student nurses.

The knowledge, skill competencies, and psychological preparedness of nurses for disasters: A systematic review

BACKGROUND

Disasters and the magnitude of destruction are increasing worldwide. Nurses constitute the largest number of healthcare providers and have major roles in disaster response and care. They need to have sufficient knowledge, skill competencies, and preparedness in responding to disasters. This review aimed to evaluate nursing preparedness to disasters in terms of knowledge, skill competencies, and psychological preparedness to disasters.

METHODS

A systematic review was conducted from recent research articles published between 2001 and 2018, which included searches from five databases: PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, Medline, and ScienceDirect. Quality of the selected studies was assessed using Mixed Methods Appraisal Tool (MMAT), and the review results were generated through an iterative narrative process of synthesis to identify common themes.

RESULTS

Twelve studies, with a total of 1443 nurses involved, met the inclusion criteria. The articles revealed the need for further development of disaster preparedness of nurses in the aspects of knowledge and skill competencies; and in particular with more focus on the education of nurses to achieve better psychological preparedness.

CONCLUSION

The results of this review showed that it is important to enhance the psychological preparedness of nurses, in addition to knowledge and skill competencies, so that they can provide the best care possible to affected individuals as well as for themselves.

Exploring the experiences and preparedness of humanitarian pharmacists in responding to an emergency-response situation

BACKGROUND

Pharmacists are more frequently being deployed along with other members of the multi-disciplinary team in order to provide humanitarian aid. This team will need to work collaboratively to overcome challenges such as constraints in access to medication, medical supplies and medical records. Recent literature reports on the role of the pharmacist across all facets of care continuing to evolve into clinical areas to support patient care. To date there is a deficiency in description and understanding of the preparedness and contribution of pharmacists within a humanitarian capacity.

OBJECTIVE

This study aims to investigate the preparedness of pharmacists working in the humanitarian field and to explore pharmacists' experiences including the challenges they face in an emergency response situation.

METHODS

An interview topic guide was developed and informed by a review of the literature and one-to-one in-depth semi-structured telephonic interviews were conducted with pharmacists involved in the humanitarian field based in England. Interviews were audio recorded and were transcribed verbatim. A member of the research team conducted the data analysis (FS) consistent with the Braun and Clarke approach, the authors (ZN and HN) provided advice and input throughout the analysis process.

RESULTS

Twelve pharmacists participated in this study, nine of whom had deployment experience; interviews took place between October 2017 and April 2018. Data analysis identified four descriptive themes (training and preparation; skills required; challenges/barriers; professional development) and numerous sub-themes.

CONCLUSIONS

This study resonates with research investigating experiences of other healthcare professionals, which report the need for more tailored and appropriate training to improve preparedness for deployment. Pharmacists also suggest specific skills and knowledge facilitate adaptability and innovate working which areas of humanitarian need require. The pharmacists did not report any psychological burden or trauma from their experiences in emergency response, which requires further study to ensure this aspect of preparation, debriefing and support is not neglected.

Nurses' disaster preparedness and core competencies in Turkey: a descriptive correlational design

AIM

This descriptive correlational study aimed to identify nurses' perceptions of their own disaster preparedness and core competencies.

BACKGROUND

As disasters have increased in number and severity in recent years, it is crucial that nurses should be appropriately prepared. There is still limited research on this issue in Turkey.

INTRODUCTION

With changes in disaster policies in the last decade, the need to improve the disaster core competencies of nurses has also increased.

METHODS

A sample of 406 nurses selected with convenience sampling and working in an 1816-bed capacity university hospital was included in this descriptive correlational study. A single-item visual scale and the 45-item Nurses Perceptions of Disaster Core Competencies Scale were used.

RESULTS

'Technical Skills' scored highest across the subscales of the scale, and 'Critical Thinking Skills' scored lowest. When the total and subscale scores were compared by age group, professional experience, working position and prior disaster experience, there were statistically significant differences.

CONCLUSIONS

The Turkish nurses had different levels of disaster core competencies and considered themselves more competent in some areas of disaster preparedness than in others. There are clearly gaps to be filled in disaster preparedness and core competencies in Turkish nurses.

IMPLICATIONS FOR NURSING AND POLICY

Nurse managers should advocate for increasing disaster preparedness for all nurses. This could be accomplished by offering formal training in disaster preparedness and/or by scheduling regular disaster drills, perhaps using a mix of tabletop exercises with occasional hospital-wide disaster scenarios. In addition, managers should regularly evaluate nurses' disaster core competencies to achieve effective preparation plans and training.

The development and psychometric testing of a Disaster Response Self-Efficacy Scale among undergraduate nursing students

BACKGROUND

Disaster nurse education has received increasing importance in China. Knowing the abilities of disaster response in undergraduate nursing students is beneficial to promote teaching and learning. However, there are few valid and reliable tools that measure the abilities of disaster response in undergraduate nursing students.

OBJECTIVES

To develop a self-report scale of self-efficacy in disaster response for Chinese undergraduate nursing students and test its psychometric properties.

PARTICIPANTS AND SETTINGS

Nursing students (N=318) from two medical colleges were chosen by purposive sampling.

METHODS

The Disaster Response Self-Efficacy Scale (DRSES) was developed and psychometrically tested. Reliability and content validity were studied. Construct validity was tested by exploratory and confirmatory factor analysis. Reliability was tested by internal consistency and test-retest reliability.

RESULTS

The DRSES consisted of 3 factors and 19 items with a 5-point rating. The content validity was 0.91, Cronbach's alpha coefficient was 0.912, and the intraclass correlation coefficient for test-retest reliability was 0.953. The construct validity was good (χ²/df=2.440, RMSEA=0.068, NFI=0.907, CFI=0.942, IFI=0.430, p<0.001).

CONCLUSIONS

The newly developed DRSES has proven good reliability and validity. It could therefore be used as an assessment tool to evaluate self-efficacy in disaster response for Chinese undergraduate nursing students.

The Emotional Well-Being of Nurses and Nurse Leaders in Crisis

In a world after 9/11, Hurricane Katrina, and Sandy Hook, plenty of literature has emerged on the subject of disaster management, but little is specific to the emotional well-being of the health care staff dedicated to serve during a crisis. Disasters, whether natural or man-made, are episodic but becoming more frequent. Nurses may find themselves in hospitals affected by a disaster, awaiting a surge of patients while supplied with only limited resources. Or, they may be deployed to austere environments where they are challenged to operate clinics, surrounded by the rubble of an earthquake. In these situations, nurse leaders need to ensure that staff members are trained to be effective disaster health care resources before crises occur. Training includes education on what nurses may observe, how they will be utilized in an emergency situation, and how they can best handle a chaotic environment, both during and after the event, in a manner that will help them keep their emotions in balance. Training before a disaster will help nurse responders develop a plan for their personal responsibilities so they can focus on the mission. The time to start training is not when the disater occurs. In a chaotic environment, most nurses will not have the necessary reserves to begin learning new concepts. Prepared nurses and their leaders must be ready to use their training prior to any crisis. They need to be able to assess that their colleagues are not suffering because of lack of sleep, food, or emotional support. Even after a disaster has initially been resolved, and nurse responders have returned to their families, nurse leaders need to follow up with their team. It may actually be during the postcrisis period that nurse responders need the most emotional support.

Readiness of hospital nurses for disaster responses in Taiwan: A cross-sectional study

BACKGROUND

Because patients in disaster areas require the most critical care, mobilising hospital nurses has become a pivotal strategy. Given the importance of disaster nursing training programmes, understanding how well prepared hospital nurses are to provide disaster care is vital.

OBJECTIVES

This paper analyses the perceived readiness of hospital nurses for a disaster response and the factors influencing their report for work outside the hospital environment.

DESIGN

A cross-sectional research design was used.

SETTINGS

This study was conducted at a military hospital in Taiwan.

PARTICIPANTS

A sample of 311 registered nurses participated in this study.

METHODS

Data were collected on readiness for disaster responses using a 40-item researcher-designed, self-administered questionnaire found to have satisfactory reliability and validity. The questionnaire has four domains: personal preparation (16 items), self-protection (11 items), emergency response (6 items), and clinical management (7 items). Data were analysed using descriptive statistics, independent t-tests and generalised linear models.

RESULTS

The majority of hospital nurses demonstrated poor readiness for disaster responses. Scores on the four domains were most associated with nurses' disaster-related training, experience in disaster response and emergency/intensive care experience.

CONCLUSIONS

Our results indicate that disaster-related training should be included in undergraduate programmes and continuing education courses to help hospital nurses recognise and improve their own readiness for disaster responses outside the hospital environment. Future research is needed to improve hospital nurses' disaster-response readiness in Taiwan and other countries.

Disaster nursing experiences of Chinese nurses responding to the Sichuan Ya'an earthquake

AIM

The aim of this study was to investigate the disaster experiences of nurses called to assist survivors one month after the 2013 Ya'an earthquake.

BACKGROUND

China has experienced an increasing number of earthquake disasters in the past four decades. Although a health and disaster management system was initiated after the 2008 Wenchuan earthquake, nurses' roles and experiences in a disaster have been overlooked.

METHODS

The researchers used qualitative descriptive design that included 16 participants. Data were collected using semi-structured interviews and observation notes, after which a qualitative content analysis was conducted.

FINDINGS

Three major themes emerged: the process of being dispatched from hospitals to the disaster zone, the effort involved in getting to and working in the affected site and reflecting on the challenges they encountered.

DISCUSSION

About half of the participants had received disaster nursing training before deploying to the disaster site, but they consistently expressed a lack of physical and psychological preparedness regarding the process of being dispatched from their hospitals to the disaster zone.

LIMITATIONS

This was a single-incident experience. Caution should be taken when trying to extend the findings to other parts of China.

CONCLUSION

These findings highlighted the need for disaster in-service training as well as for having disaster plans in place.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Hospital and nursing leaders should provide disaster training opportunities that included topics such as compiling resource inventories, formulating disaster drills and simulations, managing emergencies, and using emergency communication methods. Health policy-makers should be required to prioritize capacity-building training for front-line nurses as well as to develop and implement disaster management plans to better prepare nurses for future disasters.

Nurse Perspectives on the Practical, Emotional, and Professional Impacts of Living and Working in Post-earthquake Canterbury, New Zealand

Introduction

This report explores nurses’ perspectives following the Canterbury (New Zealand) 2010-2011 earthquake sequence and the subsequent recovery process.

Problem

Little is known about the experiences of health care professionals during a disaster recovery process, and this research generates insights about the challenges faced.

Methods

Qualitative semi-structured interviews were undertaken with 11 nurses from the Christchurch (New Zealand) area to explore the challenges faced by the nurses during and following the earthquakes. The interviews took place three years after the start of the earthquake experience to enable exploration of longer term aspects of the recovery process. The interview transcripts were analyzed and coded using a grounded theory approach.

Results

The data analysis identified that the nurses had faced a number of challenges and these were characterized as practical, emotional, and professional. While some of the challenges were short-lived in the aftermath of the earthquakes, some were long-lasting due to the extended nature of the recovery process. Dealing with house damage, insurance negotiations, and working in damaged environments had a negative impact on the nurses. The nurses experienced a range of emotions, both negative and positive, after the disaster, though many had needed time to elapse before feeling able to reflect on their experiences.

Discussion

The findings suggest that secondary stressors have a negative impact on the psychosocial recovery process. The nurses recognized that they received support from others and were also required to focus on others. Keeping busy appeared to be the most common coping strategy. This lack of reflection on their experiences may have resulted in delayed emotional responses. Some of the nurses changed their work role, hours, and responsibilities suggesting that working in this environment was having a detrimental impact.

Conclusion

The research indicates the challenges faced by nurses in the initial impact of the earthquakes and during the longer term recovery process. There is a need to consider the psychosocial impact of working and living in a post-disaster context and to develop support packages to ensure the health and well-being of nurses in this environment.

JohalSS,MounseyZ,BrannellyP,JohnstonDM.Nurse perspectives on the practical, emotional, and professional impacts of living and working in post-earthquake Canterbury, New Zealand.Prehosp Disaster Med.2016;31(1):10–16.