Understanding Nursing's Role in Health Systems Response to Large-Scale Radiologic Disasters

Diagnostics of care about environment: A systematic review through nursing taxonomies

AIM

To analyse the representation of the environment in nursing diagnostic taxonomies.

DESIGN

Systematic scoping review through nursing taxonomies.

METHODS

The first phase identified nursing diagnostic taxonomies by systematic review. The diagnoses were associated with the environment by analysis of terms into the diagnosis label and definition. Data analysis was quantitative with frequency measurements. The second phase mapped the identified diagnoses to establish equivalences using analysis by terms in the diagnostic labels. Finally, the findings obtained in the first phase were compared with the OMAHA System.

RESULTS

The bibliographic search identified 112 studies and 16 standardized languages for diagnoses. NANDA-I and ICNP were the most frequent taxonomies; ATIC, the most recent; and OMAHA, the oldest. 2,062 diagnoses from four diagnostic taxonomies were analysed, and 361 associations corresponding to 352 environmental diagnoses were identified. All taxonomies included the environment but with different weight relative to the interpersonal and geopolitical category.

Islamic-based Disaster Response Competencies: Perceptions, Roles and Barriers Perceived by Nurses in Aceh, Indonesia

Introduction:

Indonesia, being a part of the Pacific “ring of fire,” is prone to disasters. Several disasters occurred from 2004 to 2019, which resulted in the loss of many lives. These disasters impacted the physical, psychological, psychosocial, and spiritual conditions of survivors. Nurses are the frontline care providers who need adequate competencies to respond to disasters.

Objective:

This study aimed to explore the nurses’ perception of disaster, roles, barriers, and Islamic-based nurses’ competencies in managing psychological, psychosocial, and spiritual problems due to disasters in hospital settings.

Methods:

This is a qualitative study conducted in three large referral hospitals in Banda Aceh, Indonesia. Focus group discussion was conducted on 24 nurses from three hospitals using the discussion guide consisting of five open-ended questions. The data was analyzed through inductive content analysis.

Results:

The study found four themes of Islamic nurses’ competencies in disaster response: 1) perception about the disaster is influenced by religiosity, belief, and values, 2) communication skills, 3) nurses’ roles in disaster response consisted of disaster competencies (the use of Islamic values in managing patients’ conditions, and family engagement, 4) competency barriers consisted of inadequate training, insufficient Islamic-based services, and inadequate involvement of policymakers. This study explored Islamic nurses’ competencies in disaster response related perceptions about the disaster, nurses’ roles, and barriers. The limitation and future of the study were also discussed.

Conclusion:

Perceptions, roles, and barriers in disaster response might influence the development of the Islamic-based nurses’ competencies in care delivery.

Anxiety, depression and cognitive emotion regulation strategies in Chinese nurses during the COVID-19 outbreak

AIMS

To explore the association between cognitive emotion regulation strategies and anxiety and depression among nurses during the COVID-19 outbreak.

BACKGROUND

Nurses play a vital role in responding to the COVID-19 outbreak, but many of them suffer from psychological problems due to the excessive workload and stress. Understanding the correlation between cognitive emotion regulation strategies and anxiety and depression will promote targeted psychosocial interventions for these affected nurses.

METHODS

This cross-sectional study of 586 nurses was conducted in Eastern China. Participants completed online questionnaires that investigated anxiety, depression and cognitive emotion regulation strategies.

RESULTS

The prevalence of nurses' anxiety and depression was 27.6% and 32.8%, respectively. Lower self-blame, rumination and catastrophizing, as well as greater acceptance and positive refocusing, were related to fewer symptoms of anxiety or depression.

CONCLUSION

The cognitive emotion regulation strategies of acceptance and positive refocusing contribute to reducing anxiety or depression. These strategies should be considered when implementing psychotherapeutic interventions to improve nurses' adverse emotional symptoms.

IMPLICATIONS FOR NURSING MANAGEMENT

This study highlights the need to assess cognitive emotion regulation strategies use in screening for anxiety and depression. Nurse managers should develop psychosocial interventions including appropriate strategies to help nurses with adverse emotions during a pandemic.

Analysis of the Training Effect of a Nursing Undergraduate Course on the Management of Radiation-Related Health Concerns-A Single Group Experiment

After the 2011 Fukushima Daiichi accident, demands regarding nursing staff's management of nuclear disasters have increased. This study aimed to evaluate a basic training program to teach undergraduate nursing students on how to deal with public anxiety following a nuclear disaster. We analyzed the data of 111 third-year nursing students attending a Japanese university. We set attainment goals in three domains (cognitive, affective, psychomotor) regarding their acquisition of consultation techniques for radiation-related health concerns. We compared pre- and post-class response scores on a knowledge test and calculated word frequencies in health consultation scenarios. The pre-class mean score was 12.2 out of 27 points and the post-class mean score (directly after the course) was 21.0, a significant increase (p < 0.001). The mean level of attainment in each of the three domains increased significantly from pre-test to post-test (p < 0.001). The variety and number of words in the health consultations also increased. Students attained the program goals for radiation-related health concerns in all domains. During disasters, there is a great need for nursing staff to administer physical and mental care to the public. This program was evaluated to be one wherein nursing staff can acquire fundamental knowledge about radiation in a short time.

Radiation Injury Treatment Network Medical and Nursing Workforce Radiation: Knowledge and Attitude Assessment

Objectives:

The Radiation Injury Treatment Network (RITN) is prepared to respond to a national disaster resulting in mass casualties with marrow toxic injuries. How effective existing RITN workforce education and training is, or whether health-care providers (HCPs) at these centers possess the knowledge and skills to care for patients following a radiation emergency is unclear. HCP knowledge regarding the medical effects and medical management of radiation-exposed patients, along with clinical competence and willingness to care for patients following a radiation emergency was assessed.

Methods:

An online survey was conducted to assess level of knowledge regarding the medical effects of radiation, medical/nursing management of patients, self-perception of clinical competence, and willingness to respond to radiation emergencies and nuclear events.

Results:

Attendance at previous radiation emergency management courses and overall knowledge scores were low for all respondents. The majority indicated they were willing to respond to a radiation event, but few believed they were clinically competent to do so.

Conclusions:

Despite willingness to respond, HCPs at RITN centers may not possess adequate knowledge of medical management of radiation patients, and appropriate response actions during a radiation emergency. RITN should increase the awareness of the importance of radiation education and training.

National Assessment of Nursing Schools and Nurse Educators Readiness for Radiation Emergencies and Nuclear Events

Nurses will play a crucial role in responding to a public health emergency resulting from nuclear war or other large-scale release of radiation into the environment and in supporting the National Health Security Strategy. Schools of nursing are ultimately responsible for developing a competent nursing workforce prepared to assess a population’s public health emergency needs and respond to these low-frequency but high-impact events. This responsibility includes the provision of specific content and training regarding how to respond and care for patients and communities in the event of a nuclear or radiation emergency. To date, however, there has been a lack of empirical evidence focusing specifically on nursing schools’ capacity to prepare nurses for radiation emergencies and nuclear events, as well as perception of risk. This study employed a cross-sectional survey administered to a nationwide sample of nursing school administrators and faculty to assess content, faculty expertise, planning, and perception of risk related to radiation emergencies and nuclear events.

The nursing profession: a critical component of the growing need for a nuclear global health workforce

BACKGROUND

Instability in the global geopolitical climate and the continuing spread of nuclear weapons and increase in their lethality has made the exchange of nuclear weapons or a terrorist attack upon a nuclear power plant a serious issue that demands appropriate planning for response. In response to this threat, the development of a nuclear global health workforce under the technical expertise of the International Atomic Energy Agency and the World Health Organization Radiation Emergency Medical Preparedness and Assistance Network has been proposed.

MAIN BODY OF THE ABSTRACT

As the largest component of the global healthcare workforce, nurses will play a critical role in both the leadership and health care effectiveness of a response to any public health emergency of international concern (PHEIC) resulting from the unprecedented numbers of trauma, thermal burn, and radiation affected patients that will require extensive involvement of the nursing professional community.

SHORT CONCLUSION

Lives can and will be saved if nurses are present. The clinical care of radiation contaminated patients (e.g. radiation burns, fluid management, infection control), thermal burn patients, and other health system response activities such as community screening for radiation exposure, triage, decontamination, administration of medical countermeasures and the provision of supportive emotional and mental health care will be overwhelmingly nurse intensive.

A new scale for disaster nursing core competencies: Development and psychometric testing

BACKGROUND

All nurses must have core competencies in preparing for, responding to and recovering from a disaster. In the Kingdom of Saudi Arabia (KSA), as in many other countries, disaster nursing core competencies are not fully understood and lack reliable, validated tools. Thus, it is imperative to develop a scale for exploring disaster nursing core competencies, roles and barriers in the KSA.

OBJECTIVES

This study's objective is to develop a valid, reliable scale that identifies and explores core competencies of disaster nursing, nurses' roles in disaster management and barriers to developing disaster nursing in the KSA.

METHODS

This study developed a new scale testing its validity and reliability. A principal component analysis (PCA) was used to develop and test psychometric properties of the new scale. The PCA used a purposive sample of nurses from emergency departments in two hospitals in the KSA. Participants rated 93 paper-based, self-report questionnaire items from 1 to 10 on a Likert scale. PCA using Varimax rotation was conducted to explore factors emerging from responses.

FINDINGS

The study's participants were 132 nurses (66% response rate). PCA of the 93 questionnaire items revealed 49 redundant items (which were deleted) and 3 factors with eigenvalues of >1. The remaining 44 items accounted for 77.3% of the total variance. The overall Cronbach's alpha was 0.96 for all factors: 0.98 for Factor 1, 0.92 for Factor 2 and 0.86 for Factor 3.

CONCLUSIONS

This study provided a validated, reliable scale for exploring nurses' core competencies, nurses' roles and barriers to developing disaster nursing in the KSA. The new scale has many implications, such as for improving education, planning and curricula.