Life recovery after disasters: a qualitative study in the Iranian context

Fair prioritization of casualties in disaster triage: a qualitative study

Background

Disasters may result in mass casualties and an imbalance between health care demands and supplies. This imbalance necessitates the prioritization of the victims based on the severity of their condition. Contributing factors and their effect on decision-making is a challenging issue in disaster triage. The present study seeks to address criteria for ethical decision-making in the prioritization of patients in disaster triage.

Methods

This conventional content analysis study was conducted in 2017. Subjects were selected from among Iranian experts using purposeful and snowball sampling methods. Data were collected using semi-structured interviews and were analyzed by the content analysis.

Results

Efficient and effective triage and priority-oriented triage were the main categories. These categories summarized a number of medical and nonmedical factors that should be considered in the prioritization of the victims in disaster triage.

Conclusion

A combination of measures should be considered to maximize the benefits of the prioritization of causalities in disasters. None of these measures alone would suffice to explain all aspects of ethical decision-making in disaster triage. Further investigations are needed to elaborate on these criteria in decision-making.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12873-021-00515-2.

Disaster mental health preparedness in the community: A systematic review study

The objective of this study was to perform a systematic review of articles that cover aspects of disaster mental health preparedness. This assessment was done by a thorough review and summary of the available studies which provided a considerable background and amplified the gaps in knowledge about community mental health preparedness. By this systematic review, we tried to identify available concept of community mental health preparedness and related tools that communities and individuals will need to prepare for natural disasters. We found there is a lack of mental health preparedness in the majority of countries; valid and reliable tools and context-bound programs should be developed based on the experiences and perceptions of the community.

Rehabilitation of vulnerable groups in emergencies and disasters: A systematic review

BACKGROUND

Natural and man-made disasters, especially those occurring in large scales not only result in human mortality, but also cause physical, psychological, and social disabilities. Providing effective rehabilitation services in time can decrease the frequency of such disabilities. The aim of the current study was to perform a systematic review related to rehabilitation of vulnerable groups in emergencies and disasters.

METHODS

The systematic review was conducted according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. The key words "recovery", "rehabilitation", "reconstruction", "transformation", "transition", "emergency", "disaster", "crisis", "hazard", "catastrophe", "tragedy", "mass casualty incident", "women", "female", "children", "pediatric", "disable", "handicap", "elder", "old" and "vulnerable" were used in combination with Boolean operators OR and AND. ISI Web of Science, PubMed, Scopus, Science Direct, Ovid, ProQuest, Wiley, Google Scholar were searched.

RESULTS

In this study a total of 11 928 articles were considered and 25 articles were selected for final review of rehabilitation of vulnerable groups based on the objective of this study. Twenty-five studies including six qualitative, sixteen cross-sectional and three randomized controlled trials were reviewed for rehabilitation of vulnerable groups in emergencies and disasters. Out of the selected papers, 23 were studied based on rehabilitation after natural disasters and the remaining were man-made disasters. Most types of rehabilitation were physical, social, psychological and economic.

CONCLUSION

The review of the papers showed different programs of physical, physiological, economic and social rehabilitations for vulnerable groups after emergencies and disasters. It may help health field managers better implement standard rehabilitation activities for vulnerable groups.

Participation a Key Factor for Life Recovery After Disaster: A Grounded Theory Study in an Iranian Context

Background

Since life recovery after disasters is a subjective and multifaceted construct influenced by different factors, and survivors’ main concerns and experiences are not clear, the researchers intended to explore this process.

Materials and Methods

This study was conducted in 2011 - 2014 based on the grounded theory approach. Participants were selected by purposeful sampling followed by theoretical sampling to achieve conceptual and theoretical saturation. Data were collected through interviews, observation, focus group discussion, and document reviews. Data were analyzed by Strauss and Corbin’s (2008) recommended approach.

Results

Transcribed data from 26 interviews (managers, health care providers, and receivers), field notes, and other documents were analyzed, and 1,652 open codes were identified. The codes were categorized, using constant comparative analysis, into five main categories including reactive exposure, subsiding emotions, need for comprehensive health recovery, improvement of normalization (new normality achievement), and contextual factors. The process of life recovery after disaster was also explored.

Conclusions

The results clarified a deep perception of participants’ experiences after disaster. The path of life recovery after disasters involves participants’ striving to achieve a comprehensive health recovery, which starts with the need for all-inclusive health recovery as a main concern; this is the motivator for a responding strategy. This strategy is participatory, and the process is progressive; achievement of a new normality is the final goal, with new development and levels of empowerment.

Impact of disaster on women in Iran and implication for emergency nurses volunteering to provide urgent humanitarian aid relief: A qualitative study

BACKGROUND

Men and women are equally affected by disasters, but they experience disaster in different ways. To provide new knowledge and promote women's involvement in all phases of the disaster management, we decided to capture the perspectives and experiences of the women themselves; and to explore the conditions affecting Iranian women after recent earthquake disasters.

METHODS

The study was designed as a qualitative content analysis. Twenty individuals were selected by purposeful sampling and data collected by in-depth, semi-structured interviews analysed qualitatively.

RESULTS

Three main themes were evident reflecting women's status after disaster: individual impacts of disaster, women and family, and women in the community. Participants experienced the emotional impact of loss, disorganisation of livelihood and challenges due to physical injuries. Women experienced changes in family function due to separation and conflicts which created challenges and needed to be managed after the disaster. Their most urgent request was to be settled in their own permanent home. This motivated the women to help reconstruction efforts.

CONCLUSIONS

Clarification of women's need after a disaster can help to mainstream gender-sensitive approaches in planning response and recovery efforts.

Challenges for resuming normal life after earthquake: a qualitative study on rural areas of iran

Background and objective: Growing evidence is indicating that some of disaster affected people face challenges to resume normal life several months after an earthquake. However, there is no sufficient in-depth understanding of complex process of resuming normal life after an earthquake in Iran, as one of the most disaster-prone countries in the world, and in rural areas as a particular setting. This study aimed to explore challenges of return to normalcy in rural earthquake-stricken areas of Iran. Methods: The study was conducted using qualitative content analysis method (Graneheim approach). Twenty people from the earthquake-stricken areas and seven qualified experts were selected via purposeful sampling .Data was collected through semi-structured interviews, focus group discussions, and field notes from August 2013 to January 2014. Data collection continued to the point of data saturation (no new information was provided by interviewees). Data saturation supported the sample size. Data analysis was based on qualitative content analysis principles. Results: “Social uncertainty and confusion” was the most prominent challenge of return to the normal life after earthquake, which was categorized into six concepts of social vulnerability, lack of comprehensive rehabilitation plan, incomplete reconstruction, ignorance of local social capital, waste of assets, and psychological problems. Conclusions: Findings showed that social uncertainty and confusion occurs as a result of negligence of some important social aspects in process of returning to the normal life. This issue, in turn, can greatly interrupt the normal developmental processes. Understanding the challenges of life recovery after disasters will help policy makers consider social rehabilitation as a key factor in facilitation of return to normal life process after earthquakes. Keywords: Disaster; earthquake; social rehabilitation; social uncertainty.

Life recovery after disasters: a qualitative study in the Iranian context

INTRODUCTION

Planned and organized long-term rehabilitation services should be provided to victims of a disaster for social integration, economic self-sufficiency, and psychological health. There are few studies on recovery and rehabilitation issues in disaster situations. This study explores the disaster-related rehabilitation process.

METHOD

This study was based on qualitative analysis. Participants included 18 individuals (eight male and ten female) with experience providing or receiving disaster health care or services. Participants were selected using purposeful sampling. Data were collected through in-depth and semi-structured interviews. All interviews were transcribed and content analysis was performed based on qualitative content analysis.

RESULTS

The study explored three main concepts of recovery and rehabilitation after a disaster: 1) needs for health recovery; 2) intent to delegate responsibility; and 3) desire for a wide scope of social support. The participants of this study indicated that to provide comprehensive recovery services, important basic needs should be considered, including the need for physical rehabilitation, social rehabilitation, and livelihood health; the need for continuity of mental health care; and the need for family re-unification services. Providing social activation can help reintegrate affected people into the community.

CONCLUSION

Effective rehabilitation care for disaster victims requires a clear definition of the rehabilitation process at different levels of the community. Involving a wide set of those most likely to be affected by the process provides a comprehensive, continuous, culturally sensitive, and family-centered plan.