Emotional and psychological implications for healthcare professionals in disasters or mass casualties: A systematic review

Traces of Earthquake: Traumatic Life Experiences and Their Effects on Volunteer Nurses in the Earthquake Zone-An Interpretative Phenomenological Study

INTRODUCTION

It is crucial to understand the effects that traumatic events related to natural disasters have on individuals in as much detail as possible. However, the literature investigating the traumatic life experiences of nurses, who play a key role in disaster management, is still limited.

OBJECTIVE

The aim of this study was to explore in depth the traumatic life experiences of volunteer nurses who participated in relief efforts after two major earthquakes in the southeastern region of Türkiye.

METHODS

This qualitative study was conducted using a phenomenological design. The study sample consisted of 16 nurses selected by the purposive and snowball sampling methods. The data were evaluated using interpretative phenomenological analysis in the Maxqda 2020 program.

RESULTS

Four themes were generated: (1) shocking facts, (2) coping methods, (3) traumatic stress reactions, and (4) traumatic growth.

CONCLUSION

While traumatic life experiences in the earthquake area led to acute stress reactions in the volunteer nurses, these experiences also contributed to their traumatic growth and development. Healthcare managers and policymakers should develop comprehensive strategies and intervention programs to safeguard the mental health of nurses in the context of natural disasters. It may also be useful to improve clinical education programs and support systems by reviewing international policies and procedures.

Caregiving experiences of Turkish intensive care unit nurses who survived in the most destructive double earthquake of the century: A qualitative study

BACKGROUND

Turkey has been exposed to many devastating earthquakes in recent years. Considering that nurses are on the front lines of responding to disasters, they need to be prepared at all times. In the literature review, it was seen that despite the roles of intensive care nurses in disasters, their experiences in caring for earthquake victims have not been adequately researched.

AIM

This study aims to investigate the experiences of intensive care nurses during the double earthquake in Turkey in 2023.

STUDY DESIGN

This descriptive qualitative research was conducted with 11 intensive care nurses working in the double earthquake in Turkey in 2023. Snowball sampling was used to select participants. Data were collected through face-to-face semi-structured interviews. Interviews were continued until data saturation was reached.

RESULTS

As part of the analysis of the interviews, the nurses' experiences were grouped under four main themes covering 10 sub-themes-'Continuing care despite difficulties', 'Staying in a dilemma', 'Two faces of the earthquake' and 'The need for perfect planning kneaded with experience.'

CONCLUSION

The main source of the difficulties and dilemmas experienced is the obligation of nurses who experienced the earthquake to continue their profession. Still, continuity of care was maintained and nurses drew positive conclusions from the negativity.

RELEVANCE TO CLINICAL PRACTICE

Considering the positive and negative effects of the earthquake, intensive care nurses should be both professionally and psychologically empowered, organizational planning should be conducted as soon as possible and their functionality should be tested through drills.

Self-care strategies used by disaster responders after the 2023 earthquake in Turkey and Syria: a mixed methods study

BACKGROUND

Disaster responders are exposed to several physical and mental health risks. This study aimed to describe self-care strategies used by disaster responders after the earthquake in Syria and eastern Turkey in February 2023.

METHODS

A study specific web-based questionnaire survey was used to collect quantitative and qualitative data according to a convergent mixed methods approach. Data from 252 disaster responders responding to the earthquakes in Turkey and Syria were analyzed using both descriptive and analytical statistics and summative content analysis of free-text answers. Data were collected in March to July, 2023.

RESULTS

The most used self-care strategies included resting, social support from colleagues in the field, extra intake of food or drink, and intake of medicines. The recovery strategies varied due to previous disaster response experience, indicating that supportive self-care strategies can be developed or learned.

CONCLUSION

Given the extreme conditions and limited possibilities of external support, sufficient self-care is an essential competence among disaster responders. Self-care strategies can be both external processed such as intake of medicines, social support from others, and internal processes such as personal reflection. Providing oneself with self-care activities seems to be a skill developed with increasing experience supported by pre-deployment training. Therefore, to enhance resilience, self-care strategies should be encompassed in pre-disaster response training.

Improve disaster literacy in nurses: a qualitative descriptive study

BACKGROUND

The enhancement of nurses' disaster literacy is crucial for effective disaster emergency management, especially for clinical nurses with no prior experience in disaster rescue. This study aims to explore the perspectives of nurses who have been involved in disaster rescue operations on strategies to advance nurses' disaster literacy.

METHODS

A qualitative descriptive study, which follows unified qualitative study reporting guidelines. Thirty disaster rescue nurses were recruited to participate in this study, who came from 30 third-class hospitals in China. From October to December 2021, information was acquired by conducting semi-structured telephone interviews with participants. Qualitative content analysis was used to examine the data.

RESULTS

Six categories and eleven subcategories were created. Strengthening disaster education and training was the main focus, and its subcategories included continuing education, nursing curriculum development, and disaster rescue experience guide. The second focus, which included scene simulation, actual combat/military simulation, and virtual reality simulation, was strengthening disaster simulation and drill. The third focus was on providing psychosocial support, which included improving self-psychological adjustment, developing resilience, and engaging in active coping. The fourth category was to strengthen nurse/hospital managers roles and leadership, which included enhancing professional identity and policies/leadership support. The fifth category was disaster preparedness, and the sixth was enhancing knowledge transformation.

CONCLUSIONS

Government agencies or healthcare organizations should actively promote the formation of nurses' disaster literacy from multiple viewpoints. Disaster education and training, simulation exercises, and psychosocial support should be prioritized.

Supporting Perioperative Safety During a Disaster Through Clinical Crisis Education

Disruptive domestic and global events can directly affect health care workers' ability to deliver safe, quality care. Health care workers should have an awareness and understanding of the disaster continuum and how their actions throughout each phase can affect the crisis response. Robust, intentional education and training for all team members is essential to uphold safe clinical environments and delivery of high-quality care during crises. This article explores key elements of providing education during a crisis response, including launching a command center, forming a structured team with strong leadership, establishing organized communication channels, conducting educational needs assessments, and developing and implementing education plans to assist with mitigating any issues related to knowledge deficits. In addition, recommendations for evaluating the effectiveness of the education at producing the desired learning outcomes are provided, as well as the implications of such a program for perioperative educators, frontline staff members, and leaders.

Understanding the impact of natural disasters on children within fist hours and days after an event: A phenomenological study through the experience of nurses

BACKGROUND

Children are a particularly vulnerable group in natural disasters such as earthquakes, and although they represent a difficult group to research in such situations, there appears to be a lack of literature investigating children's experiences in the immediate post-earthquake period. Experienced nurses can shed light on children's experiences.

AIM

This study was conducted to examine the experiences of nurses caring for children affected by the earthquake in Kahramanmaraş, Turkey.

METHODS

This phenomenological study was conducted with nurses who provided care to children during the Kahramanmaraş earthquake between May and August 2023. The study sample consisted of 14 nurses selected using a purposive sampling technique. Data were collected through in-depth interviews by using the "Introductory Information Form" and "Semi-structured Interview Form" developed by the researchers. The interviews were subsequently analyzed using Colaizzi's method.

RESULTS

The results revealed five themes under two main themes. Under the main theme of nurse, there are subthemes of chaos, helplessness-incompetence, while under the main theme of child, there are subthemes of unresponsiveness, intertwined needs, empathy, and care. The study also highlights the chaotic environment in the immediate aftermath of the earthquake, characterized by a high number of pediatric casualties and psychological trauma, and the nurses' feelings of helplessness as a result of being separated from their families.

CONCLUSION

This study found that nurses caring for children in the earthquake had difficulties in managing children's hospital processes and they demonstrated an empathic approach by trying to communicate with the children in their care. The nurses stated that children should be supported psychologically as well as having their basic needs such as water, food, and shelter met.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Health policymakers should be aware that in the early stages of major disasters such as earthquakes, children are not only physically injured but also have basic needs such as water, shelter, and food, and are emotionally affected. It is recommended that disaster management plans be developed to address all children's needs and nurses be provided with psychological support and training to improve their knowledge and skills.

Disaster preparedness among nurses in disaster-prone countries: A systematic review

BACKGROUND

Disaster preparedness is crucial for mitigating the impact of disasters and saving lives. Ensuring preparedness for disaster response and management, particularly among nurses in disaster-prone countries, is essential due to the serious threats disasters pose to affected populations. This study was conducted to appraise and synthesize the literature examining preparedness for disaster management and response among nurses in countries with the highest disaster risks.

METHODS

A systematic review of the literature published from 2000 onwards was conducted using five databases: SCOPUS, PubMed, MEDLINE, PsychINFO, and CINAHL. Twenty-one relevant articles were identified for this review.

RESULTS

The findings revealed that nurses in countries at high risk of disasters had inadequate disaster knowledge and skills, leaving them ill-prepared to respond to such situations. Previous experience in disaster relief, disaster-related education and training, and higher academic qualifications were associated with increased readiness for disaster response and management.

CONCLUSION

The review's findings provide insight into the current state of disaster preparedness among nurses in disaster-prone nations. The review identified evidence highlighting the value of disaster-related education and training, as well as disaster response experience, in fostering preparedness among nurses. These results can inform policymakers, hospital administrators, and nurse administrators in developing strategies for promoting disaster preparedness in nurses through evidence-based training programs and interventions.

Exploring the consequences of nurses' involvement in disaster response: findings from a qualitative content analysis study

BACKGROUND

The presence of nurses during disasters can lead to many consequences. Understanding the nurses' experiences of these consequences can provide valuable insights. Therefore, this study was conducted to explore the experiences of Iranian nurses regarding the consequences they faced when being present during disasters.

METHODS

This qualitative descriptive study employed a content analysis approach to examine the topic at hand. 20 nurses working in the emergency units of Kerman hospitals were selected through purposive sampling. In-depth semi-structured interviews were conducted to collect the data. The data were analyzed using qualitative content analysis proposed by Graneheim and Lundman. MAXQDA 10 was used to manage data.

RESULTS

After analysis of the interviews, two main categories were identified: overlapping of job frustrations and acquiring experience in difficult conditions. The main category of acquiring experience in difficult conditions comprised the following subcategories: improved quality of care, experience and dedication in fulfilling the role, reduced stress, occupational motivation and enthusiasm, increased self-confidence, and improved social status. On the other hand, the category of overlapping of job frustrations also consisted of the subcategories of physical strength deterioration, psychological and emotional distress, discontinued from supports, feelings of hopelessness, increased exposure to violence and aggression, and occurrence of family problems.

CONCLUSION

Being present during disasters and obtaining the necessary competencies can have positive consequences that serve as turning points in the personal and professional growth of nurses. Additionally, favorable outcomes can help nurses cope with adverse circumstances. Managers can utilize the findings of this study to develop strategies aimed at reducing negative outcomes and enhancing positive ones among nurses during disasters.

Disaster literacy in disaster emergency response: a national qualitative study among nurses

BACKGROUND

As the largest group of healthcare professionals, nurses play an indispensable and crucial role in disaster response. The enhancement of nurses' disaster literacy is imperative for effective disaster emergency management. However, there is currently a lack of knowledge regarding nurses' disaster literacy. This study represents the first attempt to explore the key components and characteristics of disaster literacy among nurses.

METHODS

A qualitative descriptive design was employed, and the reporting followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines (refer to File S1). The purposive sampling method was utilized. Thirty-one rescue nurses from 31 medical institutions across 25 provinces and regions in China were recruited to participate in the study. The respondents were requested to share their experiences and insights regarding disaster rescue operations. Inductive content analysis was employed for data examination.

RESULTS

The results indicated that rescue nurses universally recognized that there was a pressing need to enhance the level of disaster literacy among nurses. The disaster literacy of nurses encompasses nine dimensions: physical and mental quality, disaster rescue general knowledge, professional and technical competence, professional ethics, teamwork, emotional ability, information literacy, leadership, and knowledge transformation.

CONCLUSIONS

To ensure national sustainability, government departments, healthcare organizations, and hospital administrators can accurately evaluate the disaster literacy of individual clinical nurses, groups, and the workforce as a whole through nine dimensions, which also can provide evidence to support the development of precision strategies to strengthen the disaster literacy of nurses.

Culture of Safety and Preparedness: Benefits of Applying a Daily Mitigation Mindset in the Hospital Setting

AIM

Utilizing the subjective experience of nurse executives who have supervised nurses during a major disaster in a hospital setting, this study aims to describe the subjective experience of nurse executives (NE) who have supervised nurses' responses to major disasters. This paper will focus on strategies to support nursing response to disasters, specifically to strengthen resiliency and the ability to maintain function despite the shock of a disaster, including those caused by climate change.

METHODS

Semi-structured interviews were conducted with 11 hospital-based nurse executives who supervised nurses during some of the worst natural and human-made disasters in different regions of the United States. A phenomenological approach was used to analyze and describe emerging themes from the qualitative data.

RESULTS

Three nurse executives demonstrated theme saturation for mitigation steps to augment traditional disaster readiness activities: (1) Assessment of human infrastructure: daily skills needed during disaster response; (2) Identification and study of failure points and metrics; (3) Strengthening human infrastructure: rectifying deficiencies; and (4) Monitoring metrics and making corrections during conventional periods.

CONCLUSION

Mitigation steps may improve outcomes in hospital function during conventional times; therefore, these steps may improve resiliency and the ability to maintain functions during major disasters, including climate change.

Effects of mass casualty incidents on anxiety, depression and PTSD among doctors and nurses: a systematic review protocol

INTRODUCTION

Both doctors and nurses showed a greater risk of being exposed to different mental health conditions following mass casualties. This systematic review aims to synthesise the existing evidence on the prevalence of anxiety, depression and post-traumatic stress disorder and their associated risk factors among doctors and nurses following mass casualty incidents.

METHODS AND ANALYSIS

Seven electronic databases (PubMed, PsycINFO, MEDLINE Ovid, Embase, CINAHL, Web of Science and Nursing & Allied Health database) will be searched from 2010 to 2022 with peer-reviewed articles in English language using the predefined keywords. Two reviewers will independently screen the titles and abstracts, as well as review the full texts using the eligibility criteria, then extract data independently. The National Institutes of Health Quality Assessment Tools (NIH-QAT) for quantitative studies, the Critical Appraisal Skills Programme (CASP) Checklist for qualitative studies and the Mixed-Methods Appraisal Tool (MMAT) for mixed-method studies will be used to measure the quality appraisal of eligible studies. A third reviewer will resolve the discrepancies when the two reviewers cannot reach an agreement in any step. The result from the eligible studies will be described following narrative synthesis with the key characteristics and findings of the included studies, and meta-analysis will be performed, if applicable.

ETHICS AND DISSEMINATION

This systematic review deals with existing published studies without any personally identifiable information of participants. Therefore, ethical approval from the research committee is not required. Findings from this review will be disseminated in peer-reviewed journals and presented at relevant international conferences.

PROSPERO REGISTRATION NUMBER

CRD42023412852.

Breath-centered virtual mind-body medicine reduces COVID-related stress in women healthcare workers of the Regional Integrated Support for Education in Northern Ireland: a single group study

Background

During the COVID-19 pandemic, healthcare workers endured prolonged stress affecting their psychological well-being. Objectives: (1) Evaluate the effects of the Breath-Body-Mind Introductory Course (BBMIC) on COVID-related stress among employees of the Regional Integrated Support for Education, Northern Ireland, (2) Reduce the risk of adverse effects from COVID-related stress, and (3) Evaluate the effects of BBMIC on indicators of psychophysiological states and the consistency with hypothesized mechanisms of action.

Methods

In this single group study, a convenience sample of 39 female healthcare workers completed informed consent and baseline measures: Perceived Stress Scale (PSS), Stress Overload Scale-Short (SOS-S), and Exercise-Induced Feelings Inventory (EFI). Following the online BBMIC 4 h/day for 3 days and the 6 week solo (20 min/day) and group practice (45 min weekly), repeat testing plus the Indicators of Psychophysiological State (IPSS) and Program Evaluation were obtained.

Results

Baseline (T1) mean PSS score was significantly elevated compared to a normative sample: PSS = 18.2 vs. 13.7 (p < 0.001) and improved significantly 11 weeks post-BBMIC (T4). SOS-S mean score declined from 10.7(T1) to 9.7 at 6 week post-test (T3). The SOS-S proportion of High Risk scores found in 22/29 participants (T1), dropped to 7/29 (T3). EFI mean subscale scores improved significantly from T1 to T2 and T3 for Revitalization (p < 0.001); Exhaustion (p < 0.002); and Tranquility (p < 0.001); but not Engagement (p < 0.289).

Conclusion

Among RISE NI healthcare workers affected by COVID-related stress, participation in the BBMIC significantly reduced scores for Perceived Stress, Stress Overload, and Exhaustion. EFI Revitalization and Tranquility scores significantly improved. More than 60% of participants reported moderate to very strong improvements in 22 indicators of psychophysiological state, e.g., tension, mood, sleep, mental focus, anger, connectedness, awareness, hopefulness, and empathy. These results are consistent with the hypothesized mechanisms of action whereby voluntarily regulated breathing exercises change interoceptive messaging to brain regulatory networks that shift psychophysiological states of distress and defense to states of calmness and connection. These positive findings warrant validation in larger, controlled studies to extend the understanding of how breath-centered Mind-body Medicine practices could mitigate adverse effects of stress.