Development in disaster nursing: The challenges of various research designs

Abstract

Human health and lives are threatened by natural disasters happening around the world, armed conflicts and terrorist attacks occurring repeatedly in various countries, and the spread of infectious diseases. The Japanese Nursing Association defines a disaster as “an unexpected event—natural or man-made—that threatens life and health of many people. Disaster includes not only primary damage caused by an earthquake, fire, etc., but also secondary threats to life and health.” Particularly, in recent years, disasters have been on the increase, due to environmental changes including global warming, as well as social changes such as an aging population and population influx into urban areas. The disaster cycle is divided into four phases: (i) acute phase (immediately to 48 h after the disaster); (ii) sub-acute phase (31 month); (iii) midto long-term phase (3a few months or years); and (iv) the silent phase. Nursing professionals with knowledge and expertise in health care and patient support can play important roles in supporting the health of disaster-affected people in all phases of the disaster cycle. For example, nurses can comprehensively assess the physical, mental and social conditions of people with health problems, and provide necessary physical and emotional care. When a disaster strikes, lifeline services are often disrupted, forcing people to shelter in evacuation centers and endure a difficult life there. Nursing professionals can work to improve the living environment of evacuation centers through services such as water supply and hygiene management (provision of clean toilet facilities etc.). They can also make proper arrangements for the delivery of medical and relief supplies. Furthermore, they can provide long-term support for disaster survivors by encouraging them to summon up the strength to carry on and rebuild their lives. As just described, nursing professionals can contribute to a wide range of areas, from emergency medical services in the acute phase, to mental health nursing care, infectious disease prevention and health guidance in the midand long-term phase. As stated above, Disaster Nursing is expected to play an important role. To fulfill the expected role, it is necessary to accumulate the knowledge on disaster nursing and systematize disaster nursing care while continuing to provide care and make improvements. To this end, research is essential. The Japan Society of Disaster Nursing defines disaster nursing as “activities to minimize the impact of a disaster on human life and health by systematically and flexibly using specialized knowledge and skills in disaster nursing and by working in cooperation with professionals in other fields.” However, it is pointed out that internationally, there is insufficient systematic knowledge of Disaster Nursing, and that the numbers of disaster nursing experts are not sufficient. Thus, five graduate schools from the five Japanese national, public and private universities that have been playing a leading role in disaster nursing (University of Kochi, University of Hyogo, Tokyo Medical and Dental University, Chiba University, the Japan Red Cross College of Nursing) jointly launched a project to develop global leaders in disaster nursing— Disaster Nursing Global Leader Degree Program (DNGLDP). This project was selected by the Ministry of Education, Culture, Sports, Science and Technology as a Project for Promotion of Global Human Resource Development (2012–2018; http://www.dngl.jp/).