Experiences of parents of children with disabilities for disaster preparedness in Indonesia: a descriptive qualitative study

Disaster preparedness and learning needs among community health nurse coordinators in South Sulawesi Indonesia

Jordanian nurses’ perceptions of their preparedness for disaster management

Disaster Knowledge, Skills, and Preparedness Among Nurses in Bengkulu, Indonesia: A Descriptive Correlational Survey Study

Disasters pose significant challenges globally, affecting millions of people annually. In Saudi Arabia, floods constitute a prevalent natural disaster, underscoring the necessity for effective disaster preparedness among Emergency Medical Services (EMS) workers. Despite their critical role in disaster response, research on disaster preparedness among EMS workers in Saudi Arabia is limited. The study aimed to explore the disaster preparedness among EMS workers in Saudi Arabia. This study applied an explanatory sequential mixed-methods design to explore disaster preparedness among EMS workers in Saudi Arabia, focusing on the qualitative phase. Semi-structured interviews were conducted with 15 EMS workers from National Guard Health Affairs (NGHA) and Ministry of Health (MOH) facilities in Riyadh, Dammam, and Jeddah. Thematic analysis was conducted following Braun and Clarke's six-step process, ensuring data rigor through Schwandt, et al's criteria for trustworthiness. The demographic characteristics of participants revealed a predominantly young, male workforce with varying levels of experience and educational backgrounds. Thematic analysis identified three key themes: (1) Newly/developed profession, highlighting the challenges faced by young EMS workers in acquiring disaster preparedness; (2) Access to opportunities and workplace resources (government versus military), indicating discrepancies in disaster preparedness support between government and military hospitals; and (3) Workplace policies and procedures, highlighting the need for clearer disaster policies, training opportunities, and role clarity among EMS workers. The study underscores the importance of addressing the unique challenges faced by EMS workers in Saudi Arabia to enhance disaster preparedness. Recommendations include targeted support for young EMS professionals, standardization of disaster training across health care facilities, and improved communication of disaster policies and procedures. These findings have implications for policy and practice in disaster management and EMS training in Saudi Arabia.

Introduction: Disasters pose significant challenges globally, affecting millions of people annually. In Saudi Arabia, floods constitute a prevalent natural disaster, underscoring the necessity for effective disaster preparedness among Emergency Medical Services (EMS) workers. Despite their critical role in disaster response, research on disaster preparedness among EMS workers in Saudi Arabia is limited. Methods: The study aimed to explore disaster preparedness among EMS workers in Saudi Arabia. This study applied an explanatory sequential mixed-methods design to explore disaster preparedness among EMS workers in Saudi Arabia, focusing on the qualitative phase. Semi-structured interviews were conducted with fifteen EMS workers from National Guard Health Affairs (NGHA) and Ministry of Health (MOH) facilities in Riyadh, Dammam, and Jeddah. Thematic analysis was conducted following Braun and Clarke’s six-step process, ensuring data rigor through Schwandt et al.’s criteria for trustworthiness. Results: The demographic characteristics of participants revealed a predominantly young, male workforce with varying levels of experience and educational backgrounds. Thematic analysis identified three key themes: (1) Newly/developed profession, highlighting the challenges faced by young EMS workers in acquiring disaster preparedness; (2) Access to opportunities and workplace resources (government versus military), indicating discrepancies in disaster preparedness support between government and military hospitals; and (3) Workplace policies and procedures, highlighting the need for clearer disaster policies, training opportunities, and role clarity among EMS workers. Conclusion: The study underscores the importance of addressing the unique challenges EMS workers face in Saudi Arabia to enhance disaster preparedness. Recommendations include targeted support for young EMS professionals, standardization of disaster training across healthcare facilities, and improved communication of disaster policies and procedures. These findings have implications for policy and practice in disaster management and EMS training in Saudi Arabia.

Hiroko Minami, RN, MPH, DNSc. Photo credit: Lorenzo Chiriatti. Today man-made or natural catastrophes seem to occur ever more frequently. Almost daily we hear of a disaster happening somewhere in the world – natural disasters such as earthquakes, tsunami, droughts, floods and hurricanes as well as man-made disasters such as airplane crashes, terrorism, war and conflict. It is estimated that 3 million people died in natural disasters alone in the last dozen years and many more were affected. Widespread occurrences of some infectious diseases, such as the HIV/AIDS pandemic, SARS and avian flu, can also be classified as disasters because of the often catastrophic consequences for countries and individuals. Damage caused by such disease outbreaks and the strategies needed to combat or cope with them are similar to those resulting from natural or man-made disasters. Large-scale disasters can wreak havoc on the health, social, and economic networks of local communities, as well as entire countries and regions. People’s lives change after a disaster and many suffer long-term consequences. In January 1995, I survived the Hanshin-Awaji Earthquake. As the first major earthquake to hit directly an urban area in Japan, it inflicted unprecedented damage in the region, and resulted in more than 6,400 deaths and 15,000 injured persons. Although I was a mental health nurse, I did not realise for many weeks following the earthquake that I was suffering from post-traumatic stress response. In the year the earthquake struck, I was Vice President of the Japanese Nursing Association (JNA) and we created a network of volunteer nurses to go to the disaster site. We found that most nurses were not prepared for assisting survivors/victims in disasters. Recognising the need for an independent society to promote disaster nursing, we established the Japan Society of Disaster Nursing in 1998. Since then we have worked to promote disaster nursing by contributing to the body of knowledge, developing nursing education programs, and implementing international research. Over the next years we prepared nurses and sent them to support the victims of natural disasters in Taiwan, Turkey, India, Iran and the countries devastated by the 2004 tsunami. As President of the International Council of Nursing (ICN), disaster relief nursing remains a priority for me. ICN encourages nurses, nursing schools and national nurses associations (NNAs) to contribute to the improvement of people’s lives and health by developing the practice of disaster nursing. It is important that nurses in all specialties be trained, prepared and ready to care for people affected by disasters. For nursing personnel to act most effectively in a crisis or emergency situation, we need to incorporate disaster preparedness in educational programmes at the preregistration and postbasic levels, and in continuing education programmes. Our background in epidemiology, physiology, pharmacology, cultural-familial structures, and psychosocial issues makes us well-suited to assisting disaster victims/survivors in the short and long-term. In the immediate aftermath of a disaster, nurses assist in efforts to mobilise the necessary resources such as access to food, water, sanitation and shelter. We provide emergency medical assistance, giving special attention to vulnerable groups, such as the ill, handicapped, children, women and older people. Women and marginalised groups are particularly ill prepared, and have difficulty surviving and recovering from disaster due to discrimination. Gender inequality may lead to inferior citizenship and legal status, lack of access to education, less mobility (due to family obligations) and economic insecurity. All of these factors render women particularly vulnerable to the repercussions of disasters. Women may also suffer from domestic and sexual violence, especially when living in refugee camps and during human-induced disasters, such as war. ICN promotes strategies that support social justice and equity of access to needed health and social services. Nurses’ technical skills and knowledge are equally important in the long term as communities organise resettlement programmes, and survivors cope with psycho-social and economic needs. While nursing care is critical and often life-saving during and after disasters, our profession also can make an enormous contribution before disaster occurs. Disaster preparedness is critical to the delivery of effective responses to the short and long-term health needs of a disaster-stricken population. It is also important for the sustainable and continued development of poorer nations. Imagine how many lives could be saved if communities were ‘disaster-resistant’. Four areas of activity are required to create disaster-resistant communities: disaster prevention, mitigation, preparedness and relief. Nurses and NNAs have a vital role to play in each of these areas. As team members, we can participate in the development and implementation of relevant legislation, policies and procedures before disaster occurs. We can lobby our governments to prepare in advance for disaster by assessing potential hazards and vulnerabilities, and by increasing their ability to predict, warn and respond to disaster. To ensure nursing input, we must actively participate in strategic planning and implementing of national disaster plans. We can network with other health and social disciplines, government bodies, community groups and nongovernmental agencies, including humanitarian organizations. Nurses are skilled at forming partnerships, and know how to be facilitative and supportive, and to communicate and negotiate effectively. We can develop, encourage and support local, regional, national and international networks to address disaster prevention, mitigation, preparedness and relief. We must call attention to the need to provide care and support for nurses and other relief workers who experience human tragedy first-hand. Often stressed and fatigued themselves, they care for disaster victims, often working with too few resources and in physically unsafe circumstances. Research has documented that nurses and other care providers may experience post-traumatic stress syndrome during and after disaster. To further the field of disaster nursing, I encourage nurses to conduct research and to write about their experiences. On page 13, three nurses present their findings about the experiences of nurses who assisted victims of the 2003 earthquake in the city of Bam, Iran. Their research emphasises the need for previously prepared practical protocols; qualified and real team work in the disaster situation; and establishment of comprehensive training programmes in disaster relief nursing. I urge nurses and NNAs in every nation to assume a leadership role in efforts to prepare their countries and regions in the event that disaster strikes. Further ideas about how to become involved are presented in ICN’s position statement, Nurses and Disaster Preparedness, available at http://www.icn.ch/psdisasterprep01.htm. This year ICN will hold an international conference based on the theme of ‘Nurses at the Forefront: Dealing with the Unexpected’. The conference is an opportunity for nurses from around the world to share their experiences and expertise, both through formal presentation of research and through informal discussions. The conference will take place from 27 May to 1 June 2007, in Yokohama in my home country of Japan. Further information is available at http://www.icn.ch/conference2007.htm. Each ICN president chooses a watchword for her four-year term of office. I chose harmony because I believe nursing is very much like an orchestra. We are a collective of talent and character – one that, together, can have great effect on our nations’ health policies and the lives of the people we serve. Our skills, caring and compassion are critical to the health of our nations in every situation, and especially before and after disaster strikes. Hiroko Minami was installed as the 25th President of the International Council of Nurses (ICN) during the ICN Quadrennial Congress in 2005. Dr Minami is Vice President of the University of Hyogo and Director of the Japanese Academy of Nursing Science. She is the immediate past President of the Japanese Nursing Association. Dr Minami established the first doctoral programme and mental health nursing specialist programme in Japan.

Disasters can affect anyone, but children are the most vulnerable. Schools play an essential role during disasters because children spend most of their time in such institutions, and teachers are among the untapped groups whose potential roles in disaster risk reduction and management (DRRM) are not yet fully realized. In order to provide baseline data that may be useful in developing an intervention geared towards maximizing the potential of teachers in DRRM, disaster preparedness was measured among teachers of Angeles City, Philippines, using a questionnaire designed using the extended parallel process model (EPPM). A total of 45 school teachers from Angeles City, Philippines, answered a structured survey questionnaire to assess their current disaster preparedness, and whether their attitude, intentions, behavior, perceived efficacy, perceived threat, and fear constitute a danger control or fear control response. A high percentage of the respondents exhibited danger control responses, although fear control responses were also observed. Perceptions of fear were highest for terrorist attacks and lowest for floods. Overall, through the use of the EPPM-based questionnaire, there is evidence that teachers basically show positive attitudes and intentions towards disaster preparedness, but lack sufficient motivation to exhibit excellent disaster preparedness behavior due to the low perceived threat.

Research has documented that immigrants tend to experience more negative consequences from natural disasters compared to native-born individuals, although research on how immigrants perceive and respond to natural disaster risks is sparse. We investigated how risk perception and disaster preparedness for natural disasters in immigrants compared to Canadian-born individuals as justifications for culturally-adapted risk communication and management. To this end, we analyzed the ratings on natural disaster risk perception beliefs and preparedness behaviors from a nationally representative survey (N = 1,089). Factor analyses revealed three underlying psychological dimensions of risk perception: external responsibility for disaster management, self-preparedness responsibility, and illusiveness of preparedness. Although immigrants and Canadian-born individuals shared the three-factor structure, there were differences in the salience of five risk perception beliefs. Despite these differences, immigrants and Canadian-born individuals were similar in the level of risk perception dimensions and disaster preparedness. Regression analyses revealed self-preparedness responsibility and external responsibility for disaster management positively predicted disaster preparedness whereas illusiveness of preparedness negatively predicted disaster preparedness in both groups. Our results showed that immigrants' risk perception and disaster preparedness were comparable to their Canadian-born counterparts. That is, immigrant status did not necessarily yield differences in risk perception and disaster preparedness. These social groups may benefit from a risk communication and management strategy that addresses these risk perception dimensions to increase disaster preparedness. Given the diversity of the immigrant population, the model remains to be tested by further population segmentation.

Objective: This study investigated the psychological symptoms and difficulties experienced by parents of children with autism.
 Method: This descriptive and cross-sectional study was conducted between November 2021 and June 2022. The sample consisted of 218 parents of children aged 3-18 living in XX. The sample was divided into two: 110 parents of children with autism and 108 parents of healthy children.
 Results: Parents of children with autism had a mean age of 36.15±6.142, while parents of healthy children had a mean age of 36.65±7.057. More than half of the parents of children with autism stated that they worried about their children’s future and had difficulty taking care of other children of theirs, making time for themselves, and maintaining daily life. On the other hand, only a quarter of the parents of healthy children stated that they worried about their children’s future and had difficulty taking care of other children of theirs, making time for themselves, and maintaining daily life. Parents of children with autism had a significantly higher mean anxiety, depression and hostility subscale score than parents of healthy children (p<0.05).
 Conclusions: Parents of children with autism experience more difficulties and present with more symptoms of anxiety, depression, and hostility than parents of healthy children. Parents of children with special needs need to be psychologically reassured and supported.
 Bangladesh Journal of Medical Science Vol. 23 No. 01 January’24 Page : 179-188

Children with autism spectrum disorder (ASD) experience impairments in their social interactions, language communication, and stereotypical patterns of behavior. Parents of children with ASD experience higher levels of stress and more depression and anxiety than parents of children with other disabilities or typically developing children. Parents of children with disabilities develop coping strategies to counteract the stresses associated with raising a child with special needs. Understanding coping strategies to help counteract the stresses associated with parenting a child with ASD may enhance well-being in parents of children with ASD, improve the quality of care provided to these children, and foster better parent-child relationships. The purpose of this study was to explore the coping strategies used by parents in Taiwan parenting a child with ASD. In this descriptive qualitative study, thematic analysis was conducted on data collected during face-to-face interviews. Fourteen parents of children with ASD were recruited using purposive sampling. Researchers employed a teamwork approach for data analysis to increase the dependability and consistency of the transcribed interviews. Team members discussed coding and identified the themes collaboratively. Taiwanese parents of children with ASD coped with the psychological impacts of parenting by employing problem-focused and emotion-focused strategies. Problem-focused strategies included communication, support, and management, whereas emotion-focused strategies included acceptance and adaptation. Findings showed that both coping strategies were useful in addressing specific situations and circumstances. Social and clinical support improved parents' mental health and children's external behaviors. Healthcare providers should evaluate how parents are coping with the stresses related to raising a child with ASD and consider the cultural factors that might influence how they accept and adapt to parenting children with ASD. Understanding these variables may be used to tailor strategies appropriate to reducing stress and improving the well-being of parents and their children. Support and resource referrals should be considered, including parent support groups, books, web-based services, and recommendations for professional consultations with social workers or therapists.

Purpose: The study aimed to evaluate the level of disaster awareness and preparedness of the employees in a Higher Education Institution. It also determined the relationship between variables and the factors that influence disaster awareness and preparedness. Method: The study used a descriptive-correlational design utilizing both quantitative and qualitative approaches in determining the level of disaster awareness and preparedness of the 212 employees in a higher education institution which utilized a complete enumeration. There were 30 randomly selected participants involved in the interview. The study utilized a researcher-made questionnaire and a validated tool to evaluate the level of disaster awareness and awareness. Both questionnaires were pre-tested using Cronbach’s reliability testing. The study also utilized an interview guide question on factors that influence disaster awareness and preparedness. The study was analyzed using simple percentage, weighted mean, chi- square and spearman rant test. Thematic content analysis was used to interpret and analyze qualitative data. Results: The employees are partially aware and partially prepared on disaster. Age, length of service and number of related trainings and seminars attended were found to have a significant relationship with the level of disaster awareness. The level of disaster preparedness was found no significant relationship to the profile. The factors that facilitate disaster awareness are trainings and seminars, disaster manual, information campaign, and warning signs. The facilitating factors for disaster preparedness are disaster drills, emergency equipment, evacuation plan, and trainings and seminars. The hindering factors for disaster awareness are passive attitude, inadequate information, limited resources, and insufficient warning signs. The factors that hinder disaster preparedness are equipment and facility uncertainty, passive attitude, and dormant disaster risk reduction team.

Current disaster knowledge, skills, and preparedness levels need to be evaluated to guide plans to strengthen disaster readiness. This study aimed to explore the Jordanian staff nurses' perception regarding their familiarity, attitudes, and practices for disaster preparedness (DP) to reduce the negative impacts of disasters. This is a cross-sectional, quantitative, descriptive study. The study was conducted on nurses working at governmental and private hospitals in Jordan. A convenience sample of 240 currently working nurses was recruited to participate in the study. The nurses were somewhat familiar with their role in DP (2.9 ± .84). The nurses' overall attitude towards DP was 2.2 ± 0.38, indicating that respondents had medium attitude levels. A low practice level for DP (1.59 ± 0.45) was also observed. Among the studied demographic variables, there was a significant relationship between experience and prior training with improved familiarity and practices. This indicates a need for strengthening nurses' practical skills as well as their theoretical knowledge. However, there is only a significant difference between attitude scale scores and disaster preparedness training (f = 10.120; p=0.002). The study findings support the need for more training (academic and/or institutional) to increase and improve nursing disaster preparedness locally and globally.

A substantial barrier to improving disaster preparedness in Australia is a lack of prescriptive national guidelines based on individual hospital capabilities. A recent literature review revealed that only one Australian hospital has published data regarding its current preparedness level. To establish baseline levels of disaster knowledge, preparedness, and willingness to respond to a disaster among one hospital's staff, and thus enable the implementation of national disaster preparedness guidelines based on realistic capabilities of individual hospitals. An anonymous questionnaire was distributed to individuals and departments that play key roles in the hospital's external disaster response. Questions concerned prior education and experience specific to disasters, general preparedness knowledge, perceived preparedness of themselves and their department, and willingness to respond to a disaster from a conventional and/or chemical, biological, or radiological incident. Responses were received from 140 individuals representing nine hospital departments. Eighty-three participants (59.3%) had previously received disaster education; 53 (37.9%) had attended a disaster simulation drill, and 18 (12.9%) had responded to an actual disaster. The average disaster preparedness knowledge score was 3.57 out of 10. The majority of respondents rated themselves as "not really" prepared and were "unsure" of their respective departments' level of preparedness. Most respondents indicated a willingness to participate in both a conventional incident involving burns and/or physical trauma, and an incident involving chemical, biological or radiological (CBR) weapons. Australian hospital staff are under-prepared to respond to a disaster because of a lack of education, insufficient simulation exercises, and limited disaster experience. The absence of specific national standards and guidelines through which individual hospitals can develop their capabilities further compounds the poverty in preparedness.

Background: More than 2.6 billion people have been impacted by natural disasters in the past ten years, including earthquakes, tsunamis, landslides, cyclones, heat waves, floods, and extreme cold. These catastrophes result in large numbers of casualties, which might strain local medical facilities and during such times medical interns can be a crucial asset in managing the issues at the hospital. The aims of disaster preparedness in the hospital are to lower morbidity and mortality, quickly offer victims with medical support, and aid in a quick and complete recovery. The objectives of this study was to assess the knowledge, attitudes, and practices of medical interns regarding disaster preparedness in a tertiary care hospital. Methods: A cross-sectional study was carried out among medical interns from a tertiary care hospital in a metropolitan city between September and November 2022. Medical interns were interviewed using a pre-tested semi-structured questionnaire on disaster preparedness and non-probability volunteer’s opt-in sampling technique was adopted. Responses were entered and analysed in Microsoft Excel. Results: 180 interns responded to the questionnaire, majority of them exhibited some basic knowledge of disaster plan and preparedness in the hospital. Their awareness and attitude for the disaster plan were significantly positive. The practices regarding disaster preparedness training and performance of drills were largely negative. Conclusions: The study participants had an understanding of disaster preparedness and plans; however, they were lacking in knowledge regarding of their roles during drill. Practices regarding the disaster preparedness training and performance of drills were inadequate.

Disasters have a huge impact on humans, environment and economy throughout the globe. Preparedness for disasters is critical for individuals, households, businesses, organizations and communities, but many remain unprepared. India has been vulnerable to a large number of natural and human-made disasters on account of its unique geo-climatic and socio-economic conditions. The study was conducted to evaluate the effectiveness of awareness programme on knowledge regarding disaster preparedness for common natural disasters among the adults residing at selected rural areas of Dehradun, Uttarakhand. A quasi experimental study using non-equivalent control group pre-test post-test design was used. Purposive sampling technique was used to select 80 adults: 40 each in control group and experimental group. Data was collected using structured knowledge questionnaire. Collected data was analyzed by descriptive and inferential statistics using SPSS-16 programme. The findings showed that the pre-test mean knowledge score among the adults of control group was 15.88 and experimental group was15.35. The post-test mean knowledge score among the adults of control group was 16.02 whereas in experimental group it was 30.05. In post-test, in control group, maximum 62.5 % adults had average knowledge, 30% had poor knowledge and 7.5% had good knowledge, whereas in experimental group, maximum 82.5% adults had good knowledge, 17.5% had average knowledge and none had poor knowledge. Hence it was concluded that the awareness programme had significant impact on improving knowledge of adults regarding disaster preparedness for common natural disasters.