Identifying mitigation strategies of comprehensive health centers against dust hazard: a qualitative study in Iran.

BACKGROUND: Exposure to dust can disrupt healthcare services and severely affect all activity domains of the health system. The aim of this study was to explore mitigation strategies for comprehensive health centers against dust hazard. METHOD: The present study was conducted using a qualitative design with a conventional content analysis approach in 2023. The participants in this study were managers and staff of comprehensive health centers and experts in health in disasters and emergencies in Kerman, Bam, Regan, and Ahvaz. Data were collected through interviews. Data collection continued until data saturation. The collected data were analyzed based on the steps proposed by Graneheim and Lundman. Participants' statements, after recording and transcribing, were categorized into semantic units. Data were analyzed by using MAXQDA software version 2020. RESULTS: The analysis of the data with 23 participants revealed 106 Codes, 13 sub- categories and 5 main categories including: (A) reducing the impact of dust hazards, (B) management functions, (C) empowerment and performance improvement, (D) maintaining and promoting safety, and (E) Inter-sectoral coordination to implement mitigation strategies. CONCLUSION: The findings showed that the mitigation strategies and solutions can be used by health policymakers and planners to reduce the impact of dust hazard, empower and motivate healthcare staff, develop training protocols to enhance risk perception of the staff and members of the community, create the necessary infrastructure for adoption of effective mitigation strategies in healthcare centers to create resilience and continue service delivery.

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.

Nurses' challenges for disaster response: a qualitative study.

BACKGROUND: Healthcare providers, particularly nurses, play a critical role in mitigating the impact of disasters on victims and the healthcare system. However, nurses face unique challenges in disasters that may not experience in their daily practice, which can make it harder for them to deal with disasters efficiently. This study aimed to investigate the challenges faced by nurses for disaster response. METHODS: A qualitative content analysis approach was used in this study. Purposeful sampling was used to select 24 nurses working in the emergency departments of hospitals in Kerman, southeastern Iran. Data were collected through semi-structured interviews and analyzed using MAXQDA10. The conventional content analysis method proposed by Graneheim and Lundman was used to analyze the data. RESULTS: The analysis of the findings resulted in one major category, insufficient ability of nurses to respond to disasters, and five subcategories: diverse nursing conditions during disasters, inappropriate interactive platform during disasters, the presence of obstacles to teamwork, lack of platform for nurses to acquire adequate disaster risk management competence, and moral tension in complex disaster situations. CONCLUSIONS: Determining the challenges that nurses face during disasters is essential for improving disaster response efforts, promoting disaster preparedness, ensuring appropriate care for patients, and reducing emotional fatigue among nurses. Finally, nursing leaders, healthcare policymakers and governments should use these findings to better support the nursing workforce in disasters.

Nursing students' patient safety competencies in the classroom and clinical settings: a cross-sectional study.

INTRODUCTION: Patient safety is one of the critical indicators of providing qualified and high-quality health care services. Determining nursing students' patient safety competencies will significantly contribute to the literature. Therefore, this study aimed to investigate Iranian nursing students' patient safety competencies in classroom and clinical settings. METHODS: In this cross-sectional study data were collected from 215 nursing of a university of medical sciences between February and May 2022, using a general questionnaire form and the Health Professional Education in Patient Safety Survey. Data analysis was done using descriptive and analytical statistics such as percentage, mean and paired-samples t-test. RESULTS: The mean scores of nursing students' the Health Professional Education in Patient Safety Survey were 3.50 ± 0.55 in the classroom and 3.45 ± 0.57 in the clinical setting. The highest mean scores of nursing students were in subdimension of "clinical safety" in both the clinical (3.91 ± 1.13) and classroom settings (3.91 ± 0.78). In addition, a statistically significant difference was found in patient safety learning confidence in the classroom versus clinical setting in the "culture of safety" subdimension. CONCLUSION: It appears that current educational programs provide opportunities to improve nursing students' patient safety, but they are not enough. Nurse educators should apply new teaching methods and evaluate clinical strategies to meet educational needs.

Is nurses' clinical competence associated with their moral identity and injury?

BACKGROUND: The enhancement of nursing care quality is closely related to the clinical competence of nurses, making it a crucial component within health systems. OBJECTIVE: The present study investigated the relationship between nurses' clinical competence, moral identity, and moral injury during the COVID-19 outbreak. RESEARCH DESIGN: This cross-sectional study was carried out among frontline nurses, using the Moral Identity Questionnaire (MIQ), the Moral Injury Symptom Scale-Healthcare Professionals version (MISS-HP), and the Competency Inventory for Registered Nurse (CIRN) as data collection tools. PARTICIPANTS: and research context: The research population for this study consisted of all frontline nurses (n = 251) employed in a hospital in southern Iran. Sampling was conducted between May 1, 2021 and September 30, 2021, during the COVID-19 outbreak. ETHICAL CONSIDERATIONS: The present study received approval from the research ethics committee of Rafsanjan University of Medical Sciences, with project No. 99267 and code of ethics ID No. IR. RUMS.REC.1399.262, dated 15.02.2021. RESULTS: According to the study findings, 42.2% of the nurses demonstrated high clinical competence, while 51.4% exhibited moderate clinical competence. The results indicated a positive correlation between moral identity and clinical competence but a negative correlation between moral injury and clinical competence. Furthermore, the variables of moral identity and moral injury were found to predict 10% of the variance in clinical competence. CONCLUSION: According to the results, moral identity and moral injury had an impact on the clinical competence of nurses. Therefore, implementing a program aimed at enhancing moral identity and providing training strategies to address moral injury during crises like the COVID-19 pandemic can lead to improvements in nurses' clinical competence and the overall quality of care they provide.

Anxiety, self-efficacy, and their determinants in school students during the COVID-19 pandemic: a survey in Southeastern Iran.

BACKGROUND: The COVID-19 pandemic has been linked to various psychological disorders, including anxiety, particularly among the general public. It is crucial to monitor the mental health of school students, who are considered a vulnerable group in society, and assess their self-efficacy, as it can significantly affect their mental health. This study aimed to investigate the levels of anxiety and self-efficacy among school students during the COVID-19 pandemic. METHODS: This cross-sectional study utilized convenience sampling to examine a sample of 335 school students from Sistan and Baluchestan province in southeastern Iran. An online questionnaire, distributed through social media platforms, was used to collect data. The questionnaire included demographic information, COVID-19 related items, the Multidimensional Anxiety Scale for Children-MASC, and the Self-Efficacy Questionnaire for Children-SEQ-C. Data analysis was conducted using IBM SPSS version 24, with a significance level set at < 0.05. RESULTS: The study revealed a significant negative correlation between children's anxiety and self-efficacy (r = -0.23, P < 0.001). Several factors were identified as predictors of anxiety, including low self-efficacy (ß = -0.29, P < 0.001), female gender (ß = 0.27, P < 0.001), concern about family members contracting COVID-19 (ß = 0.18, P < 0.001), persistent advice of others to adopt preventive measures (ß = 0.14, P < 0.005), level of education (ß = -0.12, P < 0.017), and perceived risk of COVID-19 infection (ß = -0.11, P < 0.030). These variables collectively accounted for 17% of the variance in anxiety. CONCLUSION: The findings of the study highlight the importance of addressing the mental health of school students, specifically their anxiety levels, during epidemics. The results also indicate that enhancing self-efficacy among students during a pandemic could be a beneficial strategy for promoting their mental health.

Effectiveness of an online training program for improving nurses' competencies in disaster risk management.

BACKGROUND: Nurses' incompetency in disaster risk management can have many negative consequences during disasters, so it is important to prepare nurses and improve their competencies in disaster risk management. This study was conducted with the aim of investigating the effectiveness of an online training program to improve competencies in disaster risk management. METHOD: This interventional study was conducted on nurses working in a specialized trauma hospital affiliated with the Kerman University of Medical Sciences in southeastern Iran in 2023. Eighty-one nurses were randomly assigned into two interventions (n = 42) and control groups (n = 39). The intervention group received an online training program in four sessions, and both groups electronically completed the demographic questionnaire and the nurses' perceptions of disaster core competencies scale (NPDCC) before and one month after the intervention. RESULTS: The study results showed no significant difference in disaster competency scores between the two groups before the intervention (p < 0.51), but the NPDCC score in the intervention group was statistically significant after the intervention compared to before the intervention (p < 0.02) and no statistically significant difference was observed between the two groups after the intervention (p < 0.16). CONCLUSION: While the online training program was found to significantly improve the NPDCC score of nurses in the intervention group, this increase was not significant when compared to the control group. Therefore, we suggest continuous practical exercises and maneuvers to improve nurses' perception of the competencies required for effective disaster management.

Exploring coping strategies of emergency medical technicians against COVID-19 stress: a qualitative study.

Introduction: The COVID-19 pandemic has been shown to cause enormous psychological burden among health care workers, including first responders. However, the psychological well-being of first responders, essential in the fight against COVID-19 pandemic, has often been ignored. This qualitative study aimed to explore the coping strategies used by EMTs to manage stress during the pandemic. Methods: The research was designed as a qualitative study, utilizing a thematic analysis framework. Semi-structured interviews were conducted with 15 EMTs from a single geographic area between September 2022 and December 2022. The data were analyzed using Braun and Clarke analytic techniques, and this study used Lincoln and Guba's to assess the reliability of the data. Results: Four main coping strategies emerged from the data: seeking social support, practicing self-care, utilizing coping mechanisms, and finding meaning and purpose in work. EMTs sought support from both professional and personal sources, engaged in physical and emotional self-care, used humor and distraction as coping mechanisms, and found meaning and purpose in helping others and growing as professionals. Conclusion: Based on the extracted results from the study on EMTs in Iran, it can be concluded that the importance of social support cannot be overstated, as it serves as a crucial buffer against the negative effects of stress and trauma. The findings suggest that addressing the social and emotional needs of EMTs is important for promoting their mental health and well-being during the pandemic.

Iranian nurses' perceptions of core competencies required for disaster risk management.

BACKGROUND: With an increase in the incidence and severity of disasters, disaster risk management receives an important priority in the health system. Nurses at all levels of healthcare play an important role in disaster risk management and they must have core preparation and competencies to respond to disasters. This study aimed to evaluate Iranian nurses' core competencies required for disaster risk management. METHODS: This cross-sectional study was conducted on 277 nurses working in three hospitals affiliated to Kerman University of Medical Sciences in 2022. The demographic information questionnaire and the nurses' perceptions of disaster core competencies scale (NPDCC) were used to collect data, and SPSS21 was used to analyze data. RESULTS: Nurses' competencies in disaster risk management were favorable (3.67 ± 0.77), with the subscales of technical skills and special diagnostic skills receiving the highest (3.91 ± 0.65) and the lowest mean scores, respectively (3.46 ± 0.87). The results found a significant difference between the scores of nurses' competencies in disaster risk management in terms of education level, age, work experience, employment status, participation in training courses related to disaster risk management, work experience in incidents and disasters. CONCLUSION: The study results suggested nurses' high level of competency in disaster risk management, but indicated gaps in their core competencies. The study results recommend authorities provide various training courses related to disaster risk management for all nurses.

Heat waves and adaptation: A global systematic review.

BACKGROUND: Given the increasing trend of global warming and extreme weather conditions, including heat waves and its effects on health, the present study was done to investigate adaptive behaviors of communities in the world for combating heat waves. METHOD: ology: In this systematic review, out of 1529 results, 57 relevant and authoritative English papers on adaptation to heat waves hazard were extracted and evaluated using valid keywords from valid databases (PubMed, WOS, EMBASE, and Scopus). In addition, multiple screening steps were done and then, the selected papers were qualitatively assessed. Evaluation results were summarized using an Extraction Table. RESULTS: In this paper, the adaptive behaviors for combating heat waves hazard were summarized into 11 categories: Education and awareness raising, Adaptation of critical infrastructure, Governments measures, Health-related measures, Application of early warning system, Protective behaviors in workplace, Physical condition, Adaptive individual behaviors, Design and architecture of the building, Green infrastructure (green cover), and Urban design. CONCLUSION: The findings of this study showed that community actions have significant effects on adaptation to heat wave. Therefore, for reducing heat wave-related negative health effects and vulnerability, more attention should be paid to the above-mentioned actions for mitigation, preparation, and responding regarding heat waves. PROSPERO REGISTRATION NUMBER: CRD42021257747.

Factors related to earthquake preparedness of households based on social-cognitive theory constructs: A systematic review.

Background: Earthquakes cause many casualties worldwide. Taking preventive measures and improving community preparedness is critical to reducing earthquake damage. The social cognitive theory explains how individual and environmental factors cause behavior. This review was conducted to identify the social cognitive theory structures, in research on the preparedness of households against earthquakes. Materials and methods: This systematic review was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A search was conducted from January 1, 2000, to October 30, 2021 in Web of Science, Scopus, PubMed, and Google Scholar. Studies were selected based on inclusion and exclusion criteria. The initial search yielded 9,225 articles, and finally, 18 articles were selected. Articles were assessed using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist. Results: Eighteen articles about disaster preparedness behaviors based on the socio-cognitive constructs were identified and reviewed. The essential constructs used in the reviewed studies included self-efficacy, collective efficacy, knowledge, outcome expectations, social support, and normative beliefs. Conclusion: By identifying the dominant structures that have been used in studies related to the preparedness of households against earthquakes, researchers can implement appropriate and more cost-effective interventions by focusing on improving suitable structures.

Post-traumatic stress disorder in medical workers involved in earthquake response: A systematic review and meta-analysis.

Introduction: Medical workers involved in responding to the earthquake are exposed to frightening scenes and witness dead bodies and severely injured moaning people, predisposing them to multiple mental health consequences. This study was aimed to determine the prevalence of Post-Traumatic Stress Disorder (PTSD) after earthquakes among medical workers using a systematic review and meta-analysis. Materials and methods: The review study was performed following PRISMA guidelines, and the study's protocol was registered in PROSPERO with the code CRD42022333069. The data resources of Google Scholar, Science Direct, Web of Science, PubMed, and Scopus were searched to specify the related studies. To perform meta-analysis, the random effects model was utilized, and the I2 index was considered to assess heterogeneity between studies. The STATA software was used for data analysis. Results: In the initial data resources search, 1399 articles were identified. From these articles, 13 were finally chosen for meta-analysis and quality assessment. The meta-analysis results indicated that the prevalence of post-earthquake PTSD among medical workers involved in the earthquake response was 16.37% (95% CI: 11.63-21.11, I2 = 97.33%, p = 0 < 0.001). Conclusion: The medical workers involved in response to the earthquake have a relatively high risk of PTSD in the short and long term. Therefore, medical workers involved in response to disasters should undergo screening for mental health disorders before and after disasters and receive the necessary training with regard to stress management, psychological resilience, and how to express their feelings and emotions.

Social vulnerabilities among immigrants and refugees in emergencies and disasters: a systematic review.

Background: Due to cultural, economic, and societal factors, immigrants and refugees are pivotal groups in dealing with social vulnerability in disasters. Ignoring or inadequate attention to those groups in preparing for and responding to disasters and health emergencies could decrease the effectiveness of efforts. This article aims to identify the most basic social vulnerabilities among immigrants and refugees and provide effective solutions to alleviate or eliminate these vulnerabilities. Methods: This systematic review was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The main keywords include Social Vulnerabilities, Immigrants, Refugees, and Disasters. All articles published up to February 2023 were reviewed regardless of language and location. A total of 575 articles were extracted from SCOPUS, Web of Science, ScienceDirect, ProQuest, PubMed, EMBASE, and PsycINFO databases, and finally, 14 articles were selected for full-text analysis. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) was used to evaluate the quality of the selected articles. Results: Fourteen articles including 4 qualitative and 10 quantitative articles were selected and analyzed in this review. The findings showed: 1. According to the consensus of the studies, the most vulnerable people who need urgent care during an epidemic due to their special conditions are immigrants and refugees; 2. In most countries, no database provides reliable, up-to-date, and accurate statistics about these people; 3. Refugees usually hesitate to express their vulnerability and receive services due to the fear of deportation; and 4. The main challenges faced by refugees are socio-economic problems such as language problems, lack of emotional and social support, and living in crowded places. Conclusion: Considering the prevalence of migration among countries, it is essential to identify the social problems and vulnerabilities of immigrants and provide effective solutions to cope with their challenges, especially during crises and emergencies. Systematic review registration: https://clinicaltrials.gov/, identifier CRD42022371345.

The viewpoints of residents of Kerman, Iran regarding the challenges and barriers of preparing households against earthquakes: A theory-guided qualitative content analysis.

Introduction: Earthquakes cause a lot of damage and casualties. For various reasons, most households are not prepared for earthquakes. This study aims to identify the challenges and barriers to households' preparedness against earthquakes from the viewpoint of Kerman residents. Methods: This qualitative-directed content analysis study was conducted from December 2021 to May 2022 in the city of Kerman in southeast Iran. Data was collected by purposive sampling through in-depth and semi-structured individual face-to-face interviews with 48 households. Results: After multiple rounds of analyzing and summarizing the data based on the social-cognitive theory and taking into consideration similarities and differences, five main categories and 19 subcategories created based on the results of data analysis and including (1) Challenges related to cognitive factors (2) Challenges related to behavioral factors (3) Challenges related to the physical environment (4) Challenges related to the social environment and (5) Challenges related to financial factors. Conclusion: Although the participants listed many challenges and barriers in different fields, in order to overcome the barriers and challenges of preparing households for an earthquake, the support of the authorities and the cooperation of the residents are necessary.

Heat wave adaptation paradigm and adaptation strategies of community: A qualitative phenomenological study in Iran.

BACKGROUND: Heat wave adaptation is a new concept related to experiencing heat. The present study aims at investigating a conceptual definition, that is, the mental framework of heat wave adaptation and its strategies. MATERIALS AND METHODS: A phenomenological study was performed to explain the mental concept. At the same time with the data collection process, data analysis was also performed using Colaizzi method. Semi-structured interview method and purposeful sampling with maximum variety were used. Interviews were conducted with 23 different subjects in the community. The accuracy of the data was guaranteed using Lincoln & Guba scientific accuracy criteria. RESULTS: The two main themes of the adaptation paradigm as well as its strategies were divided into the main categories of theoretical and operational concepts, as well as personal care measures and government measures. Under the category of individual measures, we obtained "clothing, nutrition, building, place of residence and lifestyle," and under the category of governance actions, the "managerial, research, health, organizational" subcategories were obtained. CONCLUSION: According to the results of the conceptual-operational definition, heat wave adaptation is an active process and an effort to reduce the adverse effects of heat waves on individual and social life, and striking a balance that will not only result in individual awareness and actions that will lead to lifestyle changes, but also mostly requires integrated and comprehensive planning in the community. On the one hand, heat waves could not only be regarded as a threat or danger, but can also become an opportunity for the development of a community through identification and smart measures, and for adaptation, the community must take it as a risk. The community should have a plan in advance, apply the necessary rules and training, and use the new facilities and rules where necessary. This practical concept definition includes the main features of heat wave adaptation.