Health in Emergencies and Disasters Quarterly
Year:2017 | Volume:2 | Issue:4|Papers Count:7

1. Introduction Hajj is one of the most important religious ceremonies of Muslims that is held in Saudi Arabia every year. However, trauma is the most important factor of mortality in this ceremony. …

Background: Disasters are stressful events not only for individuals who suffer from personal loss but also for the community at large. It seems necessary to study the mental health of the community in disaster situations so as to endorse their health, care planning and prevent disorders. A pure understanding of the community mental health preparedness, based on the experiences and perceptions of involved people is necessary in order to attain this aim. The purpose of this article is to put forth a subjective and comprehensive description of community mental health preparedness in disasters.Materials and Methods: A qualitative inductive content analysis method was exploited since community mental health preparedness is a subjective, context bond and complex phenomenon, which is better described based on in-depth experience and perceptions of involved people. The study consisted of 14 participants including experts and lay people. Data were collected through in-depth, semi-structured interviews. All interviews were transcribed and data analysis was accomplished based on qualitative inductive content analysis principles.Results: From the analysis of the data content, 5 themes were explored including 1) Cultural values and beliefs; 2) Risk beliefs; 3) Mental preparedness in disasters; 4) Psychological process; 5) Trust.Conclusion: Mental health preparedness is a multifactorial phenomenon that requires a clear understanding and definition of perceived threats, public trust on social structure and formal and informal supportive organization. This preparedness involves proportional, mental, social, familial, religious beliefs, and cultural sensitivity along with the ability to handle mentally disastrous situation, which can be measured after concept analysis and tool development process.

Background: Iran is exposed to a wide range of natural hazards. The occurrence of unexpected disasters and incidents is mostly destructive and devastating. In such circumstances, the community’s ability to meet healthcare needs and demands experiences great challenge.Hospitals are the primary healthcare providers in the communities, and their preparedness is crucial in saving lives during a disaster. Given the importance of hospital risk management program, in this study, we examined the effect of comprehensive risk management on the preparedness of Rofeide Rehabilitation Hospital.Materials and Methods: This is a pretest–posttest quasi-experimental study. The data were assessed by National Standard Tool through nine components. Before the intervention, the hospital preparedness was assessed using the standard tool through interviews and observations and also completed with the cooperation of Hospital Risk Management Committee. The intervention was designed in two parts including holding a two-day workshop on hospital preparedness for senior managers of hospital and nursing managers. In the next step, the risk assessment, preparation of response plan, and establishment of incident command system were conducted. At the end, the hospital preparedness was compared linearly before and after the intervention.Results: The hospital preparedness increased from poor to a moderate level by 48 points. Six out of 9 hospital preparedness components including command and control, communications, increased capacity, the continuation of vital services, procurement and logistics, and recovery after disasters were found to be improved after the intervention, and only three components including safety and security, triage, and staffing did not significantly improve.Conclusion: Considering the positive impact of the implementation of the risk management program on the preparedness of Rofeide Rehabilitation Hospital and promotion of its preparedness level from poor to moderate, as well as relatively high vulnerability of hospitals against internal and external risks, national hospitals are recommended to use the comprehensive hospital risk management model to be more prepared for disasters.

Background: Collaboration of patients in caring is regarded as a gold standard in professional care associated with modern nursing. Considering the complexity of the concept, it is imperative to analyze caring of patients with motor disability caused by traffic accidents.Materials and Methods: This is a qualitative study to analyze the concept of collaboration in caring for traffic casualties using a hybrid model in three stages. In the first stage, to conduct a systemic review, a literature search was performed using databases such as Blackwell, CINAHL, MEDLINE, and Elsevier with the key word Collaboration in caring and orthopedic victims of traffic accidents. The literature search resulted in 110 related reviews up to 2016.In the second stage or field stage, for the importance of collaboration in caring for traffic casualties, 7 traffic victims and 3 nurses were interviewed and data were analyzed by content analysis. Finally, in the third stage, an overall analysis was performed according to the findings in previous stages.Results: Combining the results of reviews and findings of field study, we obtained 87 codes, 14 subcategories, and 5 categories (“organizational factors in sharing information and knowledge”, “promoting a sense of responsibility in patient”, “patient empowerment for health promotion”, “mutual trust”, and “hypersensitivity to active engagement to return to normal life”) in content analysis.Conclusion: Recognizing the concept of collaboration of patient with motor disability in caring from the orthopedic viewpoint, managers and nurses will be able to plan and execute management and educational activities according to the insight obtained from scientific findings to provide suitable conditions in this regard.

Background: Every year, accidents and disasters occur in Iran and result in death and injuries of common people. People’s demand for health care units involves not only the requirement for medical centers but also staffs to work in them. Therefore, the purpose of this study is to investigate the performance readiness and non-structural functional safety of different health care centers and units of Kermanshah University of Medical Sciences in dealing with natural disasters.Materials and Methods: This is a cross-sectional descriptive and analytical study conducted in connection with the non-structural safety status of 837 health care centers and facilities at the headquarters of Kermanshah University of Medical Sciences in 2015. Established checklists were distributed among 24 assessment teams and completed by trained experts after assessing the status quo of the health units with relevance to the checklist.Results: The results showed that in terms of natural hazards, the highest and lowest likelihood of occurrences were related to earthquake (75%) and landslide (20%), respectively. In the field of functional readiness of health units and various other departments at the headquarters of health centers, fire extinguishing section had the highest percentage of readiness with 68%.However, the risk reduction measures and health insurance coverage had the lowest percentage of readiness in responding to disasters with 3% and 0%, respectively. The non-structural sanitary homes recorded 48% of readiness, whereas the network headquarters and health centers recorded 35% of readiness, which denoted the highest and lowest rate in the context of vulnerability, respectively.Conclusion: In general, the results showed that the average performance percentage and non-structural vulnerability of health units and various other departments are moderate at the headquarters of health centers. According to the study results, disasters like earthquake, dust, flood, and landslide frequently required preparedness in the whole region.

Background: In the case of a disastrous event, stress and anxiety often result in psychological diseases such as depression and post-traumatic stress disorder. Health care providers even suffer from such disaster-related disorders. Psychological complications can negatively influence their ability in providing care. Thus, this study aimed to examine the reliability and validity of the Persian version of Readiness for Events with Psychological Emergencies Assessment Tool (REPEAT).Materials and Methods: This cross-sectional study was designed to validate the Persian version of REPEAT. Data were gathered from 140 managers and staff members of select university hospitals in Tehran, Lorestan, and Semnan Provinces through convenient sampling.They were invited to complete REPEAT, which comprised 7 dimensions and 28 statements.Then, the qualitative content, construct validity, and reliability were determined.Results: In exploratory factor analysis, seven factors (including internal organizational structure and chain of command, resources and infrastructure, knowledge and skills, coordination with external organizations, risk assessment and monitoring, psychological support, and communication and information sharing) were extracted. The following eigenvalues were recorded for these seven factors: 3.59, 3.41, 2.78, 2.61, 2.94, 2.40, and 1.39, respectively.The results of Cronbach’s alpha showed that the internal consistency of the Persian version of REPEAT was 0.805. The intraclass correlation coefficient was found to be 0.809 (CI95: 0.501-0.903, P<0.001).Conclusion: The results of data analysis revealed that this instrument is highly reliable and valid and can be used as an appropriate tool to measure psychological preparedness of hospitals. However, further validation is needed.

Ebola is an infectious disease, which is caused by a virus belonging to the Filoviridae group.The outbreak of the disease in the African countries in 2015 caused massive death and contamination of the healthcare personnel those who were engaged in treating the infected patients and caused irreparable damage to the healthcare system. In this study, the vulnerability of the team of health service providers during the Ebola outbreak in Liberia, Guinea and Sierra Leone is studied. The article also proposes solutions that can be learned as a lesson, help in increasing their resilience in similar biological hazards and planning management strategies for similar events in the future. Long before the outbreak took place, West African countries were already facing acute problems in terms of access to health services and health infrastructure.The most important shortcomings for the same were identified as insufficient number of health personnel and capacity shortage that prevented the people from being ready to deal with such uncalled events viz. accidents and epidemic disease outbreak. The Ebola epidemic exacerbated the persisting problems caused due to a shortage of personnel in these countries and caused the death of a large number of common people as well as healthcare personnel. Generally, the vulnerability of the health team working during the Ebola outbreak could be divided into five general dimensions: 1. Management weakness; 2. Lack of engineering and environmental control; 3. Obstacles in the use of personal protective equipment; 4. Not having enough skills and practice exercises; and 5. Ignoring the social factors and satisfaction of the healthcare personnel. The main theme of the study was failure to understand the risk of personnel in accidents and disasters. Findings revealed building capacity and reducing vulnerability of the healthcare personnel against disasters and epidemics depends upon the perceived risk, which is a decisive factor for any intervention. Maintenance of human resources is impossible unless with the sole aim of promoting resilience in various areas of management, health, environmental control, the proper use of personal protective equipment, teaching training, skill upgrading of personnel, and increased social and material support are achieved.