Skip to main content
NCBI home page
Wiley Open Access Collection logoLink to Wiley Open Access Collection
. 2024 Jul 8;72(1):e13020. doi: 10.1111/inr.13020

Disaster management competence, disaster preparedness belief, and disaster preparedness relationship: Nurses after the 2023 Turkey earthquake

Şenay Şermet Kaya 1,✉, Eylül Gülnur Erdoğan 2
PMCID: PMC11840655  PMID: 38973366

Abstract

Aim

To examine the relationship between nurses' competency levels in disaster nursing management, their disaster preparedness and disaster preparedness beliefs.

Background

Nurses’ competency in disaster nursing management makes disaster response easier. Factors that may affect this reason should be examined.

Methods

The study was conducted between April and July 2023 with nurses working in a province in the first‐degree earthquake zone in Turkey. The sample of the study consisted of a total of 207 nurses who were selected from primary, secondary, and tertiary care institutions by using the stratified sampling method. Data were collected with a personal information form, the Competencies for Disaster Nursing Management Questionnaire, the Disaster Preparedness Scale, and the General Disaster Preparedness Beliefs Scale. Mann–Whitney U and Kruskal–Wallis tests, Spearman regression coefficient, and multiple linear regression analysis were used to analyze the data.

Results

There was a positive correlation between nurses' competency levels regarding duties and responsibilities and their disaster preparedness levels. Having disaster‐related training also positively affected the level of competence in duties and responsibilities. Belief in disaster preparedness and having “partial” knowledge about the disaster had no relationship with competencies.

Discussion

According to the International Council of Nurses and current studies on disaster nursing, “competence areas” are among the priority study subjects.

Conclusion

According to the study results, disaster preparedness and having disaster‐related education are effective factors in nurses' competencies related to duties and responsibilities.

Implications for nursing policy

The results of this study may increase awareness in the healthcare system about nurses' disaster management competency levels and the factors that may affect this. It is recommended that disaster preparedness and disaster‐related education factors should be taken into account in the initiatives and policies to be planned to improve the duty and responsibility competence of nurses.

Keywords: Disaster management, disaster nursing, disaster preparedness

INTRODUCTION

Nurses’ competency in disaster response is very important in reducing the negative consequences on the health of people affected by disasters (Brewer et al., 2020). In 2009, the International Council of Nurses (ICN) identified four core competency areas that nurses should possess (ICN, 2009). However, in recent years, it has been recognized that these competency areas are inadequate for specialist nurses undertaking advanced practice or leadership roles in disaster nursing. Therefore, the ICN 2019 report highlighted the need for eight competency areas: “basic preparation and planning, communication, incident management systems, safety and security, assessment, response, rescue, and law and ethics” (ICN, 2019). In the Delphi study, which included practitioners, researchers, educators, and nurse leaders from 26 countries, it was stated that “areas of competency” should be among the priority subjects in nursing research on disaster management (Molassiotis et al., 2022). In the literature, there are many studies at the international level on nurses’ disaster‐related competencies (Chegini et al., 2022; Said & Chiang, 2020; Songwathana & Timalsina, 2021) but they are very limited in our country (Demirtaş & Altuntaş, 2023; Yorulmaz & Karadeniz, 2021). These national and international studies have shown that the competency levels of nurses are not at the desired level and need to be improved.

Nurses' competency in disaster nursing management facilitates disaster response. Factors that may influence this should be examined. There are some studies in the literature investigating the relationship between competencies and variables such as willingness to participate in disaster response (Choi & Lee, 2021), self‐efficacy, and disaster experience(Mousavi et al., 2020). Additionally, the importance of pre‐disaster preparation has been emphasized to ensure that nurses can perform their duties competently and respond quickly in the event of a disaster (Koçak & Serin, 2023; Said & Chiang, 2020; Songwathana & Timalsina, 2021). For example, Chegini et al. (2022) reported a positive relationship between disaster preparedness and disaster basic competence perception but noted gaps that still need to be addressed between these two variables. In Murphy et al. (2021), nurses' disaster preparedness levels were found to be low, yet they rated their disaster competence as close to good in their self‐evaluation. A systematic review reported that nurses were not adequately prepared for disasters and did not feel confident in responding effectively (Labrague et al., 2018). It is also known that beliefs are among the motivating and activating factors in the development of disaster preparedness behaviors (Baytiyeh & Naja, 2016; Vildan & Cengiz, 2020). Being sensitive to disaster preparedness behaviors, valuing them, believing in their benefits, understanding barriers to their implementation, and having self‐confidence in performing the behaviors can all be decisive in disaster preparedness (Choi & Lee, 2021; Inal & Dogan, 2018). These results indicate that there is insufficient evidence regarding disaster‐related competence, readiness, and belief variables. Moreover, there is no literature examining these three variables together (Chegini et al., 2022; Said & Chiang, 2020).

Increasing nurses' competencies in disaster preparedness and response plays an important role in reducing disaster‐related mortality and morbidity (Yüksel, 2018). Studies conducted worldwide have shown that most nurses are not ready to cope with disasters and lack the necessary preparation, training, and skills for an appropriate response (Labrague et al., 2018). This situation reveals the existence of a significant global problem. Studies conducted in Turkey also support similar findings. It has been revealed that nurses are generally not prepared for disasters and consider themselves inadequate in meeting the necessary basic competencies (Taşkıran & Baykal, 2017).

Nurses' preparedness for disasters plays a critical role in coping with the increasing number of disasters worldwide and in efforts to reduce their negative consequences on affected societies. Therefore, assessing the adequacy of nurses' preparedness for disasters and identifying areas for improvement are essential to ensure that nurses are adequately equipped for such events. This is crucial for nurses to effectively intervene in disaster situations and participate in the emergency management and coordination of health services. The findings of this study can raise awareness among health system managers, particularly in hospitals, about the levels of nurses' competency in disaster management and the factors that may influence it. This awareness can facilitate the planning of interventions aimed at enhancing nurses' competencies. Consequently, such interventions can help prevent crises in healthcare systems during emergencies (Sheikhbardsiri et al., 2021).

The aim of this study was to determine the disaster preparedness beliefs, readiness, and disaster preparedness competencies of nurses.

Research questions

  • What is the disaster management competency level of nurses?

  • What is the general disaster preparedness level of nurses?

  • What is the general disaster readiness belief level of nurses?

  • Is there a relationship between nurses' disaster management competency levels and their disaster preparedness levels?

  • Is there a relationship between nurses' disaster management competency levels and their disaster readiness beliefs?

METHODS

Population and sample of the study

The population of this descriptive research consisted of 661 nurses working in primary, secondary, and tertiary healthcare institutions affiliated with Bilecik Provincial Health Directorate. The sample size was calculated as 244 nurses by using the sampling of the known population formula and based on a margin of error of 5% and a confidence interval of 95%. The sample size was planned to include 80 nurses from primary care, 82 from secondary care, and 82 from tertiary care by using the stratified sampling method, and the study was completed with a total of 207 nurses. Inclusion criteria were working in a primary/secondary/tertiary healthcare institution and volunteering to participate in the research.

Data collection

Study data were collected online between April 25 and July 27, 2023 (two and a half months after the large Kahramanmaraş earthquakes) to facilitate nurses' participation in the research due to their busy working conditions (Kocaman et al., 2018; Ozvurmaz & Öncü, 2018). The link to the questionnaire was sent to nurses online through the management of each health institution. The questionnaire (https://forms.gle/FDTR5u2y5MRNLDHE7) included standardized instructions about the purpose of the study and the procedure for completing the survey. Participants were allowed to submit the questionnaire when all questions were answered. Therefore, there were no incomplete or partially completed questionnaires.

Data collection tools

Personal information form

This form was developed by the researchers following a review of the literature (Durgut, 2019; Inal & Dogan, 2018) and consisted of 15 questions about nurses' sociodemographic characteristics (age, gender, unit, etc.) and disaster‐related knowledge (disaster education, disaster experience, disaster‐related tasks/work, etc.). 

The General Disaster Preparedness Belief Scale (GDPBS)

This scale was developed by Inal and Dogan (2018). It is a five‐point Likert‐type scale consisting of 31 items and 6 subdimensions. Subdimensions of the scale are perceived susceptibility, perceived seriousness, perceived usefulness, perceived barriers, action drivers, and self‐efficacy.  It has no cutoff point. Scores on the scale vary from 31 to 155. The score range of the subdimensions is as follows: self‐efficacy subdimension, 8–40; action‐activators subdimension, 5–25 points; perceived sensitivity subdimension, 6–30 points; perceived obstacles subdimension, 6–30 points; perceived usefulness subdimension, 3–15 points; perceived seriousness subdimension, 3–15 points. Cronbach's alpha (α) value is 0.93 for the total scale and varies between 0.74 and 0.90 for the subscales. It was found to be 0.68 in this research. As the score obtained from the scale increases, the level of disaster preparedness belief increases, too.

The Disaster Preparedness Scale (DPS)

This scale was developed by Sentuna and Fahri (2020). It is a four‐point Likert‐type scale with 13 questions and 4 subdimensions. The subdimensions of the scale are disaster physical protection, planning, disaster assistance, disaster warning, and signals.  The items on the scale are scored as “definitely yes: 3.21–4.00,” “yes: 2.41–3.20,” “no: 1.61–2.40,” and “definitely no: 0.81–1.60.” The minimum score from the scale is 13 and the maximum is 52. Cronbach's alpha (α) value is 0.82 for the total scale, and it was found to be 0.88 in this study. High scores on the scale show high levels of disaster preparedness.

Competencies for Disaster Nursing Management Questionnaire (CDNMQ)

This scale was developed by Al Thobaity et al. (2016) and adapted into Turkish by Durgut (2019). It is a 10‐point Likert‐type scale consisting of 43 items and three subdimensions. Subdimensions of the scale are duties and responsibilities of nurses in disaster management, core competencies of nurses in disaster management, and barriers to developing core competencies. The score range of the subdimensions is as follows: responsibilities of nurses in disaster management subdimension, 5–50 points; core competencies of nurses in disaster management subdimension, 30–300 points; barriers to developing core competencies subdimension, 8–80 points. Scores on the total scale range from 43 to 430. Cronbach's alpha (α) value was 0.96 for the total scale and between 0.88 and 0.98 for the subscales. The alpha value was found to be 0.98 for the total scale in this research.

Ethical consideration

Before the study was initiated, the written approval of the Bilecik Şeyh Edebali university ethics committee (decision no: 2023.03.30; number: E‐10333602‐050.04.01‐166057) and the Provincial Health Directorate (decision no: 2023/21) was obtained. Participants had to read and approve the informed consent, which involved explanations about the purpose of the study before they started responding to the scale items.

Data analysis

The Statistical Package of Social Sciences (SPSS 20.00, Chicago, IL, USA) software package was used to evaluate the data. Frequency (n), percentage (%), mean (x ® ± SD), median, 25th and 75th quartile values (M [Q25–Q75]) were used for presenting descriptive characteristics. The distribution of the data was evaluated with the Kolmogorov–Smirnov test. Continuous variables were compared using Mann–Whitney U and Kruskal–Wallis tests. Significance between variables with more than two groups was tested using a post hoc test (Bonferroni). Relationships between scales were evaluated with Spearman correlation analysis. The effects of the independent variables that were found significant in the comparisons on the CDNMQ total and subscale scores were examined with multiple linear regression analysis. The significance level was accepted as p < 0.05.

RESULTS

Participants’ sociodemographic characteristics

The mean age of the nurses (n = 207) participating in the study was 33.94 ± 8.63 years, 86.5% were female, 87% were university graduates, 52.7% worked in a public hospital, and 46.4% worked in a ward/outpatient clinic. According to nurses’ statements, 77.8% did not have a job directly related to disasters, 30% knew disaster approaches, and 47.3% had received disaster‐related education (Table 1).

TABLE 1.

CDNMQ total and subdimension scores according to sociodemographic characteristics and disaster preparedness experience.

CDNMQ
Characteristics n % Total M(Q25/Q75) Duty and responsibility M(Q25/Q75) Core competency M(Q25/Q75) Barriers encountered M(Q25/Q75)
Gender
Female 179 86.5 314.0 (244.0/360.0) 18.0 (10.0/25.0) 244.0 (179.0/293.0) 52.0 (35.0/62.0)
Male 28 13.5 295.00 (247.75/362.00) 6.25 (14.50/27.50) 223.0 (179.25/293.75) 56.0 (43.75/64.00)
Z/p −0.229/0.819 −0.752/0.452 −0.088/0.930 −1.454/0.146
Age
19–25 31 15.0 295.0 (211.0/351.00) 19.0 (12.00/27.0) 210.0 (160.0/296.0) 46.0 (31.0/57.0) a
26–32 78 37.7 313.0 (245.00/364.75) 18.5 (9.00/25.00) 252.0 (180.00/292.00) 56.0 (39.25/64.0) a
33–39 32 15.5 326.0 (280.00/354.25) 17.5 (6.0/22.75) 260.0 (210.0/288.75) 57.50 (39.25/64.0) a
≥40 66 31.9 306.0 (226.50/362.50) 18.5 (11.00/26.25) 222.0 (170.75/294.25) 49.50 (31.25/58.25) a
H/p 2.753/0.432 2.275/0.517 2.340/0.720 8.298/0.040
Marital status
Married 121 58.5 316.0 (243.50/355.0) 18.0 (10.50/26.0) 242.0 (180.00/289.0) 51.0 (32.00/62.50)
Single 86 41.5 308.5 (244.75/367.50) 18.5 (9.00/25.25) 241.50 (174.75/297.25) 55.5 (37.00/63.25)
Z/p −0.562/0.574 −0.193/0.847 −0.236/0.813 −0.992/0.321
Education
High school 10 4.8 369.50 (274.25/384.0) 16.0 (5.750/32.0) 292.5 (191.50/300.0) 64.0 (56.00/71.0) a
University 180 87.0 301.5 (242.00/356.0) 18.0 (11.00/25.0) 240.0 (179.00/291.75) 52.0 (34.25/62.75) b
Postgraduate 17 8.2 352.0 (300.0/365.50) 20.0 (9.50/27.0) 270.0 (224.50/298.50) 51.0 (36.00/57.00) b,c
H/p 5.646/0.059 0.151/0.927 3.371/0.185 9.672/0.008
Total work experience
0–12 months 32 15.5 290.5 (230.50/352.0) 20.0 (12.25/24.00) 225.0 (154.50/271.50) 52.5 (39.25/63.00)
2–3 years 36 17.4 302.0 (246.25/375.25) 19.5 (13.00/27.75) 245.5 (180.0/298.75) 54.5 (36.00/61.75)
4–6 years 34 16.4 294.50 (242.0/364.0) 14.0 (7.75/25.00) 229.0 (177.75/292.00) 55.0 (38.25/64.00)
–≥7 years 105 50.7 322.0 (245.0/356.0) 18.0 (9.00/25.50) 259.0 (180.0/293.00) 51.0 (32.00/62.50)
H/p 1.536/0.674 2.801/0.423 2.335/0.506 0.690/0.875
Institution
State hospital 109 52.7 323.0 (248.0/363.50) 19.0 (12.00/27.00) 259.0 (180.00/295.0) 49.00 (31.50/60.00)
Training and research hospital 72 34.8 296.5 (238.75/362.50) 16.5 (7.00/24.75) 221.0 (174.50/292.75) 55.0 (40.00/64.00)
FHC/CMHC/ DHD 26 12.6 294.5 (244.25/341.50) 17.5 (7.75/23.50) 230.0 (179.75/289.0) 57.0 (38.00/64.00)
H/p 0.558/0.757 3.745/0.154 0.829/0.661 5.915/0.052
Department
Service/outpatient clinic 96 46.4 288.5 (225.50/358.00) 17.0 (10.00/25.00) 222.5 (161.50/293.0) 51.0 (32.50/61.75)
Operating room/intensive care 52 25.1 324.0 (261.50/368.50) 18.0 (10.25/25.75) 266.5 (202.50/295.75) 54.5 (43.00/63.00)
Emergency room 25 12.1 313.0 (266.0/366.50) 23.0 (13.50/28.00) 271.0 (179.50/297.0) 56.0 (37.50/64.00)
Other 34 16.4 307.0 (244.25/353.75) 18.50 (8.75/25.25) 250.5 (179.75/289.0) 50.5 (38.25/63.25)
H/p 4.228/0.238 2.687/0.442 2.848/0.416 1.364/0.714
Having a job directly related to disasters
Yes 11 5.3 293.0 (236.0/372.0) 25.00 (17.00/40.00) a 210.0 (179.00/286.00) 56.00 (32.00/57.00)
Used to have 35 16.9 299.0 (245.0/360.0) 22.0 (14.00/31.00) a,b 216.0 (184.00/295.00) 55.00 (36.00/63.00)
No 161 77.8 316.0 (241.50/360.50) 17.00 (9.00/24.50) c 244.0 (175.00/293.00) 52.00 (36.00/63.50)
H/p 0.062/0.969 8.422/0.015 0.228/0.892 0.223/0.895
Knowledge about approaches to disaster
Yes 62 30.0 334.0 (273.75/369.25) 24.50 (12.75/32.00) a 269.50 (207.25/300.00) a 48.50 (32.00/60.25)
No 24 11.6 273.50 (176.50/341.25) 10.50 (6.00/19.50) b 194.50 (142.00/284.25) b 50.00 (24.00/62.50)
Limited 121 58.5 300.0 (241.50/358.00) 17.00 (10.00/23.50) b,c 240.0 (177.00/290.50) a,b 56.00 (40.00/64.00)
H/p 8.601/0.014 18.241/0.001 9.420/0.009 3.741/0.154
Having received education on disasters
Yes 98 47.3 318.0 (260.50/363.00) 22.00 (12.75/28.25) 262.0 (193.75/295.25) 48.00 (32.00/60.00)
No 109 52.7 298.0 (237.0/359.50) 15.00 (8.50/23.50) 236.0 (173.00/292.00) 56.00 (39.00/64.00)
Z/p −1.109/0.268 −3.206/0.001 −1.458/0.145 −2.269/0.023
Experience with any natural disaster
Yes 105 50.7 95.00 (245.0/358.50) 20.00 (11.00/26.50) 216.0 (180.0/292.50) 53.00 (37.00/63.00)
No 102 49.3 327.0 (236.75/363.25) 16.00 (9.00/24.25) 270.0 (169.25/293.50) 53.00 (37.00/63.00)
Z/p −0.692/0.489 −1.720/0.085 −0.578/0.563 −0.311/0.755
Having taken an official or voluntary role in the disaster
Yes 46 22.2 299.0 (270.00/367.00) 21.50 (11.75/30.25) 213.0 (201.0/294.00) 56.00 (39.25/64.0)
No 161 77.8 316.0 (239.50/359.50) 18.00 (9.50/24.00) 244.0 (174.0/293.00) 51.00 (35.50/62.0)
Z/p −0.738/0.460 −1.947/0.052 −0.419/0.675 −0.981/0.321
Considering volunteering in a possible disaster
Yes 120 58.0 331.0 (245.00/370.0) a 19.00 (11.25/28.0) a 268.50 (190.0/299.0) a 52.50 (32.50/63.0) a
No 19 9.2 257.0 (163.00/308.0) b 7.00 (5.00/12.0) b 172.00 (138.0/240.0) b 61.00 (32.00/72.0) b
Undecided 68 32.9 316.0 (248.5/353.75) a,c 19.00 (12.00/24.0) a,c 240.0 (179.0/287.75) a,c 51.00 (39.00/58.0) a,b
H/p 10.154/0.006 15.756/0.001 15.803/0.001 6.089/0.048
Open in a new tab

CMHC, community mental health center; DHD, district health directorate; F, one‐way ANOVA; FHC, family health center; H, Kruskal–Wallis; M, median; SD, standard deviation; X̄, mean; Z, Mann–Whitney U test.

a,b,c: There is no difference between groups with the same letter.

Bold values indicates statistically significant at p < 0.05.

Participants' characteristics concerning disaster management competencies

Nurses' mean score on the total CDNMQ was 294.6 ± 79 (Table 2). The comparison of nurses' median CDNMQ scores by their sociodemographic characteristics showed a statistically significant difference only between the barrier subscale scores and age and educational status (p < 0.05) (Table 1). When the median CDNMQ scores were compared in terms of characteristics related to disaster experience (Table 1), significant relationships were detected between the following variables and the total scale and subscales: having a job related to disasters and the duty and responsibility subscale; having knowledge about approaches to disasters and the total scale and all subscales, except for barriers encountered; having received education on disasters and duty and responsibility and barriers encountered subscales; thinking about working as a volunteer in a possible disaster and the total scale and all subscales (p < 0.05).

TABLE 2.

CDNMQ, GDPBS, and DPS total and subdimension scores and the relationship between them.

CDNMQ
Characteristics Mean ± SD Median (min–max) r Total Duty and responsibilities Core competency Barriers encountered
GDPBS total 95.57 ± 9.88 98 (49–133) r –0.017 −0.068 −0.044 −0.088
Perceived sensitivity 20.25 ± 2.04 20 (13–26) r −0.032 −0.105 −0.079 0.207**
Perceived severity 9.37 ± 1.88 10 (3–13) r −0.140* −0.225** −0.140* 0.070
Perceived benefits 12.19 ± 2.87 12 (3–15) r 0.161* 0.306** 0.192** −0.189**
Perceived barriers 13.40 ± 4.46 13 (6–25) r −0.182** −0.269** −0.224** 0.150*
Motivators 16.01 ± 2.70 16 (5–25) r 0.104 −0.061 0.070 0.207**
Self‐sufficiency 26.32 ± 3.64 27 (8–36) r 0.132 0.158* 0.114 −0.062
DPS total 37.34 ± 7.25 36 (15–60) r 0.078 0.397** 0.068 −0.206**
Disaster physical protection 16.98 ± 3.45 17 (7–28) r 0.055 0.364** 0.36 −0.147
Disaster planning 7.42 ± 2.30 7 (3–12) r 0.068 0.346** 0.067 −0.178*
Disaster relief 8.59 ± 1.66 9 (3–12) r 0.194** 0.281** 0.182** −0.071
Disaster warning and signals 4.34 ± 1.37 4 (2–8) r −0.025 0.258** −0.034 −0.220**
CDNMQ total 294.63 ± 79.49 314 (43–406)
Duty and responsibility 19.25 ± 11.02 18 (5–50)
Core competency 227.40 ± 69.71 242 (30–300)
Barriers 49.97 ± 17.76 53 (8–80)
Open in a new tab
*

p < 0.05. **p < 0.001, r: Spearman correlation coefficient.

Predictive factors of the disaster management competencies

Nurses' CDNMQ, GDPBS and DPS total and subscale scores and the relationship between them are presented in Table 2. The results of the regression analysis performed to examine the effects of the independent variables that were found significant in the comparisons (age, education level, having knowledge about the approach to disaster, having a disaster‐related job, having received disaster‐related education, volunteering to work in disasters, and the total scores on the GDPBS and DPS) on CDNMQ total and subdimension scores are presented in Table 3. The variables examined for the duty and responsibility subdimension explained approximately 19% of the total variance (adj R 2 = 0.193, F = 7.174, p < 0.001). Disaster preparedness (β = 0.379) had the strongest effect on the duty and responsibility score, and this was followed by having received disaster‐related education (β = 0.173) and having “limited” knowledge about approaches to disaster subscales (β = −0.164). The variables examined for the barriers encountered subscale explained approximately 5% of the total variance (adj R 2 = 0.050, F = 2.352, p < 0.05). The barriers encountered subscale negatively affected the disaster preparedness subdimension score (β = −0.173). No significant model could be obtained for the CDNMQ total and core competencies subdimensions (p > 0.05).

TABLE 3.

Results of multiple linear regression analysis for the subdimensions of CDNMQ.

CDNMQ
Independent variables Duty and responsibility Barriers encountered
B SE Beta t p B SE Beta t p
Constant 6.036 8.294 0.728 0.468 49.047 14.509 3.380 0.001
Age −0.102 0.082 −0.80 −1.246 0.214 −0.163 0.143 −0.079 −1.142 0.255
Education (undergraduate) 0.251 2.071 0.008 0.121 0.904 −6.192 3.623 −0.118 −1.709 0.089
Having a disaster‐related job (no) −1.372 1.827 −0.052 −0.751 0.454 −2.415 3.196 −0.057 −0.756 0.451
Having knowledge about approaches to disaster (limited) −3.666 1.706 −0.164 −2.149 0.033 3.664 2.985 0.102 1.227 0.221
Having received disaster‐related education (yes) 5.955 2.617 0.173 2.275 0.024 3.796 4.578 0.069 0.829 0.408
Wanting to volunteer during a disaster (undecided) 0.014 1.495 0.001 0.009 0.992 −0.497 2.616 −0.013 −0.190 0.850
Total GDPBS score −0.073 0.072 −0.065 −1.005 0.316 0.228 0.127 0.127 1.796 0.074
Total DPS score 0.576 0.104 0.379 5.540 0.000 −0.423 0.0182 −0.173 −2.329 0.021
R: 0.474; R 2: 0.225; adj. R 2: 0.193; F: 7.174; p < 0.001; Durbin−Watson: 1.806 R: 0.295; R 2: 0.087; adj. R 2: 0.05; F: 2.352; p < 0.05; Durbin−Watson: 1.903
Open in a new tab

bold values indicates statistically indicates at p < 0.05.

DISCUSSION

In this study, which was conducted to examine the disaster management competency levels and related factors of nurses working in a province located in a first‐degree earthquake zone, nurses’ disaster management competencies were not at the desired level. While preparedness and having received disaster‐related education positively affected nurses’ duties and responsibilities in disaster management, having limited knowledge had a negative effect. In addition, an increase in the level of disaster preparedness reduced the barriers to nurses’ development of their core competencies.

Nurses' competency levels regarding disaster management were not adequate. Accordingly, nurses do not know and apply their duties, responsibilities, and core competencies regarding disaster management adequately. They also face barriers, such as a lack of health organization support, workplace education programs, educational resources, and disaster‐oriented expert personnel, to fulfill their competencies. Research into the subject is quite limited in our country (Demirtaş & Altuntaş, 2023). A comprehensive international review study showed that nurses in developing countries were inadequate in “all areas” of disaster nursing competencies (Songwathana & Timalsina, 2021). Similar to these results, it has been reported that nursing students' intervention skills in disaster situations are weak and need to be improved (Kang et al., 2023; Kaviani et al., 2022). Similar to our country, many international studies have shown that the competency levels of nurses are not sufficient and should be improved starting from the undergraduate education level (Chegini et al., 2022; Gallardo et al., 2015; Said & Chiang, 2020; Yorulmaz & Karadeniz, 2021).

Nurses must be prepared for disasters, perform their functions competently during a disaster, and respond quickly (Koçak & Serin, 2023; Songwathana & Timalsina, 2021). In this study, nurses' disaster preparedness level was found to be an important predictor of their “duty and responsibility‐related competencies” in disaster management. In other words, as nurses' disaster preparedness levels increased, they fulfilled more of their duties and responsibilities regarding disaster management. In parallel with this result, the readiness levels of nurses in our study were not found at the desired level, similar to their competency levels. No studies in the literature have examined the relationship between these two factors, but there are studies in which they have been examined together. In a comprehensive review study, it was revealed that nurses' disaster preparedness levels in terms of knowledge and skill competencies were low or medium and that less importance was given to psychological preparedness (Said & Chiang, 2020). A study conducted with emergency room nurses showed a positive relationship between the perception of disaster core competencies and the level of disaster preparedness (Chegini et al., 2022). In another study conducted with emergency room nurses, although their disaster preparedness was low, they stated in their self‐evaluation that their disaster competence was close to sufficient. It was concluded in the study that nurses overestimated their competence levels. Overestimating disaster capabilities can negatively impact patient outcomes during a major incident. Therefore, nurses need to be aware of their own competency levels. The way to achieve this awareness is not through having formal medical disaster training but through an advanced diploma and clinical experience (Murphy et al., 2021). As the frequency and severity of disasters have increased in recent years, it has become even more important for nurses to be ready to deal with these occurrences (Chegini et al., 2022). It has been reported that nurses, especially in developing countries, are not adequately prepared to deal with disasters and that this is related to institutional and organizational factors as well as education and training (Songwathana & Timalsina, 2021). Paton (2019) reported that preparedness had “structural,” “survival,” and “psychological” aspects and, that for complete preparation, a series of stages must be passed (Bočkarjova et al., 2009). For this reason, the author stated that preparation had to be recognized as a developmental process and managed accordingly. In a systematic review study, it was reported that nurses were not adequately prepared for disasters and did not feel confident in responding to them effectively. According to the same study, factors that increased preparedness for disaster response included disaster response experience and disaster‐related education (Labrague et al., 2018). In a study conducted with nurses assigned to disaster areas after the large East Japan earthquake, it was reported that the readiness levels of nurses were moderate and, in some dimensions, low. Readiness scores of nurses who had referral and professional experience and were specialists were found to be higher (Maeda et al., 2016). These results showed that nurses’ readiness levels needed to be increased to be competent in areas, such as disaster planning, communication in the disaster area, ethics, event command system, decontamination, security, and event response (Al Thobaity et al., 2017). Additionally, nurses should be aware of their potential in disaster competencies. Evidence regarding the concept of disaster preparedness is still insufficient. Therefore, the applicability of the results should be carefully considered, especially when considered in conjunction with the ICN's (2019) expectation of advanced practice proficiency in disaster nursing. More studies on this subject are recommended.

Beliefs may affect disaster preparedness behaviors positively or negatively (Vildan & Cengiz, 2020). In this study, nurses' disaster preparedness beliefs were lower than expected and had no effect on their competencies. When the subdimensions were examined, although the relationship between them was low, it was seen that as the nurses' beliefs that the measures to be taken against the earthquake were useful and that the barriers decreased increased, they fulfilled their duties and responsibilities more. Although studies involving nurses on the subject are quite limited in the literature, an old study showed that the belief that nurses were adequately prepared for disaster situations increased confidence in disaster response (Chapman & Arbon, 2008). Choi and Lee (2021) that nurses with high self‐efficacy were more willing to intervene in disasters. Self‐efficacy is the belief that a person can perform the necessary tasks in an emergency with a positive outcome. This belief affects nurses' willingness to respond to a disaster because it allows them to decide how much effort they need to put into their behavior. Vildan and Cengiz (2020), in their study with individuals aged 18 and over, found that disaster preparedness beliefs had a direct positive effect on disaster preparedness attitudes and behaviors. Beliefs provide a framework for understanding, interpreting, preparing for, and responding to disasters. It has been reported that disaster‐related experience develops beliefs, helps individuals understand the consequences of a disaster, and influences emotions and feelings. Having experienced a disaster before can be a strong source of motivation for preparedness (Becker et al., 2017). Accordingly, the low disaster preparedness beliefs of nurses in our study may have been because a significant portion of the nurses had not experienced any disasters and/or had not taken part in a disaster. In this case, it can be said that nurses need simulated disaster drills and real drills (Songwathana & Timalsina, 2021). In addition, studies should be conducted to reinforce nurses' belief in the benefits of disaster preparedness, and realistic interventions (not just on paper) should be planned to reduce barriers to their competency. Thus, nurses' beliefs about disaster preparedness, and therefore their motivation, can increase and they can become more competent.

Nurses must be equipped with the knowledge and skills to provide comprehensive and holistic care to the population affected by disasters or at risk of disasters so that they can respond competently to them (Al Thobaity et al., 2017). In this study, the majority of nurses had partial knowledge of disaster approaches (58.5%) and a significant part of them (52.7%) had not received training on this subject. In addition, it was determined that these factors (having received training on how to approach disasters and having partial knowledge of how to approach disasters) had an impact on the competencies related to duties and responsibilities. While having received disaster‐related education positively affected nurses' competencies about their duties and responsibilities, having limited knowledge had a negative effect. Research on the subject has revealed that educational activities, education level, and experience are the main factors affecting nurses' core competencies in disasters (Chegini et al., 2022; Demirtaş & Altuntaş, 2023; Emaliyawati et al., 2021; Jang & Cho, 2023; Marin & Witt, 2015). However, despite many educational activities, it is known that nurses lack knowledge and skills in disaster management and do not feel ready to respond to disasters (Labrague et al., 2018; Said & Chiang, 2020). It has been reported that the biggest related factor is the way countries approach disasters, as well as factors such as the strategies used in the education of employees and the content, duration, and frequency of education (Al Thobaity et al., 2017; Maeda et al., 2016; Paton, 2019). In addition, the importance given to disaster nursing during undergraduate education is among the key factors (Keskin & Handan, 2023; Toraman & Konal, 2023). Highly recommended strategies in the literature to increase the knowledge and skills of nurses in disaster management include education in disaster nursing, sessions on routine disaster scenarios, simulated disaster drills, and real drills (Chegini et al., 2022; Songwathana & Timalsina, 2021). It is reported that including knowledge of core competency areas, such as “understanding the content and location of the disaster plan,” “communication during a disaster,” and “ethical issues,” in the education content will strengthen nurses' preparation to respond to disasters competently (Al Thobaity et al., 2017). In addition, it has been reported that annual repetition of education programs is extremely important (Maeda et al., 2016) and that nurses can be trained with little additional cost through established clinical communication channels and their preparedness can be increased (Amberson et al., 2020). In addition, today disaster management is almost impossible without the use of new technologies, and therefore telenursing applications should be used in disasters. In this regard, it is recommended to include medical informatics content in the nursing education curriculum and to conduct research studies on the development of guidelines for telenursing (Nejadshafiee et al., 2022).

Understanding the role of nurses in mitigating and resolving existing problems, and providing essential services and timely care to victims, is paramount in reducing disabilities and fatalities and in effectively managing complex crises (Firouzkouhi et al., 2021). Therefore, it is crucial to utilize disaster nursing models to guide various aspects such as disaster nursing education curriculum development, enhancing preparation processes for disaster situations, facilitating ethical decision‐making, recognizing healthcare team coordination and challenges, and educating the society about pre‐disaster preparation and post‐disaster recovery processes. Despite the potential of disaster nursing models to inform disaster risk reduction strategies, systematic efforts in this regard are still in their nascent stages (Pourvakhshoori et al., 2017).

Limitations

This study has some strengths. First, as far as it is known, this is the first study to examine nurses' disaster management competencies together with disaster preparedness and disaster preparedness belief factors. Although this constitutes the strength of the study, it creates limitations in discussing the results. The second strength is that the province where the study was conducted is located in a first‐degree earthquake zone. This is important in terms of providing evidence about the priority health services that our country and similar countries should plan in regions with first‐degree earthquake risks. This study was conducted with a sample of Turkish nurses; therefore, the generalizability of the results is limited. During the application, some nurses may have avoided expressing their real situation or exaggerated it. As the study was conducted online, nurses who did not use social media tools could not be reached.

CONCLUSIONS

The results of this research showed that the level of disaster preparedness had an impact on task and responsibility competencies in disaster management. Disaster preparedness was found effective in reducing barriers to developing core competencies. Additionally, it was determined that having training on how to approach disasters affected duty and responsibility competencies positively while having “partial” knowledge had a negative effect. The disaster management competencies of nurses were not at the expected level.

Nurses must have a high level of competence to be able to maintain the quality and standards of care in a chaotic environment, to cope with unusual/complex cases, and to adapt to changing roles, responsibilities, and expectations in a multidisciplinary team. Revealing the factors that may affect nurses' disaster management competencies will guide the initiatives planned to improve their competencies. For nurses to competently manage changing disaster conditions, they need to be prepared for disasters and have training in disaster approaches.

During the planning of these training programs, the ICN should identify three levels of nurses requiring competency in disaster nursing, each with increasing levels of complexity. Therefore, nurses of similar competency levels should be grouped together, and training content should be developed tailored to their specific needs. Training programs that do not consider their knowledge and experience levels may deter nurses from participating or diminish their interest in the training.

In the short term, to increase the number of competent nurses in disaster services, nurses intending to work in disaster services (at the third level) should be identified and provided with appropriate training. Desktop training, which only provides partial knowledge about disasters and involves simply flipping through slides or signing attendance sheets during face‐to‐face sessions, should be replaced with comprehensive training programs aimed at genuine education. Nurses' participation in training should not be left to their discretion; instead, measures should be in place to ensure participation, including the implementation of sanctions when necessary. To develop more systematic, evidence‐based, and highly applicable training programs, disaster nursing models should serve as roadmaps. Additionally, the applicability of disaster nursing models should be thoroughly studied for further enhancement.

In addition, nurses' excessive workload is one of the factors that diminish their interest and participation in disaster training. Therefore, efforts should be made to reduce nurses' workload and allocate time for them to willingly and easily engage in disaster training. To prioritize applicability in training programs, the experiences of nurses who have encountered disasters should not be ignored. These experiences should be carefully examined, integrated with theory, and used to develop practical and easily implementable training curricula and programs.

Implications for nursing and health policy

The results of the study provide information about effective and ineffective factors in training nurses who can manage disasters more competently. Nurse educators can include topics and practices that will increase students' disaster preparedness and knowledge of disaster approaches in the undergraduate education curriculum. Since disaster management is unthinkable without technology, it is important to include subjects such as medical informatics and telenursing in the nursing curriculum to strengthen preparedness efforts. Nurse managers can periodically evaluate nurses' level of knowledge of disaster preparedness and approaches to disaster and plan supportive interventions as needed. Additionally, managers can ensure that nurses take part in tasks and simulative training that will reinforce their readiness. In addition, nurses need to be ready and competent in disaster management and be aware of their knowledge and skills in this regard in terms of the patients/individuals being cared for and the health services provided during crises. Continuous monitoring of nurses' disaster management competencies and associated factors should be part of the preparedness studies of health systems. The results of this study can increase the awareness of the health system in this regard. Finally, for nurses competent in disaster management, legally enforceable policies that will ensure their disaster preparedness and increase the level of their knowledge about disasters should be planned. In future studies, disaster‐related beliefs and competencies may be examined in depth with qualitative research. In addition to preparing nurses for disasters and equipping them with knowledge and skills, studies that will make them aware of their own potential to use their knowledge and skills in disaster response and reveal their importance for healthcare services can be planned.

AUTHOR CONTRIBUTIONS

Study design: Şenay Şermet Kaya. Data collection: Eylül Gülnur Erdoğan. Data analysis: Şenay Şermet Kaya and Eylül Gülnur Erdoğan. Study supervision: Şenay Şermet Kaya and Eylül Gülnur Erdoğan. Manuscript writing: Şenay Şermet Kaya and Eylül Gülnur Erdoğan. Critical revisions for important intellectual content: Şenay Şermet Kaya and Eylül Gülnur Erdoğan.

CONFLICT OF INTEREST STATEMENT

The authors declare no conflict of interest.

FUNDING INFORMATION

No funding support was received for this study. The authors alone are responsible for the content and writing of this article. We would like to thank the Scientific and Technological Research Council of Turkey (TUBİTAK) for its support in publishing this study as “open access”.

ACKNOWLEDGMENTS

The authors are grateful to the participants of this study.

Şermet Kaya, Ş. & Erdoğan, E.G. (2025) Disaster management competence, disaster preparedness belief, and disaster preparedness relationship: Nurses after the 2023 Turkey earthquake. International Nursing Review, 72, e13020. 10.1111/inr.13020

REFERENCES

  1. Al Thobaity, A. , Plummer, V. & Williams, B. (2017) What are the most common domains of the core competencies of disaster nursing? A scoping review. International Emergency Nursing, 31, 64–71. 10.1016/j.ienj.2016.10.003 PMID: 28029612 [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Al Thobaity, A. , Williams, B. & Plummer, V. (2016) A new scale for disaster nursing core competencies: development and psychometric testing. Australasian Emergency Nursing Journal, 19(1), 11–19. 10.1016/j.aenj.2015.12.001 PMID: 26778698 [DOI] [PubMed] [Google Scholar]
  3. Amberson, T. , Wells, C. & Gossman, S. (2020) Increasing disaster preparedness in emergency nurses: a quality improvement initiative. Journal of emergency nursing, 46(5), 654–665.e21. e621. 10.1016/j.jen.2020.05.001 PMID: 32828482 [DOI] [PubMed] [Google Scholar]
  4. Baytiyeh, H. & Naja, M. (2016) The effects of fatalism and denial on earthquake preparedness levels. Disaster Prevention and Management, 25(2), 154–167. 10.1108/DPM-07-2015-0168 [DOI] [Google Scholar]
  5. Becker, J.S. , Paton, D. , Johnston, D.M. , Ronan, K.R. & McClure, J. (2017) The role of prior experience in informing and motivating earthquake preparedness. International Journal of Disaster Risk Reduction, 22, 179–193. 10.1016/j.ijdrr.2017.03.006 [DOI] [Google Scholar]
  6. Bočkarjova, M. , Van der Veen, A. & Geurts, P. (2009) A PMT‐TTM model of protective motivation for flood danger in the Netherlands. Paper presented at the ITC working papers series .
  7. Brewer, C.A. , Hutton, A. , Hammad, K.S. & Geale, S.K. (2020) A feasibility study on disaster preparedness in regional and rural emergency departments in New South Wales: nurses self‐assessment of knowledge, skills and preparation for disaster management. Australasian Emergency Care, 23(1), 29–36. 10.1016/j.auec.2019.12.005 PMID: 31926956 [DOI] [PubMed] [Google Scholar]
  8. Chapman, K. & Arbon, P. (2008) Are nurses ready?: Disaster preparedness in the acute setting. Australasian Emergency Nursing Journal, 11(3), 135–144. 10.1016/j.aenj.2008.04.002 [DOI] [Google Scholar]
  9. Chegini, Z. , Arab‐Zozani, M. , Kakemam, E. , Lotfi, M. , Nobakht, A. & Aziz Karkan, H. (2022) Disaster preparedness and core competencies among emergency nurses: a cross‐sectional study. Nursing Open, 9(2), 1294–1302. 10.1002/nop2.1172 PMID: 34985209 [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Choi, H.S. & Lee, J.‐E. (2021) Hospital nurses’ willingness to respond in a disaster. JONA: The Journal of Nursing Administration, 51(2), 81–88. 10.1097/NNA.0000000000000974 [DOI] [PubMed] [Google Scholar]
  11. Demirtaş, H. & Altuntaş, S. (2023) Nurses' competence levels in disaster nursing management in Turkey: a comparative cross‐sectional study. International Nursing Review, 10.1111/inr.12829 [DOI] [PubMed] [Google Scholar]
  12. Durgut, U. (2019) Competencies for disaster nursing management questionnaire turkish validity and reliability study. Tekirdag Namik Kemal University, Institute of Health Sciences, Department of Surgical Nursing Master Thesis, Tekirdağ. [Google Scholar]
  13. Emaliyawati, E. , Ibrahim, K. , Trisyani, Y. , Mirwanti, R. , Ilhami, F.M. & Arifin, H. (2021) Determinants of nurse preparedness in disaster management: a cross‐sectional study among the community health nurses in coastal areas. Open Access Emergency Medicine: OAEM, 13, 373–379. 10.2147/OAEM.S323168 [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Firouzkouhi, M. , Kako, M. , Abdollahimohammad, A. , Balouchi, A. & Farzi, J. (2021) Nurses’ roles in nursing disaster model: a systematic scoping review. Iranian Journal of Public Health, 50(5), 879. 10.18502/ijph.v50i5.6105 [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Gallardo, A.R. , Djalali, A. , Foletti, M. , Ragazzoni, L. , Della Corte, F. , Lupescu, O. , Arculeo, C. , Von Arnim, G. , Friedl, T. & Ashkenazi, M. (2015) Core competencies in disaster management and humanitarian assistance: a systematic review. Disaster Medicine and Public Health Preparedness, 9(4), 430–439. 10.1017/dmp.2015.24 [DOI] [PubMed] [Google Scholar]
  16. ICN, W . (2009) ICN framework of disaster nursing competencies . Available chrome‐extension://efaidnbmnnnibpcajpcglclefindmkaj/ http://www.apednn.org/doc/resourcespublications/ICN%20Framework%20of%20Disaster%20Nursing%20Competencies%20ICN%202009.pdf [Accessed 14th May 2023].
  17. International Council of Nursing (ICN) . (2019) ICN core competencies in disaster nursing version 2 .0. Available ICN, https://acrobat.adobe.com/id/urn:aaid:sc:AP:2b24ec3f‐151b‐4c99‐9fa6‐babfefb029c1 [Accessed 21st May 2023].
  18. Inal, E. & Dogan, N. (2018) Improvement of general disaster preparedness belief scale based on health belief model. Prehospital and Disaster Medicine, 33(6), 627–636. 10.1017/S1049023X18001012 [DOI] [PubMed] [Google Scholar]
  19. Jang, S.J. & Cho, S. (2023) Disaster nursing competencies of rural nurses during COVID‐19: a cross‐sectional study. Collegian, 30(2), 264–269. 10.1016/j.colegn.2022.09.007 [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Kang, J.‐S. , Lee, H. & Seo, J.M. (2023) Relationship between nursing students’ awareness of disaster, preparedness for disaster, willingness to participate in disaster response, and disaster nursing competency. Disaster Medicine and Public Health Preparedness, 17, e220. 10.1017/dmp.2022.198 [DOI] [PubMed] [Google Scholar]
  21. Kaviani, F. , Aliakbari, F. , Sheikhbardsiri, H. & Arbon, P. (2022) Nursing students’ competency to attend disaster situations: a study in western Iran. Disaster Medicine and Public Health Preparedness, 16(5), 2044–2048. 10.1017/dmp.2021.263 [DOI] [PubMed] [Google Scholar]
  22. Keskin, A.Y. & Handan, A. (2023) Assessment of undergraduate nursing students’ self‐efficiency in disaster response. Journal of Nursing Effect, 16(3), 332–342. 10.46483/jnef.1327474 [DOI] [Google Scholar]
  23. Kocaman, G. , Yürümezoğlu, H.A. , Uncu, S. , Türkmen, E. , Göktepe, N. & İntepeler, Ş.S. (2018) The development of healthy work environment standards for nurses in Turkey. Journal of Education and Research in Nursing, 15(1), 30–38. 10.5222/HEAD.2018.030 [DOI] [Google Scholar]
  24. Koçak, H.S. & Serin, E.K. (2023) Are nurses ready for a disaster in Turkey? A hospital case. Disaster Medicine and Public Health Preparedness, 17, e436. 10.1017/dmp.2023.100 [DOI] [PubMed] [Google Scholar]
  25. Labrague, L. , Hammad, K. , Gloe, D. , McEnroe‐Petitte, D. , Fronda, D. , Obeidat, A. , Leocadio, M. , Cayaban, A. & Mirafuentes, E. (2018) Disaster preparedness among nurses: a systematic review of literature. International Nursing Review, 65(1), 41–53. 10.1111/inr.12369 [DOI] [PubMed] [Google Scholar]
  26. Maeda, T. , Kotera, S. , Matsuda, N. & Edwards, G.D. (2016) Disaster readiness among nurses in Japan: current status following the Great East Japan earthquake. International Journal of Nursing, 3(1), 15–28. 10.15640/ijn.v3n1a3 [DOI] [Google Scholar]
  27. Marin, S.M. & Witt, R.R. (2015) Hospital nurses’ competencies in disaster situations: a qualitative study in the south of Brazil. Prehospital and Disaster Medicine, 30(6), 548–552. 10.1017/S1049023X1500521X [DOI] [PubMed] [Google Scholar]
  28. Molassiotis, A. , Guo, C. , West, C. & Loke, A.Y. (2022) Identifying the priorities in nursing research on disaster management: a Delphi study and international survey. International Journal of Disaster Risk Reduction, 74, 102935. 10.1016/j.ijdrr.2022.102935 [DOI] [Google Scholar]
  29. Mousavi, S.M. , Majidi, S.A. , Shabahang, R. , Besharat, M. , Bagheri Sheykhangafshe, F. & Samiee, Z. (2020) The prediction of disaster nursing competency based on the self‐efficacy and disaster‐related experiences of nurses. Journal of Clinical Nursing and Midwifery, 9(1), 582–590. SID. https://sid.ir/paper/370675/en [Google Scholar]
  30. Murphy, J.P. , Kurland, L. , Rådestad, M. , Magnusson, S. , Ringqvist, T. & Rüter, A. (2021) Emergency department registered nurses overestimate their disaster competency: a cross‐sectional study. International Emergency Nursing, 58, 101019. 10.1016/j.ienj.2021.101019 [DOI] [PubMed] [Google Scholar]
  31. Nejadshafiee, M. , Nekoei‐Moghadam, M. , Bahaadinbeigy, K. , Khankeh, H. & Sheikhbardsiri, H. (2022) Providing telenursing care for victims: a simulated study for introducing of possibility nursing interventions in disasters. BMC Medical Informatics and Decision Making, 22(1), 54. 10.1186/s12911-022-01792-y [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Ozvurmaz, S. & Öncü, A.Z. (2018) The effect of shift working and rotating shifts on nurses. Journal of Adnan Menderes University Health Sciences Faculty, 2(1), 39–46. [Google Scholar]
  33. Paton, D. (2019) Disaster risk reduction: psychological perspectives on preparedness. Australian Journal of Psychology, 71(4), 327–341. 10.1111/ajpy.12237 [DOI] [Google Scholar]
  34. Pourvakhshoori, N. , Norouzi, K. , Ahmadi, F. , Hosseini, M. & Khankeh, H. (2017) Nursing in disasters: a review of existing models. International Emergency Nursing, 31, 58–63. 10.1016/j.ienj.2016.06.004 [DOI] [PubMed] [Google Scholar]
  35. Said, N.B. & Chiang, V.C. (2020) The knowledge, skill competencies, and psychological preparedness of nurses for disasters: a systematic review. International Emergency Nursing, 48, 100806. 10.1016/j.ienj.2019.100806 [DOI] [PubMed] [Google Scholar]
  36. Sheikhbardsiri, H. , Doustmohammadi, M.M. , Afshar, P.J. , Heidarijamebozorgi, M. , Khankeh, H. & Beyramijam, M. (2021) Anxiety, stress and depression levels among nurses of educational hospitals in Iran: time of performing nursing care for suspected and confirmed COVID‐19 patients. Journal of Education and Health Promotion, 10, 447. 10.4103/jehp.jehp_1319_20 [DOI] [PMC free article] [PubMed] [Google Scholar]
  37. Songwathana, P. & Timalsina, R. (2021) Disaster preparedness among nurses of developing countries: an integrative review. International Emergency Nursing, 55, 100955. 10.1016/j.ienj.2020.100955 [DOI] [PubMed] [Google Scholar]
  38. Sentuna, B. & Fahri, C. (2020) A scale development study in Balikesir sampling: disaster preparedness scale. İdealkent, 11(31), 1959–1983. 10.31198/idealkent.728896 [DOI] [Google Scholar]
  39. Taşkıran, G. & Baykal, Ü. (2017) Disasters and nurses’ preparedness for disasters in Turkey: literature review. Journal of Health and Nursing Management, 4(2), 79–88. 10.5222/SHYD.2017.079 [DOI] [Google Scholar]
  40. Toraman, A.U. & Konal, E. (2023) Determination of nursing students' self‐efficacy in disaster response. Journal of Izmir Katip Celebi University Health Sciences Faculty, 8(2), 509–514. [Google Scholar]
  41. Vildan, O. & Cengiz, E. (2020) Investigation of factors affecting disaster preparedness behaviors: a structural equality modeling. Gümüşhane University Journal of Social Sciences, 12(3), 1252–1269. 10.36362/gumus.958936 [DOI] [Google Scholar]
  42. Yorulmaz, D.S. & Karadeniz, H. (2021) Review of theses in the field of nursing on disasters conducted in Turkey between the years 2000 and 2020. Turkiye Klinikleri Journal of Nursing Sciences,851–857, , 13(4),. 10.5336/nurses.2020-80070 [DOI] [Google Scholar]
  43. Yüksel, S. (2018) Hospital and emergency preparation in disasters. Öztekin SD, editör. Disaster Nursing. Ankara. Turkiye Klinikleri Surgical Nursing‐Special Topics, 4(3), 16–22. [Google Scholar]

Articles from International Nursing Review are provided here courtesy of Wiley

RESOURCES