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Development, Psychometric Testing, and Use of a Disaster Nursing Competency Scale in Iran: A Mixed Methods Study

Published online by Cambridge University Press:  17 August 2021

Fatemeh Aliakbari
Community-Oriented Nursing Midwifery Research Center, Shahrekord University of Medical Sciences, Shahrekord, Islamic Republic of Iran
Fereshteh Aein
Community-Oriented Nursing Midwifery Research Center, Shahrekord University of Medical Sciences, Shahrekord, Islamic Republic of Iran
Masoud Bahrami*
Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
Paul Arbon
Torrens Resilience Institute, Flinders University, Adelaide, Australia
Corresponding author: Masoud Bahrami, Email:


Nurses play an important role during disaster response and recovery. Few tools are available to assess the relative competence of nurses in disaster. This study aimed to develop, test, and evaluate a disaster nursing competency scale. This was an exploratory mixed methods study. In the qualitative phase, 35 Iranian nurses and managers with experience in disaster relief were asked about the skills they need to respond effectively to a disaster event. From the qualitative data, a 50-item questionnaire was developed. In the quantitative phase, exploratory factor analysis was conducted with 400 samples followed by a test-retest reliability assessment with 30 nurses. The developed and validated instrument was applied to 200 nurses in Iran to assess their competency. From content analysis of the qualitative data, 5 main themes emerged. In the quantitative phase, exploratory factor analysis loaded 50 items into 4 domains named management, legal and ethical, specific personal, and technical competence. Use of the tool showed that nurses estimated their competence overall at 70.28%. Findings demonstrate the necessity for new domains in disaster nursing competencies; which may be applicable as a useful tool and guideline to improve nursing education and practice.

Concepts in Disaster Medicine
© Society for Disaster Medicine and Public Health, Inc. 2021

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Centre for Research on the Epidemiology of Disasters. EM-DAT: the OFDA/CRED. 2019. Universities Catholique de. Louvain Brussels, Belgium. Accessed July 18, 2021.Google Scholar
CRED. Natural disasters 2017. Brussels: CRED; 2018 EM-DAT file dated 02/07/2018. Accessed September 27, 2020.Google Scholar
Guha-Sapir, D, Hoyois, P, Below, R. Annual disaster statistical review 2015: the numbers and trends. Brussels: CRED; 2016. file:///C:/Users/User/AppData/Local/Temp/ADSR_2015.pdf. Accessed July 18, 2021.Google Scholar
OCHA. Global humanitarian overview 2019 monthly funding update - 30 September 2019 [EN/AR/FR]. Accessed June 19, 2020.Google Scholar
Aliakbari, F, Ghaedamini, M, Deris, F, et al. Relationship between nurses’ decision-making style and their disaster response competencies. Disaster Med Public Health Prep. 2020:1-6. doi: 10.1017/dmp.2020.225 CrossRefGoogle Scholar
Veenema, TG, Burkle, FM Jr, Dallas, CE. The nursing profession: a critical component of the growing need for a nuclear global health workforce. Confl Health. 2019;13:9. doi: 10.1186/s13031-019-0197-x CrossRefGoogle ScholarPubMed
Alzahrani, F, Kyratsis, Y. Emergency nurse disaster preparedness during mass gatherings: a cross-sectional survey of emergency nurses’ perceptions in hospitals in Mecca, Saudi Arabia. BMJ Open. 2017;7:e013563. doi: 10.1136/bmjopen-2016-013563 CrossRefGoogle ScholarPubMed
PHAO and WHO. Strategic plan 2013-2018. Disaster risk reduction and response. 2019. Accessed February 12, 2020.Google Scholar
Ahayalimudin, N, Osman, NNS. Disaster management: emergency nursing and medical personnel’s knowledge, attitude and practices of the East Coast region hospitals of Malaysia. Australas Emerg Nurs J. 2016; 19(4):203-209.CrossRefGoogle ScholarPubMed
Scrymgeour, GC, Smith, L, Paton, D. Exploring the demands on nurses working in health care facilities during a large-scale natural disaster: often an invisible role within a highly visible event. Sage Open. 2016;6(2):2158244016655587.CrossRefGoogle Scholar
Bahrami, M, Aliakbari, F, Aein, F. Iranian nurses’ perception of essential competences in disaster response: a qualitative study. J Educ Health Promot. 2014;3:81.Google ScholarPubMed
Karami, A, Farokhzadian, J, Foroughameri, G. Nurses’ professional competency and organizational commitment: is it important for human resource management? PLoS One. 2017;12(11):e0187863.CrossRefGoogle ScholarPubMed
Loke, AY, Fung, OWM. Nurses’ competencies in disaster nursing: implications for curriculum development and public health. Int J Environ Res Public Health. 2014;11(3):3289-3303. doi: 10.3390/ijerph110303289 Google ScholarPubMed
Gallardo, AR, Djalali, A, Foletti, M, et al. Core competencies in disaster management and humanitarian assistance: a systematic review. Disaster Med Public Health Prep. 2015;9(4):430-439.CrossRefGoogle Scholar
Miligi, E, Selim, A. Saudi nursing students’ attitudes towards the nursing profession. Eur J Bus Manage. 2014;6(29):197-208.Google Scholar
Veenema, TG, Griffin, A, Gable, AR, et al. Nurses as leaders in disaster preparedness and response--a call to action. J Nurs Scholarsh. 2016;48(2):187-200.CrossRefGoogle ScholarPubMed
Natareno, K. Disaster knowledge and awareness of nurses related to triage in mass casualty incidents (2018). Master’s Theses, Dissertations, Graduate Research and Major Papers Overview. 268. doi: CrossRefGoogle Scholar
Pang, SM, Chan, SS, Cheng, Y. Pilot training program for developing disaster nursing competencies among undergraduate students in China. Nurs Health Sci. 2009;11;367-373.CrossRefGoogle ScholarPubMed
International Council of Nurses. Nurses: A Voice to Lead Health for All. Geneva: International Council of Nurses. April 3, 2019. Accessed July 20, 2021.Google Scholar
Al Thobaity, A, Williams, B, Plummer, V. A new scale for disaster nursing core competencies: development and psychometric testing. Australas Emerg Nurs J. 2016;19:11-19.CrossRefGoogle ScholarPubMed
Aliakbari, F, Hammad, K, Bahrami, M, et al. Ethical and legal challenges associated with disaster nursing. Nurs Ethics. 2015;22(4):493-503.CrossRefGoogle ScholarPubMed
Creswell, JW, Plano Clark, VL. Designing and Conducting Mixed Methods Research. 2nd ed. New Delhi: Sage Publication; 2012.Google Scholar
Graneheim, UH, Lundman, B. (2004). Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today. 2004;24(2):105-112.CrossRefGoogle ScholarPubMed
Streubert, H, Carpenter, DR. Qualitative Research in Nursing: Advancing the Humanistic Imperative. Philadelphia: Lippincott Williams and Wilkins Publisher Ltd; 2011.Google Scholar
Weller, K, Groffik, A, Chuch, MK, et al. Development and validation of the Urticaria Control Test: a patient-reported outcome instrument for assessing urticaria control. J Allergy Clin Immunol. 2014;133(5):1365-1372.CrossRefGoogle ScholarPubMed
Rodríguez-Espíndola, O, Albores, P, Brewster, C. Disaster preparedness in humanitarian logistics: a collaborative approach for resource management in floods. Eur J Oper Res. 2018;264(3):978-993.CrossRefGoogle Scholar
Djalali, A, Khankeh, H, Öhlén, G, et al. Response to earthquakes: a qualitative study. Scand J Trauma Resusc Emerg Med. 2011;19:30.CrossRefGoogle ScholarPubMed
Vo, AH, Brooks, GB, Bourdeau, M, et al. University of Texas Medical Branch telemedicine disaster response and recovery: lessons learned from hurricane Ike. Telemed J E Health. 2010;16:627-633.CrossRefGoogle ScholarPubMed
Karabacak, U, Ozturk, H, Bahcecik, N. Crisis management: the activities of nurse managers in Turkey. Nurs Econ. 2011;29(6):323-330.Google ScholarPubMed
Adelman, DS, Legg, TJ. Disaster Nursing, A Handbook for Practice. Canada: Jones and Bartlett Publishing; 2009.Google Scholar
Putra, A, Kep, S, Petpichetchian, W, et al. Review: public health nurses’ roles and competencies in disaster management. Nurse Media J Nurs. 2011;1(1):1-14.Google Scholar