The long-term impact of the earthquake on substance use.

Earthquake is associated with several health conditions such as posttraumatic stress disorder (PTSD), depression, and cardiovascular disease. However, the association between earthquakes and substance use has been less studied to date. We conducted a historical cohort study 17 years after the Bam earthquake by enrolling 818 households using multi-stage cluster sampling. The sample consisted of earthquake-exposed and non-exposed citizens. The ASSIST screening test was used to determine substance use. Logistic regression analysis was used to evaluate the association of variables of interest with substance use. Nearly 60% of the study subjects were female and the mean ± SD age of the sample was 46.6 ± 11.5 years. The prevalence of tobacco, alcohol, and other drug use in the exposed group was 19.5%, 24.9%, and 21.6%, respectively. The corresponding figures in the non-exposed group were 15.6%, 19.3%, and 20.1%, respectively (P > 0.05). The logistic regression model found no association between the history of earthquake exposure and the risk of any current drug use. Our results showed those 17 years after the Bam earthquake, there was no relationship between earthquake exposure and substance use.

Providing telenursing care for victims: a simulated study for introducing of possibility nursing interventions in disasters.

INTRODUCTION: Uncertainty occurrence of disasters requires special attention and a shortage of health care specialists is a challenge for health care systems; therefore, the use of telenursing care during a disaster is an appropriate way to provide care. This study aimed to investigate telenursing operational possibilities in disasters. METHODS: A cross-sectional study was performed by implementing a functional exercise (Drill) for the possibility of nursing interventions in the response phase to disasters at Kerman University of Medical Sciences in 2021. Two evaluators examined and scored the possibility of providing telenursing care using a researcher-made checklist and we surveyed Inter-rater agreement between two evaluators by Cohen's kappa coefficient. Data were analyzed using descriptive tests and SPSS 20 software. RESULTS: Findings showed that implementation of telenursing care would be helpful in future disasters. The scores received from assessment of the evaluation checklist for this simulated exercise program by the first evaluator was 83.25 and for the second evaluator was 72.00. The results of the study showed that the mean score of the possibility of telenursing in disasters was at a high level 77.50. Thus, the quality of the telenursing care in simulated conditions was satisfactory. CONCLUSION: Today, disaster management is almost impossible without using new technologies. This study found that due to the lack of specialized nursing staff in the deprived areas affected by disasters, the most important way to provide health care for a large group of the population is to develop effective health services so that everyone can use these services equally and fairly.

Latent Profiles of Posttraumatic Growth: 17 years After the Bam Earthquake in Iran.

OBJECTIVE: Posttraumatic growth (PTG) is a positive psychological change after challenging life events. The purpose of this study was to investigate the effects of positive and long-term psychological changes in people who experienced the Bam earthquake. METHODS: A total of 916 adolescents were surveyed 17 years after the earthquake. Self-report questionnaires were administered to participants. A latent profile analysis (LPA) was conducted to extract the subgroups of adults. RESULTS: The LPA identified 5 meaningfully profiles that were characterized based on the pattern of PTG dimensions. The common profile was profile, which perceived very low "relating to others" dimension and medium for other PTG dimensions. Also, the results showed significant differences among gender and age and nonsignificant differences in marital status and education level among the profiles of PTG. CONCLUSIONS: For stressful situations, the different dimensions of PTG change indirectly in every person. In Bam, some patterns are seen according to PTG after 17 y. Among these dimensions, the part of "relating to others", has the greatest change. Another conclusion is that according to a relatively high profile for 5 clusters, it seems the impact of 17 y should be less on PTG as the number of extractive patterns is approximately high for the case.

Patterns of traumatic events and its relations with posttraumatic growth and religiosity in Iranian college students.

BACKGROUND: Traumatic events and psychological damage are common. Identifying different types of traumatic events contributes to the development of psychopathology and can be very helpful in macroeducational and treatment planners. The current study extracted the patterns (overlap) of different traumatic events that Iranian college students commonly experience, with the aim of understanding their association with posttraumatic growth (PTG) and religiosity. MATERIALS AND METHODS: Four hundred and sixty-six students from Kerman universities completed a cross-sectional survey about religion, and questions about PTG and traumatic events have experienced in the past 5 years. The latent class analysis (LCA) was used for extracting patterns of traumatic events, and the one-way ANOVA test was used to compare PTG and religiosity across these classes in Iranian college students. RESULTS: The LCA revealed that a three-class solution had an adequate relative and absolute fit. The three classes were labeled and characterized as multiple-traumatic events (2.9%), intermediate-traumatic events (31.1%), and low-traumatic events (66.0%). In ANOVA results for PTG and Duke University Religion Index (DUREL) domains across classes, individuals in the multiple-traumatic classes had the lowest score of PTG and DUREL domains. CONCLUSION: Although the current study showed the relative frequency of multiple-traumatic events in Iranian students is low, individuals categorized in this class had the lowest PTG, and these findings reveal the necessitation of planning and interventions for PTG.

Posttraumatic growth after earthquake: A systematic review and meta-analysis.

BACKGROUND: Posttraumatic growth (PTG) represents a positive personal change after adverse events, such as natural disasters, including earthquake. However, the association between exposure to earthquake and level of PTG is still unknown. Thus, the aim of this systematic review and meta-analyses (MA) is to assess the level of PTG in people exposed to earthquake. METHODS: Studies were identified via Scopus, PsycInfo, Web of Science, PubMed, EMBASE, ProQuest, Cochran Library, Ovid, Google Scholar, OpenGrey, congress, and conferences research papers. The level of PTG was presented as mean and standard deviation. Subgroup analyses were conducted to control for the amount of time that had passed since stressor onset and age of the study population. The meta-regression was used to explore the sources of between-study heterogeneity, including sample size and age. RESULTS: The MA of all 21 studies using no restrictions related to age and time of the PTG measurement since traumatic event showed low level of PTG (41.71; 95%CI = 34.26; 49.16, I2: 62.44%, p: .000). Subgroup analyses controlled for the age demonstrated that level of PTG was higher in adults (49.47; 95% CI = 42.35; 56.58, I2: 0%, p = .466) when compared to children and adolescents (35.38; 95% CI = 23.65; 47.11, I2: 69.09%, p < .00). Moreover, the pooled weight mean of PTG measured 1 year and less than 1 year since the earthquake varied between medium (46.04; 95%CI = 34.45; 57.63, I2:51.2%, p: .037) and high (59.03; 95%CI = 41.46; 76.41, I2: 0%, p: .990) levels, respectively. CONCLUSION: The results of our MA showed low level of PTG in earthquake survivors. However, the mean value of PTG in adults was higher when compared to children and adolescents. In addition, the mean PTG was found to decrease over time since traumatic events.

Morbidity and mortality from technological disasters in Iran: A narrative review.

Iran as a developing country is at risk of vulnerability to technological disasters. These types of disasters occur frequently in last years and affected thousands of lives. Technological disasters in Iran cause thousands of deaths, thousands of injuries, and millions of dollars' economic loss in recent years. We searched suitable keywords in national and international disaster databases for gathering epidemiological data in these disasters in Iran. In addition, we searched suitable keywords in scientific databases including Google Scholar, Scopus, PubMed, Web of Knowledge, Scientific Information Database, Magiran, and Irandoc. After screening, only 19 articles discussed challenges of technological disasters in the country. Road accidents, explosions and fires, mine accidents, and railway accidents are common events in the country. After 2015, these types of disaster cause 823 deaths and injuries. Experience of response to these disasters showed that technological disaster management in the country faces too many challenges including comprehensive and prospective programs, weakness of necessary infrastructure for urban management, weakness in group work and interorganizational coordination, lack of coherent involvement of people and nongovernmental organizations, lack of information coverage during the disaster, volunteers in police service presence at scene, and normalization of these events. Due to interorganizational nature of mitigation in technological disasters, it must be developed coordination between various organizations to mitigate these types of disasters.

The design of an estimation norm to assess nurses required for educational and non-educational hospitals using workload indicators of staffing need in Iran.

BACKGROUND: One of the effective strategies in the fair distribution of human resources is the use of estimation norm of human workforce. A norm is a coefficient or an indicator for estimating the required human resources in an organization. Due to the changes in the available working hours of nurses in recent years and to use of a standard method, the Iranian Ministry of Health decided to update nursing estimation norm in hospitals in 2014-2015. This study aimed to design a nurse-required estimation norm for educational and non-educational hospitals based on the workload indicator in Iran. METHODS: This was a descriptive cross-sectional study, carried out from December 2015 to November 2016 in 49 wards in 12 educational and 17 non-educational hospitals in Mashhad, Iran. The wards and hospitals who had the best performance in nursing care quality indicators were selected. Focus group, work study, consensus, interview, and reviewing documents, staff and patient records, and the calculations of modified Workload Indicators of Staffing Needs (WISN) were used to collect the data. RESULTS: Patient care, cardiopulmonary resuscitation, and transfer out of the hospital were identified as the main activities of holding focus groups. Interviews and reviewing documents led to the identification of 10 factors associated with nurses' available working time. In both educational and non-educational hospitals, the annual working time of all nurses except nurses working in the burn and psychiatric, burn ICU, and pediatric psychiatry wards, which was 1302 h per year, was 1411 h per year. The calculations of the modified WISN method showed that the lowest norm in educational hospitals was for psychiatric, eye surgery, and dermatology wards (0.53) and in non-educational hospitals was for ENT ward (0.57). The highest norm in educational and non-educational hospitals was for burn ICU (3.95) and general ICU (3.07) wards, respectively. CONCLUSION: The nursing estimation norm in different wards of the hospital varies, considering that the time available to nurses and their workload in different wards and hospitals are different, and each ward has its special norm therefore, a single norm for all wards and hospitals cannot be used for a fair distribution of nurses.

Meta-evaluation of published studies on evaluation of health disaster preparedness exercises through a systematic review.

OBJECTIVE: Exercise evaluation is one of the most important steps and sometimes neglected in designing and taking exercises, in this stage of exercise, it systematically identifying, gathering, and interpreting related information to indicate how an exercise has fulfilled its objectives. The present study aimed to assess the most important evaluation techniques applied in evaluating health exercises for emergencies and disasters. METHODS: This was meta-evaluation study through a systematic review. In this research, we searched papers based on specific and relevant keywords in research databases including ISI web of science, PubMed, Scopus, Science Direct, Ovid, ProQuest, Wiley, Google Scholar, and Persian database such as ISC and SID. The search keywords and strategies are followed; "simulation," "practice," "drill," "exercise," "instrument," "tool," "questionnaire," " measurement," "checklist," "scale," "test," "inventory," "battery," "evaluation," "assessment," "appraisal," "emergency," "disaster," "cricise," "hazard," "catastrophe,: "hospital", "prehospital," "health centers," "treatment centers," were used in combination with Boolean operators OR and AND. RESULTS: The research findings indicate that there are different techniques and methods for data collection to evaluate performance exercises of health centers and affiliated organizations in disasters and emergencies including debriefing inventories, self-report, questionnaire, interview, observation, shooting video, and photographing, electronic equipment which can be individually or collectively used depending on exercise objectives or purposes. CONCLUSION: Taking exercise in the health sector is one of the important steps in preparation and implementation of disaster risk management programs. This study can be thus utilized to improve preparedness of different sectors of health system according to the latest available evaluation techniques and methods for better implementation of disaster exercise evaluation stages.

Motivation of the nurses in pre-hospital emergency and educational hospitals emergency in the southeast of Iran.

INTRODUCTION: Nurses, as the largest human resource element of health care systems, have a major role in providing ongoing, high-quality care to patients. Therefore, due to the importance of this issue, this study aimed to determine job motivation of the nurses in pre-hospital and educational hospitals emergency in the southeast of Iran. METHODS: In this study, a cross-sectional method was used, and it was conducted in educational hospitals and pre-hospital emergencies under supervision of the Kerman University of Medical Sciences in 2017. Using a valid and reliable questionnaire, we assessed job motivation of the nurses using a census method (N = 275). Data were analyzed by implementing descriptive statistics including mean and standard deviation (SD), and analytical statistics such as Kolmogorov-Smirnov, ANOVA, t-test, X2, Pearson, and multivariate regression tests using SPSS 16 and P ≤ 0.05. RESULTS: Among the pre-hospital emergency nurses, the average of the educational factors was 25.33, financial factors was 6.34, psychological factors was 20.07, welfare factors was 0.63, and administrative factors was 8.16. Among the nurses of the educational hospitals emergency, these factors were 25.33, 6.51, 20.34, 16.55, and 8.39, respectively. Two group's nurses were at the intermediate level of the job motivation. CONCLUSION: Dynamic and predetermined goals of emergency include providing services as soon as possible and stabilizing patient's condition during the golden and vital time of rescue. Findings suggest that national and local policies in Iran may need to examine factors that contribute to the promotion of the motivation as well as focusing on how to improve them.