Hostname: page-component-54dcc4c588-hp6zs Total loading time: 0 Render date: 2025-10-03T13:36:23.586Z Has data issue: false hasContentIssue false

Navigating Challenges and Building Resilience: Qualitative Insights into Disaster Nursing Preparedness in Chinese Non–First-Tier Cities

Published online by Cambridge University Press:  27 August 2025

Liyi Song
Affiliation:
Nursing Department, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China Department of Emergency Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
Lin Du
Affiliation:
Nursing Department, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China Department of Nephrology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
Li Xu*
Affiliation:
Nursing Department, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China Department of Neurosurgery, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
Min Wu
Affiliation:
Intensive Care Unit, Central Hospital of Yongcheng, Yongcheng, China
Xueyan Li*
Affiliation:
Nursing Department, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
*
Corresponding authors: Li Xu and Xueyan Li; Emails: jiashuran0330@163.com; yoyolixueyan@163.com
Corresponding authors: Li Xu and Xueyan Li; Emails: jiashuran0330@163.com; yoyolixueyan@163.com

Abstract

Objectives

This qualitative study aimed to explore the lived experiences, challenges, and perceptions of nurses regarding disaster preparedness in non–first-tier (inland) cities in China. Building upon our previous quantitative findings, we sought to understand the psychological, professional, and organizational factors that influence nurses’ disaster response capabilities in resource-limited settings.

Methods

A descriptive phenomenological approach was employed. Semistructured in-depth interviews were conducted with 12 nurses from four comprehensive hospitals at or above the second level in Yongcheng City, Henan Province, China, between September and December 2023. Participants were purposively selected based on their involvement in disaster response activities. Interviews were audio-recorded, transcribed verbatim, and analyzed using Colaizzi’s 7-step method.

Results

Five major themes emerged from the analysis: (1) Psychological Stress and Emotional Adaptation, (2) Disaster Emergency Response Capacity and Management, (3) Communication and Collaboration, (4) Challenges in Disaster Nursing Capacity Development, and (5) Impact of Disaster Relief Participation. Key findings revealed that nurses experienced significant psychological pressure during disaster response, struggled with limited specialized training opportunities, faced challenges in team coordination, and identified institutional barriers to disaster preparedness enhancement. Despite these challenges, participants demonstrated strong professional commitment and developed personal coping strategies.

Conclusions

This study provides critical insights into the lived experiences of nurses during disaster response in Chinese non–first-tier cities. The findings highlight the need for systematic psychological support mechanisms, specialized disaster nursing training programs tailored to local contexts, enhanced interhospital collaboration networks, and stronger institutional commitment to disaster preparedness. These insights complement our previous quantitative findings and offer a comprehensive foundation for developing targeted interventions to enhance disaster nursing capabilities in resource-limited settings.

Information

Type
Original Research
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of Society for Disaster Medicine and Public Health, Inc

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

Footnotes

These authors contributed equally to this work as first authors.

References

Asian Disaster Reduction Center. Good practices Total Disaster Risk Management. 2010. Accessed February 26, 2022. https://www.adrc.asia/publications/TDRM2005/TDRM_Good_Practices/GP2009_e.phpGoogle Scholar
World Health Organization. Nursing and midwifery. 2024. https://www.who.int/news-room/fact-sheets/detail/nursing-and-midwiferyGoogle Scholar
United Nations Office for Disaster Risk Reduction. UNDRR Annual report 2020[EB/OL]. Accessed April 22, 2023. https://www.undrr.org.annual-report/2020Google Scholar
Wang, J, Sun, X, Lu, S, et al. Disaster preparedness and associated factors among emergency nurses in Guangdong Province, China: a descriptive cross-sectional study. Disaster Med Public Health Prep. Dec 1 2021;17:e65.10.1017/dmp.2021.327CrossRefGoogle ScholarPubMed
Core Competencies in Disaster Nursing: Version 2.0[EB/OL]. (2019-11) [2022-11-15]. https://www.icn.ch/node/1285Google Scholar
Li, Y, Turale, S, Stone, TE, Petrini, M. A grounded theory study of “turning into a strong nurse”: earthquake experiences and perspectives on disaster nursing education. Nurse Educ Today. Sep 2015;35(9):e4349.10.1016/j.nedt.2015.05.020CrossRefGoogle ScholarPubMed
Zhang, J, Yang, L, Cao, X, et al. Assessment of disaster preparedness and related impact factors among emergency nurses in tertiary hospitals: descriptive cross-sectional study from Henan Province of China. Front Public Health. 2023;11:1093959.10.3389/fpubh.2023.1093959CrossRefGoogle ScholarPubMed
Wu, M, Li, X, Wang, Y, Xu, L. Investigation and analysis of disaster preparedness among nurses in Chinese non-first-tier (inland) cities: a case study from Yongcheng City, Henan Province. Disaster Med Public Health Prep. Jan 3 2025;18:e342.10.1017/dmp.2024.300CrossRefGoogle ScholarPubMed
Creswell, JW, Poth, CN. Qualitative Inquiry and Research Design: Choosing Among Five Approaches. 4th ed. SAGE Publications; 2018.Google Scholar
Giorgi, A. The Descriptive Phenomenological Method in Psychology: A Modified Husserlian Approach. Duquesne University Press; 2009.Google Scholar
Colaizzi, PF. Psychological research as the phenomenologist views it. In: Valle, RS, King, M, eds. Existential-Phenomenological Alternatives for Psychology. Oxford University Press; 1978:4871.Google Scholar
Lincoln, YS, Guba, EG. Naturalistic Inquiry. SAGE Publications; 1985.CrossRefGoogle Scholar
Brooks, SK, Dunn, R, Amlôt, R, Rubin, GJ, Greenberg, N. A systematic, thematic review of social and occupational factors associated with psychological outcomes in healthcare employees during an infectious disease outbreak. J Occup Environ Med. Mar 2018;60(3):248257.10.1097/JOM.0000000000001235CrossRefGoogle ScholarPubMed
Labrague, LJ, De Los Santos, JAA. COVID-19 anxiety among front-line nurses: predictive role of organisational support, personal resilience and social support. J Nurs Manag. Oct 2020;28(7):16531661.10.1111/jonm.13121CrossRefGoogle ScholarPubMed
Hugelius, K, Adolfsson, A, Örtenwall, P, Gifford, M. Being both helpers and victims: health professionals’ experiences of working during a natural disaster. Prehosp Disaster Med. Apr 2017;32(2):117123.10.1017/S1049023X16001412CrossRefGoogle ScholarPubMed
Rushton, CH, Caldwell, M, Kurtz, M. CE: moral distress: a catalyst in building moral resilience. Am J Nurs. Jul 2016;116(7):4049.10.1097/01.NAJ.0000484933.40476.5bCrossRefGoogle ScholarPubMed
Veenema, TG, Griffin, A, Gable, AR, et al. Nurses as leaders in disaster preparedness and response—a call to action. J Nurs Scholarsh. Mar 2016;48(2):187200.10.1111/jnu.12198CrossRefGoogle ScholarPubMed
Sun, N, Wei, L, Shi, S, et al. A qualitative study on the psychological experience of caregivers of COVID-19 patients. Am J Infect Control. Jun 2020;48(6):592598.10.1016/j.ajic.2020.03.018CrossRefGoogle ScholarPubMed
Mao, X, Yang, Q, Li, X, et al. An illumination of the ICN’s core competencies in disaster nursing version 2.0: advanced nursing response to COVID-19 outbreak in China. J Nurs Manag. Apr 2021;29(3):412420.10.1111/jonm.13195CrossRefGoogle ScholarPubMed
Xia, R, Li, S, Chen, B, Jin, Q, Zhang, Z. Evaluating the effectiveness of a disaster preparedness nursing education program in Chengdu, China. Public Health Nurs. Mar 2020;37(2):287294.10.1111/phn.12685CrossRefGoogle ScholarPubMed
Yan, YE, Turale, S, Stone, T, Petrini, M. Disaster nursing skills, knowledge and attitudes required in earthquake relief: implications for nursing education. Int Nurs Rev. Sep 2015;62(3):351359.10.1111/inr.12175CrossRefGoogle ScholarPubMed
Baack, S, Alfred, D. Nurses’ preparedness and perceived competence in managing disasters. J Nurs Scholarsh. Sep 2013;45(3):281287.10.1111/jnu.12029CrossRefGoogle ScholarPubMed
Tzeng, WC, Feng, HP, Cheng, WT, et al. Readiness of hospital nurses for disaster responses in Taiwan: a cross-sectional study. Nurse Educ Today. Dec 2016;47:3742.10.1016/j.nedt.2016.02.025CrossRefGoogle ScholarPubMed
Veenema, TG, Losinski, SL, Hilmi, LM. Increasing emergency preparedness. Am J Nurs. Jan 2016;116(1):4953.10.1097/01.NAJ.0000476169.28424.0bCrossRefGoogle ScholarPubMed
Sonneborn, O, Miller, C, Head, L, Cross, R. Disaster education and preparedness in the acute care setting: a cross sectional survey of operating theatre nurse’s disaster knowledge and education. Nurse Educ Today. Jun 2018;65:2329.10.1016/j.nedt.2018.02.015CrossRefGoogle ScholarPubMed
Salas, E, Reyes, DL, McDaniel, SH. The science of teamwork: progress, reflections, and the road ahead. Am Psychol. May–Jun 2018;73(4):593600.10.1037/amp0000334CrossRefGoogle ScholarPubMed
Qin, YJ, Liu, JH, Xie, YJ, et al. Disaster preparedness among populations in Shenzhen, China, with and without chronic disease. Disaster Med Public Health Prep. Feb 18 2022;17:e82.10.1017/dmp.2021.354CrossRefGoogle ScholarPubMed
Luo, C. Management of a nursing unit in a temporary COVID-19 specialized hospital in Wuhan, China. Disaster Med Public Health Prep. Apr 2022;16(2):741747.10.1017/dmp.2020.373CrossRefGoogle Scholar
Zhang, D, Zhang, L, Gong, A. Development of disaster nursing in China: from the spirit of nightingale to COVID-19. Disaster Med Public Health Prep. Apr 2021;15(2):e32e35.10.1017/dmp.2020.468CrossRefGoogle Scholar
Veenema, TG, Lavin, RP, Griffin, A, Gable, AR, Couig, MP, Dobalian, A. Call to action: the case for advancing disaster nursing education in the United States. J Nurs Scholarsh. Nov 2017;49(6):688696.10.1111/jnu.12338CrossRefGoogle ScholarPubMed
Manning-Jones, S, dT, Ian, and Stephens, C. The relationship between vicarious posttraumatic growth and secondary traumatic stress among health professionals. J Loss and Trauma. 04 Mar 2017;22(3):256270.10.1080/15325024.2017.1284516CrossRefGoogle Scholar
Brooks, S, Amlôt, R, Rubin, GJ, Greenberg, N. Psychological resilience and post-traumatic growth in disaster-exposed organisations: overview of the literature. BMJ Mil Health. Feb 2020;166(1):5256.10.1136/jramc-2017-000876CrossRefGoogle ScholarPubMed