Journal of Education and Health Promotion

Abstract BACKGROUND AND AIM: Earthquake is a natural disaster severely affecting the societies’ health,
hygiene, and welfare as such the most effective method to respond to its damages is to develop a
readiness plan. This study aimed to discover thematic patterns and co‑author relationships extracted
from relevant publications to plan an earthquake response.
MATERIALS AND METHODS: This descriptive–analytical study adopted the scientometric approach
and used word co‑occurrence and social network analysis. The published articles indexed in PubMed
were retrieved from 1970 to 2021 using a combination of keywords “earthquake and response.” The
data were analyzed in VOSviewer, UCINET, and NetDraw software.
RESULTS: The following six thematic clusters with a social map were extracted: Initial response of
the healthcare system, response to probabilistic risks after the hazard, response to mental health and
community resilience, response to public health, response to post‑traumatic stress disorders, and
staff’s response to the needs assessment and continuity of diagnostic treatment services. Moreover,
social network analysis revealed the great impact of Japanese and Chinese authors and institutes.
CONCLUSION: The present study detected many gaps in the literature on earthquake response,
which can contribute to developing a general framework to prepare integrated healthcare earthquake
response plans to promote the performance of this system.

Abstract BACKGROUNDS: Due to the severity of the earthquake, it may need immediate treatment and
transfer of the injured people to advanced medical centers, as well as dispatch of the expert team
and specialized health equipment to the accident‑affected area. Aerial emergency is an important
responsibility of the health care system in this situation. The study aimed to extract the prehospital
emergency challenges of Iran aerial operations emergency in response to the earthquake.
MATERIALS AND METHODS: The study was qualitative content analysis with conventional
approach. Sampling was done in a purposive method and data were collected through semi‑structured
interview. The panel involved consists of 26 health professionals in medical emergencies. Recorded
interviews were transcribed into written and then conventional content analysis was used to derive
coding categories directly from the text data.
RESULTS: Content analysis is provided 97 initial codes, 20 subcategories and 4 main categories
including challenges of “response assessment,” “support,” ”pre‑hospital staff‑management,” and
“response operation,” respectively.
CONCLUSIONS: The results showed that the necessity to assess the affected area, staffing, and
management actions, including integrated operations command and the development of a dedicated
response plan, as well as the use of strategies inter‑organizational coordination in the response
phase to earthquake. This study also emphasized that providing standard equipment, support actions,
and strengthening communication infrastructure, and updating the aerial emergency system should
be considered as one of the priorities of the emergency organization of Iran to provide a desired
response to the earthquake.

Abstract INTRODUCTION: The state of health‑care disaster preparedness in Iran prior to the possible
earthquakes is not well documented. This study identified the challenges of the Iranian health system
before possible earthquakes in Tehran based on the World Health Organization (WHO) framework.
MATERIALS AND METHODS: In this qualitative study, in‑depth and semi‑structured interviews were
conducted for 17 health experts and authorities, who were selected based on purposive sampling
method. The questions were designed based on the proposed framework of the WHO in six areas
including policies and planning, communication, collaboration and coordination, training, volunteers
and the public, and surge capability. The data were analyzed by using framework analysis.
RESULTS: The main themes included weak communication infrastructures, inappropriate assessment
of specialized training courses and lack of a clear scenario, integrated urban commanding,
extra‑sectorial coordination, and data banks for public volunteers.
CONCLUSION: Iran health‑care disaster preparedness was tested by many earthquakes. This
research showed that disaster preparedness in Iran faces several challenges.

Abstract BACKGROUND: Iran has experienced an increasing number of earthquake disasters in the past
three decades. Due to nurses’ unique role as professional and volunteer responders in times of
disaster, more information is required regarding the capabilities they need to provide more effective
care during the crisis. The aim of this study was to identify professional capabilities needed by nurses
to provide care to the injured of earthquake.
MATERIALS AND METHODS: The present study was conducted as a qualitative conventional content
analysis, and data collection was carried out through 16 semi‑structured and in‑depth interviews with
the nurses involved in providing care to the injured in the Kermanshah earthquake. The data were
analyzed following Graneheim and Lundman’s approach.
RESULTS: Data analysis led to the emergence of 427 primary codes, 10 subcategories, and four
categories. The four categories included clinical competence (professional knowledge and clinical
skills), personal competences (communication skills, resiliency, and creativity and innovation
in providing care), ethical competence (commitment to ethics and professional responsibility),
and essential skills in caring for the injured (skills in triage, psychological care skills, and skills in
observation and monitoring)
CONCLUSION: The present study identified a wide range of professional capabilities required by
nurses in disasters. Given that nurses do not acquire some of these specialized and technical skills
during their education, it is recommended to enhance the professional capacity of nurses in disasters.
In addition, special training programs in this field can be incorporated into the curriculum of nursing
programs and in-service nursing education.

Abstract BACKGROUND AND AIM: Some people exposed to disasters will suffer from acute stress
disorder (ASD) due to the negative consequences of these disasters. Evaluating this disorder at a
large scale requires a credible and standardized tool. Therefore, the current study aims to investigate
the psychometric properties of the ASD questionnaire for people exposed to Kerman earthquake.
METHODS: This is a descriptive‑tooling study, conducted on 435 men and women older than 18 years
living in earthquake‑affected areas of Kerman Province (Kouh‑e‑Banan). The study was carried out
using the Persian translating of the English version of the Diagnostic and Statistical Manual of Mental
Disorders, Fifth Edition ASD questionnaire on accessible individuals living in temporary residence
tents in two initial and final stages and different stages of validity and reliability evaluation was carried
out. The findings were analyzed using descriptive statistics and Pearson’s correlation coefficient.
RESULTS: During the evaluation of content validity, no questions were eliminated. To carry out
factor analysis, sampling competence, and suitability of sample size were confirmed through
Kaiser–Meyer–Olkin and Bartlett’s tests. In the factor analysis stage, 14 items in three factors were
defined. The factors were included reexperiencing and analysis, arousal (continuous irritability), and
avoidance factors which together explained 59.43% of percentage distribution. In the next stage
of evaluating divergent validity, the results indicated a significant and inverse correlation between
ASD score and quality of life score (r = −0.43, P = 0.002) of the participants, while there was also
a positive and significant correlation between ASD score and general health disorder score of
the participants (r = 0.47, P < 0.0001). The reliability of the questionnaire was investigated using
Cronbach’s alpha, and inner class correlation coefficient was calculated to be 0.9.
CONCLUSIONS: The tool investigated in this study has suitable validity and reliability and is effective
for use by psychologists and relief workers for necessary interventions and prevention of ASD in
disasters.

Abstract One of the methods, especially those living in remote areas or have crashed and does not have
access to specialists is telemedicine. Telemedicine describes the use of medical information
exchanged from one site to another via electronic communications to improve patients’ health
status and care. Travel and wait times between the initial consultations with the patient’s own
general practitioner and referral to specialist can be reduced and specialists have successfully
provided remote triage and treatment consults of victims via the robot. The robot proved
to be a useful means to extend resources and provide expert consulting if specialists were
unable to physically be at the site. In fact, the telemedicine system is providing health care
services for individuals who are not available because of geographical and environmental
conditions. The aim of this study was to identify telemedicine applications in disaster, and
proposed use of this technology in areas where the shortage of specialists in remote areas
in disasters. This study was un-systematic (narrative) review. The literature was searched
for using of telemedicine in disaster and remote places with the help of libraries, conference
proceedings, data bank, and also search engines available at Google, Google scholar. In
our searches, we employed the following keywords and their combinations: telemedicine,
remote place, earthquake, disaster, war, and telecommunication in the searching areas of
title, keyword, abstract, and full text. In this study, more than 85 articles and reports were
collected and 26 of them were selected based on their relevancy. This literature review helps
define the concept of “components and usages of the Telemedicine in disaster” as the new
technology in the present age.

Abstract ABSTRACT
Context: Damages and loss of life sustained during an earthquake results from falling structures
and flying glass and objects. To address these and other problems, new information technology
and systems as a means can improve crisis management and crisis response. The most
important factor for managing the crisis depends on our readiness before disasters by useful
data. Aims: This study aimed to determine the Earthquake Information Management System
(EIMS) in India, Afghanistan and Iran, and describe how we can reduce destruction by EIMS
in crisis management. Materials and Methods: This study was an analytical comparison in
which data were collected by questionnaire, observation and checklist. The population was
EIMS in selected countries. Sources of information were staff in related organizations, scientific
documentations and Internet. For data analysis, Criteria Rating Technique, Delphi Technique
and descriptive methods were used. Results: Findings showed that EIMS in India (Disaster
Information Management System), Afghanistan (Management Information for Natural Disasters)
and Iran are decentralized. The Indian state has organized an expert group to inspect issues
about disaster decreasing strategy. In Iran, there was no useful and efficient EIMS to evaluate
earthquake information. Conclusions: According to outcomes, it is clear that an information
system can only influence decisions if it is relevant, reliable and available for the decisionmakers in a timely fashion. Therefore, it is necessary to reform and design a model. The model
contains responsible organizations and their functions.