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      “Expecting the Unexpected:” Nurses' Response and Preparedness of Terrorism-Related Disaster Events in Quetta City, Pakistan

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          Abstract

          Background: In addition to the psychiatric and societal misery, terrorism places an exceptional burden while delivering healthcare services. Accordingly, a responsive and well-prepared healthcare system ensures effective management of terrorism-related events. Within this context, with a strong historic grounding in addressing situations of societal crisis nurses are well-placed in contributing to the global arena of humanitarian policy and social research. Therefore, assessing their response and preparedness is vital in effective management of a terrorism-related disaster. For that very reason, we aimed to evaluate nurses' preparedness and response toward terrorism-related disaster events in Quetta city, Pakistan.

          Methods: A qualitative design was adopted to explore nurses' response and preparedness of terrorism-related disaster events. By using a semi-structured interview guide through the phenomenology-based approach, in-depth, face-to-face interviews were conducted. Nurses practicing at the Trauma Center of Sandeman Provincial Hospital (SPH), Quetta, were approached for the study. All interviews were audio-taped, transcribed verbatim, and were then analyzed for thematic contents by the standard content analysis framework.

          Results: Fifteen nurses were interviewed and thematic content analysis revealed five themes. All nurses have experienced, responded to, and managed terrorism-related disaster events. They were prepared both professionally and psychologically in dealing with a terrorism-related disaster. Among limitations, space and workforce were highlighted by almost all the respondents. Lack of disaster-related curricula, absence of a protocol, recurrence of the disaster, and hostile behavior of victim's attendants during an emergency were highlighted as a key barrier toward terrorism-related disaster management.

          Conclusion: The skills and expertise needed to address a terrorism-related disaster are well-understood by the nurses but are lacking for various reasons. In addition to the review and adaption of the nursing curriculum specifically for terrorism-related disaster management, collaboration and dialogue between various stakeholders is required to efficiently manage terrorism-related disaster events.

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          Saturation in qualitative research: exploring its conceptualization and operationalization

          Benjamin Saunders, Julius Sim, Tom Kingstone … (2017)
          Saturation has attained widespread acceptance as a methodological principle in qualitative research. It is commonly taken to indicate that, on the basis of the data that have been collected or analysed hitherto, further data collection and/or analysis are unnecessary. However, there appears to be uncertainty as to how saturation should be conceptualized, and inconsistencies in its use. In this paper, we look to clarify the nature, purposes and uses of saturation, and in doing so add to theoretical debate on the role of saturation across different methodologies. We identify four distinct approaches to saturation, which differ in terms of the extent to which an inductive or a deductive logic is adopted, and the relative emphasis on data collection, data analysis, and theorizing. We explore the purposes saturation might serve in relation to these different approaches, and the implications for how and when saturation will be sought. In examining these issues, we highlight the uncertain logic underlying saturation—as essentially a predictive statement about the unobserved based on the observed, a judgement that, we argue, results in equivocation, and may in part explain the confusion surrounding its use. We conclude that saturation should be operationalized in a way that is consistent with the research question(s), and the theoretical position and analytic framework adopted, but also that there should be some limit to its scope, so as not to risk saturation losing its coherence and potency if its conceptualization and uses are stretched too widely.
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            Content analysis and thematic analysis: Implications for conducting a qualitative descriptive study.

            Mojtaba Vaismoradi, Hannele Turunen, Terese Bondas (2013)
            Qualitative content analysis and thematic analysis are two commonly used approaches in data analysis of nursing research, but boundaries between the two have not been clearly specified. In other words, they are being used interchangeably and it seems difficult for the researcher to choose between them. In this respect, this paper describes and discusses the boundaries between qualitative content analysis and thematic analysis and presents implications to improve the consistency between the purpose of related studies and the method of data analyses. This is a discussion paper, comprising an analytical overview and discussion of the definitions, aims, philosophical background, data gathering, and analysis of content analysis and thematic analysis, and addressing their methodological subtleties. It is concluded that in spite of many similarities between the approaches, including cutting across data and searching for patterns and themes, their main difference lies in the opportunity for quantification of data. It means that measuring the frequency of different categories and themes is possible in content analysis with caution as a proxy for significance. © 2013 Wiley Publishing Asia Pty Ltd.
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              Principles of Good Practice for the Translation and Cultural Adaptation Process for Patient-Reported Outcomes (PRO) Measures: report of the ISPOR Task Force for Translation and Cultural Adaptation.

              Diane Wild, Alyson Grove, Mona Martin … (2005)
              In 1999, ISPOR formed the Quality of Life Special Interest group (QoL-SIG)--Translation and Cultural Adaptation group (TCA group) to stimulate discussion on and create guidelines and standards for the translation and cultural adaptation of patient-reported outcome (PRO) measures. After identifying a general lack of consistency in current methods and published guidelines, the TCA group saw a need to develop a holistic perspective that synthesized the full spectrum of published methods. This process resulted in the development of Translation and Cultural Adaptation of Patient Reported Outcomes Measures--Principles of Good Practice (PGP), a report on current methods, and an appraisal of their strengths and weaknesses. The TCA Group undertook a review of evidence from current practice, a review of the literature and existing guidelines, and consideration of the issues facing the pharmaceutical industry, regulators, and the broader outcomes research community. Each approach to translation and cultural adaptation was considered systematically in terms of rationale, components, key actors, and the potential benefits and risks associated with each approach and step. The results of this review were subjected to discussion and challenge within the TCA group, as well as consultation with the outcomes research community at large. Through this review, a consensus emerged on a broad approach, along with a detailed critique of the strengths and weaknesses of the differing methodologies. The results of this review are set out as "Translation and Cultural Adaptation of Patient Reported Outcomes Measures--Principles of Good Practice" and are reported in this document.
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                Author and article information

                Contributors
                Journal
                Journal ID (nlm-ta): Front Public Health
                Journal ID (iso-abbrev): Front Public Health
                Journal ID (publisher-id): Front. Public Health
                Title: Frontiers in Public Health
                Publisher: Frontiers Media S.A.
                ISSN (Electronic): 2296-2565
                Publication date (Electronic): 25 May 2021
                Publication date Collection: 2021
                Volume: 9
                Electronic Location Identifier: 695143
                Affiliations
                [1] 1Faculty of Pharmacy and Health Sciences, University of Balochistan Quetta , Quetta, Pakistan
                [2] 2Department of Statistics, University of Balochistan Quetta , Quetta, Pakistan
                [3] 3Sandeman Provincial Hospital , Quetta, Pakistan
                [4] 4Department of Gynecology and Obstetrics, Bolan Medical College , Quetta, Pakistan
                [5] 5Department of Pharmacy, Sardar Bahadur Khan Womens' University , Quetta, Pakistan
                [6] 6Health Department, Government of Balochistan , Quetta, Pakistan
                Author notes

                Edited by: Shazia Qasim Jamshed, Sultan Zainal Abidin University, Malaysia

                Reviewed by: Furqan Khurshid Hashmi, Punjab University, Pakistan; Naeem Mubarak, Lahore Medical and Dental College, Pakistan; Ghulam Murtaza, COMSATS University Islamabad, Lahore Campus, Pakistan

                *Correspondence: Fahad Saleem fahaduob@ 123456gmail.com

                This article was submitted to Public Health Policy, a section of the journal Frontiers in Public Health

                Article
                DOI: 10.3389/fpubh.2021.695143
                PMC ID: 8185202
                SO-VID: 738bbd6e-ead2-4a8e-8fe1-17da3af47bd3
                Copyright © Copyright © 2021 Khilji, Raziq, Shoaib, Baloch, Raza, Iqbal, Ishaq, Haider, Iqbal, Ahmad and Saleem.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                Date received : 14 April 2021
                Date accepted : 22 April 2021
                Page count
                Figures: 0, Tables: 2, Equations: 0, References: 60, Pages: 10, Words: 7593
                Categories
                Subject: Public Health
                Subject: Original Research

                Keywords: medication services,terrorism,disaster,preparedness and response,nurses
                Data availability:
                Keywords: medication services, terrorism, disaster, preparedness and response, nurses

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