Development in disaster nursing: The challenges of various research designs

Human health and lives are threatened by natural disasters happening around the world, armed conflicts and terrorist attacks occurring repeatedly in various countries, and the spread of infectious diseases. The Japanese Nursing Association defines a disaster as "an unexpected event-natural or man-made-that threatens life and health of many people. Disaster includes not only primary damage caused by an earthquake, fire, etc., but also secondary threats to life and health." Particularly, in recent years, disasters have been on the increase, due to environmental changes including global warming, as well as social changes such as an aging population and population influx into urban areas. The disaster cycle is divided into four phases: (i) acute phase (immediately to 48 h after the disaster); (ii) sub-acute phase (1 month); (iii) mid-to long-term phase (a few months or years); and (iv) the silent phase. Nursing professionals with knowledge and expertise in health care and patient support can play important roles in supporting the health of disaster-affected people in all phases of the disaster cycle. For example, nurses can comprehensively assess the physical, mental and social conditions of people with health problems, and provide necessary physical and emotional care. When a disaster strikes, lifeline services are often disrupted, forcing people to shelter in evacuation centers and endure a difficult life there. Nursing professionals can work to improve the living environment of evacuation centers through services such as water supply and hygiene management (provision of clean toilet facilities etc.). They can also make proper arrangements for the delivery of medical and relief supplies. Furthermore, they can provide long-term support for disaster survivors by encouraging them to summon up the strength to carry on and rebuild their lives. As just described, nursing professionals can contribute to a wide range of areas, from emergency medical services in the acute phase, to mental health nursing care, infectious disease prevention and health guidance in the mid-and long-term phase.