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55
Contents lists available at ScienceDirect 56
57
58
Chinese Journal of Traumatology 59
60
journal homepage: http://www.elsevier.com/locate/CJTEE 61
62
63
Original Article 64
65
1
Q6 Indonesian nurses’ perception of disaster management preparedness 66
2 67
3
4
Q5,1 Martono Martono a, Nursalam Nursalam b, Satino Satino a, Ferry Efendi b, *, Angeline Bushy c 68
69
a
5 Nursing Department, Health Polytechnic of Surakarta, Ministry of Health Indonesia 70
b
6 Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
c
College of Nursing, University of Central Florida, USA
71
7 72
8 73
9 74
10 a r t i c l e i n f o a b s t r a c t
75
11 76
Article history: Purpose: Using a quantitative approach, this study aims to assess Indonesian nurses’ perception of their
12 Received 25 April 2018 77
knowledge, skills, and preparedness regarding disaster management.
13 Received in revised form 78
Methods: This study was a descriptive comparison in design. The research samples are Indonesian nurses
14 21 August 2018
working in medical service and educational institutions. The variable of nurses’ preparedness to cope 79
15 Accepted 13 September 2018
Available online xxx
with disaster victims was measured using the Disaster Preparedness Evaluation Tool (DPET), which was 80
16 electronically distributed to all nurses in Indonesia. Data were analyzed using a statistical descriptive 81
17 one-way Analysis of Variance (ANOVA) and t-test with a significance level of 95%. 82
Keywords:
18 Disasters
Results: In total, 1341 Indonesian nurses completed this survey. The average scores of preparedness to cope 83
19 Knowledge with disasters, the ability to recover from disaster, and evaluation of disaster were 3.13, 2.53, and 2.46, 84
20 Nurses respectively. In general, nurses surveyed in this study are less prepared for disasters, and do not under-
85
21 Preparedness stand their roles both during the phase of disaster preparedness, and when coping with a post-disaster
86
situation.
22 87
Conclusion: Nurses’ preparedness and understanding of their roles in coping with disasters are still low.
23 88
Therefore, their capacity in preparedness, responses, recovery, and evaluation of disasters needs
24 improvement through continuing education. The efforts needed are significant due to potential disasters 89
25 in Indonesia and adequate nurses resources. 90
26 © 2018 Production and hosting by Elsevier B.V. on behalf of Daping Hospital and the Research Institute of 91
27 Surgery of the Third Military Medical University. This is an open access article under the CC BY-NC-ND 92
28 license (http://creativecommons.org/licenses/by-nc-nd/4.0/). 93
29 94
30 95
31 96
32 97
33 Introduction other forms of natural disasters. Labrague et al.3 in 2015 reported
98
34 that when coping with natural disaster in Philippines, 80% of nurses
99
35 Building resilience and minimizing loss following natural haz- were not fully prepared. Also, it is reported that more than 57.7% of
100
36 ards are priorities of all governments across the world. Data from nurses did not understand disaster management protocols in their
101
37 the International Federation of Red Cross and Red Crescent Soci- workplace. In Hong Kong, it is reported that nurses were less pre-
102
38 eties revealed the five most common disasters in the world during pared to cope with disasters, but were aware of the importance of
103
39 2005e2014, respectively floods, storms, heat waves, and droughts. preparation.4 While for Jordanian nurses, continual reinforcement
104
40 Of all these natural hazards, 48% occurred in Asia, and we related are needed to improve self-efficacy in managing disasters.5 Recent
105
41 more than 85% of casualties.1 studies conducted in one province in Indonesia showed that the
106
42 Indonesia is well known for being in the ring of fire.2 disaster preparedness level among community health nurse
107
43 Geographically and geologically, Indonesia is highly prone to di- coordinators needed to be leveraged.6 Another study focused on
108
44 sasters, since it is located above tectonic plate spanning throughout disaster risk reduction by relying on community-based initiative
109
45 the Indonesia archipelago with systemic activities causing Indonesia addressed the lack of resources faced by communities.7 Knowledge
110
46 to be highly vulnerable to earthquake, flood, landslide, tsunami, and among adolescents on tsunami-vulnerable coastal areas needs to be
111
47 improved through education and training.8
112
48 Further study suggested that disaster-related training and
113
49 continuing education is one of prominent strategy in building
* Corresponding author. 114
50 E-mail address: ferry-e@fkp.unair.ac.id (F. Efendi).
nurses' preparation toward disaster.9 All of these studies were done
115
51 Peer review under responsibility of Daping Hospital and the Research Institute in specific region which hindered the generalizability of the finding.
116
52 of Surgery of the Third Military Medical University. Disasters may happen at any time without any prediction. Efforts to
117
53 118
https://doi.org/10.1016/j.cjtee.2018.09.002
54 1008-1275/© 2018 Production and hosting by Elsevier B.V. on behalf of Daping Hospital and the Research Institute of Surgery of the Third Military Medical University. This is 119
an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Please cite this article as: Martono M et al., Indonesian nurses’ perception of disaster management preparedness, Chinese Journal of
Traumatology, https://doi.org/10.1016/j.cjtee.2018.09.002
 CJTEE349_proof ■ 14 December 2018 ■ 2/6

2 M. Martono et al. / Chinese Journal of Traumatology xxx (xxxx) xxx

1 anticipate disasters have been made, with varying degrees of questionnaire consisted of 46 questions using a 6-point Likert scale. 66
2 adversities. The effects of a disaster can be harmful to human life as The scoring system for favorable questions uses the following 67
3 well as the environment. The tsunami in 2004 resulted in 227,000 criteria: 6 for ‘strongly agree’, 5 for ‘agree’, 4 for ‘doubtful/neither 68
4 deaths in Asia and 1.7 million people were evacuated.10 Meanwhile, agree nor disagree’, 3 for ‘less agree’, 2 for ‘disagree’, and 1 for 69
5 Jayasuriya and McCawley (2010) reported that more than 220,000 ‘strongly disagree’. Cronbach's alpha internal consistency reliability 70
6 men, women, and children in developing countries in Asia died for the original instrument was reported 0.91.17 71
7 associated with tsunami wave in 2004.11 Other studies revealed 72
8 that disasters are serious disturbances to communities and soci- Statistical test 73
9 eties which may cause material, physical, social, economic, and 74
10 environmental damage and exceedingly affect people's capability The statistical tests used for analyzing nurses’ perception of 75
11 to sustain themselves.12,13 disaster management preparedness were a descriptive statistical 76
12 Efforts in dealing with disasters should be the responsibilities of test, a one-way ANOVA, and a t-test with significance level of 95%. 77
13 governmental agencies, nongovernmental organizations, and soci- 78
14 ety. Indonesia in recent years has changed its disaster management Ethical considerations 79
15 strategies, from emphasizing emergency response and preparedness 80
16 to disaster management preparedness. Cornier explained that the The study was approved by the Ethics Committees at the Faculty 81
17 key factors of an effective emergency management plan for disasters of Nursing, Universitas Airlangga (615-KEPK). Participation on the 82
18 include public knowledge, healthcare involvement, comprehensive study was voluntary and respondents were maintained anonymity. 83
19 training, protocol, technology, and effective communication. 84
20 Therefore, participation and assuming responsibility by intersectoral 85
Results
21 entities is vital including governmental agencies, nongovernmental 86
22 organizations, and the public along with the health care providers, 87
Of the 1481 subjects completing the online questionnaires, 1341
23 particularly nurses, are essential.12 88
responded and met the criteria (90.55%), while 140 (9.45%) were
24 Human resources for health care provides is an important 89
eliminated due to incomplete responses and/or did not meet the
25 element in Indonesia especially for the professional nurses.14e16 90
criteria. Therefore 1341 nurses were enrolled in this study. Distri-
26 Nurses play important role in disaster preparedness such as 91
bution of general information included 67.3% female; 59.4% at the
27 educating the public to reduce disaster vulnerability and working in a 92
age of 26e32 years, 91.3% graduated from diploma in nursing, 52.9%
28 disaster situation. Thus, when disaster happens, nurses need to have 93
working for 5e10 years, and 98.4% receiving some training in
29 adequate skills related to disaster preparedness and disaster man- 94
disaster emergency.
30 agement. However, the research suggests that nurses often are not 95
Testing of normality was conducted by Kolmogorov Smirnov
31 sufficiently prepared to deal with disaster-related responsibilities.3,12 96
statistical test, which showed the data were normally distributed
32 Using a quantitative approach, this study aims to explain nurses’ 97
(knowledge r ¼ 0.219; skills r ¼ 0.258; evaluation r ¼ 0.128) (see
33 perception of their knowledge, skills, and preparedness in coping 98
Table 1). The results of one-way ANOVA test are presented in Q2
34 with disasters that may occur in Indonesia. 99
Table 2, which reveals that education contributed to significant
35 100
differences in perception of preparedness to cope with disaster
36 Methods 101
skills. Meanwhile, length of employment did not show any differ-
37 102
ences in perception based on knowledge, skills, and evaluation.
38 Research design 103
39 104
40 A descriptive cross-sectional survey was used to explore the 105
41 Table 1 106
perception of Indonesian nurses about their preparedness for
Demographic characteristics (n ¼ 1341).
42 disaster management. Using an online survey, we surveyed Indo- 107
43 nesian nurses working all over Indonesia. Potential participants Characteristics n % 108
44 were recruited from social media and any online group related to Sex 109
45 Indonesian nurses over four months. The survey was anonymous Male 438 32.7 110
46 and self-administered, invitation message for the study was sent to Female 903 67.3 111
Age (years)
47 the social media site containing the link. Inclusion criteria for the 112
21-25 406 30.3
48 nurses included nurses working in healthcare service institutions 26-32 797 59.4 113
49 and educational institutions agreeing to take part in this research 33-37 30 2.2 114
50 and registered as nurses in Indonesia. The survey was piloted 38-44 54 4.0 115
45-50 37 2.8
51 amongst a small sample of Indonesian nurses in order to repeat the 116
51-56 17 1.3
52 procedures and the questionnaires. Education
117
53 Diploma in nursing 1224 91.3 118
54 Research instruments S1 67 5.0 119
55 S2 44 3.3 120
S3 6 0.4
56 Data for this research were collected using a survey question- 121
Length of employment (years)
57 naire adapted from the Disaster Preparedness Evaluation Tool <5 515 38.4 122
58 (DPET).12,17 Translation of the questionnaires from English to 5-10 709 52.9 123
59 Indonesian was carried out by professional translator and experts 11-15 27 2.0 124
60 16-20 52 3.9 125
in disaster management. DPET is an evaluation tool designed to
21-25 18 1.3
61 measure three phases of disaster management, including (1) pre- 26-30 9 0.7
126
62 paredness with Cronbach's alpha internal consistency reliability of >30 11 0.8 127
63 0.879, (2) mitigation and response with Cronbach's alpha internal Experiences on previous training in emergency 128
64 consistency reliability of 0.940, and (3) evaluation with Cronbach's Yes 1320 98.4 129
No 21 1.6
65 alpha internal consistency reliability of 0.940. The translated 130

Please cite this article as: Martono M et al., Indonesian nurses’ perception of disaster management preparedness, Chinese Journal of
Traumatology, https://doi.org/10.1016/j.cjtee.2018.09.002
 CJTEE349_proof ■ 14 December 2018 ■ 3/6

M. Martono et al. / Chinese Journal of Traumatology xxx (xxxx) xxx 3

1 Table 2 66
2 Differences in nurses’ perception of preparedness based on age, education, and length of work. 67
3 Field Sum of Squares df Mean square F value p value 68
4 Age
69
5 *Knowledge 70
6 Between groups 41.608 64 0.650 0.686 0.972 71
7 Within groups 1209.485 1276 0.948 72
Total 1251.093 1340
8 73
*Skills
9 Between groups 51.069 46 1.110 1.197 0.174 74
10 Within groups 1200.024 1294 0.927 75
11 Total 1251.093 1340 76
12 *Evaluation 77
between groups 15.290 18 0.849 0.909 0.568
13 Within groups 1235.803 1322 0.935
78
14 Total 1251.093 1340 79
15 Education 80
16 *Knowledge 81
Between groups 13.340 64 0.208 1.018 0.440
17 82
Within groups 261.342 1276 0.205
18 Total 274.682 1340 83
19 *Skills 84
20 Between groups 13.473 46 0.293 1.451 0.027 85
21 Within groups 261.208 1294 0.202 86
Total 274.682 1340
22 *Evaluation
87
23 Between groups 2.935 18 0.163 0.793 0.710 88
24 Within groups 271.747 1322 0.206 89
25 Total 274.682 1340 90
Length of Work
26 91
*Knowledge
27 Between groups 40.336 64 0.630 0.644 0.987 92
28 Within groups 1248.069 1276 0.978 93
29 Total 1288.404 1340 94
30 *Skills 95
Between groups 51.072 46 1.110 1.161 0.216
31 96
Within groups 1237.332 1294 0.956
32 Total 1288.404 1340 97
33 *Evaluation 98
34 Between groups 13.007 18 0.723 0.749 0.761 99
Within groups 1275.397 1322 0.965
35 100
Total 1288.404 1340
36 Experience in joining training 101
37 *Knowledge 102
38 Between groups 0.751 64 0.012 0.991 0.498 103
39 Within groups 15.103 1276 0.012 104
Total 15.854 1340
40 105
*Skills
41 Between groups .962 46 0.021 1.818 0.001 106
42 Within groups 14.891 1294 0.012 107
43 Total 15.854 1340 108
*Evaluation
44 109
Between groups 0.078 18 0.004 0.361 0.994
45 Within groups 15.776 1322 0.012
110
46 Total 15.854 1340 111
47 112
48 113
49 114
Table 3 shows training about emergency did not contribute to Table 5 shows that the 25 items on the DPET had three sub-
50 115
different perception of nurses’ preparedness, particularly in terms categories, including (i) knowledge, (ii) disaster management
51 116
of knowledge (p ¼ 0.774) and evaluation (r ¼ 0.289). However, skills, and (iii) family preparedness; the average score measured
52 117
training itself associated with their skills (p ¼ 0.030). with a 6-point Likert scale was 3.13. Correlation among items in this
53 118
Table 4 reveals that a reliability test on nurses’ perception part was 0.20 (Cronbach's alpha ¼ 0.856).
54 119
resulted in an overall inter-item correlation score of 0.88 Table 6 shows that 15 items of questions focused on two
55 120
(knowledge ¼ 0.901, skills ¼ 0.895, and evaluation ¼ 0.802). sub-categories, patient's knowledge and skills; the average score
56 121
57 122
58 Table 4 123
59 Table 3 The results of an inter-item correlation test of nurses’ perception of disaster pre- 124
Independent sample t-test results of the differences in nurses’ perception of disaster paredness (6-point Likert scale).
60 preparedness based on emergency training experiences.
125
61 Perception Mean Variance SD Item (n) Score 126
62 Field F SD t value p value 127
Knowledge 125.03 206.172 13.178 25 0.901
63 Knowledge 0.565 10.501 0.294 0.774 Skills 76.31 260.964 10.753 15 0.895 128
64 Skills 2.769 6.445 2.465 0.030 Evaluation 30.77 469.504 4.426 6 0.802 129
Evaluation 0.003 4.100 1.112 0.289 Total 46 0.776
65 130

Please cite this article as: Martono M et al., Indonesian nurses’ perception of disaster management preparedness, Chinese Journal of
Traumatology, https://doi.org/10.1016/j.cjtee.2018.09.002
 CJTEE349_proof ■ 14 December 2018 ■ 4/6

4 M. Martono et al. / Chinese Journal of Traumatology xxx (xxxx) xxx

1 Table 5 66
2 The results of a correlation test for each survey items of nurses’ preparedness in coping with disaster (n ¼ 1341). 67
3 Disaster knowledge Mean SD 68
4 1 I would be interested in educational classes on disaster preparedness that relate specifically to my community situation. 5.68 0.625
69
5 2 I am aware of classes about disaster preparedness and management that are offered, for example, at my workplace, the 5.72 0.636 70
6 university, or in the community. 71
7 3 I find that the published works of research on disaster preparedness are understandable. 4.04 1.109 72
4 I know the limits of my knowledge, skills, and authority as a nurse to act in disaster situations, and I would know when I 4.28 0.931
8 73
exceed them.
9 5 Finding relevant information about disaster preparedness related to my community needs is an obstacle to my level of 3.88 1.716 74
10 preparedness. 75
11 6 I am aware of what the potential vulnerabilities in my community are (e.g. earthquake, floods, terror). 3.24 1.004 76
12 7 In the case of a disaster situation, I think that there is sufficient support from local officials or state level. 3.23 1.107 77
8 I know where to find relevant research or information related to disaster preparedness and management to fill in gaps in 3.95 1.104
13 my knowledge.
78
14 9 I have a list of contacts in the medical or health community in which I practice who know referral contacts in case of a 2.19 0.948 79
15 disaster situation (e.g. health department). 80
16 10 I find that the published works of research on disaster preparedness and management are easily accessible. 2.97 1.096 81
11 I participate in one of the following educational activities on a regular basis:continuing education classes, seminars, or 4.92 1.243
17 82
conferences dealing with disaster preparedness.
18 12 I am familiar with the local emergency response system for disasters. 4.07 1.048 83
19 13 I know who to contact (chain of command) in disaster situations in my community. 2.09 1.032 84
20 14 I read journal articles related to disaster preparedness. 2.99 1.094 85
21 15 I participate/have participated in creating new guidelines, emergency plans, or lobbying for improvements on the local 1.72 1.312 86
or national level.
22 16 I have participated in emergency plan drafting and emergency planning for disastersituations in my community. 1.84 1.273
87
23 Disaster skills 88
24 1 I am familiar with accepted triage principles used in disaster situations. 3.14 1.038 89
25 2 I participate in disaster drills or exercises at my workplace (e.g. clinic, hospital) on a regular basis. 3.26 1.054 90
3 I consider myself prepared for the management of disasters. 3.01 1.117
26 91
4 In the case of a bioterrorism attack, I know how to use personal protective equipment. 1.36 0.982
27 5 I would be considered a key leadership figure in my community in a disaster situation. 2.91 1.178 92
28 6 In the case of a bioterrorism, I know how to perform isolation procedures so that I minimize the risks of community 1.89 1.202 93
29 exposure. 94
30 7 In the case of a bioterrorism, I know how to execute decontamination procedures. 1.90 1.165 95
Family preparedness for a disaster
31 96
1 I have personal/family emergency plans in place for disaster situations. 2.03 1.148
32 2 I have an agreement with loved ones and family members on how to execute our personal/family emergency plans. 2.00 1.219 97
33 98
34 99
35 measured using a Likert scale ranging from 1 to 6 is 2.53. Correla- Discussion 100
36 tion among items in this part was 0.43 (Cronbach's alpha ¼ 0.918). 101
37 Table 7 indicates that from 6 items comprising two categories, Demographic characteristics 102
38 knowledge and management, the average score obtained measured 103
39 using a 6-point Likert scale is 2.46. Correlation among items in this The study results indicate that age and length of employment did 104
40 part was 0.50 (Cronbach's alpha ¼ 0.846). not result in different perceptions of nurses in Indonesia when 105
41 coping with disasters, particularly in the categories of knowledge, 106
42 107
43 108
44 Table 6 109
45 Nurses’ responsive ability in coping with disaster (n ¼ 1341). 110
46 Knowledge-specific response Mean SD 111
47 112
1 I am able to describe my role in the response phase of a disaster in the context of my workplace, the general public, 2.39 1.222
48 media, and personal contacts. 113
49 2 I am familiar with the organizational logistics and roles among local, and state agencies in disaster response situations. 2.99 1.161 114
50 3 I am familiar with psychological interventions, behavioral therapy, cognitive strategies, support groups, and incident 2.73 1.204 115
debriefing for patients who experience emotional or physical trauma.
51 116
Patient management during response
52 1 I can manage the common symptoms and reactions of disaster survivors that are of affective, behavioral, cognitive, and 3.36 0.982
117
53 physical nature. 118
54 2 I would feel confident providing patient education on stress and abnormal functioning related to trauma. 2.91 1.178 119
55 3 I can identify possible indicators of mass exposure evidenced by a clustering of patients with similar symptoms. 2.89 1.202 120
4 As a nurse, I would feel confident as a manager or coordinator of a shelter. 2.90 1.165
56 121
5 I feel reasonably confident that I can treat patients independently without supervision of a physician in a disaster 2.01 1.040
57 situation. 122
58 6 I would feel confident working as a triage nurse practitioner and setting up temporary clinics in disaster situations. 2.94 1.142 123
59 7 As a nurse, I would feel confident in my abilities as a direct care provider and first responder in disaster situations. 2.28 0.949 124
60 8 I would feel confident implementing emergency plans, evacuation procedures, and similar functions. 2.18 1.055 125
9 As a nurse, I would feel reasonably confident in my abilities to be a member of a decontamination team. 2.13 0.949
61 10 I am familiar with biological weapons (e.g. anthrax, plague, botulism, smallpox), their signs and symptoms, and effective 2.16 0.925
126
62 treatments. 127
63 11 I feel confident discerning deviations in health assessments indicating potential exposure to biological agents. 2.14 0.951 128
64 12 In the case of a bioterrorism, I know how to perform focused health history and assessment, specific to the bio-agents 1.97 1.111 129
that are used.
65 130

Please cite this article as: Martono M et al., Indonesian nurses’ perception of disaster management preparedness, Chinese Journal of
Traumatology, https://doi.org/10.1016/j.cjtee.2018.09.002
 CJTEE349_proof ■ 14 December 2018 ■ 5/6

M. Martono et al. / Chinese Journal of Traumatology xxx (xxxx) xxx 5

1 Table 7 66
2 Nurses’ evaluation levels in dealing with disaster (n ¼ 1341). 67
3 Recovery knowledge Mean SD 68
4 1 I am familiar with what the scope of my role as a nurse in a post-disaster situation would be. 3.15 1.138
69
5 Recovery management 70
6 1 I am able to discern the signs and symptoms of acute stress disorder and post-traumatic stress 2.15 0.860 71
7 disorder (PTSD). 72
2 I participate in peer evaluation of skills on disaster preparedness and response. 3.06 1.129
8 73
3 I would feel confident providing education on coping skills and training for patients who experience 2.35 0.809
9 traumatic situations so they are able to manage themselves. 74
10 4 I am familiar with how to perform focused health assessment for PTSD. 2.01 0.986 75
11 5 I feel confident managing (treating, evaluating) emotional outcomes for acute stress disorder or 2.05 0.920 76
12 PTSD following disaster or trauma in a multidisciplinary way such as referrals and follow-ups, and I 77
know what to expect in ensuing months.
13 78
14 79
15 80
16 skills, and evaluation. The findings are consistent with those of Najafi services is considered a low priority. Further, it is reported that 81
17 et al.18 who reported age did not relate to disaster preparedness. nurses do not fulfill most of their roles at optimum level associated 82
18 Gladston and Nayak19 reported similar results of no association with the lack of preparation at all associated institutions.24 The 83
19 between age, marital status, education, and length of work on findings are supported by research in the Philippines by Labrague 84
knowledge and perception of preparedness in managing disasters. €
et al.3 and Oztekin et al.12 indicating that nurses are not fully pre-
20 85
21 Levels of education and experience coupled with training on pared to handle disasters because they do not understand disaster 86
22 disaster response and preparedness showed significant differences management protocol in their workplace. 87
23 in “skills” but did not have any effect on knowledge and evaluation These findings are different from the results by Tzeng et al.9 88
24 in dealing with disasters. The findings of the research correspond to indicating the majority of nurses in military hospitals in Taiwan 89
25 the results of study by Muttarak and Pothisiri20 that educational are prepared in coping with disaster. This was attributed to the 90
26 qualifications and experience of training and disaster management experiences of disaster management training, disaster prepared- 91
27 can improve disaster preparedness actions. Moreover, there ness, and emergency/intensive care. 92
28 are minimal evidence that education qualifications can improve 93
29 cognitive ability related to emerging preparedness. 94
30 Response level 95
31 Preparedness level 96
32 The second part of the DPET survey17 on nurses' responding 97
33 The 25 question items on the survey adapted from the DPET ability consisted of two sub-categories of (i) specific responses on 98
34 survey17 were divided into three sub-categories, i.e. (i) knowledge knowledge (3 items) and (ii) patient management during responses 99
35 on disaster (16 items), (ii) disaster management skills (7 items), and (12 items). The findings are scored 3.00 with a 6-point Likert scale, 100
36 family preparedness (2 items); the average score for the test ob- which revealed that nurses have not fully understood their roles 101
37 tained with Likert scale type 1e6 is 3.13.17 From the online survey during the disaster preparedness phase, and fully organizational 102
38 distributed, the average score of sub-category of knowledge on coordination, and lack confidence in their ability at handling pa- 103
39 disasters is 3.55. Adequate knowledge on disaster preparedness tients having both physical and emotional trauma, and to effec- 104
40 relates to the fact that nurses have experienced training on disaster tively manage their condition. This is due to conflicts of interest at 105
41 management in their places of work, conducted by either hospital the workplace, limited frequency of training in disaster response 106
42 or healthcare education institutions. Furthermore, some had and preparedness provided by hospitals and educational in- 107
43 education in their basic nursing curriculum that integrated disaster stitutions. Also, methods and sources of teaching disaster man- 108
44 management. The information is a component in the national agement are not sufficiently related to in real situations of disaster. 109
45 curriculum for healthcare services, particularly health polytechnics Efforts should be made to strengthen disaster response and pre- 110
46 in Indonesia. Nurses’ education experiences can enhance their paredness involving participation of many sectors systematic and 111
47 positive knowledge on disaster management preparedness. well-planned program and learning experiences should include 112
48 The results of the survey on knowledge about disaster align with simulation for disaster management. Such efforts provide experi- 113
49 the findings of Alrazeeni21 regarding the integration of a course on ence and insight on disaster management and can strengthen 114
50 disaster management in the emergency medical services (EMS) cur- nurses’ self-confidence in coping with disaster and providing 115
51 riculum; along with practical training, this will help prepare students support in a disaster situation. 116
52 in EMS to better comprehend disaster management. Further, students Those recommendations are supported by Duong22 who re- 117
53 of EMS assert the needs of the integration of disaster management in ported a significant correlation between training frequency for 118
54 the curriculum for the undergraduate program. Similar findings are nurses and their confidence. In other words with more training on 119
55 revealed in Duong's22 study that nurses' preparedness and trust disaster management they have higher confidence in their ability 120
56 regarding responses on disasters are influenced by their previous with disaster management. Nurses are more confident that they 121
57 experiences, education, and training on disaster management. can support people in a real disaster situation. Similar recom- 122
58 However, nurses in Indonesia validate and reaffirm that they are mendations are offered by Basnet et al.25 who reported that 123
59 not fully prepared for handling real disaster situations since most disaster management training should be provided for all nurses, 124
60 have not performed duties under these extreme conditions. There particularly those working at non-governmental hospitals, who 125
61 is no disaster planning program that has been approved by medical have not received any training on disaster management, to enhance 126
62 service centers at primary and hospital level, even though most of their knowledge in responding to possible disaster. This study 127
63 the nurses received training on disaster management. The findings emphasizes that nurses should be equipped with relevant training 128
64 are consistent with previous data from World Health Organization, in disaster management and integrated with nurses’ activities in 129
65 reporting that preparedness of nurses working in primary medical the future agenda. 130

Please cite this article as: Martono M et al., Indonesian nurses’ perception of disaster management preparedness, Chinese Journal of
Traumatology, https://doi.org/10.1016/j.cjtee.2018.09.002
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6 M. Martono et al. / Chinese Journal of Traumatology xxx (xxxx) xxx

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Please cite this article as: Martono M et al., Indonesian nurses’ perception of disaster management preparedness, Chinese Journal of
Traumatology, https://doi.org/10.1016/j.cjtee.2018.09.002