Relationship between disaster preparedness perception, self-efficacy, and psychological capital among Turkish nurses
Abstract
Background
Although disasters continue to increase all over the world and international nursing organizations warn nurses to be ready for disasters, it is stated that the training of nurses for disasters is inadequate in Turkey as in many countries, and studies on this subject are limited
Aim
This study aimed to explore the relationship between disaster preparedness perception, self-efficacy, and psychological capital among Turkish nurses.
Methods
This cross-sectional study was conducted with 270 nurses working at a university hospital in Turkey from May 2023 to December 2023.
Results
The mean Disaster Preparedness Perception Scale, General Self-Efficacy Scale, and Psychological Capital Questionnaire scores of the nurses were 73.19 ± 11.06, 31.24 ± 3.89, and 98.05 ± 11.35, respectively. According to linear regression analysis, self-efficacy, psychological capital, receiving disaster training, and being exposed to disaster were significant predictive factors that affected disaster preparedness perception.
Conclusion
To improve nurses' disaster preparedness, it is vital to strengthen their self-efficacy and psychological capital through various strategies.
Implications for nursing policy
Managers should identify individual and organizational barriers that affect nurses' readiness for disasters, prepare nurses for all stages of disaster management through continuous training, scenario-based simulation exercises and drills, and create a disaster management culture in the organization.
BACKGROUND
Disaster is defined as “a sudden ecological event of extraordinary magnitude and severity that creates the need for external assistance” (WHO, 2019). Disasters are any natural (earthquake, landslide, volcanic eruption, flood, hurricane, tornado, pandemic, etc.) or technological (fires, industrial pollution, nuclear radiation, toxic wastes, transportation accidents, factory explosions, etc.) events that leave indelible marks on people's lives and cause physical, psychological, economic, and social losses (Baker, 2021; Castner, 2020; Chegini et al., 2022). Increases in the frequency and severity of disasters worldwide have reached remarkable levels (Baker, 2021; Castner, 2020). The Emergency Events Database (EM-DAT) reported that 399 natural disasters occurred worldwide in 2023, affecting 93.1 million people, causing 86 473 deaths, and resulting in economic losses amounting to 202.7 billion dollars (EM-DAT, 2024). Similarly, large-scale disasters have been occurring in Turkey for years, with two earthquakes centered in Kahramanmaraş on February 6, 2023, being the latest example. These earthquakes, impacting numerous urban areas with a population of around 18 million, resulted in 56 683 fatalities, tens of thousands of injuries, 42.9 billion dollars in economic losses, and extensive destruction of the ancient cities of humanity (Ediz & Yanik, 2024; EM-DAT, 2024). The Kahramanmaraş earthquakes caused widespread trauma and were deemed the disasters of the century due to their anticipated occurrence, the lack of preparedness, and their terrifying and highly destructive impact (Altuntaş et al., 2023; Uwishema, 2023). Consequently, this earthquake has once again demonstrated the necessity of being prepared for disasters (Altuntaş et al., 2023).
Effective disaster management is required to be prepared for disasters. Nurses, the most important members of the healthcare team, can assume a dynamic role at every stage of the disaster cycle (Erkin et al., 2023; Songwathana & Timalsina, 2021). Nurses need to be well prepared and have sufficient knowledge and skills in effective disaster intervention to provide holistic and quality healthcare services before, during, and after disasters due to their roles as caregivers, educators, coordinators, consultants, and rehabilitators (Labrague et al., 2018; Tas et al., 2020). Today, all nurses are expected to know disaster management and take part in all phases of disasters, regardless of their specialization (Baker, 2021; Chegini et al., 2022; Wang et al., 2023). However, previous studies show that nurses do not feel ready to intervene in disasters (Alzahrani & Kyratsis, 2017; Baker, 2021; Labrague et al., 2018). Similarly, in studies conducted in Turkey, it is stated that the nurses' knowledge and skills about being prepared for disasters and making effective interventions in disasters are not at the desirable level (Ediz & Yanik, 2024; Erkin et al., 2023). Therefore, enhancing the competencies of nurses necessitates an initial assessment of their perceptions of disaster preparedness and the factors influencing these perceptions (Chegini et al., 2022).
Several factors greatly influence nurses' ability to respond to disasters (Alzahrani & Kyratsis, 2017). One of them is self-efficacy (Labrague et al., 2021; Wutjatmiko et al., 2018). Self-efficacy is “the extent to which an individual believes him or herself to be capable of performing a specific behavior in a specific situation” (Bandura, 1997). Self-efficacy also represents personal confidence and belief that creates a strong motivation for nurses to prepare for disaster situations based on their roles and functions. Thus, self-efficacy perception determines the behavior and performance of nurses in disasters and contributes to feeling more optimistic and resilient in the face of challenges (Jonson et al., 2017; Wutjatmiko et al., 2018).
Another factor affecting the perception of disaster preparedness is psychological capital. In fact, psychological capital is an important personal resource for individuals to effectively manage, and adapt to, a challenging environment (Duan et al., 2022; Yildiz, 2019). Since disaster relief is also a task performed in stressful situations, nurses need to have high psychological capital. Psychological capital, which is an effective way to increase inner strength and support individual development, helps healthcare professionals adapt to psychological and physical problems caused by interpersonal relationships or work stress and develop personal confidence (Liu et al., 2021; Yildiz, 2019). In addition, healthcare professionals with high psychological capital are confident in their ability to fulfill their roles, including emergency preparedness and responses to adverse events and potential threats (Stratman & Youssef-Morgan, 2019).
Although disasters continue to increase all over the world and international nursing organizations warn nurses to be ready for disasters, it can be stated that the training of nurses for disasters is inadequate in Turkey as in many countries, and studies on this subject are limited (Ediz & Yanik, 2024; Erkin et al., 2023). However, nurses constitute one of the most vital human resources in the disaster management process (Baker, 2021; Wang et al., 2023). Nurses are required to be prepared for disasters and to conduct recovery efforts in the post-disaster period, in addition to saving lives and safeguarding the health of disaster victims during the emergency phase of a disaster. To accomplish this, psychological capital and self-efficacy must be highly developed (Duan et al., 2022). However, there are almost no studies examining the effect of self-efficacy and psychological capital on disaster preparedness perception in the literature (Duan et al., 2022; Wutjatmiko et al., 2018). Accordingly, this study aimed to determine the relationship between disaster preparedness perception, general self-efficacy, and psychological capital in nurses. The findings are anticipated to enhance nurses' disaster preparedness perceptions and to assess the essential components required for a successful disaster management program.
Study questions
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What are the disaster preparedness perception, self-efficacy, and psychological capital levels of Turkish nurses?
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Is there a relationship between disaster preparedness perception, self-efficacy, and psychological capital?
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What are the predictors of Turkish nurses' disaster preparedness perception?
METHODS
Design
This cross-sectional study was carried out with nurses working at a university hospital in the west of Turkey between May 2023 and December 2023. The study was conducted based on the Strengthening Reporting of Observational Studies in Epidemiology (STROBE) checklist.
Sample
The study population consisted of 405 nurses with a bachelor's degree working in a university hospital. The sample size was calculated on the G*power 3.1.9.2 statistical software (Faul et al., 2007), and the minimum sample size was determined as 258 nurses, with an effect size of 0.20, α = 0.05, and β = 0.10. The study was completed with 270 nurses who met the inclusion criteria on the specified dates. The inclusion criteria were as follows: being a registered nurse and willing to participate in the study. The exclusion criteria were as follows: being on leave, on report, or in training at other hospitals. After the study was completed, post-hoc power analysis was performed with the G*power 3.1.9.2 statistical software. According to power analysis results, based on α = 0.05 and n = 270 nurses, the power level to determine the relationship between disaster preparedness perception and both general self-efficacy (r = 0.448) and psychological capital (r = 0.542) was found to be 1.00.
Measurements
The data were collected using a Personal Information Form, the Nurses’ Disaster Preparedness Perception Scale, the General Self-Efficacy Scale, and the Psychological Capital Questionnaire.
Personal information form
This form was prepared by the researchers in line with the literature (Altuntaş et al., 2023; Duan et al., 2022; Erkin et al., 2023; Tas et al., 2020). It includes 10 questions about nurses’ sociodemographic and professional characteristics (age, gender, marital status, economic status, working year, receiving disaster training, exposure to disaster, etc.).
Nurses’ Disaster Preparedness Perception Scale (NDPPS)
The scale was developed by Özcan (2013) to measure how prepared nurses feel for disasters, and Cronbach's alpha coefficient was calculated as 0.90. The NDPPS consists of 20 items rated on a five-point Likert-type scale (1: strongly disagree, 2: disagree, 3: partially agree, 4: agree, 5: strongly agree). The scale has three subscales, namely, preparation stage, intervention stage, and post-disaster stage. The total score obtained from the NDPPS varies between 20 and 100. As the score increases, the nurses' disaster preparedness perception also increases (Özcan, 2013). The Cronbach's alpha value of the scale was found to be 0.92 in this study.
General Self-Efficacy Scale (GSES)
The scale was developed by Schwarzer and Jerusalem (1995) to assess the perceived sense of self-efficacy in dealing with different challenges or unprecedented situations. The adaptation study of the scale into Turkish was conducted by Aypay (2010), and Cronbach's alpha coefficient was determined as 0.83. The GSES consists of 10 items, which are scored on a four-point Likert-type scale (1: not at all true, 2: hardly true, 3: moderately true, 4: exactly true). Scores range from 10 to 40, with a higher score indicating higher self-efficacy (Aypay, 2010; Schwarzer & Jerusalem, 1995). The Cronbach's alpha coefficient of the GSES in this study was determined as 0.87.
Psychological Capital Questionnaire (PCQ)
The questionnaire was developed by Luthans et al. (2007) to measure employees’ psychological capital level. The Turkish validity and reliability study of the PCQ was conducted by Cetin and Basim (2012), and the Cronbach's alpha value was determined as 0.91. The questionnaire has four subscales: hope, efficacy, resilience, and optimism. The Turkish version of the PCQ consists of 21 items, which are scored on a six-point Likert-type scale from 1 (strongly disagree) to 6 (strongly agree). The total score obtained from the PCQ varies between 21 and 126. The higher score indicates a higher level of psychological capital (Cetin & Basim, 2012). In the present study, the Cronbach's alpha reliability coefficient was calculated as 0.89 for the scale.
Data collection
All the nurses were informed about the study, and their consent was obtained. The researcher distributed the questionnaire sheets to the nurses to fill it. It took from 30 to 40 minutes to complete the questionnaire sheet. The number of collected questionnaires from nurses per day ranged from 5 to 10 sheets. The data were collected two days a week on Monday and Friday from 9:00 a.m. to 4:00 p.m. in the presence of the researcher to clarify any ambiguity.
Ethical considerations
This study was approved by the Çanakkale Onsekiz Mart University Graduate Education Institute Scientific Research Ethics Committee (Approval Date: March 30, 2023; Approval Number: 2023/73). Institutional permission was granted by the chief physician of Çanakkale Onsekiz Mart University Hospital. In addition, the principle of volunteerism was adopted in the study, and written consent was obtained from those nurses who agreed to participate.
Data analysis
The data were analyzed on the SPSS 23.0 software (SPSS, Inc., Chicago, IL, USA). The normality of the data was assessed using the Shapiro–Wilk test. Categorical data were expressed as n (%), and the ratio data were described as mean ± SD. The independent samples t-test and one-way analysis of variance were used to compare disaster preparedness perceptions according to the participating nurses' sociodemographic and professional characteristics. Pearson correlation analysis was used to examine the relationship between disaster preparedness perceptions and both self-efficacy and psychological capital. The predictors of the nurses' disaster preparedness perceptions were determined by multivariate linear regression analysis. Significance was determined at p < 0.05 with a 95% confidence interval.
RESULTS
Nurses’ characteristics
The mean age of the nurses was 33.75 ± 7.33 years (ranging from 21 to 50 years), and 80.4% were female. Of the nurses, 72.3% were married, 44.2% did not have children, 60.2% had a moderate economic status, 57.1% had been working as a nurse for ≤10 years, and 44.6% worked in an internal or surgical clinic. In addition, of the nurses included in the study, 75.0% had received disaster training, 80.8% were not exposed to disaster, and 10.3% were volunteering during disasters.
Mean scores the nurses obtained from NDPPS, GSES, and PCQ
In the present study, the mean scores obtained by nursing students were 73.19 ± 11.06 on the NDPPS, 31.24 ± 3.89 on the GSES, and 98.05 ± 11.35 on the PCQ (Table 1).
| Scales | Mean ± SD | Min–Max | Score range |
|---|---|---|---|
| Nurses’ Disaster Preparedness Perception Scale | 73.19 ± 11.06 | 39–97 | 20–100 |
| Preparation stage | 24.59 ± 4.86 | 6–30 | 6–30 |
| Intervention stage | 30.65 ± 6.23 | 12–44 | 9–45 |
| Post-disaster stage | 17.94 ± 2.99 | 11–25 | 5–25 |
| General Self-Efficacy Scale | 31.24 ± 3.89 | 20–40 | 10–40 |
| Psychological Capital Questionnaire | 98.05 ± 11.35 | 58–122 | 21–126 |
| Self-efficacy | 28.46 ± 3.58 | 16–36 | 6–36 |
| Hope | 28.07 ± 3.63 | 16–36 | 6–36 |
| Optimism | 17.78 ± 3.03 | 6–24 | 4–24 |
| Resilience | 23.74 ± 3.02 | 13–30 | 5–30 |
- Abbreviations: GSES, General Self-Efficacy Scale; NDPPS, Nurses’ Disaster Preparedness Perception Scale; PCQ, Psychological Capital Questionnaire.
Disaster preparedness perceptions according to some characteristics of nurses
As is seen in Table 2, while disaster preparedness perception was significantly higher in the nurses who were married, received disaster training, and were exposed to disasters, it was lower in the nurses who did not have children.
| Characteristics | n | % | Mean ± SD | t / F | p |
|---|---|---|---|---|---|
| Age (X ± SD: 33.75 ± 7.33; min–max: 21–50) | |||||
| 21–35 years | 136 | 60.7 | 72.95 ± 11.27 | 0.404a | 0.687 |
| 36–50 years | 88 | 39.3 | 73.56 ± 10.78 | ||
| Gender | |||||
| Female | 180 | 80.4 | 73.79 ± 10.39 | 1.643a | 0.102 |
| Male | 44 | 19.6 | 70.75 ± 13.32 | ||
| Marital status | |||||
| Married | 162 | 72.3 | 74.54 ± 10.13 | 2.998a | 0.003 |
| Single | 62 | 27.7 | 69.68 ± 12.60 | ||
| Number of children | |||||
| No children | 99 | 44.2 | 70.23 ± 11.94 | 6696b | 0.002 |
| 1 child | 64 | 28.6 | 75.48 ± 10.01 | ||
| ≥2 children | 61 | 27.2 | 75.60 ± 10.50 | ||
| Economic status | |||||
| Bad | 62 | 27.7 | 72.80 ± 10.74 | 0.055b | 0.946 |
| Moderate | 135 | 60.2 | 73.32 ± 10.97 | ||
| Good | 27 | 12.1 | 73.48 ± 12.54 | ||
| Working year | |||||
| ≤10 years | 128 | 57.1 | 72.82 ± 11.40 | 0.587a | 0.558 |
| ≥11 years | 96 | 42.9 | 73.69 ± 10.63 | ||
| Working unit | |||||
| Internal or surgical clinic | 100 | 44.6 | 72.52 ± 11.46 | 1.749b | 0.140 |
| Intensive care unit | 68 | 30.4 | 72.94 ± 10.51 | ||
| Policlinic | 35 | 15.6 | 72.23 ± 12.87 | ||
| Emergency department | 11 | 4.9 | 80.82 ± 10.53 | ||
| Operating room | 10 | 4.5 | 76.70 ± 10.54 | ||
| Receiving disaster training | |||||
| Yes | 168 | 75.0 | 75.27 ± 10.31 | 5.138a | ˂0.001 |
| No | 56 | 25.0 | 66.96 ± 10.96 | ||
| Being exposed to disaster | |||||
| Yes | 43 | 19.2 | 79.02 ± 10.78 | 3.968a | ˂0.001 |
| No | 181 | 80.8 | 71.82 ± 10.91 | ||
| Disaster volunteer | |||||
| Yes | 23 | 10.3 | 73.33 ± 10.86 | 0.527a | 0.599 |
| No | 201 | 89.7 | 72.04 ± 12.91 | ||
- aIndependent samples t-test; bOne-way analysis of variance.
Correlation between NDPPS, GSES, and PCQ
Table 3 presents the correlation between disaster preparedness perceptions and both general self-efficacy and psychological capital. There was a moderate positive correlation between disaster preparedness perception and general self-efficacy (r = 0.448, p < 0.001) and psychological capital (r = 0.542, p < 0.001).
Predictors of nurses’ disaster preparedness perceptions
The significant predictors of the nurses’ disaster preparedness perception were general self-efficacy (β = 0.186), psychological capital (β = 0.373), receiving disaster training (β = 0.169), and exposure to disaster (β = 0.145) (p < 0.001). In addition, the predictive power of the regression model was 37.8% (Table 4).
| Variables | B | SE | β | t | p | 95% CI | |
|---|---|---|---|---|---|---|---|
| LL | UL | ||||||
| Constant | 33.793 | 7.251 | 4.660 | <0.001 | 19.503 | 48.084 | |
| General self-efficacy | 0.528 | 0.183 | 0.186 | 2.876 | 0.004 | 0.166 | 0.889 |
| Psychological capital | 0.363 | 0.064 | 0.373 | 5.688 | <0.001 | 0.237 | 0.489 |
| Receiving disaster training (1: no) | 4.311 | 1.423 | 0.169 | 3.030 | 0.003 | 1.507 | 7.115 |
| Being exposed to disaster (1: no) | 4.050 | 1.531 | 0.145 | 2.646 | 0.009 | 1.033 | 7.067 |
- Abbreviations: Adj. R2 = 0.378; F = 33.254; p < 0.001.
- Adj. R2 = adjusted R square; B, Partial regression coefficient; β, standard partial regression coefficient; 95% CI, 95% confidence interval; LL, lower limit; UL, upper limit.
DISCUSSION
Regrettably, Turkey has been the victim of numerous disasters in recent years. Consequently, it has been underscored that disaster preparedness and response planning should be prioritized in order to address the deficiencies and challenges that have arisen (Altuntaş et al., 2023; Uwishema, 2023). Therefore, determining nurses' perceptions of disaster preparedness, the dimensions in which they are unprepared, and the factors affecting them are important for strengthening disaster nursing competencies (Chegini et al., 2022; Songwathana & Timalsina, 2021).
In this study, the nurses' disaster preparedness perceptions were moderate. This finding indicated that the nurses were inadequately prepared for disaster management. Similarly, studies conducted in different countries, including Turkey, reported that nurses' disaster preparedness perception was moderate (Baker, 2021; Chegini et al., 2022; Ediz & Yanik, 2024; Hasheesh, 2023; Wang et al., 2023) or even low (Alzahrani & Kyratsis, 2017; Erkin et al., 2023). Furthermore, the present study determined that the nurses' intervention scores were the lowest, while their disaster preparedness scores were the highest. All these results show that disaster knowledge is a critical component of preparedness (Alzahrani & Kyratsis, 2017; Chegini et al., 2022). In fact, a study that was conducted with nurses who were employed in the regions affected by the earthquakes centered in Kahramanmaraş in 2023, which were described as the disaster of the century in Turkey, determined that nurses required disaster preparedness training and possessed high technical skills but low critical thinking skills. In the same study, nurses stated that they primarily needed training on disaster management, communication in disaster management, and post-traumatic mental care to improve disaster preparedness (Altuntaş et al., 2023). Labrague et al. (2018) also revealed in their systematic review that nurses were not adequately prepared to respond effectively to disasters and did not feel safe. However, nurses must become part of their local or national disaster management programs (Altuntaş et al., 2023; Labrague et al., 2018). In this direction, nurses' readiness for disasters can be enhanced by integrating a disaster nursing course at the undergraduate level, which includes practical emergency applications such as scenario-based simulation exercises. Furthermore, updating this knowledge through continuous education programs after graduation is essential for maintaining preparedness (Chegini et al., 2022; Ediz & Yanik, 2024; Hasheesh, 2023).
In this study, self-efficacy was found to be an important concept when the predictors of the nurses' perception of disaster preparedness were analyzed. The self-efficacy level of the nurses was at a moderate level, and as the self-efficacy level increased, the perception of disaster preparedness also increased. Similarly, previous studies found a strong relationship between emergency preparedness behaviors and self-efficacy (Marceron & Rohrbeck, 2019; Wutjatmiko et al., 2018). It is also suggested that self-efficacy is the most important determinant of a nurse's willingness to help in a disaster (Said et al., 2020). Conversely, nurses with lower self-efficacy are less competent to respond to any disaster or emergency (Uhm et al., 2019). Accordingly, it can be stated that self-efficacy is a vital factor that determines the behavior and performance of nurses in a disaster situation and that it is important to provide opportunities for all nurses, regardless of their level, to improve their self-efficacy through various strategies (Jonson et al., 2017; Labrague et al., 2021).
The findings of the current study indicated that the nurses generally exhibited a moderate to high level of psychological capital and that psychological capital emerged as a predictor of disaster preparedness perception among the participants. Psychological capital is an important and powerful personal resource that is closely related to performance (Chen et al., 2024; Feng, 2020). Indeed, Duan et al. (2022) found a positive relationship between psychological capital and disaster preparedness. Wang et al. (2021) found that psychological capital had a significant effect on the decision-making process regarding emergency preparedness behavior. They also stated that psychological capital offered a unique opportunity to increase the enthusiasm of healthcare personnel to carry out emergency preparedness activities (Wang et al., 2021). For nurses to have a more positive, optimistic, hopeful, confident attitude, and effective coping methods in the face of disasters, managers need to take micro and macro measures to improve the psychological capital of nurses (Duan et al., 2022; Wang et al., 2021).
In the current study, disaster preparedness perception is related to receiving disaster training. In the literature, it was reported that nurses who received training on disaster management had a higher perception of disaster preparedness (Baker, 2021; Ediz & Yanik, 2024; Hasheesh, 2023; Rizqillah & Suna, 2018). Training can positively influence disaster preparedness behavior through direct and indirect channels. Moreover, training can increase the acquisition of knowledge, values, and priorities, and the capacity to plan for the future and use resources efficiently (Ediz & Yanik, 2024; Hasheesh, 2023). Besides training, prior disaster exposure is another key factor determining disaster preparedness perception. Previous studies support this finding (Erkin et al., 2023; Rizqillah & Suna, 2018). Previous disaster experience can trigger preparedness behavior through channels similar to training. Training can reduce the likelihood of an individual being affected by a disaster by increasing disaster preparedness. In the same way, individuals who have been impacted by disasters in the past may be more adequately prepared for future disasters as their awareness and understanding of the potential consequences of disasters increase (Erkin et al., 2023; Rizqillah & Suna, 2018). It is clear that both disaster training and experience positively change disaster awareness and preparedness behavior. Therefore, in order for nurses to be prepared for future disasters, it is critical that their fundamental education includes disaster training and is supported with both structured and frequent training and practices such as drills during their working years (Chegini et al., 2022; Ediz & Yanik, 2024; Hasheesh, 2023).
Limitations
The present study has some limitations. The findings are derived from self-reported data provided by nurses from a university hospital who volunteered to participate, which restricts the generalizability of the results to all nurses across Turkey. Another weakness of this study is that it was carried out in a cross-sectional design.
CONCLUSIONS
The results suggest that Turkish nurses generally perceive their disaster preparedness as moderate and that this perception correlates with their general self-efficacy and psychological capital. Additionally, receiving disaster training and previous exposure to disasters were identified as predictors of disaster preparedness perception, independent of self-efficacy and psychological capital. The results of the present study highlighted the importance of considering self-efficacy and psychological capital in future disaster planning and training for nurses.
Implications for nursing and health policy
Disaster management requires the cooperation of educational institutions, health institutions, government agencies, and nongovernmental organizations. Considering the increasing frequency and impact of disasters worldwide, it is essential to keep disaster awareness constantly updated. First of all, it is necessary to reveal the current situation with large-scale studies determining nurses' disaster preparedness and response competencies. To improve the knowledge and skills of nurses in all aspects of disaster preparedness, it would be useful to add a disaster nursing course to the curriculum at the undergraduate and graduate levels. Managers can ensure nurses' preparedness for disaster response through continuous training, scenario-based simulation exercises, and drills. Self-efficacy and psychological capital can be improved to increase nurses' disaster preparedness perceptions. Moreover, it is imperative for every institution to possess a disaster plan. Furthermore, all nurses should possess knowledge of their institution's disaster plan, comprehend their duties and obligations in disaster situations, engage in regular evaluations of the disaster plan, and actively contribute to discussions concerning its execution. Future studies could explore individual and organizational barriers hindering nurses' preparedness for disasters, strategies to enhance nurses' readiness across all phases of disaster management, and initiatives to cultivate a disaster management culture and increase awareness within healthcare institutions.
AUTHOR CONTRIBUTIONS
Study design: Merve Ataç Öksüz, Dilek Avci, and Ali Kaplan. Data collection: Merve Ataç Öksüz, and Ali Kaplan. Data analysis: Dilek Avci and Merve Ataç Öksüz. Study supervision: Dilek Avci. Manuscript writing: Merve Ataç Öksüz, Dilek Avci, and Ali Kaplan. Critical revisions for important intellectual content: Dilek Avci and Merve Ataç Öksüz.
ACKNOWLEDGMENTS
The authors gratefully acknowledge the nurses for collaborating in this study.
CONFLICT OF INTEREST STATEMENT
The authors have no relevant financial or nonfinancial interests to disclose, nor competing interests to declare.
FUNDING INFORMATION
This study received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
ETHICS STATEMENT
This study was approved by the Çanakkale Onsekiz Mart University Graduate Education Institute Scientific Research Ethics Committee (Approval Date: March 30, 2023; Approval Number: 2023/73).
Open Research
DATA AVAILABILITY STATEMENT
Data are available upon reasonable request, by sending an email to the corresponding author.
