| Author: | Mao, Xiaorong |
| Title: | Disaster resilience : the development and validation of a tool for measuring disaster resilience of disaster healthcare rescuers |
| Advisors: | Loke Yuen, Alice (SN) |
| Degree: | Ph.D. |
| Year: | 2020 |
| Subject: | Hong Kong Polytechnic University -- Dissertations First responders -- Psychology Medical personnel Disaster relief |
| Department: | School of Nursing |
| Pages: | xx, 355 pages : color illustrations |
| Language: | English |
| Abstract: | Project Title: Disaster resilience: the development and validation of a tool for measuring disaster resilience of disaster healthcare rescuers Background: With the increasing number of disasters worldwide, a large number of people have been affected and the economic losses have been significant. Disasters have also had a harmed impact on the physical, psychological, and sociological health of the people involved in rescue efforts. Resilience is a desirable quality of disaster rescue workers, since being resilient will increase one's self-protection and survival skills during a disaster. Resilience is also reported to be a positive factor that will protect disaster rescue workers against psychiatric disorders after deployment to disaster sites. It is advisable that disaster rescue workers should be recruited among those who have a high level of resilience or that resilience enhancement intervention programs be offered to rescue workers who will be deployed to disaster sites. There is a need to have a validated and reliable measuring tool of disaster resilience for the recruitment of disaster rescue workers and to evaluate the effectiveness of these developed interventions intended to enhance the resilience of individuals as an outcome. Aim: The purpose of this project is to develop and validate a measuring tool for disaster resilience of disaster healthcare rescue workers. Objectives: (1) To explore the characteristics/attributes of the resilience of disaster healthcare rescuers; (2) To develop a measuring tool for disaster resilience of healthcare rescue workers; (3) To validate the developed tool for measuring disaster resilience of healthcare rescuers. Methods: This project consisted of two phases: (I) the evidence phase, and (II) the study phase. In phase I, there are three steps: (Ia) the characteristics/attributes of resilience of disaster rescue workers were identified through a review of relevant literature, (Ib) the concept of 'disaster resilience' in disaster rescue workers was analyzed by adopting the Walker and Avant approach of concept analysis, (Ic) a scoping review of measuring tools of resilience for adults was conducted to identify the essential domains of resilience. Phase II is a mixed-method study, which also includes three steps: (IIa) a focus group interview study, (IIb) a modified Delphi survey preceded by the development of a prototype tool for measuring 'disaster resilience' for healthcare rescuers, and (IIc) a cross-sectional study for instrument validation. A focus group interview study (IIa) was conducted to identify the characteristics of the resilience of disaster healthcare rescue workers. The findings from this study are a supplementary source of data to support the evidence identified from reviews of literature. A prototype measuring tool for disaster resilience among healthcare rescuers was developed before a modified Delphi survey. In this step, the domains of the disaster resilience were identified by the findings of reviews of literature from phase I and the focus group interview study in Phase IIa. A modified Delphi panel query among international experts in disaster rescue work (IIb) was conducted to establish the content validity and refine the domains and items of the prototype tool. The experts were invited to provide comments and suggestions on the domains/components of the prototype measuring tool for disaster resilience of healthcare rescuers through the ranking of the importance and relevance of each item on the prototype tool on a four-point Likert scale. A total of two rounds of Delphi survey was conducted when consensus achieved. A cross-sectional survey then was conducted among registered disaster healthcare rescuers, regardless of whether they had been deployed to rescue works to test for the reliability, criterion-related validity, and construct validity of a tool for measuring the disaster resilience of healthcare disaster rescuers. Results: In the modified Delphi study, an eight-domain, including 27 items, disaster resilience measuring tool (DRMT) for healthcare rescue workers was developed and confirmed. The median range of all of the included items of this tool was 3.50 to 4.00 and the interquartile range was 0.00 to 1.00, and all items achieved ≥ 85% agreement by the experts. The Kendall coordination coefficient W was 0.21 to 0.33 in the first and second rounds experts query, respectively, with P < 0.01. The I-CVI ranged from 0.85 to 1.0, while the S-CVI/UA and S-CVI /Ave were 0.69 and 0.97, respectively. In the cross-sectional study to establish the validity of the resulting instrument from phase IIb. The disaster resilience measuring tool demonstrated adequate internal consistency (Cronbach's alpha > 0.84) and stability over the two-week study period (intra-class correlation coefficient > 0.85). The exploratory factor analysis showed that 65.93% of the total variance was explained and a four-factor model, including 19-item, was confirmed. The confirmatory factor analysis showed goodness of fit: x2/df (2.846), GFI (0.916 ≥ 0.90), CFI (0.949 ≥ 0.90), AGFI (0.891 ≥ 0.80), and RMSEA (0.063 ≤ 0.08). The disaster resilience measuring tool showed significant associations with other scales, and a cut-off point of 60 was suggested. Conclusions: The content validity of the tool for measuring the disaster resilience of healthcare rescuers was excellent. The disaster resilience measuring tool has satisfactory psychometric properties and is a valid, reliable, and valuable instrument for assessing disaster resilience in healthcare rescue workers. The scale needs to be further tested among other populations and those from other cultures. Project Significance and Value: (1) The analysis of the concept 'disaster resilience' can lead to a better understanding the personal character and qualities of resilience of disaster rescue workers; (2) the developed measuring tool for disaster resilience can be used as a screening tool by the disaster management team when recruiting disaster rescue workers; (3) tailored-made program can be developed based on the identified domains/components of disaster resilience. (4) The tool can be used to evaluate the effectiveness of such programs aimed at enhancing the disaster resilience of individuals as an outcome. It is anticipated that the tool will be used as a screening tool in the recruitment of disaster healthcare rescue workers or as an outcome measure of resilience enhancement programs, with the ultimate aim to prevent/decrease the possibility of negative psychological consequences of disaster rescue workers after deployment. |
| Rights: | All rights reserved |
| Access: | open access |
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| File | Description | Size | Format | |
|---|---|---|---|---|
| 991022378657703411.pdf | For All Users | 5.82 MB | Adobe PDF | View/Open |
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