Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-24T16:33:27.072Z Has data issue: false hasContentIssue false
  • English
  • Français

Prioritizing “Psychological” Consequences for Disaster Preparedness and Response: A Framework for Addressing the Emotional, Behavioral, and Cognitive Effects of Patient Surge in Large-Scale Disasters

Published online by Cambridge University Press:  08 April 2013

Lisa S. Meredith ,
David P. Eisenman ,
Terri Tanielian ,
Stephanie L. Taylor ,
Ricardo Basurto-Davila ,
James Zazzali ,
Dickson Diamond ,
Barbara Cienfuegos  and
Sandra Shields
Get access Rights & Permissions [Opens in a new window]

Abstract

While information for the medical aspects of disaster surge is increasingly available, there is little guidance for health care facilities on how to manage the psychological aspects of large-scale disasters that might involve a surge of psychological casualties. In addition, no models are available to guide the development of training curricula to address these needs. This article describes 2 conceptual frameworks to guide hospitals and clinics in managing such consequences. One framework was developed to understand the antecedents of psychological effects or “psychological triggers” (restricted movement, limited resources, limited information, trauma exposure, and perceived personal or family risk) that cause the emotional, behavioral, and cognitive reactions following large-scale disasters. Another framework, adapted from the Donabedian quality of care model, was developed to guide appropriate disaster response by health care facilities in addressing the consequences of reactions to psychological triggers. This framework specifies structural components (internal organizational structure and chain of command, resources and infrastructure, and knowledge and skills) that should be in place before an event to minimize consequences. The framework also specifies process components (coordination with external organizations, risk assessment and monitoring, psychological support, and communication and information sharing) to support evidence-informed interventions.

(Disaster Med Public Health Preparedness. 2011;5:73-80)

Keywords

stress, psychologicaldisaster responsesurge capacityhospital planninghealth facilitiesstress disorders, post-traumaticmental health servicescommunity health planningemergency services, psychiatricdisaster preparedness and responsehealth care servicesmental healthsurge capacity
Type
Concepts in Disaster Medicine
Information
Disaster Medicine and Public Health Preparedness , Volume 5 , Issue 1 , March 2011 , pp. 73 - 80
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Department of Homeland Security. The National Response Plan.2008. http://www.dhs.gov/files/programs/editorial_0566.shtm. Accessed May 8, 2008.Google Scholar
2.Joint Commission on Accreditation of Healthcare Organizations. Health Care at the Crossroads: Strategies for Creating and Sustaining Community-wide Emergency Preparedness Strategies.2003.http://www.jcaho.org/about+us/public+policy+initiatives/emergency_preparedness.pdf. Accessed June 10, 2008.Google Scholar
3.Dayton, C, Ibrahim, J, Augenbraun, M.Integrated plan to augment surge capacity. Prehosp Disaster Med. 2008;23 (2):113–119.Google Scholar
4.Terhakopian, A, Benedek, DM.Hospital disaster preparedness: mental and behavioral health interventions for infectious disease outbreaks and bioterrorism incidents. Am J Disaster Med. 2007;2 (1):43–50.CrossRefGoogle ScholarPubMed
5.Hawley, SR, Hawley, GC, St Romain, T, Ablah, E.Quantitative impact of mental health preparedness training for public health professionals. Biosecur Bioterror. 2007;5 (4):347–352.CrossRefGoogle ScholarPubMed
6.Lemyre, L, Clément, M, Corneil, W.A psychosocial risk assessment and management framework to enhance response to CBRN terrorism threats and attacks. Biosecur Bioterror. 2005;3 (4):316–330.CrossRefGoogle ScholarPubMed
7.DiMaggio, C, Galea, S, Richardson, LD.Emergency department visits for behavioral and mental health care after a terrorist attack. Ann Emerg Med. 2007;50 (3):327–334.Google Scholar
8.DiGiovanni, C, Conley, J, Chiu, D, Zaborski, J.Factors influencing compliance with quarantine in Toronto during the 2003 SARS outbreak. Biosecur Bioterror. 2004;2 (4):265–272.Google Scholar
9.Shaffer, D, Armstrong, G, Higgins, K.Increased US prescription trends associated with the CDC Bacillus anthracis antimicrobial postexposure prophylaxis campaign. Pharmacoepidemiol Drug Saf. 2003;12 (3):177–182.Google Scholar
10.Hassett, AL, Sigal, LH.Unforeseen consequences of terrorism: medically unexplained symptoms in a time of fear. Arch Intern Med. 2002;162 (16):1809–1813.CrossRefGoogle Scholar
11.Diamond, D, Pastor, LH, McIntosh, RG.Medical management of terrorism-related behavioral syndromes. Psychiatr Ann. 2004;34 (9):689–695.Google Scholar
12.Gurwitch, RH, Kees, M, Becker, SM, Schreiber, M, Pfefferbaum, B, Diamond, D.When disaster strikes: Responding to the needs of children. Prehosp Disaster Med. 2004;19 (1):21–28.Google Scholar
13.Tansey, CM, Louie, M, Loeb, M.One-year outcomes and health care utilization in survivors of severe acute respiratory syndrome. Arch Intern Med. 2007;167 (12):1312–1320.Google Scholar
14.Styra, R, Hawryluck, L, Robinson, S, Kasapinovic, S, Fones, C, Gold, WL.Impact on health care workers employed in high-risk areas during the Toronto SARS outbreak. J Psychosom Res. 2008;64 (2):177–183.CrossRefGoogle ScholarPubMed
15.Veenema, TG, Walden, B, Feinstein, N, Williams, JP.Factors affecting hospital-based nurses' willingness to respond to a radiation emergency. Disaster Med Public Health Prep. 2008;2 (4):224–229.CrossRefGoogle ScholarPubMed
16.Masterson, L, Steffen, C, Brin, M, Kordick, MF, Christos, S.Willingness to respond: of emergency department personnel and their predicted participation in mass casualty terrorist events. J Emerg Med. 2009;36 (1):43–49.Google Scholar
17.Cone, DC, Cummings, BA.Hospital disaster staffing: if you call, will they come? Am J Disaster Med. 2006;1 (1):28–36.CrossRefGoogle ScholarPubMed
18.Chaffee, M.Willingness of health care personnel to work in a disaster: an integrative review of the literature. Disaster Med Public Health Prep. 2009;3 (1):42–56.Google Scholar
19.Locke, SE.Psychosomatic medicine and biodefense preparedness—a new role for the American Psychosomatic Society. Psychosom Med. 2006;68 (5):698–705.CrossRefGoogle ScholarPubMed
20.Hawley, SR, Hawley, GC, Ablah, E, St Romain, T, Molgaard, CA, Orr, SA.Mental health emergency preparedness: the need for training and coordination at the state level. Prehosp Disaster Med. 2007;22 (3):199–204, discussion 205-206.CrossRefGoogle ScholarPubMed
21.Becker, SM, Middleton, SA.Improving hospital preparedness for radiological terrorism: perspectives from emergency department physicians and nurses. Disaster Med Public Health Prep. 2008;2 (3):174–184.Google Scholar
22.Parker, CL, Barnett, DJ, Everly, GS Jr, Links, JM.Expanding disaster mental health response: a conceptual training framework for public health professionals. Int J Emerg Ment Health. 2006;8 (2):101–109.Google ScholarPubMed
23.Parker, CL, Everly, GS Jr, Barnett, DJ, Links, JM.Establishing evidence-informed core intervention competencies in psychological first aid for public health personnel. Int J Emerg Ment Health. 2006;8 (2):83–92.Google Scholar
24.Bonnett, CJ, Peery, BN, Cantrill, SV.Surge capacity: a proposed conceptual framework. Am J Emerg Med. 2007;25 (3):297–306.Google Scholar
25.Barbera, J, Macintyre, AGMedical and health incident management (MaHIM) system: a comprehensive functional system description for mass casualty medical and health incident management.2002. http://www.gwu.edu/~icdrm/publications/index.html. Accessed May 8, 2008.Google Scholar
26.Joint Commission on Accreditation of Healthcare Organizations. Surge Hospitals: Providing Safe Care in Emergencies.2006. http://www.jointcommission.org/Surge_Hospital__Providing_Safe_Care_in_Emergencies/. Accessed May 8, 2008.Google Scholar
27.Hick, JL, Hanfling, D, Burstein, JL.Health care facility and community strategies for patient care surge capacity. Ann Emerg Med. 2004;44 (3):253–261.Google Scholar
28.Rubinson, L, Nuzzo, JB, Talmor, DS, O’Toole, T, Kramer, BR, Inglesby, TV.Augmentation of hospital critical care capacity after bioterrorist attacks or epidemics: recommendations of the Working Group on Emergency Mass Critical Care. Crit Care Med. 2005;33 (10):2393–2403.Google Scholar
29.Davis, DP, Poste, JC, Hicks, T, Polk, D, Rymer, TE, Jacoby, I.Hospital bed surge capacity in the event of a mass-casualty incident. Prehosp Disaster Med. 2005;20 (3):169–176.CrossRefGoogle ScholarPubMed
30.Meredith, LS, Eisenman, DP, Tanielian, T, Taylor, SL, Basurto, R.Preparing Hospitals and Clinics for the Psychological Consequences of a Terrorist Incident or Other Public Health Emergency and Preparing Los Angeles County Department of Mental Health Staff to Respond to Hospitals and Clinics Following Large-Scale Emergencies. Santa Monica, CA: RAND Corp; 2007.Google Scholar
31.Hawryluck, L, Gold, WL, Robinson, S, Pogorski, S, Galea, S, Styra, R.SARS control and psychological effects of quarantine, Toronto, Canada. Emerg Infect Dis. 2004;10 (7):1206–1212.CrossRefGoogle ScholarPubMed
32.Maunder, R, Hunter, J, Vincent, L.The immediate psychological and occupational impact of the 2003 SARS outbreak in a teaching hospital. CMAJ. 2003;168 (10):1245–1251.Google ScholarPubMed
33.Jayasinghe, N, Giosan, C, Evans, S, Spielman, L, Difede, J.Anger and posttraumatic stress disorder in disaster relief workers exposed to the September 11, 2001 World Trade Center disaster: one-year follow-up study. J Nerv Ment Dis. 2008;196 (11):844–846.Google Scholar
34.Norris, FH, Friedman, MJ, Watson, PJ, Byrne, CM, Diaz, E, Kaniasty, K.60,000 disaster victims speak: Part I. An empirical review of the empirical literature, 1981-2001. Psychiatry. 2002;65 (3):207–239.CrossRefGoogle Scholar
35.Laugharne, J, Janca, A, Widiger, T.Posttraumatic stress disorder and terrorism: 5 years after 9/11. Curr Opin Psychiatry. 2007;20 (1):36–41.CrossRefGoogle ScholarPubMed
36.DiGrande, L, Perrin, MA, Thorpe, LE.Posttraumatic stress symptoms, PTSD, and risk factors among lower Manhattan residents 2-3 years after the September 11, 2001 terrorist attacks. J Trauma Stress. 2008;21 (3):264–273.CrossRefGoogle ScholarPubMed
37.Silver, RC, Holman, EA, McIntosh, DN, Poulin, M, Gil-Rivas, V.Nationwide longitudinal study of psychological responses to September 11. JAMA. 2002;288 (10):1235–1244.Google Scholar
38.Schaufeli, W, Buunk, B.Burnout: An overview of 25 years of research and theorizing. In: Schabracq M, Winnubst J, Cooper CL, eds. The Handbook of Work and Health Psychology. Chichester, England: John Wiley & Sons, Ltd; 2003:383-425.Google Scholar
39.Shiao, JS, Koh, D, Lo, LH, Lim, MK, Guo, YL.Factors predicting nurses' consideration of leaving their job during the SARS outbreak. Nurs Ethics. 2007;14 (1):5–17.Google Scholar
40.Maunder, RG, Lancee, WJ, Balderson, KE.Long-term psychological and occupational effects of providing hospital healthcare during SARS outbreak. Emerg Infect Dis. 2006;12 (12):1924–1932.CrossRefGoogle ScholarPubMed
41.Meredith, LS, Eisenman, DP, Rhodes, H, Ryan, G, Long, A.Trust influences response to public health messages during a bioterrorist event. J Health Commun. 2007;12 (3):217–232.Google Scholar
42.Institute of Medicine. Preparing for the Psychological Consequences of Terrorism: A Public Health Strategy. Washington, DC: The National Academies Press; 2003.Google Scholar
43.Donabedian, A.Evaluating the quality of medical care. Milbank Mem Fund Q. 1966;44 (3):166–206.Google Scholar
44.Federal Emergency Management Agency. http://www.fema.gov/. Accessed January 22, 2008.Google Scholar
45.National Child Traumatic Stress Network & National Center for PTSD. Psychological First Aid: Field Operations Guide.2006. http://www.ptsd.va.gov. Accessed May 12, 2008.Google Scholar
46.Hamblen, JL, Gibson, LE, Mueser, KT, Norris, FH.Cognitive behavioral therapy for prolonged postdisaster distress. J Clin Psychol. 2006;62 (8):1043–1052.Google Scholar