Iran Journal of Nursing

Introduction
Disaster health education and people’s participation in different educational courses related to disasters can lead to positive results such as reduced mortality and morbidity in human societies, improved community health, and reduced costs of healthcare centers. Therefore, it seems necessary to pay special attention to this subject and to prepare standard programs for disaster health education in the preparedness phase of the disaster management cycle. Such educational programs should be designed based on the educational needs of healthcare providers to achieve maximum learning. The personnel of the medical centers should have an effective response to disasters. The need assessment is the basis of the development and design of educational programs. Today, educational programs are constantly changing to adapt to increased human knowledge and skills. Educational needs assessment is done to formulate goals, priorities, and educational content, through which it is planned to increase people’s knowledge and skills according to their most essential educational needs.  For educational planning during disasters, the needs assessment is more important due to the complexity and novelty of the subject, as well as Iran’s susceptibility to natural disasters. Considering the vulnerability of mothers and infants during disasters, this study aims to determine the educational needs of healthcare providers for maternal and newborn care during disasters in Iran.

Methods
This is a cross-sectional study that was conducted in 2017. Participants were 208 healthcare providers (nurses, midwives, and practical nurses) from nine armed forces hospitals in Tehran city, who were selected by a census method. The needs assessment was carried out in the gynecologic surgery department, maternity ward, perinatal clinic, and the neighboring clinics. The data collection tool were two questionnaires: a demographic form (surveying age, gender, occupation, education level, marital status, and history of attending disasters) and a researcher-made questionnaire with 64 items and 10 subscales, five subscales related to management areas and four subscales related to care areas. The items were rated on a five-point Likert scale. The face, content, and construct validity of the questionnaire were acceptable. For the reliability, Cronbach’s alpha was calculated as 0.94. The data was analyzed using descriptive and inferential statistics in SPSS software, version 16.

Results
The mean age of participants was 37.7 years. The majority of them were nurses (35.2%) and female (92.3%).The highest mean scores on the educational needs assessment scale were related to sexual violence management (4.30±0.01) and information management (4.28±0.01). This indicates the high educational needs in these areas. In the fields of postpartum care in newborns (2.19±0.96) and responsiveness (2.98±0.89), the lowest scores were reported. In total, the educational needs of healthcare providers for maternal and newborn care during disasters was high (3.3±0.43).

Conclusion
Determining educational needs of healthcare providers is one of the challenging issues during disasters. In the current study, the educational needs assessment of the healthcare providers for providing for maternal and newborn care during disasters in Iran was performed.  Based on the results, the healthcare providers need education how to care for mothers and infants during disasters. Therefore, it is recommended that training courses be designed be held for health care providers of the armed forces hospitals in Iran based on the stated educational needs. Production of educational content and educational assistance in the field of maternal and newborn care during disasters and implementation of in-service training courses, workshops, and maneuvers based on the educational needs during disasters are also recommended.

Ethical Considerations
Compliance with ethical guidelines
This study was approved by the Ethics Committee of the AJA University of Medical Sciences (Code: IR.AJAUMS.REC.1396.83).

Funding
The paper was extracted from the master’s thesis of Leila Poursoleiman, funded by the AJA University of Medical Sciences.

Authors' contributions
Data collection and the initial draft preparation: Leila Poursoleiman; supervision: Shahla Aliyari; data analysis: Amirhosein Pishgooie. All authors read and approved the final manuscript.

Conflict of interest
The authors declared no conflict of interest.

Acknowledgments
The authors would like to thank the participants for their cooperation in this study.

References

1. Waltzman M, Fleegler E. Preparing for natural disasters. Clin Pediatr Emerg Med. 2009; 10(3):144-8. [DOI:10.1016/j.cpem.2009.07.009]
2. Poursoleyman L, Aliyari S, Sharififar S T, Pishgooie S A H. Development of Instructional Curriculum of Maternal and Newborn Care for Army Health Providers in Disasters. Military Caring Scien. 2018; 5 (1) :1-12. [DOI:10.29252/mcs.5.1.1]
3. Heydari A, Afzalaghaee M, Houshmand E, Shabanikiya H. Assessing the risk perception of natural disasters among the staff of hospitals in Mashhad, Iran. Health Emerg Disasters Q. 2022; 7(4):227-34. [DOI:10.32598/hdq.7.4.259.5]
4. Shooshtari Sh, Abedi MR, Bahrami M, Samouei R. Determining the reasons behind women's vulnerability during disasters: A qualitative study. Safety Promot Inj Prev. 2017; 5(1):51-8. [Link]
5. International Council of Nurses. Core Competencies in disaster nursing version 2.0. Geneva: International Council Of Nurses; 2019. [Link]
6. Sohrabizadeh S, Jahangiri K, Khani Jazani R. Reproductive health in the recent disasters of Iran: A management perspective. BMC Public Health. 2018; 18(1):389. [DOI:10.1186/s12889-018-5311-2] [PMID]
7. Harville EW, Xiong X, Buekens P. Hurricane Katrina and perinatal health. Birth. 2009; 36(4):325-31.  [DOI:10.1111/j.1523-536X.2009.00360.x] [PMID]Pourhosseini SS, Ardalan A, Mehrolhassani MH. Key aspects of providing healthcare services in disaster response stage. Iran J Public Health. 2015; 44(1):111-8. [PMID]
8. Pourhosseini SS, Ardalan A, Mehrolhassani MH. Key aspects of providing healthcare services in disaster response stage. Iran J Public Health. 2015; 44(1):111-8. [PMID] [PMCID]
9. Nakhaei M, Tabiee S, Saadatjou SA, SabzehKar F. [The effect of educational intervention on nurses’ preparedness in emergencies and disasters (Persian)]. J Birjand Univ Med Sci. 2019; 26(3):237-48.  [DOI:10.32592/JBirjandUnivMedSci.2019.26.3.105]
10. Hajifoghaha M, Nahidi F, Alizadeh S, Golezar S, Dabiri F, Mokhlesi SS, et al. Midwives’ educational needs in Iran: A narrative review. Iran J Nurs Midwifery Res. 2019; 25(1):1-6. [DOI:10.4103/ijnmr.IJNMR_82_19] [PMID]
11. Moghadas T, Asgari H, Rohani M, Nasirzadeh M, Akhavan S, Ansaripour S, etal. Educational needs assessment of general physicians employed in 24-h urban and rural health centers about emergency patients’ management in Isfahan Province.  Int J Educ Psychol Res. 2017; 3:36-41. [Link]
12. Maree C, Yazbek M, Leech R. Process of development of a contemporary curriculum in advanced midwifery. Health SA. 2018; 23:1037. [DOI:10.4102/hsag.v23i0.1037] [PMID]
13. Ghoreyshyzadeh F, HoseinPour F, Ghaffari R, Nourdadgar A. Educational needs assessment of family health providers in Tabriz Health Care Centers in 2015. Res Dev Med Educ. 2017; 6(1):12-8. [DOI:10.15171/rdme.2017.003]
14. Seyedaskari SM, Rozbehi A, Bahmanbijari B, Mahdavinia J, Beigzadeh A, Rezaei H. Assessment of training needs of education experts in Kerman University of Medical Sciences. Am J Educ Res. 2016; 4(10):736-40. [Link]
15. Taghizadeh Z, Montazeri A, Khoshnam-rad M. [Educational Needs of midwifery students regarding mother and infant mortality prevention services in critical situations (Persian)]. Hayat. 2015; 21(2):54-66. [Link]
16. Colov NS. [Need for extensive education when implementing new fetal monitoring technology (Danish)].Ugeskr Laeger. 2007; 169(39):3294-7. [PMID]
17. Telfer M, Zaslow R, Chalo Nabirye R, Nalugo Mbalinda S. Review of midwifery education in Uganda: Toward a framework for integrated learning and midwifery model of care. Midwifery. 2021; 103:103145. [DOI:10.1016/j.midw.2021.103145] [PMID]
18. Amiri M, Mohammadi GH, Khosravi A, Chaman R, Arabi M, Sadeghi E, et al. [Hospital preparedness of Semnan Province to deal with disasters (Persian)]. J Knowl Health. 2012; 6(3):44-9. [Link]
19. Goli-Roshan S, Aziznejad-Roshan P, Khafri S, Gholizadah-Gardrodbary M. [The effect of training based on educational needs on clinical learning of undergraduate nursing students (Persian)]. Res Med Educ. 2017; 9(2):12- 3. [DOI:10.29252/rme.9.2.12]
20. Duong K. Disaster education and training of emergency nurses in South Australia. Australas Emerg Nurs J. 2009; 12(3):86-92. [DOI:10.1016/j.aenj.2009.05.001]
21. Brinjee D, Al Thobaity A, Almalki M, Alahmari W. Identify the disaster nursing training and education needs for nurses in Taif City, Saudi Arabia. Risk Manag Health Policy. 2021; 14:2301-0 [DOI:10.2147/RMHP.S312940] [PMID]
22. Sereshti M, Banaeian Sh, Delaram M, Kazimeian A, Safdari F, Shamaei Z. [Educational needs of midwife alumni work in health care centers (Persian)]. Educ Strategy Med Sci. 2011; 4(1):31-7. [Link]
23. Loke AY, Guo C, Molassiotis A. Development of disaster nursing education and training programs in the past 20 years (2000-2019): A systematic review. Nurse Educ Today. 2021; 99:104809. [DOI:10.1016/j.nedt.2021.104809] [PMID]
24. Senobari M, Havakhor N. [Evaluation of nurses’ educational needs assessment in crisis nursing management in the educational and medical centers affiliated to Ahvaz Jundishapur University of Medical Sciences based on Jennings Model (Persian)]. Educ Dev Judishapur. 2020; 11(Supplement):154-66. [Link]
25. Bazyar J, Pourvakhshoori N, Safarpour H, Farrokhi M, Khankeh HR, Daliri S, et al. Hospital disaster preparedness in Iran: A systematic review and meta-analysis. Iran J Public Health. 2020; 49(5):83750. [PMID]
26. Balut MD, Der-Martirosian C, Dobalian A. Disaster preparedness training needs of health care workers at the US Department of veterans affairs. South Med J. 2022; 115(2):158-163. [PMID] 
27. Mahdizadeh AH, Taheri Z. [Educational needs assessment of nurses working in hospitals of Tehran University (Persian)]. J Nurs Edu. 2016; 5(3):1-9.  [DOI:10.21859/jne-05031]
28. Ezati P, Vaziri M, Adli F. [Educational needs assessment in the medical emergency technicians of Tehran Emergency Center (Persian)]. Safety Promot Inj Prev. 2017; 5(2):109-19. [DOI:10.22037/meipm.v5i2.18692]
29. Parsaei M, Khankeh H, HabibiSaravi R, Hosseini SH. [Hospital disaster preparedness in Mazandaran Province, Iran 2017 (Persian)]. J Mazandaran Univ Med Sci. 2019; 28(168):108-17.  [Link]
30. Khorasani D, Hatami H, Zare A. [Assessing structural and non-structural safety and readiness of healthcare centers in Bojnord in dealing with functional, non-structural and structural dimensions of disasters in 1400 (Persian)]. Toloo-e-Behdasht. 2022; 21(4):89-103. [DOI:10.18502/tbj.v21i4.11504]
31. Klein KR, Rosenthal MS, Klausner HA. Blackout 2003: Preparedness and lessons learned from the perspectives of four hospitals. Prehosp Disaster Med. 2005; 20(5):343-9. [DOI:10.1017/S1049023X00002818] [PMID]
32. Rabiee A, Ardalan A, Pourhosseini SS. [Assessment of coordination among lead agencies of natural disasters management in Iran (Persian)]. Hakim J. 2013; 16(2):107-17. [Link]
33. Cignacco E, Zu Sayn-Wittgenstein F, Sénac C, Hurni A, Wyssmüller D, Grand-Guillaume-Perrenoud JA, etal. Sexual and reproductive healthcare for women asylum seekers in Switzerland: A multi-method evaluation. BMC Health Serv Res. 2018; 18(1):712. [DOI:10.1186/s12913-018-3502-2] [PMID]
34. Shahali S, Mohammadi E, Lamyian M, Kashanian M, Eslami M. [Experience of healthcare providers to deal with victims of sexual assault: A qualitative research (Persian)]. J Qual Res Health Sci. 2014; 3(1):37-50. [Link]
35. National Sexual Violence Resource Center. Sexual violence in disasters [Internet]. 2021 [Updated 2023 December]. available from: [Link]
36. Connell J, Kelly J, Nagle C. Imminent birth education for rural and remote settings: An evaluation study. Aust J Rural Health. 2019; 27(5):405-11.  [DOI:10.1111/ajr.12547] [PMID]
37. Irajpour A, Nazari F, Alavi M. [Educational needs assessment of emergency centers staff and emergency nurses of teaching hospitals affiliated to Isfahan University of Medical Sciences (Persian)]. Iran J Med Educ. 2017; 17:126-31. [Link]