The Present Situation of Disaster Nursing Education at
Nursing Colleges and Universities in Asian Region

Head of Researcher: Mariko Ohara,
Partner researchers：Mayumi Miura, Takako Ito, Yuko Kuroda, Akiko Sakai,
Tatsue Yamazaki, Chikako Itagaki(Former Educational Committee of Japan Society of Disaster Nursing)

Abstract
The purpose of this research is to clarify how disaster nursing subject is introduced at nursing
colleges and universities and its actual situation that possess different educational background in
Asian region.
Number of target nursing colleges and universities is 205 in 11 countries. Survey
questionnaire is delivered to disaster nursing teachers of the nursing universities and/or nursing
departments. Answers were collected from 51 universities and analyzed.
Results of analysis are as follows: 1) 44 out of 51 universities provide disaster nursing classes.
1 university provide a special seminar on disaster nursing. 3 universities are in the process ofplanning of disaster nursing classes. 2) Lecture method was reported that about half of themprovide combination with theory and exercises/drills. 3) Half of colleges and universities
provide the disaster nursing subject as a required subject, and half of them provide as an elective
subject. 4) The subject theme was named “disaster nursing” in 7 universities, and in 23
colleges and universities the subject was taught as a part of ”emergency nursing” and/or “adultnursing”. It revealed that disaster nursing is understood as critical care nursing in acute stage
after disaster.
Collection ratio of questionnaire was 25% which is low, however these answers wereconsidered as meaningful reply from nursing teachers who had strong interest and concerns fordisaster nursing education. 41 universities replied that they wish to have information exchange
and interchange programs with colleges and universities overseas that help them develop theirdisaster nursing education for their countries.
Key words: Asian region、nursing university、disaster nursing education

PrefaceNatural disasters and number of the victim are increasing in the world year by year, especially
it is said that 90% of the victim live in Asian region. Many natural disasters such as the biggest
earthquakes, typhoon, intense rainfall, volcano eruption occurred in Japan as well as train crashas manmade disaster. In 2008, May 12, the biggest Sichuan earthquake with Magnitude 7.8 wehave ever experienced occurred in South-West area in China and frightened the people of theworld. Japanese government dispatched International Emergency Rescue Team and Japan

Disaster Relief Medical Team to China. Their activities were highly regarded. In thissituation, since April, 2009, nursing education curriculum were revised under the theme of“Unification of Nursing Theory and Practice”. Then disaster nursing subject notified as one ofelective subjects. When we knew that disaster nursing has not taught except at Japanese Red
Cross College of Nursing before “Hanshin-Awaji Great Earthquake” in 19951)., we recognizedthat disaster nursing subject could establish a certain position in the curriculum nowadays.
This is the result of continuous disaster relief activities and accumulated records andpresentation of activities that contributed development disaster nursing subject. Disasternursing activities, 2-5) survey and 6-8) reports are presented in Asian countries, too. We can feel
their experiences of disaster nursing activities of each country.
It is considered that not only Japan but the countries in Asian region which had experiences ofdisasters increased the needs of information exchange, opportunities of disaster education andresearches from acute stage to rehabilitation and reconstruction stage.
Therefore Educational Committee, Japan Society of Disaster Nursing set the purpose of thisinvestigation to clarify current situation of disaster nursing education at nursing colleges anduniversities in Asian region.

１．Purpose
The purpose of the research is to clarify the current situation of how disaster nursing subject isintroduced and actual situation at nursing colleges and universities in Asian region.

2．Method1) Target:
Nursing teachers who are in charge of disaster nursing education and work for 205 nursing
colleges and universities and/or nursing departments in 11 countries in Asian region. These
universities were chosen by former Educational Committee of Japan Society of DisasterNursing. Standard concept of their choice was either some members of the committee havevisited in the past or wish to have collaborative linkage with those universities in future.
2) Period: From April to October, 2007
3) Method:
Questionnaire was sent to the vice chancellor or the dean of target colleges and universities andwas sent back by a return envelope.
4) Contents:
Items of questions were the same which was used for ⁹⁾survey of actual situation of disasternursing education in 2004 & 2007 with permission of composer. Components were nursing
teachers’ attribute (age, experience, specialized field, occupation, academic background, license,
disaster experience, years of teaching of disaster nursing, if they have disaster relief experienceor not.) and situation of disaster nursing education at the colleges and universities (Name ofsubject that disaster nursing is included. Which year it is taught, credit, hours of classes, arequired subject or an elective subject, structure of lecture, existence of syllabus ）. All theanswers were designed on mark sheet with column for free writing.

5) Method of Analysis:
The marked answers were collected simply.
categories.

Free writing parts were analyzed by common

6) Ethical Consideration:
One sheet is attached to the questionnaire that explained about ethical consideration to thedean of university. It mentioned about the purpose, free decision to fill in questionnaire, notgiven any disadvantages by questionnaire, and each individual person will not be clarified
because of anonymous method.

3．Result
Nursing teachers from 51(24.9%) universities out of 206 from 7 countries sent back thequestionnaire. 17 of the most respondents was Korea. 11 of the second most respondents
was Thailand. The third with 9 respondents was Philippines. 5 respondents reached from
China. Taiwan and Indonesia sent us each 4 questionnaires. 1 questionnaire was returned
from unknown country. Location of universities that sent us back the questionnaire are locatedin disaster area in the past(Table 1).
1)Background of respondents
Age over 40 is the most respondents(78.4%), and only 2 from under age 30. The female
respondents are 45(88.2%) and those who have more than 20 years experience on nursing
education are 22(43.1%). 11 answerers(21.6%) have experience for 10～19 years, that means
more than 10 years experienced staff are occupied for 60% (Table 2). Doctor program
graduates were 25 (49%). Master program graduates were 20(39.2%). It revealed that 90% ofthem obtained master degree.( Table 3)
Regarding occupations, 35 answerers were licensure only as a nurse. 10 of them qualified as anurse and a midwife. 2 of them qualified as a nurse and a public health nurses. Other 2 ofthem qualified as a nurse with certification of emergency nurse and home care nursing. Other 2
nurses are not qualified as a nurse, but one of them qualified as a public health nurse. Anotherone’s qualification was unknown. (Table 4)
Regarding title, 20(39.2%) of them assigned as an associate professor. Then 15(29.4%) got
the position as a professor. 12(23.5%) assigned as a lecturer. 3(5.9%) worked as an assistantlecturer. (Table 5)2) Relevant to disaster nursing education
Respondents who have less than 1 year experience of disaster nursing are 24(47.1%）, 1 to 5
years experience are 12(23.5% ), which meant about 70% of replied people had less than 5 years
experience. (Table 6)
8 respondents did not fill in item of length of teaching experience, 6 of them wrote somecomments about contents of lectures.
Titles of teachers who teach disaster nursing at present are shown on (Table 8). 25 professors(49%) with Ph.D. teach nursing education which are about half of all. The answer sheet
designed plural form. 15 respondents covered 1 field, 21 respondents covered more than 3 fields,
and 1 respondent covered 9 fields. 14 of them (27.5%) teach community health nursing. 11of themteach basic nursing and emergency nursing. One professor teaches disaster nursing among
other specialized fields.
Respondents who have more than 5 years teaching experiences are 7 and 5 out of 7 teachers
have taught emergency nursing.
3) Victim rescue experience
Regarding experiences either to have been a victim or a rescue member, 17(33.3%) of themexperienced as a victim and 19 (37.3%) of them as a rescu member.
12 out of 17 victims also had rescue experience, also 71% of 19 rescues experience personnel
were the victims as well.
Regarding the type of disaster, 6 victims reported earthquake, 1～3 victims reported about
flood, sea wave(Tsunami), typhoon, fire, explosion of volcano and SARS.(Severe AcuteRespiratory Syndrome)
Rescue activities are mainly distributing the food, disaster prevention activities and/or adelegation from Red Cross.
4) About a lecture of disaster nursing
7 out of 51(13.7%) answered that they don’t provide any disaster nursing classes. Among 7
answers, 3 of them are planning to start disaster nursing classes and 1 of them replied that she
provide a special lecture on disaster nursing (Table 8).
There were 41 answers about structure of classes. 20 out of 41(48.8%) only gave lectures.
3(7.3%) of them provided combination of lecture and desk simulation. 18(41.9%) of themprovided mixed classes with lectures and exercises. About half of them answered that theygave simulation exercises (Table 9).
3 of them answered that they have training in collaboration with hospital. Disaster nursing wastaught as required subject at 23 colleges and as elective
subjects at 20 colleges. Also 18 out of 43 respondents (41.9%) answered that they havesyllabus. Rest of them seemed that they taught disaster nursing as a part of other subjects.
Regarding the name of subject, 7 of them taught under the name of disaster nursing. 5 out of
7 answered that they already made syllabus.
23 of them taught as emergency nursing and adult nursing. 5 of them taught as nursing
management. 2 of them taught as community health nursing and 1 person taught as mental
health nursing is 1. (Table 10)
Teaching year of disaster nursing varies. 1 out of 21 answers reported that disaster nursing istaught in master programs. 4 people answered that they teach over a period of couple years. In
details, one person taught in the second, third and forth year. 2 persons taught in the third andforth year. Another 1 person taught in the second and third year. 9 persons taught in the forthyear, 4 persons taught in the third and second year. 1 person taught in the first year. Teachingin the forth year found the most (Table11)
About credit, 23 people gave 1 credit which was the most, and 3 persons gave 4 credits. Aboutstudy hours, between 11 to 15 hours are the most number with 14 people and there was a range
between minimum 4 hours to maximum 54 hours. It might be misunderstood the meaning ofteaching ours weather it is actual disaster nursing hours or total hours of the subject that disasternursing was included. There are only 3 answers that said 15 hours and 30 hours of disasternursing were taught.
Answers for necessity of disaster nursing in basic nursing education was quite high as 49(96%),

only 2(4%) are answered N/A. and people who wish to havewere 41(80.4%).

communication with oversea5) Awareness of disaster nursing study
18 people wrote some comments on the sheet. 5 wrote that they want to learn the knowledge
and skills that Japan established, and 2 wrote that they want to share researches. Also 7 wrotethat they want to have a partnership.
Finally, 5 people strongly agreed that we should set up “disaster nursing theory” and other 3
wrote that we should introduce the techniques of lectures. Other 3 answered that it was difficult
to make people understand the need because a disaster rarely occurs.

4．Consideration
1) Present situation of disaster nursing education
With this investigation extended to nursing universities and nursing departments, it became
clear that half of them just provide lectures on disaster nursing and rest of them added desk
simulation, exercises and drills. Even some of them implemented joint training of CPR andtriage in collaboration with the hospital. Also 23 of them taught disaster nursing in the subjectof emergency nursing and adult nursing. This implied contents of classes became more
simulation type to respond against occurrence of disaster as physical assessment and emergency
care. Also 5 answers meant that they put importance to nursing management in disaster. As
elements of management in disaster, risk management, stress management, death management,
health needs and nursing management are noted that showed wider range of disaster nursing
studies.
In acute stage right after the disaster, most important activity is to save the life of the people.
Mass media follow keen attention. In this stage rescue team draw big expectation in their role.
It’s a challenge how to save survivors’ lives in providing critical nursing care. Therefore
disaster nursing training is badly needed. In another situation of the victim, some are obliged
to live in the refugee shelter after they are saved. Refugees living environment is severe with athreat of infectious diseases. Here assistance the victim from nursing aspects will be highly
regarded to improve condition10）.
There are common challenges and findings for the victim in any regions. Therefore it isessential that we should share knowledge and techniques of disaster nursing beyond countries.
This investigation proved this idea that many nursing teaches wished to have interchanges withother countries. It meant that nurses have common mission. Life of the people refer tocommunity based culture. Accordingly nursing care needs will be specified in each region.
When those needs are clarified, necessary assistance and care will be revealed. At this moment
it’s preferable that suitable disaster nursing education that meet community situation shall bemade. This matched the result of questionnaire on community disaster prevention and disasternursing to nurses of Japan Disaster Rescue Team who were dispatched to Nepal11）.
Considering both aspects of commonality and specialty, points from acute stage to middle andlong term planning must be taken in for the fulfillment of disaster nursing education in addition
to more interchanges among nurses.
2）Awareness of nursing teachers against disaster nursing study
Target of this investigation were nursing colleges and universities in Asian region.

Answers

from nursing teachers who work for 51(25%) nursing colleges and universities reached us.
Among them 94% of teachers reported that they teach disaster nursing that showed highimplementation ratio. Those 51 nursing colleges and universities experienced a big disaster ina past or study and prepare for disaster prevention against frequent attack of disasters. 12.13）.
Moreover about half of teachers who answered the questionnaire experienced disaster or
rescue activity. Therefore they had strong interests in disaster nursing and work for disasternursing education. In the comments sheets, they noted as follows: I wish to study and/or makeresearches on disaster nursing together. I am implementing disaster nursing activities. It’s
not easy to teach disaster nursing, but it’s really needed. 80.4% of them wished to haveinterchanges with other countries that showed their deep awareness.
Regarding their working years, 40% of them have worked more than 20 years,
however, only a little more than 10% of them have teaching experience of disaster nursing.
For this data, we can say disaster nursing study(theory) is a new domain.
Since Hanshin-Awaji Great Earthquake in 1995, disaster nursing has been developed rapidly
with strong social needs. Suggestion14-17）for establishment of disaster nursing curriculum andseminar for disaster nursing as continuing nursing education program and disaster nursing
seminar for nursing teachers are offered. These trend promotes fulfillment of disaster nursing.
According to the survey by Japanese basic nursing educational institutions (collection of 454
questionnaires in 2004 and 494 questionnaires in 2007), implementation of disaster nursing
education showed 38.1% in 2004. Then ratio was rapidly increased up to 65.8% in 2007. It
proved that the need of disaster nursing education was recognized and concrete activities havestarted9）.
We could confirm that nursing teachers who answered for questionnaire of this investigation
were pioneers in respective country. It is considered that they need opportunities of learningand information exchanges to develop disaster nursing education that meet situation of eachcountry.

5．Conclusion
Collection rate of questionnaire was 25% which was comparatively low. Therefore analysis ofresult can not be generalized. One of the causes of low collection rate seemed that colleges
and universities which disaster nursing was not taught didn’t return the questionnaire. In casedisaster occurred, it’s not always possible to settle the situation by its region or country,
assistance is requested to neighboring region, countries of the world. Therefore we need toestablish the networking for better supports each other. In this regard, establishment of Japan
Society of Disaster Nursing and following activities both in disaster site and doing researches
are meaningful. Also, Japanese Nursing Association has continued disaster nursing activities
as one of major activities. These are the valuable activities that could be recognized fromother countries. As analysis of the questionnaire is shown, many respondents wished to sharefindings and lessons learned with Japan.
We expect that awareness for disaster nursing will be raised by the result of this investigation.

Reference
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Disaster Medical Education 16-21, Japanese Ministry of Health, Labour and Welfare, 1997
2) Yoko Hironaka ， Miwako Arai,Takako Itani, et al: The Philippines Santa Lucia

Resettlement Area Health Survey by using Rapid Assessment， Journal of The Japanese
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2003
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Big Earthquake in Bam,Iran-Necessity of Support on Reconstruction of Life of Victim
Nurses-，Journal of Japan Society of Disaster Nursing6(2)，21-30,2004
4) Chie Watanabe: Survey of Actual Conditions of Sri Lanka after the Indian Ocean/Sumatra
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Disaster.-Some Subject-in “Omaya”of the Reconstruction Term，journal of Japan Societyof Disaster Nursing6(2)，41-51，2004
6) Miki takeuchi Hiroko Hiruta: Activity Report "Surgery Tent:" International Emergency
Medical Support and Disaster Nursing Activity Report on the Sumatra Island Offshore
Earthquake/Indian Ocean Tsunami Disaster, Japanese Special Feature (The Japanese
Journal of Nursing Science), 30 (6), 90-92, 2005
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dispatched to Sumatra offshore Earthquake Indian Ocean Tsunami Disaster support
activity, Kango Tenbou, 30(4), 454-458, 2005
8) Tatsue Yamazaki:Having learned from Indonesia Sumatra offshore large-scale earthquake
and Indian Ocean tsunami disaster support activity –Subacute disaster nursing support
which took a long term into consideration during from activity for period，journal of Japan
Society of Disaster Nursing9(2)，40-48，2007
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People and Community:A Report － The 21st Century Center of Excellence
Program‐Development of a Center of Excellence for Disaster Nursing in a UbiquitousSociety‐ ，34-35，2008
10) Yuko Kuroda：Nursing Care in Shelters: The Necessity for Combined Relief Centers、International Nursing Review Japanese Special Feature28(3)、52-59,200511) Mariko Ohara: Issues for Disaster Nursing Education in Nepal, Japanese Red Cross
Musashino Junior College of Nursing Annual Report 15, 1-16, 2002
12) Ogcheol Lee , Translation by Aya Nakaoka: Disaster Nursing Education in South Korea，International Nursing Review Japanese Special Feature，28(3)，132-133，2005
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Prevention and Relief Systems in China，Journal of Japan Society of Disaster Nursing6(3)，31-38，2005
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Education, Kango Tenbou 31(8), 869-875, 200615) Mariko Ohara: Establishment of Disaster Nursing Curricurum, Kango Tenbou 31(8),876-88316) Mariko Ohara:Developed Methodology in Disaster Nursing Education of University(Bachelor Degree), Nursing Education 47(3), 200617) AikoYamamoto:Promoting Preparedness for Disaster –Recommendation from DisasterNursing-，Journal of Japan Society of Disaster Nursing8(2)，2‐7，2006

Table1.

Result of Survey by Countries and Rate of Replies
Countries

Numbers(Result Number=51)
ofUniversities

Number of
Replies(％)

That sent questionnaire
Republic of the Philippines

54

9(16.7)

Republic of Korea

48

17(35.4)

Peoples’ Republic of China

39

5(12.8)Kingdom of Thailand

32

11(34.4)

Republic of Indonesia

143(21.4)

Republic of china

104(40.0)Peoples’ Republic of Bangladesh

30

Democratic Socialist Republic of Sri Lanka

2

1(50.0)Federal Democratic Republic of Nepal

20

Kingdom of Cambodia

10

Republic of Uzbekistan

１0( Former Kingdom of Nepal)

Nationality unknown
Total

1
206

51(24.8)

Table2.

Numbers and Rate of Replies by Countries (n=51)

Countriesn(%)

Republic of Korea

17(33.3)

Kingdom of Thailand

11(21.6)

Republic of the Philippines

9(17.6)Peoples’ Republic of China5( 9.8)

Republic of China4( 7.8)

Republic of Indonesia4( 7.8)

Democratic Socialist Republic of Sri Lanka

1( 2.0)

Table 3.

Range ofAge

Background of personnel who answered questionnaire

n（%）

sex

n(%)

4( 7.8)Length of experience
as a nurse

20～29

2（4.0）

male

30～39

9（17.6）female 45(88.2)

10 – 19 years

40～49

20（39.2）n/sMore than 20years

50～

20（39.2）

2( 3.9)Less than 9years

n=51

n(%)

18
（35.3）
11（21.6）
22（43.1）

Table 4.

Level of Degree

n=51

Table5.

Qualification

n=51

Degreen(%)

Qualificationn(%)

Doctor of Philosophy

25(49.0)

Nurse

35(68.6)

Master degree20(39.2)

Nurse ＆Bachelor degree
othersTable 6.

Job Title

Midwife10(19.6)5( 9.8)Nurse ＆ Public Health Nurse2( 3.9)1( 2.0)

Nurse ＆ others2( 3.9)Public Health Nurse1(2.0)

others1( 2.0)

n=51

Title

n(%)

Professor

15(29.4)

Associate Professor

20(39.2)

Lecturer

12(23.5)

Assistant Lecturer3( 5.9)others1( 2.0)Title 7.

Length of disaster nursing education ＆ its method
Lecture・simulation,

etc

n/s

Length of yearsn(%)

Less than 1year

24(47.1)12

7

5

1 - 5years

12(23.5)3

81

5 - 10years

4( 7.8)1

2

1

more than 10 years

3( 5.9)

1

2

0

n/s

8(15.7)1

3

4

Title 8.

only lecturen=51

Area of specialization （Multiple answers allowed.）

Area of specializationn(％)

Area of specializationn(％)

Nursing25(49.0)

Home care nursing

4(7.8)

Community health nursing

14(27.5)

Psychological nursing

4(7.8)

Fundamental nursing

11(21.6)

International nursing

4(7.8)

Critical care nursing

11(21.6)

Nursing management3(5.9)

Aged nursing

10（19.6)

History of nursing

2(3.9)

Maternity nursing

10(19.6)

Infection, Risk management2(3.9)

Theory of nursing

9(17.6)Perinatal nursing

2(3.9)

Chronic nursing

9(17.6)

Disaster nursing

1(2.0)

education

Emergency care

Pediatric nursing

8(15.7)

Nursing skills

7(13.7)

Adult nursing

1(2.0)

Rehabilitation nursing

6(11.8)Communication skills

1(2.0)

Cancer nursing

5(9.8)

nursing2(3.9)

Table9.

Subject of disaster nursing n=51

Table10.

Type of method

n=41

Subjectn(％)

Type of method

ｎ(％)

yes

44(86.3)

only lectures

20(48.8)

lectures, simulation

no3(5.9)

exercises,
technical exercises, practical

21(51.2)

training
no, but planningno, but provide as a
special lecture

Table11. Subjects ＆type

3(5.9)

1(2.0)of method

n=38

only

Subjects

nolectures, simulation exercises,
lectureemergency care nursing

19

9

10

disaster nursing

7

4

3

nursing management

4

2

2

community health nursing

2

2

0

psychological nursing

1

1

0

adult nursing･etcTable12.

Teaching year of disaster nursing

Year

no

4th year9

3rd year3

2nd year3

1st year1

Master degree

1

3rd

＆4th

2

2nd

＆3rd

1

2nd･3rd and･4th

1

n=21