title: A grounded theory study of 'turning into a strong nurse': Earthquake experiences and perspectives on disaster nursing education.
abstract: BACKGROUND
  While Asia has the dubious distinction of being the world's most natural disaster-prone area, disaster nursing education and training are sparse in many Asian countries, especially China where this study took place.
  
  
  OBJECTIVE
  To explore the earthquake disaster experiences of Chinese nurses and develop a substantive theory of earthquake disaster nursing that will help inform future development of disaster nursing education.
  
  
  METHODS
  A qualitative study employing grounded theory, informed by symbolic interactionism.
  
  
  METHODS
  Fifteen Chinese registered nurses from five hospitals in Jiangxi Province who undertook relief efforts after the 2008 Wenchuan Earthquake.
  
  
  METHODS
  Data were collected in 2012-2013 in digitally-recorded, semi-structured, in-depth interviews and reflective field notes, and analyzed using Glaser's grounded theory method.
  
  
  RESULTS
  Participants were unprepared educationally and psychologically for their disaster work. Supporting the emergent theory of "working in that terrible environment", was the core category of "turning into a strong nurse", a process of three stages: "going to the disaster"; "immersing in the disaster"; and "trying to let disaster experiences fade away". The participants found themselves thrust in "terrible" scenes of destruction, experienced personal dangers and ethical dilemmas, and tried the best they could to help survivors, communities and themselves, with limited resources and confronting professional work.
  
  
  CONCLUSIONS
  Our rich findings confirm those of other studies in China and elsewhere, that attention must be paid to disaster education and training for nurses, as well as the mental health of nurses who work in disaster areas. Emergent theory helps to inform nurse educators, researchers, leaders and policy makers in China, and elsewhere in developing strategies to better prepare nurses for future disasters, and assist communities to prepare for and recover after earthquake disasters.
authors.affiliation: HOPE School of Nursing, Wuhan University, Wuhan, Hubei Province, China; Faculty of Nursing, Jiujiang University, Jiujiang, Jiangxi Province, China. Electronic address: cherryleeleo@163.com.
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
authors.affiliation: Faculty of Nursing, Chiang Mai University, Chiang Mai 50200, Thailand. Electronic address: INReditor@icn.ch.
authors.forename: Sue
authors.initials: S
authors.lastname: Turale
authors.affiliation: Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan. Electronic address: teriston@yamaguchi-u.ac.jp.
authors.forename: Teresa E
authors.initials: TE
authors.lastname: Stone
authors.affiliation: HOPE School of Nursing, Wuhan University, Wuhan, Hubei Province, China. Electronic address: petrinima2012@gmail.com.
authors.forename: Marcia
authors.initials: M
authors.lastname: Petrini
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D002681:China; D004190:Disasters; D055866:Earthquakes; D004506:Education, Nursing; D004638:Emergency Treatment / Q000451:nursing* / Q000523:psychology; D005260:Female; D066296:Grounded Theory; D006301:Health Services Needs and Demand / Q000592:standards*; D006801:Humans; D008297:Male; D008603:Mental Health; D009726:Nurses / Q000523:psychology*; D036301:Qualitative Research; D013315:Stress, Psychological / Q000451:nursing / Q000523:psychology
keywords: Disaster nursing education; Disaster preparedness; Disasters; Earthquake relief, disaster nursing; Grounded theory