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The preparedness of disaster among nurses in community health centers in rural areas during the COVID-19 pandemic in Malang City
Mukhamad Fathonia,b,
Corresponding author
mfathony@ub.ac.id

Corresponding author.
, Turniningtyas Ayu Rachmawatib, Elvira Sari Dewia, Ari Prasetya Djatib, Sumi Lestarib, Ah Yusufc, Christrijogo Sumartono Waluyod
a Department of Nursing, Faculty of Health, Universitas Brawijaya, Malang, Indonesia
b Universitas Brawijaya, Malang, Indonesia
c Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
d Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Natural disasters worldwide are expected to take place nearly every day&#44; where the greatest events in the Asia-Pacific region reached 40&#37; of the total disasters in the world with 80&#37; of victims coming from the area&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Indonesia is one of the countries in Asia that is geographically located in disaster-prone areas&#46; The number of positive cases of COVID-19 in Malang continues to increase&#46; A total update on COVID-19 in Malang shows that there have been 3301 positive cases with 7754 cured and 832 died from COVID-19&#44; recorded until 04 August 2021&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Based on these data&#44; following the international standards of the Council of Nursing &#40;ICN&#41;&#44; nurses were required to serve as disaster nursing in emergency response&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> This role puts nurses&#8212;as health care providers&#8212;in the front line&#44; a direct care provider playing an active role in the handling of victims in disaster response whose aim is to alleviate the impact of casualties that may occur<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a>&#46; This remains a challenge for nurses because the management of disaster victims during emergency response is still not optimal in some developing countries&#44; including Indonesia&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">One underlying reason is the improvements needed in nursing education institutions for providing the necessary knowledge and skills during the management of disaster victims&#46; Therefore&#44; most nursing graduates do not have the adequate knowledge and skills to volunteer at the time of disasters&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Abdelalim and Ibrahim<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> stated that&#44; at this time&#44; the right step in improving the knowledge and skills of nurses is to provide early education on disaster to nursing students&#46; The provision of early education for nursing students is expected to increase the knowledge in terms of the management of real victims during emergency response&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Method</span><p id="par0025" class="elsevierStylePara elsevierViewall">This study is a descriptive exploratory with a cross sectional design&#46; The research was conducted at Malang City&#44; East Java provincial for all nurses who worked at primary health care 16 community health care&#46; The quota sampling technique used for 60 nurses in ED and 60 nurses in non-ED respectively&#46; Selection of the sample was based on the following inclusion criteria&#58; &#40;1&#41; a nurse who has a minimum working period of &#8805;1 year&#59; &#40;2&#41; has a smartphone&#59; &#40;3&#41; has a minimum education diploma in nursing&#59; and &#40;4&#41; is not on leave or study assignments&#46; The reasons for those inclusion criteria were nurses who have worked for at least 1 year in both units have the competencies and understanding of disaster preparedness information that obtained from experience and disaster training program&#46; Due to in COVID-19 pandemic&#44; the questionnaire used the Google Form application&#44; which required respondents to have a smartphone&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The data collection tool was a Disaster Preparedness Questionnaire &#40;DPQ&#41;&#59; a questionnaire in a Likert scale&#44; consisting of 30 items&#46; The questionnaire has the validity and reliability test with the highest correlation values 0&#46;725 and 0&#46;821 respectively&#46; The study used a questionnaire consisting of two parts&#44; namely&#58; demographic data and the DPQ questionnaire&#46; Because of COVID-19 pandemic during this study&#44; the data collection method was carried out by providing an online-based questionnaire using Google form&#46; This research was approved by the Ethics Committee of Faculty of Nursing&#44; Airlangga University with number 2095-KEPK&#47;2020&#46; Respondents were provided research information via Google form&#44; and provided written informed consent voluntarily to be involved in this study&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Results</span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Characteristics of respondents</span><p id="par0035" class="elsevierStylePara elsevierViewall">The respondents in this study were nurses of a community health center&#44; as presented in the following frequency distribution characteristics of respondents &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Nurses&#8217; knowledge before and after intervention simulation standards</span><p id="par0040" class="elsevierStylePara elsevierViewall">In <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#44; the variable data displays the respondents&#8217; knowledge before and after the intervention in the control group&#46; <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a> infers that there is an increase in knowledge after being given intervention standard simulation as opposed to before the intervention&#46; The average score early on at the pretest is 26&#46;39&#44; which increased to 70&#46;28 after intervention in the post-test&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Bivariate analysis</span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">The effects of knowledge on the improvement of preparedness</span><p id="par0045" class="elsevierStylePara elsevierViewall">The analysis that uses gamma correlation test obtained the results of knowledge factors &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;005&#59; <span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;35&#41;&#44; attitude &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;000&#59; <span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;46&#41;&#44; means of infrastructure &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;000&#59; <span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;54&#41;&#44; and self-control &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;000&#59; <span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;52&#41; for quarantined Coronavirus Disease &#40;COVID-19&#41; patients&#46; Knowledge&#44; attitude&#44; infrastructure&#44; and safe house factors can influence self-control for Coronavirus Disease &#40;COVID-19&#41;&#46; In rural areas&#44; health education&#8212;as an education and empowerment for patient self-control for COVID-19&#8212;is one of the efforts to encourage patients to obey health protocol during the pandemic in Malang &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">The effect of simulation standards on preparedness</span><p id="par0050" class="elsevierStylePara elsevierViewall">Based on the analysis using the paired <span class="elsevierStyleItalic">t</span>-test in <a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#44; it can be seen that the differences between the mean scores of knowledge before and after the intervention shows significance with <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;000 &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46; Therefore&#44; we can conclude that there are differences between the mean score of knowledge before and after the intervention standard simulation in the treatment group&#46; This may imply that the standard simulation methods can significantly increase students&#8217; knowledge in providing treatment for victims in a disaster simulation&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Discussion</span><p id="par0055" class="elsevierStylePara elsevierViewall">The preparedness of community health center employ knowledge in victim management in disaster emergency response simulation for patients with COVID-19&#46; Based on the research results presented in <a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#44; it is evident that the value of the knowledge variable before and after the re-intervention increased in the treatment group&#46; The mean difference in the knowledge scores before and after the intervention with paired <span class="elsevierStyleItalic">t</span>-test in the treatment group had a value of <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;000&#46; This <span class="elsevierStyleItalic">p</span>-value indicates that there are significant differences in the scores before and after the intervention&#46; In other words&#44; it can be concluded that the administration of TDE interventions significantly influences the increase in COVID-19 knowledge&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">The findings in <a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a> above are in accordance with that of Chung<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> in his study&#44; involving 175 respondents who were given intervention in the form of role-playing games in the treatment group and electronic games in the control group&#46; 85&#37; of the participants with role-playing tablet games had a more significant increase in knowledge than the respondents with the electronic-game intervention&#44; which was 77&#37;&#46; Knowledge retention was also better in the respondent group with tabletop role-playing games intervention&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">This increase was due to the fact that games with tabletop role-playing games actively involve individuals to participate in joint simulations&#44; so that they get feedback from fellow actors in the simulation&#46; This feedback will later provide an overview that is easier for the participants to understand&#46; Meanwhile&#44; electronic games only involve individuals in terms of independent learning without playing roles together in a two-way direction&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Other studies are also similar to the above results according to Dyson et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> who used a quasi-experimental design with 40 respondents divided into control and treatment groups&#46; After being subjected to the role-play intervention using tabletop&#44; the creativity of each respondent significantly increased in the treatment group&#46; Creativity can increase significantly because the cognitive abilities of the respondents also increased&#46; This is because of the tabletop exercise media&#44; the respondents were able to imagine actual events that occurred according to the description of the scenario that had been made before&#44; so participants easily understood and accepted the material easily&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">A recent study by Pate et al&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> involved 113 pharmaceutical students as respondents who were given a tabletop emergency preparedness exercise intervention for 3<span class="elsevierStyleHsp" style=""></span>h every week for 1 month&#46; The result suggests an increase in respondents&#8217; knowledge of disaster preparedness and the role of pharmacy in the emergency response phase by 73&#8211;75&#37;&#46; In addition&#44; the respondents also experienced an increase in the level of awareness and willingness to participate in disaster emergency response by 85&#37;&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conclusions</span><p id="par0080" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">1&#46;</span><p id="par0085" class="elsevierStylePara elsevierViewall">The preparedness of the nurses in community health center in rural area during the COVID-19 pandemic in Malang are very important for strengthening the commitment of assertive behavior through self-control and they need to be given so that the community is aware of the importance of complying with health protocols for the common good&#46;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">2&#46;</span><p id="par0090" class="elsevierStylePara elsevierViewall">This needs to be added to mental nursing interventions as a part of psychosocial therapy for social problems in the community&#44; primarily for reducing the pressure due to the enforcement of social distancing to control and prevent the spread of COVID-19&#46;</p></li></ul></p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Conflict of interest</span><p id="par0105" class="elsevierStylePara elsevierViewall">The authors declare no conflict of interest&#46;</p></span></span>"
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          "titulo" => "Results"
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            0 => array:2 [
              "identificador" => "sec0020"
              "titulo" => "Characteristics of respondents"
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            1 => array:2 [
              "identificador" => "sec0025"
              "titulo" => "Nurses&#8217; knowledge before and after intervention simulation standards"
            ]
          ]
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        5 => array:3 [
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          "titulo" => "Bivariate analysis"
          "secciones" => array:2 [
            0 => array:2 [
              "identificador" => "sec0035"
              "titulo" => "The effects of knowledge on the improvement of preparedness"
            ]
            1 => array:2 [
              "identificador" => "sec0040"
              "titulo" => "The effect of simulation standards on preparedness"
            ]
          ]
        ]
        6 => array:2 [
          "identificador" => "sec0045"
          "titulo" => "Discussion"
        ]
        7 => array:2 [
          "identificador" => "sec0050"
          "titulo" => "Conclusions"
        ]
        8 => array:2 [
          "identificador" => "sec0055"
          "titulo" => "Conflict of interest"
        ]
        9 => array:2 [
          "identificador" => "xack619480"
          "titulo" => "Acknowledgements"
        ]
        10 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2021-09-26"
    "fechaAceptado" => "2022-03-26"
    "PalabrasClave" => array:1 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec1544152"
          "palabras" => array:6 [
            0 => "Readiness"
            1 => "Preparedness"
            2 => "Nurses"
            3 => "Disaster"
            4 => "Community health centers"
            5 => "COVID-19"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:1 [
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Positive COVID-19 cases in Malang City&#44; Indonesia continue to increase&#46; Until 04 August 2021&#44; the COVID-19 update shows 3301 positive cases with 7754 cured and 832 deaths&#46; This study aims to identify nurses preparedness in rural area community health centers during the COVID-19 pandemic in Malang for self-control to implement health protocol&#46; This study intends to provide insights on controlling COVID-19 spread in Malang&#44; Indonesia&#46;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">This research is a quantitative study with correlative analytic observational design and a cross-sectional approach involving 120 nurses from 16 primary health centers&#46; The results of the bivariate analysis using gamma correlation test are&#58; knowledge factors &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;005&#59; <span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;35&#41;&#44; attitude &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;000&#59; <span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;46&#41;&#44; means of infrastructure &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;000&#59; <span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;54&#41;&#44; and self-control &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;000&#59; <span class="elsevierStyleItalic">r</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;52&#41; for the quarantined COVID-19 patients&#46; Knowledge&#44; attitude&#44; infrastructure&#44; and safe house factors can influence self-control for COVID-19&#46; In rural areas&#44; health education&#8212;as education and empowerment for patient self-control&#8212;is an effort to encourage them to obey health protocol during the pandemic&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Nurse readiness and preparedness during the pandemic is crucial for strengthening the assertive behavior commitment through self-control&#46; This ensures the community&#39;s awareness of the importance of complying with health protocols for the common good&#46; Mental nursing intervention needs to be added as a part of psychosocial therapy for the community&#39;s social problems&#44; primarily in reducing the pressure due to the social distancing enforcement to control and prevent COVID-19 spread&#46;</p></span>"
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Peer-review under responsibility of the scientific committee of the 3rd Aceh International Nursing Conference &#40;AINC&#41;&#46; Full-text and the content of it is under responsibility of authors of the article&#46;</p>"
      ]
    ]
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                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Characteristics&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " colspan="2" align="center" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Age&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">26&#8211;30 years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">28&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">44&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">56&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">50&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">36&#8211;45 years&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Male&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">38&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">82&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">95&#37; CI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pre-test&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26&#46;39&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">9&#46;04&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&#46;89&#8211;30&#46;89&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">Post-test&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Mean<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>SD&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Mean difference &#40;95&#37; CI&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pre-test&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">23&#46;89<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&#46;00&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">60&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">81&#46;67<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#46;04&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">26&#46;39<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>9&#46;04&nbsp;\t\t\t\t\t\t\n
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                0 => array:1 [
                  "referenciaCompleta" => "International Council of Nursing&#46; ICN framework of disaster nursing competencies&#59; 2009&#46;"
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                      "titulo" => "Pilot training program for developing disaster nursing competencies among undergraduate students in China"
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                          "etal" => false
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                            0 => "S&#46;M&#46;C&#46; Pang"
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                            2 => "Y&#46; Cheng"
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                    0 => array:2 [
                      "doi" => "10.1111/j.1442-2018.2009.00499.x"
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                        "tituloSerie" => "Nurs Health Sci&#46;"
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                      "titulo" => "Public health nurses&#8217; roles and competencies in disaster management"
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                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46; Putra"
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Nurse Media J Nurs&#46;"
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                        "paginaFinal" => "14"
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                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Traffic education for children with a tabletop model"
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                      "titulo" => "Nurses knowledge&#44; attitudes&#44; practices and familiarity regarding disaster and emergency preparedness in Saudi Arabia"
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                          "autores" => array:2 [
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                      "Revista" => array:5 [
                        "tituloSerie" => "Am J Nurs Sci&#46;"
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                      "Revista" => array:5 [
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Article information
ISSN: 11308621
Original language: English
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es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos