Evidence Aid bulletin: 27 April 2023

Hello everyone,

We are pleased to send you Evidence Aid’s April 2023 bulletin, containing shortened versions of three of our published summaries on topics related to ethical guidance for disaster response, mental health of migrants, and factors influencing hospital resilience. Each summary speaks to Evidence Aid’s motivation to ensure that, despite the numerous disasters caused by natural hazards which occur across the globe yearly, not every one turns into a catastrophe. Evidence-based research can provide decision-makers with the best available documentation to guide their actions, even in times of crises. Please forward this bulletin to others who might be interested.

Additionally, anyone who would like to receive these bulletins directly or has questions about our work should contact Jane Copsey (info@evidenceaid.org). If you like our work and think it is important that we continue through 2023, please consider donating here.

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Ethical guidance for disaster response, specifically around crisis standards of care: a systematic review

Terrorism, pandemics, disasters, and similar mass casualty events have propelled health care systems to improve emergency preparedness and response protocols. Ethical guidance has grown increasingly common in disaster response plans. As such, the authors systematically reviewed the prevalence and content of ethical guidance offered for disaster response, with a focus on crisis standards of care (CSCs). The authors found that most engagement with CSCs relate to triage and more generally, why ethics is needed in disaster response, including during mass casualty events. Such responses include the duty to care, duty to steward resources, transparency, consistency, proportionality, and accountability, all of which are analysed in the report. The authors further suggest that all ethical analyses should relate to implementation issues, including triage plans, liability protection, public engagement, and modification plans according to the individual disaster at hand.

Citation: Leider JP, et al. Ethical Guidance for Disaster Response, Specifically Around Crisis Standards of Care: A Systematic Review. American Journal of Public Health. 2017;107:e1–9.

You can find a full summary of this review in Managing Physical Injuries in Disasters.

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Mental health of migrants who were exposed to armed conflict before migration

Additional vulnerabilities of migrants include those who have been exposed to armed conflict before migration, often resulting in negative mental health consequences including generalized anxiety disorder (GAD), major depressive disorder (MDD) and post-traumatic stress order (PTSD). In this systematic review, the authors included studies that used standardised psychiatric interviews to assess GAD, MDD, and PTSD among migrants equal to or over 18 years of age. Their study found that migrants who are exposed to armed conflict are at higher risk of mental health disorders, leading the authors to suggest that mental healthcare should be assessed soon after resettlement, with particular attention on young adults.

Citation: Mesa-Vieira C, et al. Mental health of migrants with pre-migration exposure to armed conflict: a systematic review and meta-analysis. Lancet Public Health. 2022;7(5):e469-81.

You can find a full summary of this review in both Managing Mental health in Disasters and Health of Refugees and Asylum Seekers.

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Factors influencing hospital resilience

Hospitals possess an integral role in providing health services, particularly during disasters. Hospital resilience is a hospital’s ability to resist, absorb, and respond to disasters by providing adaptive care. It was found that to achieve resilience, hospitals must coordinate across processes, resources, and technologies with the aim of addressing any unexpected and expected changes. In their systematic review, the authors found that there has been a steady growth of articles addressing hospital influence, as well as that Southeast Asian countries have a demonstrated special interest in hospital resilience. Influencing factors, including staff, infrastructure, management, and logistics were examined for their preparedness, response, and recovery. The analysis illustrated that although the preparation phase is the most important in the resilience process, it does not diminish the importance of response and recovery phases. The results also indicate that proper training and drills directed at the empowerment of staff, as well as advancing surge capacity, have grown increasingly of interest in studies.

Citation: Khademi Jolgehnejad A, et al. Factors Influencing Hospital Resilience. Disaster Medicine and Public Health Preparedness. 2021;15(5):661-8.

You can find a full summary of this review in our Resilient Health Systems collection.

Thank you for reading this month’s bulletin! As a final reminder, anyone who would like to receive these bulletins directly or has questions about our work should contact Jane Copsey (info@evidenceaid.org).

If you like our work and think it is important that we continue through 2023, please consider donating here.

From,

Your Evidence Aid team