Open research questions in Disaster Response and Management

What the literature leaves open

• Since the partic- ipants consisted of individuals over the age of 18, there is insufficient information regarding the use and results of the new scale in children and adolescents.

  A multidimensional tool in disaster medicine: Development of the disaster anxiety scale · 2026 · DOI

• For Institutional Design (1) Align incentives with culture: Embed rewards within recognition programs, peer modeling, and storytelling to internalize helping behaviors. (2) Avoid over-instrumentalization: Use non-monetary, value-based incentives to prevent transactional interpretations of prosocial behavior. (3) Build supportive systems: Strengthen psychological safety, feedback mecha- nisms, and ethical guidance to shift readiness from “I could” to “I will”.

  Strengthening Workplace Health Promotion Through Emergency Preparedness: A Normative Mediation Analysis · 2026 · DOI

• The following recommendations can be developed in line with this study: 1. Crisis Management Training Should Be Made Mandatory: In-service crisis management training for school principals should be restructured to be informative, supported by practical scenarios, and should be inte- grated into the Ministry of National Education legislation (Table 1). 2. Psychological Resilience and Emotional Intelligence Training Should Be Increased: Development programs focused on emotional intelligence and resilience should be implemented to enable principals to protect their own psychological health and manage the school climate in crisis environments. 3. Crisis Committees Should Be Established in Schools: A crisis committee should be established in every school to be activated in times of crisis; this committee should conduct regular drills with predetermined job de- scriptions. 4. A Distributed Leadership Culture Should Be Encouraged: Instead of centralizing decisions during crisis periods, shared leadership practices SIEF, Vol.31, No.2, 2026 5134 Şahin. (Türkiye). Crises in Schools and Principals’ Management Skills. 5. with teachers and other staff should be encouraged, increasing the school’s holistic reflexivity. Interventions to Address Teacher Loneliness Should Be Developed: In light of findings that teachers become isolated during crisis periods, guidance systems should be established to enable school administrators to recognize this loneliness and establish support mechanisms. 6. Crisis Leadership Modules Should Be Added to Education Faculties: Mandatory or elective courses on “crisis leadership” should be added to the educational administration programs of education faculties to in- crease the preparedness of aspiring administrators for crises. 7. A National Strategy Should Be Developed for Policymakers: The Minis- try of National Education should develop a comprehensive national- level guideline, protocol, and resource pool to support school adminis- trators in crises. As this study is a literature review focusing on research published be- tween 2015 and 2025, evidence regarding which combination of leadership strategies yields the most effective short- and long-term outcomes across dif- ferent crisis contexts remains limited. Future investigations should prioritize comparative case studies that systematically assess outcomes such as safety, continuity of learning, and psychosocial recovery in schools employing vary- ing leadership approaches. Additionally, longitudinal research is necessary to examine how schools internalize lessons from crises and translate them into enduring policy reforms.

  Crises in Schools and Crısis Management Skills of Principals · 2026 · DOI

• Because this study is a literature review, and limited to the literature between the years 2015-2025, empirical testing of which mix of strategies produces the best short- and long-term outcomes in different contexts remains limited.

  Crises in Schools and Crısis Management Skills of Principals · 2026 · DOI

• The authors’ recommendation is to begin exploring ways to enhance learning on themes of trauma-informed classrooms alongside the emergent themes teachers reported as needing to address in continued training, employing multiple modalities such as online, hybrid, and face-to-face learning to increase depth and breadth of learning. In addition to the need to address trauma in the classroom focused on students, the preliminary data indicate that significant attention is required to develop training that also supports teachers in navigating burnout and the stress of being an educator in a wartime environment. The findings reinforce scholarship demonstrating that teacher well-being is fundamentally linked to student recovery and educational continuity in crisis settings (Falk et al., 2022).

  Scaling Training on Trauma-Informed Education in Ukraine During Crisis · 2026 · DOI

• , (2018) highlight, many disaster response teams are insufficiently prepared to assist persons with disabilities during emergencies, leading to gaps in care and support (Grech & Weber, 2025, p.

  Health-related disaster risk communication in the 6 February 2023Türkiye earthquake: Insights from vulnerable groups and healthcare professionals · 2026 · DOI

• For Regulatory Bodies and Health Authorities National and international healthcare design regulatory bodies should revise post- pandemic design guidance frameworks to reflect the evidence-quality hierarchy established in this review, weighting Tier 2 and Tier 3 intervention guidance more heavily than Tier 1 guidance relative to current practice. Specifically, the single-room design evidence base is now sufficiently robust to support its adoption as a baseline standard for new acute hospital construction rather than an aspirational recommendation.

  The Post-Pandemic Hospital: A Systematic Review of Architectural and Spatial Intervention Literature (2020–2026) · 2026 · DOI

• preparedness tailored to the Romanian context. fundamental conclusion emerges from this discussion: the systems management of health during armed confl icts is not a specialized or peripheral fi eld, but a core national security imperative. The central to this imperative are medical laboratories, which represent a critical component of the health infrastructure. Failure to ensure their resilience and continuity can precipitate a transition from military confl ict to a large-scale biological public health emergency with regional implications. diagnostic In Ukraine, evidence clearly demonstrates that even brief power outages in laboratories can pose refrigeration risks: substantial 255255255255255255255255255 HEALTHCARE MANAGEMENT IN CONFLICT SETTINGS: THE CRITICAL ROLE HEALTHCARE MANAGEMENT IN CONFLICT SETTINGS: THE CRITICAL ROLE HEALTHCARE MANAGEMENT IN CONFLICT SETTINGS: THE CRITICAL ROLE OF MEDICAL LABORATORIES AND BIOSAFETY OF MEDICAL LABORATORIES AND BIOSAFETY OF MEDICAL LABORATORIES AND BIOSAFETY stored the potential systems fail, samples for degrade, and accidental pathogen release increases signifi cantly. Similarly, in Gaza and other regions aff ected by protracted confl ict, reagents shortages of and reliable energy sources have diagnostic disrupted repeatedly infectious allowing capabilities, diseases to propagate without adequate control and contributing to elevated preventable mortality.

  HEALTHCARE MANAGEMENT IN CONFLICT SETTINGS: THE CRITICAL ROLE OF MEDICAL LABORATORIES AND BIOSAFETY · 2026 · DOI

• A systematic review and meta-analysis were not possible due to the limited availability of empirical research on civilian-led crisis teams (Cumpston et al., 2019). Restrict- ing the review to English reports limited the search scope. Due to the diverse language used to describe civilian-led teams, some articles may have been missed despite our multifaceted search strategy. In addition, we did not include anti-carceral crisis lines (e.g., Walls Down Collective, Trans Lifeline) as these services typically do not offer in-person intervention, and therefore did not meet our eligibility crite- ria for a civilian-led crisis response team.

  Restructuring Crisis Response Programs as Civilian-Led: A Scoping Review · 2026 · DOI

• Several limitations should be considered. Firstly and most importantly, the instrument measures self-reported preparedness (knowledge/confidence) rather than objective competence, so scores may be influenced by self-report bias and may not accurately reflect clinical performance (confidence ≠ competence). Secondly, the sample is Lebanon-based, which may limit generalizability to settings with different training structures, scope-of-practice models and ED re sources. Thirdly, test–retest reliability was not evaluated, so the temporal stability of scores remains unknown. Fourthly, criterion validity was not assessed; the scale was not correlated with external objective benchmarks such as Objective Structured Clinical Examination (OSCE)/checklist performance, standardized clinical vignettes, clinical error rates, or observed real-world management quality. Future studies should correlate questionnaire scores with objective competence measures (clinical vignettes/OSCE/checklists) and evaluate responsiveness (pre–post change) following training programs.

  Validity of a Questionnaire Assessing Preparedness and Self-Reported Confidence of Lebanese Emergency Department Personnel in Managing Ophthalmic Emergencies and Mass Ocular Trauma · 2026 · DOI

• For example, a national survey of Swedish perioperative healthcare professionals using the KAP model found that many respondents had limited knowledge of opioid-free anesthesia evidence and that practice patterns often remained opioid-centric, with barriers such as conceptual ambiguity and lack of clear guidelines reported by participants [18].

  Knowledge, attitudes, and practices of anesthesiology healthcare professionals regarding crisis resource management in Shanghai, China: a cross-sectional study · 2026 · DOI

• Although nurses constitute the largest segment of the global health workforce and are frequently mobilized during disasters, their roles in DVI and mass fatality management remain poorly defined in international standards and disaster nursing frameworks.

  Nursing roles and competencies in disaster victim identification: a scoping review · 2026 · DOI

• This perspective has several limitations. It is conceptual and policy-oriented and does not include primary data collection or statistical analysis of the cardiovascular events. The discussion focuses primarily on Gulf host states and does not provide a com- prehensive global comparison of surveillance approaches in other conflict-exposed or disaster-prone regions. Methodological chal- lenges remain for future research, including defining diagnostic thresholds for subclinical myocardial injury following alerts and ensuring equitable data collection among migrant populations. These limitations highlight the need for prospective studies and pilot surveillance programs to validate the hypotheses proposed in this study. The main aim is to highlight emerging research gaps rather than provide a comprehensive methodological framework.

  Alert-associated cardiovascular events in Gulf civilian populations: emerging risks and surveillance opportunities · 2026 · DOI

• This Delphi study is the first to address the role and mandate of nurses in disasters within the German-speaking region. The results can potentially be used as a valuable basis for further national policy discussions and may enrich international debates on the role of nurses in disaster preparedness and response structures. Although every effort has been made to avoid limitations, the following points should be carefully considered when interpreting the results. First, the Delphi sample was non-representative and composed of participants selected for their subject-specific expertise. This approach likely limited the inclusion of broader, potentially dissenting perspectives. Although iterative expansion of the panel across survey rounds was intended to capture a wider range of perspectives, the sample’s composition still represents a key limitation in the generalizability and comprehensiveness of the findings. Second, the panel size remained within an acceptable range for Delphi studies. Nevertheless, the relatively low response rate – especially in the final two rounds – may have introduced bias towards more engaged or interested stakeholders. Third, the representation of participants from the three Germanspeaking countries (Germany, Austria, and Switzerland) may also have been uneven. Although invitations were distributed proportionally across all three countries, the final responses cannot be disaggregated by country due to anonymization. Fourth, the findings are closely tied to the structural, educational, and political context of the German-speaking countries. Even if the findings cannot be directly transferred to other national contexts – especially those with different healthcare systems, roles of nursing staff, or disaster management structures – the insights gained here can serve as a starting point for further discussion.

  The Role and Mandate of Nurses in Disasters: A Delphi Study in German‐Speaking Countries · 2026 · DOI

• The high same-day discharge rate and absence of in-hospital mortality among patients arriving alive suggest that institutional preparedness and surge strategies may support MCI response, although causal attribution is limited by the descriptive design and lack of severity-adjusted comparison.

  Hospital Disaster Preparedness and Response to a Pediatric Mass Casualty Incident in Central India: A Retrospective Quality Improvement Analysis · 2026 · DOI

• considered: - The study utilized a non-probability convenience sampling approach with a relatively small sample size (N=71), which may limit the generalizability of the findings to all hospitals in Lebanon. Furthermore, by targeting nursing leadership and supervisors as key informants, the study captures high-level perspectives on departmental oversight but may introduce selection bias. Consequently, the findings primarily reflect the insights of nursing management and may not fully capture the frontline experiences of bedside emergency staff. - The reliance on self-reported data may introduce participant perception bias. Additionally, the possibility © 2026 the author(s). 7 PaNorama of emergeNcy mediciNe 2026. 4(1):10 doi: 10.26738/Poem.V4i1.10 of common method bias exists, as both predictor and outcome variables were collected from the same respondents simultaneously. This suggests that some observed associations may partly reflect general response tendencies rather than distinct underlying constructs. - The cross-sectional design restricts the ability to evaluate the long-term evolution of hospital practices over time. More over, the focus on specific institutional contexts means the results may not be directly comparable to facilities with different infrastructures or policies. involved - While the study distinguished between leadership and staff in MCM, detailed professional sub-categories were not systematically captured. Incorporating objective metrics, such as response times or mortality rates, in future research would provide a more granular assessment of MCM effectiveness. ethiCAl ConsiderAtions Ethical approval was obtained from the Ethical Committee-Holy Family University, approval number [004/2026]. Administrative authorization was also obtained from the participating hospitals.

  Emergency Staff Perceptions of Mass Casualty Management Effectiveness in Lebanese Hospitals: A Cross-Sectional Study · 2026 · DOI

• Our observation among managers is equivalent insignificant of experience and level in the organization. By interviewing managers, we gained insights into their perceptions of their leadership abilities and actions during the crises. The interviewed group included managers from various organizational levels, with responsibilities across different professions and varying levels of experience, offering a broad and diverse perspective. A key strength of this study is its contribution to the understanding of managers’ demands and resources in their work environment, affecting their work-related health, which remains an area in need of further research. However, a limitation of the study is that it reflects managers’ selfassessments of their performance, rather than measuring the impact of their leadership on the organization or their employees. This is an area that requires further investigation. The qualitative approach makes the generalization to other areas within the hospital difficult, however, findings may be transferred if contextual factors are carefully considered. It should also be noted that the CFIR framework has most commonly been used to guide planned and structured implementation of evidence-based methods, rather than context-adjusted organisational work-environment interventions. In this study, CFIR 2.0 was applied in a context-sensitive and partial way to structure managers’ accounts of crisis management. The findings should therefore be interpreted with this specific application and context in mind.The research team’s professional backgrounds inevitably shaped the research process. Several authors had extensive clinical and leadership experience within maternity care during the pandemic, which provided contextual sensitivity but also required reflexivity throughout the analysis. To strengthen trustworthiness, we applied strategies described by Elo et al., focusing on credibility, dependability, confirmability, and transferability, adapted to a deductive content analysis approach. Credibility was enhanced by involving several researchers in the coding process, discussing and reaching consensus on how the CFIR framework was applied, and by illustrating the analytical process with examples. Dependability was supported by a transparent description of the data collection and analytic procedures, enabling other researchers to follow the logic of the study. Confirmability was strengthened by regular discussions within the research team, where different professional perspectives were used to challenge interpretations and ensure that findings were grounded in the data rather than in individual preconceptions. Transferability was addressed by providing a detailed description of the study context and sampling strategy and thereby allowing readers to judge the relevance for other settings.

  Crisis leadership and strategic decisions in Swedish maternity care during the COVID-19 pandemic: A deductive analysis from the COPE staff project · 2026 · DOI

• This study was guided by Lincoln and Guba’s [37] framework for trustworthiness, encompassing credibility, dependabil- ity, confirmability and transferability. Given the complexity of collaboration among emergency first responders during major incidents, methodological rigour was essential. To ensure credibility, focus group interviews were selected in preference to individual interviews in order to capture shared experiences, challenge assumptions and explore interprofessional dynamics in situ. This for- mat, inspired by Krueger’s [31] content analysis approach, encouraged interaction and reflection among participants from the ambulance service, fire brigade and police. Mod- erators with contextual familiarity but no hierarchical ties facilitated open dialogue, thereby reducing the risk of social desirability bias. Analytical credibility was further strength- ened through peer debriefing and reflexive team discus- sions throughout the research process. Dependability was addressed by maintaining a clear audit trail of decisions made during the data collection and analysis. A consist- ent, iterative coding strategy guided by Krueger’s model was applied across all transcripts, with regular reassess- ment of categories to ensure coherence with the empirical material. To support confirmability, interpretations were grounded in the participants’ own words and the research- ers’ preunderstandings were consciously bridled. Findings were substantiated with illustrative quotations and diver- gent views were reported to reflect the breadth of perspec- tives. Transferability, while inherently limited by context, was enhanced through rich descriptions of the study set- ting and participant composition. Purposeful sampling ensured diversity of roles and experiences, allowing insights that may be relevant to other multi-agency emergency set- tings. A possible limitation is that we only considered bio- logical sex, without accounting for individuals who identify as non-binary or those who preferred not to disclose their gender [54]. Although participant numbers and represen- tation varied across focus groups, potentially influencing group dynamics, the findings remained consistent between groups and the inclusion of all services in each group may have further strengthened transferability.

  Collaboration among emergency first responders at major incidents – an explorative focus group study · 2026 · DOI

• In the publicly available literature, there are no studies on the selection of training techniques tobest prepare the members of law enforcement and rescue teams arriving as the first respondersto the correct diagnosis of the CBRNE threat, despite the impact of the largest possible numberof external conditions, hereinafter referred to as factors.

  SELECTED ASPECTS OF CONSTRUCTING SCENARIOS OF FIRST RESPONDER EXERCISES IN CONDITIONS OF AN UNRECOGNIZED TERRORIST THREAT · 2024 · DOI

• Although the existing literature suggests an association between earthquakes and increased threats to respiratory health, gaps and unmet needs still require further investiga- tion. To address these gaps, future research should concen- trate on the following areas. Identifying Specific Pollutants and Environmental Factors Earthquakes can release various pollutants into the air, such as PM, gases, and toxic substances. Determining the specific pollutants, toxicants, and irritants responsible for the respira- tory health impacts observed during and after earthquakes is important. This knowledge can help in developing targeted mitigation strategies and interventions.

  Impact of Earthquakes on Lung Health · 2024 · DOI

• Results The increased number of EMT calls, their extended operation time in the case of some interventions, time for additional personal protection caused that the number of PRM system entities was insufficient.

  Effectiveness of the System State Medical Rescue in times of an epidemic threat, as example of the Sars Cov - 2 pandemic · 2023 · DOI

• Unintentional Re-traumatisation It is now well understood in the literature, but not well understood by some helping professionals and volunteers who have not lived through a disaster with multiple deaths, that some aspects of normal counselling, psychotherapy and psychological debriefing can unintentionally retraumatise people and leave them considerably worse off than before the engagement.

  After the Earthquakes: Immediate Post- Disaster Work with Children and Families · 2011

• Despite the frequency of post-disaster relocation and evidence of its effect on psychological morbidity, there is a relative paucity of studies; the few examples in the literature reveal weak study designs, inconsistent results, and inattention to physical health impacts and the challenges facing vulnerable populations.

  Health effects of relocation following disaster: a systematic review of the literature · 2008 · DOI

• Furthermore, the provision of psychosocial support to students and teachers remains insufficient, negatively affecting their ability to adapt to crises.

  The Degree of Resilience in Responding to Crises and Emergencies in Jerusalem Schools · 2026 · DOI

• Exit strategies were lacking, while services to address mental health, non-communicable diseases, senior citizens and people with disabilities were not prioritised in the Health Cluster strategic plans and partners' response.

  The National Health Cluster in Yemen: assessing the coordination of health response during humanitarian crises · 2022 · DOI

Most-cited papers in Disaster Response and Management

• Supporting the Health Care Workforce During the COVID-19 Global Epidemic · JAMA · 2020 · 1,061 citations
• Disaster preparedness among nurses: a systematic review of literature · International Nursing Review · 2017 · 358 citations
• Conceptualizing and Defining Public Health Emergency Preparedness · American Journal of Public Health · 2007 · 271 citations
• Emergency remote learning during COVID-19 crisis: Students’ engagement · Education and Information Technologies · 2021 · 158 citations
• Development of disaster nursing education and training programs in the past 20 years (2000–2019): A systematic review · Nurse Education Today · 2021 · 142 citations
• Health effects of relocation following disaster: a systematic review of the literature · Disasters · 2008 · 125 citations
• Experiences of front‐line nurses combating coronavirus disease‐2019 in China: A qualitative analysis · Public Health Nursing · 2020 · 112 citations
• Thriving or Surviving Emergency Remote Teaching Necessitated by COVID-19: University Teachers’ Perspectives · The Asia-Pacific Education Researcher · 2021 · 102 citations
• Education in emergencies: Lessons from COVID-19 in South Africa · International Review of Education · 2021 · 85 citations
• Nurses’ disaster preparedness and core competencies in Turkey: a descriptive correlational design · International Nursing Review · 2019 · 81 citations

Most recent work

• Critical care during natural disasters: ICU insights from Valencia’s October 2024 floods · Medicina Intensiva · 2026
• The Role and Mandate of Nurses in Disasters: A Delphi Study in German‐Speaking Countries · International Nursing Review · 2026
• International humanitarian obligations regarding the provision of medical care and the protection of medical personnel in armed conflicts and emergencies · Uzhhorod National University Herald Series Law · 2026
• Health-related disaster risk communication in the 6 February 2023Türkiye earthquake: Insights from vulnerable groups and healthcare professionals · Connectist Istanbul University Journal of Communication Sciences · 2026
• Barriers to debriefing critical events in a Canadian community emergency department · Canadian Journal of Emergency Medicine · 2026
• Pharmaceutical needs at temporary dispensing sites in Suzu City during the subacute phase after the 2024 Noto Peninsula Earthquake: a cross-sectional study of disaster prescription trends · Journal of Pharmaceutical Health Care and Sciences · 2026
• Deep vein thrombosis and coagulopathy following cyclone events: pathophysiology, risk factors, and prevention · Annals of Medicine & Surgery · 2026
• Post-Earthquake Cardiac Anxiety In The Elderly · Anatolian Journal of Emergency Medicine · 2026
• The effect of disaster preparedness training programs on nurses’ readiness and competence: a systematic review of randomized controlled trials · Teaching and Learning in Nursing · 2026
• Collaboration among emergency first responders at major incidents – an explorative focus group study · Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine · 2026

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