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Design and validation of a hospital emergency department preparedness questionnaire for radiation accidents, nuclear accidents, and nuclear terrorism in Iran

Milad Ahmadi Marzaleh, MPH, PhD, Rita Rezaee, PhD, Abbas Rezaianzadeh, PhD, Mahnaz Rakhshan, PhD, Gholamhassan Haddadi, PhD, Mahmoudreza Peyravi, MD, PhD


Background and objectives: Radiation accidents can cause numerous challenges to hospitals, the appropriate medical responses to which may save the lives of countless people. The present study aimed at the design and validation of an Emergency Department preparedness questionnaire for hospital emergency departments (EDs) in the case of radiation accidents, nuclear accidents, and nuclear terrorism in Iran.

Materials and methods: This multistage cross-sectional study was conducted in 2019. The questionnaire items were created with the reference to article reviews and expert judgement. The validity of the questionnaire was assessed through face, content, and construct validities. Additionally, its reliability was estimated using measures of internal consistency and stability, namely Cronbachs alpha and intraclass correlation coefficient (ICC). To this end, the questionnaire was completed by the ED staff in the hospitals of Iran.

Results: The proposed 48-item questionnaire consisted of three themes: staff preparedness, stuff preparedness, and structure preparedness. The face and content validities were confirmed by expert judgement. All items remained with content validity ratio (CVR) > 0.7 and the mean content validity index (CVI) = 0.891. The overall Cronbachs alpha and ICC were 0.781 and 0.709, respectively for the whole questionnaire.

Conclusion: Hospital ED preparedness in radiation and nuclear accidents requires readiness of staff, stuff, and structure of the ED, the consideration of which will properly respond to radiation and nuclear accidents. Thus, upstream organizations like the Ministry of Health and the Emergency Organization should oblige hospital EDs to make themselves be more prepared by codifying certain imperative laws and policies.


preparedness, emergency department, hospital, radiation accidents, nuclear accidents, terrorism

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