Registered Nurses’ Views and Experiences of Delivering Care in War and Conflict Areas: A Systematic Review
Abstract
:1. Introduction
2. Background
3. Materials and Methods
3.1. Search Strategy
3.2. Eligibility Criteria
3.3. Study Screening
3.4. Data Extraction Process
3.5. Quality Appraisal and Study Synthesis
4. Results
4.1. Search Outcomes
4.2. Characteristics of Included Studies
4.3. Narrative Synthesis of Results
4.3.1. Challenges in Nursing Practice
4.3.2. Meaning of Experience
4.3.3. Scope of Practice
4.3.4. Nursing Support Pre- and Post-War and Conflict
5. Discussion
6. Conclusions and Implications for Practice
Limitations and Strengths of the Study
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Conflicts of Interest
References
- Matthews, J.H.; Whitehead, P.B.; Ward, C.; Kyner, M.; Crowder, T. Florence Nightingale: Visionary for the role of clinical nurse specialist. Online J. Issues Nurs. 2020, 25, 1. [Google Scholar] [CrossRef]
- Backus, P.G. Female Nurses during the Civil War: Angels of the Battlefield. Available online: https://www.battlefields.org/learn/articles/female-nurses-during-civil-war (accessed on 25 May 2022).
- Reilly, R.F. Medical and surgical care during the American Civil War, 1861–1865. Proceedings 2016, 29, 138–142. [Google Scholar] [CrossRef] [PubMed]
- Krueger, D. The Red Cross, the Daughters of the American Revolution, and the Origins of the Army Nurse Corps in the Spanish-American War. J. Mil. Hist. 2019, 83, 409–434. [Google Scholar]
- Baker, T.E. Surgeon general’s staff. Gunn rated each applicant’s dossier and forwarded her. In An Encyclopedia of American Women at War: From the Home Front to the Battlefields; ABC-CLIO, LLC: Santa Barbara, CA, USA, 2013; Volume 37. [Google Scholar]
- The Free Dictionary. Available online: https://legal-dictionary.thefreedictionary.com/War (accessed on 10 September 2022).
- Australian Army Research Centre. What is War? Defining War, Conflict and Competition. Available online: https://researchcentre.army.gov.au/library/land-power-forum/what-war-defining-war-conflict-and-competition (accessed on 10 September 2022).
- Tom-James, L.O. Bioterrorism: Exploring factors for improving nurse preparedness, policies, and practices. Ph.D. Thesis, Walden University, Minneapolis City, MN, USA, 2020. [Google Scholar]
- Tschudin, V.; Schmitz, C. The impact of conflict and war on international nursing and ethics. Nurs. Ethics 2003, 10, 354–367. [Google Scholar] [CrossRef]
- O’Connor, K. Nursing ethics and the 21st-Century Armed Conflict: The example of Ciudad Juárez. J. Transcult. Nurs. 2017, 28, 6–14. [Google Scholar] [CrossRef] [PubMed]
- Garfield, R.; Dresden, E.; Rafferty, A.M. Commentary: The evolving role of nurses in terrorism and war. Am. J. Infect. Control 2003, 31, 163–167. [Google Scholar] [CrossRef]
- Wands, L.M. Caring for veterans returning home from Middle Eastern wars. Nurs. Sci. Q. 2011, 24, 180–186. [Google Scholar] [CrossRef]
- Elliott, B.; Chargualaf, K.A.; Patterson, B. Military to civilian nurse: Personal and professional reconstruction. J. Clin. Nurs. 2017, 26, 1375–1384. [Google Scholar] [CrossRef]
- Al Thobaity, A.; Plummer, V.; Innes, K.; Copnell, B. Perceptions of knowledge of disaster management among military and civilian nurses in Saudi Arabia. Australas. Emerg. Nurs. J. 2015, 18, 156–164. [Google Scholar] [CrossRef]
- Labrague, L.J.; Hammad, K.; Gloe, D.S.; McEnroe-Petitte, D.M.; Fronda, D.C.; Obeidat, A.A.; Leocadio, M.C.; Cayaban, A.R.; Mirafuentes, E.C. Disaster preparedness among nurses: A systematic review of literature. Int. Nurs. Rev. 2018, 65, 41–53. [Google Scholar] [CrossRef] [Green Version]
- Bargagliotti, L.A.T. The contemporary image of professional nursing. In The Contemporary Image of Professional Nursing; Elsevier: Amsterdam, The Netherlands, 2018; p. 21. [Google Scholar]
- Magnusson, C.; Herlitz, J.; Axelsson, C. Patient characteristics, triage utilisation, level of care, and outcomes in an unselected adult patient population seen by the emergency medical services: A prospective observational study. BMC Emerg. Med. 2020, 20, 7. [Google Scholar] [CrossRef]
- Sussman, M.S.; Ryon, E.L.; Urrechaga, E.M.; Cioci, A.C.; Herrington, T.J.; Pizano, L.R.; Garcia, G.D.; Namias, N.; Wetstein, P.J.; Buzzelli, M.D.; et al. The key to combat readiness is a strong military-civilian partnership. Mil. Med. 2021, 186, 571–576. [Google Scholar] [CrossRef] [PubMed]
- Page, M.J.; McKenzie, J.E.; Bossuyt, P.M.; Boutron, I.; Hoffmann, T.C.; Mulrow, C.D.; Shamseer, L.; Tetzlaff, J.M.; Akl, E.A.; Brennan, S.E.; et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ 2021, 372, n71. [Google Scholar] [CrossRef] [PubMed]
- Agrawal, A.; Rasouli, M. EndNote 1-2-3 Easy!: Reference Management for the Professional; Springer: Berlin/Heidelberg, Germany, 2019. [Google Scholar]
- Hong, Q.N.; Pluye, P.; Fabregues, S.; Bartlett, G.; Boardman, F.; Cargo, M.; Dagenais, P.; Gagnon, M.-P.; Griffiths, F.; Nicolau, B.; et al. Mixed methods appraisal tool (MMAT), version 2018. Regist. Copyr. 2018, 1148552, 10. [Google Scholar]
- Popay, J.; Roberts, H.; Sowden, A.; Petticrew, M.; Arai, L.; Rodgers, M.; Britten, N.; Roen, K.; Duffy, S. Guidance on the Conduct of Narrative Synthesis in Systematic Reviews: A Product from the ESRC Methods Programme. Available online: http://www.lancs.ac.uk/shm/research/nssr/research/dissemination/publications.php (accessed on 21 May 2022).
- Kenny, D.J.; Hull, M.S. Critical care nurses’ experiences caring for the casualties of war evacuated from the front line: Lessons learned and needs identified. Crit. Care Nurs. Clin. N. Am. 2008, 20, 41–49. [Google Scholar] [CrossRef] [PubMed]
- Shamia, N.A.; Thabet, A.A.M.; Vostanis, P. Exposure to war traumatic experiences, post-traumatic stress disorder and post-traumatic growth among nurses in Gaza. J. Psychiatr. Ment. Health Nurs. 2015, 22, 749. [Google Scholar] [CrossRef] [PubMed]
- Tjoflåt, I. Nursing practice in war zones and wisdom acquired. Nord. J. Nurs. Res. 1997, 17, 47–49. [Google Scholar] [CrossRef]
- Agazio, J. Army nursing practice challenges in humanitarian and wartime missions. Int. J. Nurs. Pract. 2010, 16, 166–175. [Google Scholar] [CrossRef]
- Goodman, P.; Edge, B.; Agazio, J.; Prue-Owens, K. Military nursing care of Iraqi patients. Mil. Med. 2013, 178, 1010–1015. [Google Scholar] [CrossRef] [Green Version]
- Griffiths, L.; Jasper, M. Warrior nurse: Duality and complementarity of role in the operational environment. J. Adv. Nurs. 2008, 1, 92. [Google Scholar] [CrossRef]
- Hagerty, B.M.; Williams, R.A.; Bingham, M.; Richard, M. Military nurses and combat-wounded patients: A qualitative analysis of psychosocial care. Perspect. Psychiatr. Care 2011, 47, 84–92. [Google Scholar] [CrossRef] [PubMed]
- Conard, P.; Scott-Tilley, D. The lived experience of female veterans deployed to the Gulf War II. Nurs. Forum 2015, 4, 228. [Google Scholar] [CrossRef] [PubMed]
- Han, J. The lived experience of Korean female military nursing officers during the Vietnam War. J. Transcult. Nurs. 2019, 30, 471–477. [Google Scholar] [CrossRef] [PubMed]
- Scannell-Desch, E.A. The lived experience of women military nurses in Vietnam during the Vietnam War. J. Nurs. Scholarsh. 1996, 28, 119–124. [Google Scholar] [CrossRef] [PubMed]
- Scannell-Desch, E.A. Lessons learned and advice from Vietnam War nurses: A qualitative study. J. Adv. Nurs. 2005, 6, 600. [Google Scholar] [CrossRef]
- Conlon, L.; Wiechula, R.; Garlick, A. Hermeneutic phenomenological study of military nursing officers. Nurs. Res. 2019, 68, 267–274. [Google Scholar] [CrossRef]
- Biedermann, N.E.; Harvey, N.R. War time experiences of triage and resuscitation: Australian Army nurses in the Vietnam War, 1967-1971. Accid. Emerg. Nurs. 2001, 3, 138. [Google Scholar] [CrossRef]
- Peyrovi, H.; Parsa-Yekta, Z.; Vosoughi, M.B.; Fathyian, N.; Ghadirian, F. From margins to centre: An oral history of the wartime experience of Iranian nurses in the Iran-Iraq War, 1980–1988. Contemp. Nurse 2015, 1, 14. [Google Scholar] [CrossRef]
- Rahimaghaee, F.; Hatamopour, K.; Seylani, K.; Delfan, V. Nurses’ perceptions of care during wartime: A qualitative study. Int. Nurs. Rev. 2016, 63, 218. [Google Scholar] [CrossRef]
- Lal, S.; Spence, D. Humanitarian nursing in developing countries: A phenomenological analysis. J. Transcult. Nurs. 2016, 27, 18–24. [Google Scholar] [CrossRef] [Green Version]
- Ekfeldt, B.; Österberg, R.; Nyström, M. Preparing for Care in a Combat Environment. Int. J. Caring Sci. 2015, 8, 1–9. [Google Scholar]
- Finnegan, A.; Lauder, W.; McKenna, H. The challenges and psychological impact of delivering nursing care within a war zone. Nurs. Outlook 2016, 64, 450–458. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Finnegan, A.; Finnegan, S.; McKenna, H.; McGhee, S.; Ricketts, L.; McCourt, K.; Warren, J.; Thomas, M. Characteristics and values of a British military nurse. International implications of War Zone qualitative research. Nurse Educ. Today 2015, 36, 86–95. [Google Scholar] [CrossRef]
- Elliott, B. Military nurses’ experiences returning from war. J. Adv. Nurs. 2015, 71, 1066. [Google Scholar] [CrossRef] [PubMed]
- Firouzkouhi, M.; Zargham-Boroujeni, A.; Nouraei, M.; Yousefi, H.; Holmes, C.A. The wartime experience of civilian nurses in Iran-Iraq war, 1980–1988: An historical research. Contemp. Nurse A J. Aust. Nurs. Prof. 2013, 44, 225–231. [Google Scholar] [CrossRef] [PubMed]
- Rushton, P.; Scott, J.E.; Callister, L.C. “It’s what we’re here for:” Nurses caring for military personnel during the Persian Gulf Wars. Nurs. Outlook 2008, 56, 179–186. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Scannell-Desch, E.; Doherty, M.E. Experiences of U.S. military nurses in the Iraq and Afghanistan wars, 2003-2009. J. Nurs. Scholarsh. 2010, 42, 3. [Google Scholar] [CrossRef] [PubMed]
- Rivers, F.M.; Gordon, S.; Speraw, S.; Reese, S. US army nurses’ reintegration and homecoming experiences after Iraq and Afghanistan. Mil. Med. 2013, 178, 166–173. [Google Scholar] [CrossRef] [Green Version]
- Bryant-Lukosius, D.; DiCenso, A.; Browne, G.; Pinelli, J. Advanced practice nursing roles: Development, implementation and evaluation. J. Adv. Nurs. 2004, 48, 519–529. [Google Scholar] [CrossRef]
- Coombs-Thorne, M.H. Nursing with the Grenfell Mission in Northern Newfoundland and Labrador, 1939–1981. Ph.D. Thesis, Department of History, University of New Brunswick, Fredericton, NB, Canada, 2010. [Google Scholar]
- Rashotte, J. Dwelling with stories that haunt us: Building a meaningful nursing practice. Nurs. Inq. 2005, 12, 34–42. [Google Scholar] [CrossRef]
- Lake, D.M.; Armstrong, M.L. Understanding the complexities of military transitions. In Veteran-Centered Care in Education and Practice; Springer Publishing Company: New York, NY, USA, 2020; Volume 1, pp. 53–73. [Google Scholar]
- Schaefer, J.D.; Welton, J.M. Evidence based practice readiness: A concept analysis. J. Nurs. Manag. 2018, 26, 621–629. [Google Scholar] [CrossRef] [PubMed]
- Dyson, T. A revolution in military learning? Cross-functional teams and knowledge transformation by lessons-learned processes. Eur. Secur. 2020, 29, 483–505. [Google Scholar] [CrossRef]
No. | Study Citation and Country | Aims | Sample | Methods | Key Findings | Recommendations |
---|---|---|---|---|---|---|
1 | Agazio (2010) United States of America (USA) | To present a detailed overview of Army nursing practice problems in military operations other than war (MOOTW) compared to recent wartime operations such as Operation Enduring Freedom and Operation Iraqi Freedom. | 75 army nurses | Qualitative Focus group interview | This study’s main findings were that nurses require competencies in wartime and MOOTW; patient care demands—deployed environment, getting down to basics, different level of care and training. | Further research is required for a more comprehensive survey to validate the skills and competencies found by this survey. |
2 | Finnegan et al. (2015) United Kingdom | To investigate the attributes and principles that military nurses possess when performing operational duties in war zones. | 18 British army nurses | Semi-structured interviews | The qualities required of military nurses War Zone nursing identified and the practical personal developments required to use their strengths | Further research required to identify the transferability to other Armed Forces and civilian practice internationally. |
3 | Biedermann (2001) Australia | To identify the essence of nursing’s role in the Vietnam War and increase the raise knowledge and understanding of nurse veterans’ experiences. | 17 Australian army nurses | Qualitative interviews | The majority of nursing sisters sent to Vietnam between 1968 and 1971 had no prior knowledge of the nature of work or environment and were clinically unprepared. Nurses were able to adapt professionally in the war zone; their memories of their experiences had a personal impact on their lives. | Further historical research is required to identify the nursing role and experiences during the Vietnam War. |
4 | Biedermann & Harvey (2001) Australia | To explore the Australian Army nurses’ experiences who were involved in the triage and resuscitation of critically wounded allied and enemy soldiers in the Vietnam War between 1967 and 1971. | 17 Australian army nurses | Qualitative interviews | What are the findings? | Further research is required to understand the preparation and support needs of Army Nurses in triaging and resuscitation of critically wounded soldiers. |
5 | Ekfeldt (2015) Sweden | To detail military nurses’ experiences of preparations for military action in a war zone. | Seven male and one female army nurses | Qualitative structured interviews | Main themes identified were: 1-Recognizing challenges, preparing for the transition from civilian care, preparation for work in a complex context and preparing to deal with anxiety 2-Making informed choices, preparation by investigating one’s motives, preparing by investigating one’s professionalism and preparation through insight into the unique meaning of the caring relationship | Further research is required to more fully understand the preparation needs of Army Nurses in a combat environment and enable reflection skills. |
6 | Conard & Scott-Tilley (2015) United States of America (USA) | To identify female nursing veterans’ experiences of war on their physical and mental health. | 12 female nursing veterans | Qualitative Face-to-Face Interviews | Seven themes identified: living in constant fear while deployed, combat has different meanings, bringing the war home, fear of being forever changed, disrespect from fellow military members, physical health—for better or worse, and combat has rewarding experiences. | Future research needed to identify the first-hand accounts of female Gulf War II nursing veterans from all military areas regarding their experience of female officers and enlisted personnel in Gulf War II. |
7 | Conlon et al. 2019 Australia | To understand the lived experiences of nursing officers when working as a member of a military trauma team. | 6 nursing military officers | Qualitative Interviews | The findings included telling their stories; the role—who we are and what we do; the environment—it is so different; training—will it ever fully prepare you; working in teams—there is no “I” in the team; and leadership—will the real leader please stand up. | No specific recommendations for future research were made. |
8 | Kenny & Hull (2008) USA and Europe | To examine the stressors of nurses working in the ICUs of two U.S. military medical treatment facilities (MTFs) before and after the beginning of the wars in Iraq (Operation Iraqi Freedom [OIF]) and Afghanistan (Operation Enduring Freedom [OEF]). | 10 ICU nurses | Survey & Questionnaire | The finding highlight that that the “stay-behind” nurses at both MTFs have experienced significant stress from (1) the deployment of colleagues and, in some cases, family members; (2) changing missions related to the care of wounded soldiers returning to the medical centre; and (3) the extra work created by deployments, with few backfill replacements, and the influx of younger patients who have increased levels of acuity and need. | Further research to identify the impact of compassion fatigue and resiliency required in military MTFs settings and the precautionary and preventative approaches required. |
9 | Elliott (2015) United States of America (USA) | To describe the military nurses’ experiences during the post-deployment phase and describe the post-deployment experience’s meaning. | 10 military nurses | Interviews | Five themes were identified from the data: learning to manage changes in the environment; facing the reality of multiple losses; feeling like it’s all so trivial now; figuring out where I ‘fit’ in all the chaos; and working through the guilt to move forward. The meaning of the participants experiences included serving a greater purpose and looking at life through a new lens. | Further research is indicated to identify the benefits seeking and making sense in relation to military nurses’ experiences could provide additional support for interventions at different stages of the deployment period. |
10 | Finnegan et al. (2016) Afghanistan | To explore the challenges and psychological stressors facing military nurses in undertaking their operation | 18 military nurses | Interviews | The factors that caused stress were identified during both deployment and returning home, and measures to address the need for rest and exercise due to being deployed in a war zone. | There is a need for further research to identify the possible stressors that can impact on military nurses in their return home. |
11 | Firouzkouhi et al. (2013) Iran and Iraq | To identify the experiences gained by civilian nurses’ activity and through the duration of the Iran and Iraq war. | 15 civilian nurses | Interviews | Health care assistants and nurses who joined the armed forces, did not have prior training in this area of nursing, yet many quickly adapted and performed their nursing role successfully. | Studies are required to identify how civilian nurses’ experiences can be used in peacetime to help prepare future nurses with knowledge of wartime nursing expectations. |
12 | Goodman et al. (2013) Iraq | To understand military nurses’ experiences of care for Iraqi patients. | 15 army nurses | Focus Group Interview | The data identified expanding practice, ethical dilemmas, and the cultural divide with details of the opportunities for learning additional knowledge and skills to increase their competence. Nurses experienced mental distress when confronted with ethical issues regarding safe patient care. Lack of trust in interpreters and animosity. Some The nurses’ challenged culturally when caring for a population with a different language, value system, customs, and traditions. | Further research is required to more fully understand the specific challenges experienced by military nurses and support their personal and professional development. |
13 | Griffiths & Jasper (2008) United Kingdom | To explore the nature of military nursing in an environment of war. | 24 military nurses | Focus group Interviews | The findings included the realities of practicing in the military in a war environment and the dual role as a nurse and member of the military and the impact on caring during war and the transition to a ‘warrior’. | Further research is needed to capture the caring nature of the nurses role within a conflict zone to prepare military, NGO, and civilian nurses for their roles. |
14 | Hagerty et al. (2011) United States of America | To explore the lived experience of combat-wounded patients and the military nurses who provided. | 20 military nurses and eight combat wounded-patients | Focus Group Interviews | The findings suggest that nurses and patients have shared experience upon which they can attach meaning and recognize that the experiences led to the ‘changed self’ and the professional and role boundaries that existed. | Further research should focus on identifying strategies to help nurses and patients cope and adapt to the stressful combat circumstances. |
15 | Han (2019) Korea | To explore the essence of the experience of Korean female nursing officers during the Vietnam War | 14 Korean female nursing officers | Interview | The findings identified that some participants experience on-going role confusion while being committed to their nursing role. A deep sense of comradery was experienced within the context of the dark side of war, with a fear of gender discrimination experienced by some, while finding the role rewarding that enabled development. | Future studies should focus on the experiences of nurses as women and officers in the conditions of war to inform future support needs prior to deployment. |
16 | Lal & Spence (2016) New Zealand | To identify the lived experience of New Zealand nurses providing humanitarian aid within surgical settings in developing countries. | 4 nurses | Interviews | For humanitarian work, specialized skills and nursing experience are required yet participants required further preparation, including cultural issues and needs | Future research should focus on contextual and cultural issues that affect nursing in humanitarian settings. |
17 | Peyrovi et al. (2015) Iran | To analyse the history of the wartime experience of Iranian nurses in the Iran-Iraq war. | 13 military nurses | Interview | Finally, data analysis of significant statements from 17 interviews yielded 5 themes and 18 subthemes. (1) “From the margins to the middle” was one of the five themes that emerged. (2) “Referral care growth,” (3) “Personal and professional development,” which includes both personal and professional growth. (4) “War nursing’s emerging cornerstone of society,” and (5) “Threats to nursing at war.” | It Is recommended that the wartime memories of Iranian nurses be collected, archived, and analysed. |
18 | Rahimaghaee et al. (2016) Iran | To explain nurses’ experiences and views on the care of injured soldiers during the Iraq–Iran war (1980–1988). | 14 nurses | Semi-structured Interview | The data revealed two main themes (Care in the war, a different culture and concept, and Care accomplishments during the war) as well as six subthemes (Unusual working conditions, Different work spirit, A real yet informal classroom, Professional self-achievements, Professional community outcomes, The changed self). | No specific recommendations for future research were made. |
19 | Rivers et al. (2013) USA | To understand the lived experience of U.S. Army nurses’ reintegration and homecoming following deployment to Iraq and/or Afghanistan | 22 army nurses | Qualitative Interview | Five themes are identified: (1) aspects of command support were described as “No one cares”; (2) meeting requirements for attendance at pre/post-deployment briefings was described as “Check the blocks”; (3) readjustments from focusing solely on-duty requirements versus multitasking, such as family obligations and everyday life, resulted in the “Stress of being home.” (4) nurses stated “They do not understand” when referring to anyone without deployment experience (family, friends, other soldiers); and (5) when referencing deployment experiences, nurses emphasized that, “It just changes you.” | Future research is indicated that focus on meeting the needs of nurses, such as processes and education to support during deployment or their return to home and family. |
20 | Rushton et al. (2008) USA | To gather experiences from nurses who have served their country in wartime, either on the front lines or in supportive roles. | 10 navy nurse corps and one air force nurse corps | Qualitative Interview | The themes identified: “It is what we’re here for,” demonstrates a commitment to care and to sacrifice. Other major themes drawn from the study included lessons learned from their wartime nursing experiences, sacrifices made, and chronicles of caring. | Further research is required to explore nurse experiences during the war. nurses. It is recommended that families and relative are physically and emotionally prepared in order to provide support to deployed nurse. |
21 | Scannell-Desch (1996) USA | To explore common components of the lived experience of women military nurses who served and after returning from Vietnam. | 24 military women nurses | Qualitative In-depth Interview | The study’s findings revealed that the Vietnam war affects the lives of nurses during and after the war. | Further studies is indicated on Vietnamese women nurses and other classes of people who have worked in war and disaster situations. |
22 | Scannell-Desch (2005) USA | To describe guidance for nurses today from the lessons learned by nurses who served in the Vietnam War. | 24 nurses—nine army, eight navy and seven air force | Qualitative Interview | Seven themes were identified: advice about journaling, training, caring for yourself, use of support systems, talking about your experiences, understanding the mission, and lack of preparation for war. | It is recommended that the facets of war should be included in military nurse training. |
23 | Scannell-Desch & Doherty (2010) USA | To describe the lived experience of U.S. military nurses who served in Iraq or Afghanistan during the war years 2003 to 2009, and life after returning from war | 37 nurses—18 army, four navy, and 15 air force | Qualitative Interview | Seven themes were identified (Deploying to War, Remembrance of War: Most Chaotic Scene, Nurses in Harm’s Way: More Than I Bargained For, Kinship and Bonding: My Military Family, My Wartime Stress: I am a Different Person Now, Professional Growth: Expanding my Skills, Listen to Me: Advice to Deploying Nurses and seven subthemes emerged from data analysis of significant statements. These themes and corresponding subthemes captured the essence of the lived experience of military nurses serving in Iraq and Afghanistan during 2003 to 2009. | The study recommended to adapt the approach in treating nurses with PTSD. Future research is identified to look at war nurses’ perspectives from countries other than the United States. |
24 | Shamia et al. (2015) Palestine | To establish the association between war traumatic experiences, posttraumatic stress disorder (PTSD) symptoms and posttraumatic growth among nurses in the Gaza Strip, 2 years after an incursion on Gaza and during a period of ongoing trauma exposure. | 274 nurses | Quantitative Survey Questionnaire | The study shows 19.7% of the nurses had absolute PTSD. There was a strong link between traumatic events and PTSD ratings and traumatic events in the community and posttraumatic development. | It is recommended nurses with PTSD should receive mental health assistance that can provide instruction, counselling, and assistance to other healthcare providers. |
25 | Tjoflåt (1997) Norway | To describe the nursing practice in war zones and skills the nurses have acquired from work | 39 nurses | Mixed-Method Questionnaire | The findings suggest that the nurses were well-prepared for this mission. The nurses gained personal and technical skills while serving in war zones. | Further, qualitative research is needed to learn more about the nursing profession in war. A study like this may help researchers better understand patients, nurses, and the unique practice situation. |
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Sadhaan, A.; Brown, M.; McLaughlin, D. Registered Nurses’ Views and Experiences of Delivering Care in War and Conflict Areas: A Systematic Review. Healthcare 2022, 10, 2168. https://doi.org/10.3390/healthcare10112168
Sadhaan A, Brown M, McLaughlin D. Registered Nurses’ Views and Experiences of Delivering Care in War and Conflict Areas: A Systematic Review. Healthcare. 2022; 10(11):2168. https://doi.org/10.3390/healthcare10112168
Chicago/Turabian StyleSadhaan, Abdullah, Michael Brown, and Derek McLaughlin. 2022. "Registered Nurses’ Views and Experiences of Delivering Care in War and Conflict Areas: A Systematic Review" Healthcare 10, no. 11: 2168. https://doi.org/10.3390/healthcare10112168