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Chapter 5: Qualitative descriptive research

Darshini Ayton

Learning outcomes

Upon completion of this chapter, you should be able to:

• Identify the key terms and concepts used in qualitative descriptive research.
• Discuss the advantages and disadvantages of qualitative descriptive research.

What is a qualitative descriptive study?

The key concept of the qualitative descriptive study is description.

Qualitative descriptive studies (also known as ‘exploratory studies’ and ‘qualitative description approaches’) are relatively new in the qualitative research landscape. They emerged predominantly in the field of nursing and midwifery over the past two decades. 1 The design of qualitative descriptive studies evolved as a means to define aspects of qualitative research that did not resemble qualitative research designs to date, despite including elements of those other study designs. 2

Qualitative descriptive studies  describe  phenomena rather than explain them. Phenomenological studies, ethnographic studies and those using grounded theory seek to explain a phenomenon. Qualitative descriptive studies aim to provide a comprehensive summary of events. The approach to this study design is journalistic, with the aim being to answer the questions who, what, where and how. 3

A qualitative descriptive study is an important and appropriate design for research questions that are focused on gaining insights about a poorly understood research area, rather than on a specific phenomenon. Since qualitative descriptive study design seeks to describe rather than explain, explanatory frameworks and theories are not required to explain or ‘ground’ a study and its results. 4 The researcher may decide that a framework or theory adds value to their interpretations, and in that case, it is perfectly acceptable to use them. However, the hallmark of genuine curiosity (naturalistic enquiry) is that the researcher does not know in advance what they will be observing or describing. 4 Because a phenomenon is being described, the qualitative descriptive analysis is more categorical and less conceptual than other methods. Qualitative content analysis is usually the main approach to data analysis in qualitative descriptive studies. 4 This has led to criticism of descriptive research being less sophisticated because less interpretation is required than with other qualitative study designs in which interpretation and explanation are key characteristics (e.g. phenomenology, grounded theory, case studies).

Diverse approaches to data collection can be utilised in qualitative description studies. However, most qualitative descriptive studies use semi-structured interviews (see Chapter 13) because they provide a reliable way to collect data. 3 The technique applied to data analysis is generally categorical and less conceptual when compared to other qualitative research designs (see Section 4). 2,3 Hence, this study design is well suited to research by practitioners, student researchers and policymakers. Its straightforward approach enables these studies to be conducted in shorter timeframes than other study designs. 3 Descriptive studies are common as the qualitative component in mixed-methods research ( see Chapter 11 ) and evaluations ( see Chapter 12 ), 1 because qualitative descriptive studies can provide information to help develop and refine questionnaires or interventions.

For example, in our research to develop a patient-reported outcome measure for people who had undergone a percutaneous coronary intervention (PCI), which is a common cardiac procedure to treat heart disease, we started by conducting a qualitative descriptive study. 5 This project was a large, mixed-methods study funded by a private health insurer. The entire research process needed to be straightforward and achievable within a year, as we had engaged an undergraduate student to undertake the research tasks. The aim of the qualitative component of the mixed-methods study was to identify and explore patients’ perceptions following PCI. We used inductive approaches to collect and analyse the data. The study was guided by the following domains for the development of patient-reported outcomes, according to US Food and Drug Administration (FDA) guidelines, which included:

• Feeling: How the patient feels physically and psychologically after medical intervention
• Function: The patient’s mobility and ability to maintain their regular routine
• Evaluation: The patient’s overall perception of the success or failure of their procedure and their perception of what contributed to it. 5(p458)

We conducted focus groups and interviews, and asked participants three questions related to the FDA outcome domains:

• From your perspective, what would be considered a successful outcome of the procedure?

Probing questions: Did the procedure meet your expectations? How do you define whether the procedure was successful?

• How did you feel after the procedure?

Probing question: How did you feel one week after and how does that compare with how you feel now?

• After your procedure, tell me about your ability to do your daily activities?

Prompt for activities including gardening, housework, personal care, work-related and family-related tasks.

Probing questions: Did you attend cardiac rehabilitation? Can you tell us about your experience of cardiac rehabilitation? What impact has medication had on your recovery?

• What, if any, lifestyle changes have you made since your procedure? 5(p459)

Data collection was conducted with 32 participants. The themes were mapped to the FDA patient-reported outcome domains, with the results confirming previous research and also highlighting new areas for exploration in the development of a new patient-reported outcome measure. For example, participants reported a lack of confidence following PCI and the importance of patient and doctor communication. Women, in particular, reported that they wanted doctors to recognise how their experiences of cardiac symptoms were different to those of men.

The study described phenomena and resulted in the development of a patient-reported outcome measure that was tested and refined using a discrete-choice experiment survey, 6 a pilot of the measure in the Victorian Cardiac Outcomes Registry and a Rasch analysis to validate the measurement’s properties. 7

Advantages and disadvantages of qualitative descriptive studies

A qualitative descriptive study is an effective design for research by practitioners, policymakers and students, due to their relatively short timeframes and low costs. The researchers can remain close to the data and the events described, and this can enable the process of analysis to be relatively simple. Qualitative descriptive studies are also useful in mixed-methods research studies. Some of the advantages of qualitative descriptive studies have led to criticism of the design approach, due to a lack of engagement with theory and the lack of interpretation and explanation of the data. 2

Table 5.1. Examples of qualitative descriptive studies

Qualitative descriptive studies are gaining popularity in health and social care due to their utility, from a resource and time perspective, for research by practitioners, policymakers and researchers. Descriptive studies can be conducted as stand-alone studies or as part of larger, mixed-methods studies.

• Bradshaw C, Atkinson S, Doody O. Employing a qualitative description approach in health care research. Glob Qual Nurs Res. 2017;4. doi:10.1177/2333393617742282
• Lambert VA, Lambert CE. Qualitative descriptive research: an acceptable design. Pac Rim Int J Nurs Res Thail. 2012;16(4):255-256. Accessed June 6, 2023. https://he02.tci-thaijo.org/index.php/PRIJNR/article/download/5805/5064
• Doyle L et al. An overview of the qualitative descriptive design within nursing research. J Res Nurs. 2020;25(5):443-455. doi:10.1177/174498711988023
• Kim H, Sefcik JS, Bradway C. Characteristics of qualitative descriptive studies: a systematic review. Res Nurs Health. 2017;40(1):23-42. doi:10.1002/nur.21768
• Ayton DR et al. Exploring patient-reported outcomes following percutaneous coronary intervention: a qualitative study. Health Expect. 2018;21(2):457-465. doi:10.1111/hex.1263
• Barker AL et al. Symptoms and feelings valued by patients after a percutaneous coronary intervention: a discrete-choice experiment to inform development of a new patient-reported outcome. BMJ Open. 2018;8:e023141. doi:10.1136/bmjopen-2018-023141
• Soh SE et al. What matters most to patients following percutaneous coronary interventions? a new patient-reported outcome measure developed using Rasch analysis. PLoS One. 2019;14(9):e0222185. doi:10.1371/journal.pone.0222185
• Hiller RM et al. Coping and support-seeking in out-of-home care: a qualitative study of the views of young people in care in England. BMJ Open. 2021;11:e038461. doi:10.1136/bmjopen-2020-038461
• Backman C, Cho-Young D. Engaging patients and informal caregivers to improve safety and facilitate person- and family-centered care during transitions from hospital to home – a qualitative descriptive study. Patient Prefer Adherence. 2019;13:617-626. doi:10.2147/PPA.S201054

Qualitative Research – a practical guide for health and social care researchers and practitioners Copyright © 2023 by Darshini Ayton is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License , except where otherwise noted.

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Descriptive Research and Qualitative Research

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• Eunsook T. Koh 2 &
• Willis L. Owen 2  

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Descriptive research is a study of status and is widely used in education, nutrition, epidemiology, and the behavioral sciences. Its value is based on the premise that problems can be solved and practices improved through observation, analysis, and description. The most common descriptive research method is the survey, which includes questionnaires, personal interviews, phone surveys, and normative surveys. Developmental research is also descriptive. Through cross-sectional and longitudinal studies, researchers investigate the interaction of diet (e.g., fat and its sources, fiber and its sources, etc.) and life styles (e.g., smoking, alcohol drinking, etc.) and of disease (e.g., cancer, coronary heart disease) development. Observational research and correlational studies constitute other forms of descriptive research. Correlational studies determine and analyze relationships between variables as well as generate predictions. Descriptive research generates data, both qualitative and quantitative, that define the state of nature at a point in time. This chapter discusses some characteristics and basic procedures of the various types of descriptive research.

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Koh, E.T., Owen, W.L. (2000). Descriptive Research and Qualitative Research. In: Introduction to Nutrition and Health Research. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-1401-5_12

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11 Descriptive and interpretive approaches to qualitative research

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This chapter explores descriptive and interpretive approaches to qualitative research. This includes the formulation of the problem, data collection, the specifics of sampling, data analysis in descriptive/interpretive qualitative research, generation of categories, and extracting and interpreting the main findings.

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Exploring Phenomena: A Brief Guide to Conducting Descriptive Qualitative Research

This article summarizes descriptive qualitative research, a method used to explore and understand the characteristics and qualities of a phenomenon. The article explains key features of the method, such as the importance of detailed descriptions, open-ended questions, and context and meaning.

It also comprehensively discusses data collection and analysis techniques, including interviews, observations, and thematic analysis. I highlight communication of research findings, along with potential limitations and biases of the method.

Table of Contents

Key features of the descriptive qualitative research.

Descriptive qualitative research is a method of research that is focused on understanding a phenomenon by examining its characteristics and qualities. We use this type of research when we want to explore a topic that has not been studied in depth before, or when we want to gain a better understanding of a previously studied topic but using a different perspective and gain valuable insights in the process.

Read more : 10 Year Plus Content Writing Insights Until the Rise of AI

Descriptive qualitative research is a type of qualitative research that explores the characteristics of a phenomenon, rather than explaining the underlying causes or mechanisms.

It involves the collection and data analysis in the form of words , images , or other non-numerical forms of information.

Goal of descriptive qualitative research

The goal of descriptive qualitative research is to provide a rich and detailed account of the phenomenon under study. Doing so allows us to develop further research questions. The activity will also help inform policy or practice.

Read more : How to Make a Research Question Using CoPilot with Bing Chat: 5 Examples

Applicability of descriptive qualitative research

Researchers in various fields can use descriptive qualitative research, including social sciences, education, psychology, health sciences, and business.

In social sciences, for example, descriptive qualitative research can be used to explore social, cultural, or political issues, and to understand the perspectives and experiences of marginalized or underrepresented groups.

In education, descriptive qualitative research can be used to explore teaching and learning processes, student experiences, and educational practices.

In health sciences, descriptive qualitative research can be used to explore patients’ experiences with illness, healthcare providers’ experiences, and health policies.

Data Collection Methods Used in Descriptive Qualitative Research

The data collection methods used in descriptive qualitative research can vary. Typically, the method involves an observation or interaction with the phenomenon being studied.

Examples include personal interview of individuals who have experience or knowledge of the phenomenon studied, focus group discussion , observing the phenomenon in its natural setting, document analysis or other forms of data collection that apply to the phenomenon.

Strengths of the Descriptive Qualitative Method

Flexible research method.

One of the key strengths of descriptive qualitative research is its flexibility. Flexibility means that the method can be used in a wide range of settings. It can be adapted to suit the needs of the researcher and the specific research question being investigated.

Few and easily obtained resources

Descriptive qualitative research can be conducted using relatively few resources, easily accessible, and can often be completed more quickly than other types of research. These resources include the following:

• research participants,
• the researcher,
• data collection tools like interviews, focus group discussions, observations, or document analysis;
• recording equipment, particularly audio or video recorders;
• transcription software for easier and faster transcription; and
• data analysis software like nVivo or ATLAS to facilitate analysis.

Despite these simple requirements, however, researchers must ensure that ethical considerations are adequately complied with (e.g. informed consent, confidentiality, privacy concerns, and data storage).

Compared to quantitative research, descriptive qualitative research can be time-consuming and resource intensive if the aim is to have a thorough and effective research outcome.

Captures the complexity and richness of a phenomenon

Another strength of descriptive qualitative research is its ability to capture the complexity and richness of a phenomenon.

Because this type of research is focused on the exploration of the characteristics and qualities of a phenomenon, it allows researchers to capture a wide range of information about the phenomenon, including its context, history, and cultural significance.

Limitations of Descriptive Qualitative Research

Can be time consuming, potential for researcher bias.

Because descriptive qualitative research often involves the interpretation of data, researchers may inadvertently introduce their own biases into the analysis. One researcher’s perspective may vary from another researcher’s viewpoint in studying the same phenomenon.

The researcher’s bias can be minimized through careful data collection and analysis techniques, but it is important for researchers to be aware of their own biases and to mitigate their impact on the research.

Does not provide the same level of generalizability as quantitative research methods

Another limitation of descriptive qualitative research is that it may not provide the same level of generalizability as quantitative research methods.

Because we often focus descriptive qualitative research on a specific phenomenon or context, it may not be possible to generalize the findings to other contexts or populations.

However, this does not mean that the findings are not valuable or informative. Descriptive qualitative research can still be an important tool for understanding specific phenomena and contexts.

Steps in Conducting Descriptive Qualitative Research

In order to conduct descriptive qualitative research, researchers typically follow a series of steps. I list them in the following section.

Step 1. Identify the research question or topic of interest

The first step is to identify the research question or topic of interest. Knowledge of the research agenda of an organization or institution where the researcher belongs will be most helpful.

The question should focus on exploring the characteristics and qualities of a phenomenon, rather than explaining its underlying causes or mechanisms.

Step 2. Determine the data collection method or methods to use

The next step is to determine the data collection methods that will be used. This may involve interviewing, observations, or analyzing documents or other forms of data. There should be a one-to-one correspondence between the research questions and the method to use. Thus, preparing a matrix to match the research question, method, and other parts of the research paper will facilitate and ensure that the research objectives are met.

The data collection methods should be chosen based on their ability to provide rich and detailed information about the phenomenon under study.

Step 3. Analyze the data collected

Once the data has been collected, the next step is to analyze it. Analysis may involve coding the data into categories or themes, or using other analytical techniques to identify patterns and relationships within the data.

The goal of the analysis is to develop a rich and detailed understanding of the phenomenon under study. Doing so allows researchers to develop further research questions or inform policy or practice.

Step 4. Disseminate the findings

Finally, the results of the descriptive qualitative research should be communicated to others. This may involve writing a report, presenting the findings at a conference, or publishing the research in a peer-reviewed journal . Other researchers can build on the findings.

In communicating the results, it is important to provide a clear and detailed account of the phenomenon under study and to contextualize the findings within the broader literature on the topic.

Usefulness of the Qualitative Descriptive Research

In conclusion, descriptive qualitative research is a valuable tool for exploring the characteristics and qualities of a phenomenon. It allows researchers to capture the complexity and richness of a phenomenon and provides a detailed understanding of its context, history, and cultural significance.

While there are some limitations to descriptive qualitative research, it can still be an important method for understanding specific phenomena and contexts.

Researchers can use a variety of data collection and analysis techniques to conduct descriptive qualitative research.

Qualitative researchers using qualitative research methods should communicate their findings to others in a clear and detailed manner.

As with any research method, it is important for researchers to approach descriptive qualitative research with a critical eye and to be aware of the potential biases and limitations of the method.

By following careful research procedures and communicating their findings clearly, descriptive qualitative researchers can make valuable contributions to our understanding of a wide range of phenomena.

Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative research in psychology, 3(2), 77-101.

Creswell, J. W. (2013). Qualitative inquiry and research design: Choosing among five approaches. Sage publications.

Denzin, N. K., & Lincoln, Y. S. (2011). The Sage handbook of qualitative research. Sage publications.

Elliott, R., Fischer, C. T., & Rennie, D. L. (1999). Evolving guidelines for publication of qualitative research studies in psychology and related fields. British Journal of Clinical Psychology, 38(3), 215-229.

Guest, G., MacQueen, K. M., & Namey, E. E. (2012). Applied thematic analysis. Sage publications.

Merriam, S. B. (2009). Qualitative research: A guide to design and implementation. John Wiley & Sons.

Miles, M. B., & Huberman, A. M. (1994). Qualitative data analysis: An expanded sourcebook. Sage publications.

Patton, M. Q. (2002). Qualitative research and evaluation methods. Sage publications.

Silverman, D. (2013). Doing qualitative research: A practical handbook. Sage publications.

Van der Riet, P., & Durrheim, K. (2012). Qualitative data analysis and interpretation. Doing research in the real world. Sage publications.

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Series: Practical guidance to qualitative research. Part 3: Sampling, data collection and analysis

Albine moser.

a Faculty of Health Care, Research Centre Autonomy and Participation of Chronically Ill People , Zuyd University of Applied Sciences , Heerlen, The Netherlands

b Faculty of Health, Medicine and Life Sciences, Department of Family Medicine , Maastricht University , Maastricht, The Netherlands

Irene Korstjens

c Faculty of Health Care, Research Centre for Midwifery Science , Zuyd University of Applied Sciences , Maastricht, The Netherlands

In the course of our supervisory work over the years, we have noticed that qualitative research tends to evoke a lot of questions and worries, so-called frequently asked questions (FAQs). This series of four articles intends to provide novice researchers with practical guidance for conducting high-quality qualitative research in primary care. By ‘novice’ we mean Master’s students and junior researchers, as well as experienced quantitative researchers who are engaging in qualitative research for the first time. This series addresses their questions and provides researchers, readers, reviewers and editors with references to criteria and tools for judging the quality of qualitative research papers. The second article focused on context, research questions and designs, and referred to publications for further reading. This third article addresses FAQs about sampling, data collection and analysis. The data collection plan needs to be broadly defined and open at first, and become flexible during data collection. Sampling strategies should be chosen in such a way that they yield rich information and are consistent with the methodological approach used. Data saturation determines sample size and will be different for each study. The most commonly used data collection methods are participant observation, face-to-face in-depth interviews and focus group discussions. Analyses in ethnographic, phenomenological, grounded theory, and content analysis studies yield different narrative findings: a detailed description of a culture, the essence of the lived experience, a theory, and a descriptive summary, respectively. The fourth and final article will focus on trustworthiness and publishing qualitative research.

Key points on sampling, data collection and analysis

• The data collection plan needs to be broadly defined and open during data collection.
• Sampling strategies should be chosen in such a way that they yield rich information and are consistent with the methodological approach used.
• Data saturation determines sample size and is different for each study.
• The most commonly used data collection methods are participant observation, face-to-face in-depth interviews and focus group discussions.
• Analyses of ethnographic, phenomenological, grounded theory, and content analysis studies yield different narrative findings: a detailed description of a culture, the essence of the lived experience, a theory or a descriptive summary, respectively.

Introduction

This article is the third paper in a series of four articles aiming to provide practical guidance to qualitative research. In an introductory paper, we have described the objective, nature and outline of the Series [ 1 ]. Part 2 of the series focused on context, research questions and design of qualitative research [ 2 ]. In this paper, Part 3, we address frequently asked questions (FAQs) about sampling, data collection and analysis.

What is a sampling plan?

A sampling plan is a formal plan specifying a sampling method, a sample size, and procedure for recruiting participants ( Box 1 ) [ 3 ]. A qualitative sampling plan describes how many observations, interviews, focus-group discussions or cases are needed to ensure that the findings will contribute rich data. In quantitative studies, the sampling plan, including sample size, is determined in detail in beforehand but qualitative research projects start with a broadly defined sampling plan. This plan enables you to include a variety of settings and situations and a variety of participants, including negative cases or extreme cases to obtain rich data. The key features of a qualitative sampling plan are as follows. First, participants are always sampled deliberately. Second, sample size differs for each study and is small. Third, the sample will emerge during the study: based on further questions raised in the process of data collection and analysis, inclusion and exclusion criteria might be altered, or the sampling sites might be changed. Finally, the sample is determined by conceptual requirements and not primarily by representativeness. You, therefore, need to provide a description of and rationale for your choices in the sampling plan. The sampling plan is appropriate when the selected participants and settings are sufficient to provide the information needed for a full understanding of the phenomenon under study.

Sampling strategies in qualitative research. Based on Polit & Beck [ 3 ].

Some practicalities: a critical first step is to select settings and situations where you have access to potential participants. Subsequently, the best strategy to apply is to recruit participants who can provide the richest information. Such participants have to be knowledgeable on the phenomenon and can articulate and reflect, and are motivated to communicate at length and in depth with you. Finally, you should review the sampling plan regularly and adapt when necessary.

What sampling strategies can I use?

Sampling is the process of selecting or searching for situations, context and/or participants who provide rich data of the phenomenon of interest [ 3 ]. In qualitative research, you sample deliberately, not at random. The most commonly used deliberate sampling strategies are purposive sampling, criterion sampling, theoretical sampling, convenience sampling and snowball sampling. Occasionally, the ‘maximum variation,’ ‘typical cases’ and ‘confirming and disconfirming’ sampling strategies are used. Key informants need to be carefully chosen. Key informants hold special and expert knowledge about the phenomenon to be studied and are willing to share information and insights with you as the researcher [ 3 ]. They also help to gain access to participants, especially when groups are studied. In addition, as researcher, you can validate your ideas and perceptions with those of the key informants.

What is the connection between sampling types and qualitative designs?

The ‘big three’ approaches of ethnography, phenomenology, and grounded theory use different types of sampling.

In ethnography, the main strategy is purposive sampling of a variety of key informants, who are most knowledgeable about a culture and are able and willing to act as representatives in revealing and interpreting the culture. For example, an ethnographic study on the cultural influences of communication in maternity care will recruit key informants from among a variety of parents-to-be, midwives and obstetricians in midwifery care practices and hospitals.

Phenomenology uses criterion sampling, in which participants meet predefined criteria. The most prominent criterion is the participant’s experience with the phenomenon under study. The researchers look for participants who have shared an experience, but vary in characteristics and in their individual experiences. For example, a phenomenological study on the lived experiences of pregnant women with psychosocial support from primary care midwives will recruit pregnant women varying in age, parity and educational level in primary midwifery practices.

Grounded theory usually starts with purposive sampling and later uses theoretical sampling to select participants who can best contribute to the developing theory. As theory construction takes place concurrently with data collection and analyses, the theoretical sampling of new participants also occurs along with the emerging theoretical concepts. For example, one grounded theory study tested several theoretical constructs to build a theory on autonomy in diabetes patients [ 4 ]. In developing the theory, the researchers started by purposefully sampling participants with diabetes differing in age, onset of diabetes and social roles, for example, employees, housewives, and retired people. After the first analysis, researchers continued with theoretically sampling, for example, participants who differed in the treatment they received, with different degrees of care dependency, and participants who receive care from a general practitioner (GP), at a hospital or from a specialist nurse, etc.

In addition to the ‘big three’ approaches, content analysis is frequently applied in primary care research, and very often uses purposive, convenience, or snowball sampling. For instance, a study on peoples’ choice of a hospital for elective orthopaedic surgery used snowball sampling [ 5 ]. One elderly person in the private network of one researcher personally approached potential respondents in her social network by means of personal invitations (including letters). In turn, respondents were asked to pass on the invitation to other eligible candidates.

Sampling is also dependent on the characteristics of the setting, e.g., access, time, vulnerability of participants, and different types of stakeholders. The setting, where sampling is carried out, is described in detail to provide thick description of the context, thereby, enabling the reader to make a transferability judgement (see Part 3: transferability). Sampling also affects the data analysis, where you continue decision-making about whom or what situations to sample next. This is based on what you consider as still missing to get the necessary information for rich findings (see Part 1: emergent design). Another point of attention is the sampling of ‘invisible groups’ or vulnerable people. Sampling of these participants would require applying multiple sampling strategies, and more time calculated in the project planning stage for sampling and recruitment [ 6 ].

How do sample size and data saturation interact?

A guiding principle in qualitative research is to sample only until data saturation has been achieved. Data saturation means the collection of qualitative data to the point where a sense of closure is attained because new data yield redundant information [ 3 ].

Data saturation is reached when no new analytical information arises anymore, and the study provides maximum information on the phenomenon. In quantitative research, by contrast, the sample size is determined by a power calculation. The usually small sample size in qualitative research depends on the information richness of the data, the variety of participants (or other units), the broadness of the research question and the phenomenon, the data collection method (e.g., individual or group interviews) and the type of sampling strategy. Mostly, you and your research team will jointly decide when data saturation has been reached, and hence whether the sampling can be ended and the sample size is sufficient. The most important criterion is the availability of enough in-depth data showing the patterns, categories and variety of the phenomenon under study. You review the analysis, findings, and the quality of the participant quotes you have collected, and then decide whether sampling might be ended because of data saturation. In many cases, you will choose to carry out two or three more observations or interviews or an additional focus group discussion to confirm that data saturation has been reached.

When designing a qualitative sampling plan, we (the authors) work with estimates. We estimate that ethnographic research should require 25–50 interviews and observations, including about four-to-six focus group discussions, while phenomenological studies require fewer than 10 interviews, grounded theory studies 20–30 interviews and content analysis 15–20 interviews or three-to-four focus group discussions. However, these numbers are very tentative and should be very carefully considered before using them. Furthermore, qualitative designs do not always mean small sample numbers. Bigger sample sizes might occur, for example, in content analysis, employing rapid qualitative approaches, and in large or longitudinal qualitative studies.

Data collection

What methods of data collection are appropriate.

The most frequently used data collection methods are participant observation, interviews, and focus group discussions. Participant observation is a method of data collection through the participation in and observation of a group or individuals over an extended period of time [ 3 ]. Interviews are another data collection method in which an interviewer asks the respondents questions [ 6 ], face-to-face, by telephone or online. The qualitative research interview seeks to describe the meanings of central themes in the life world of the participants. The main task in interviewing is to understand the meaning of what participants say [ 5 ]. Focus group discussions are a data collection method with a small group of people to discuss a given topic, usually guided by a moderator using a questioning-route [ 8 ]. It is common in qualitative research to combine more than one data collection method in one study. You should always choose your data collection method wisely. Data collection in qualitative research is unstructured and flexible. You often make decisions on data collection while engaging in fieldwork, the guiding questions being with whom, what, when, where and how. The most basic or ‘light’ version of qualitative data collection is that of open questions in surveys. Box 2 provides an overview of the ‘big three’ qualitative approaches and their most commonly used data collection methods.

Qualitative data collection methods.

What role should I adopt when conducting participant observations?

What is important is to immerse yourself in the research setting, to enable you to study it from the inside. There are four types of researcher involvement in observations, and in your qualitative study, you may apply all four. In the first type, as ‘complete participant’, you become part of the setting and play an insider role, just as you do in your own work setting. This role might be appropriate when studying persons who are difficult to access. The second type is ‘active participation’. You have gained access to a particular setting and observed the group under study. You can move around at will and can observe in detail and depth and in different situations. The third role is ‘moderate participation’. You do not actually work in the setting you wish to study but are located there as a researcher. You might adopt this role when you are not affiliated to the care setting you wish to study. The fourth role is that of the ‘complete observer’, in which you merely observe (bystander role) and do not participate in the setting at all. However, you cannot perform any observations without access to the care setting. Such access might be easily obtained when you collect data by observations in your own primary care setting. In some cases, you might observe other care settings, which are relevant to primary care, for instance observing the discharge procedure for vulnerable elderly people from hospital to primary care.

How do I perform observations?

It is important to decide what to focus on in each individual observation. The focus of observations is important because you can never observe everything, and you can only observe each situation once. Your focus might differ between observations. Each observation should provide you with answers regarding ‘Who do you observe?’, ‘What do you observe’, ‘Where does the observation take place?’, ‘When does it take place?’, ‘How does it happen?’, and ‘Why does it happen as it happens?’ Observations are not static but proceed in three stages: descriptive, focused, and selective. Descriptive means that you observe, on the basis of general questions, everything that goes on in the setting. Focused observation means that you observe certain situations for some time, with some areas becoming more prominent. Selective means that you observe highly specific issues only. For example, if you want to observe the discharge procedure for vulnerable elderly people from hospitals to general practice, you might begin with broad observations to get to know the general procedure. This might involve observing several different patient situations. You might find that the involvement of primary care nurses deserves special attention, so you might then focus on the roles of hospital staff and primary care nurses, and their interactions. Finally, you might want to observe only the specific situations where hospital staff and primary care nurses exchange information. You take field notes from all these observations and add your own reflections on the situations you observed. You jot down words, whole sentences or parts of situations, and your reflections on a piece of paper. After the observations, the field notes need to be worked out and transcribed immediately to be able to include detailed descriptions.

Further reading on interviews and focus group discussion.

Qualitative data analysis.

What are the general features of an interview?

Interviews involve interactions between the interviewer(s) and the respondent(s) based on interview questions. Individual, or face-to-face, interviews should be distinguished from focus group discussions. The interview questions are written down in an interview guide [ 7 ] for individual interviews or a questioning route [ 8 ] for focus group discussions, with questions focusing on the phenomenon under study. The sequence of the questions is pre-determined. In individual interviews, the sequence depends on the respondents and how the interviews unfold. During the interview, as the conversation evolves, you go back and forth through the sequence of questions. It should be a dialogue, not a strict question–answer interview. In a focus group discussion, the sequence is intended to facilitate the interaction between the participants, and you might adapt the sequence depending on how their discussion evolves. Working with an interview guide or questioning route enables you to collect information on specific topics from all participants. You are in control in the sense that you give direction to the interview, while the participants are in control of their answers. However, you need to be open-minded to recognize that some relevant topics for participants may not have been covered in your interview guide or questioning route, and need to be added. During the data collection process, you develop the interview guide or questioning route further and revise it based on the analysis.

The interview guide and questioning route might include open and general as well as subordinate or detailed questions, probes and prompts. Probes are exploratory questions, for example, ‘Can you tell me more about this?’ or ‘Then what happened?’ Prompts are words and signs to encourage participants to tell more. Examples of stimulating prompts are eye contact, leaning forward and open body language.

Further reading on qualitative analysis.

What is a face-to-face interview?

A face-to-face interview is an individual interview, that is, a conversation between participant and interviewer. Interviews can focus on past or present situations, and on personal issues. Most qualitative studies start with open interviews to get a broad ‘picture’ of what is going on. You should not provide a great deal of guidance and avoid influencing the answers to fit ‘your’ point of view, as you want to obtain the participant’s own experiences, perceptions, thoughts, and feelings. You should encourage the participants to speak freely. As the interview evolves, your subsequent major and subordinate questions become more focused. A face-to-face or individual interview might last between 30 and 90 min.

Most interviews are semi-structured [ 3 ]. To prepare an interview guide to enhance that a set of topics will be covered by every participant, you might use a framework for constructing a semi-structured interview guide [ 10 ]: (1) identify the prerequisites to use a semi-structured interview and evaluate if a semi-structured interview is the appropriate data collection method; (2) retrieve and utilize previous knowledge to gain a comprehensive and adequate understanding of the phenomenon under study; (3) formulate a preliminary interview guide by operationalizing the previous knowledge; (4) pilot-test the preliminary interview guide to confirm the coverage and relevance of the content and to identify the need for reformulation of questions; (5) complete the interview guide to collect rich data with a clear and logical guide.

The first few minutes of an interview are decisive. The participant wants to feel at ease before sharing his or her experiences. In a semi-structured interview, you would start with open questions related to the topic, which invite the participant to talk freely. The questions aim to encourage participants to tell their personal experiences, including feelings and emotions and often focus on a particular experience or specific events. As you want to get as much detail as possible, you also ask follow-up questions or encourage telling more details by using probes and prompts or keeping a short period of silence [ 6 ]. You first ask what and why questions and then how questions.

You need to be prepared for handling problems you might encounter, such as gaining access, dealing with multiple formal and informal gatekeepers, negotiating space and privacy for recording data, socially desirable answers from participants, reluctance of participants to tell their story, deciding on the appropriate role (emotional involvement), and exiting from fieldwork prematurely.

What is a focus group discussion and when can I use it?

A focus group discussion is a way to gather together people to discuss a specific topic of interest. The people participating in the focus group discussion share certain characteristics, e.g., professional background, or share similar experiences, e.g., having diabetes. You use their interaction to collect the information you need on a particular topic. To what depth of information the discussion goes depends on the extent to which focus group participants can stimulate each other in discussing and sharing their views and experiences. Focus group participants respond to you and to each other. Focus group discussions are often used to explore patients’ experiences of their condition and interactions with health professionals, to evaluate programmes and treatment, to gain an understanding of health professionals’ roles and identities, to examine the perception of professional education, or to obtain perspectives on primary care issues. A focus group discussion usually lasts 90–120 mins.

You might use guidelines for developing a questioning route [ 9 ]: (1) brainstorm about possible topics you want to cover; (2) sequence the questioning: arrange general questions first, and then, more specific questions, and ask positive questions before negative questions; (3) phrase the questions: use open-ended questions, ask participants to think back and reflect on their personal experiences, avoid asking ‘why’ questions, keep questions simple and make your questions sound conversational, be careful about giving examples; (4) estimate the time for each question and consider: the complexity of the question, the category of the question, level of participant’s expertise, the size of the focus group discussion, and the amount of discussion you want related to the question; (5) obtain feedback from others (peers); (6) revise the questions based on the feedback; and (7) test the questions by doing a mock focus group discussion. All questions need to provide an answer to the phenomenon under study.

You need to be prepared to manage difficulties as they arise, for example, dominant participants during the discussion, little or no interaction and discussion between participants, participants who have difficulties sharing their real feelings about sensitive topics with others, and participants who behave differently when they are observed.

How should I compose a focus group and how many participants are needed?

The purpose of the focus group discussion determines the composition. Smaller groups might be more suitable for complex (and sometimes controversial) topics. Also, smaller focus groups give the participants more time to voice their views and provide more detailed information, while participants in larger focus groups might generate greater variety of information. In composing a smaller or larger focus group, you need to ensure that the participants are likely to have different viewpoints that stimulate the discussion. For example, if you want to discuss the management of obesity in a primary care district, you might want to have a group composed of professionals who work with these patients but also have a variety of backgrounds, e.g. GPs, community nurses, practice nurses in general practice, school nurses, midwives or dieticians.

Focus groups generally consist of 6–12 participants. Careful time management is important, since you have to determine how much time you want to devote to answering each question, and how much time is available for each individual participant. For example, if you have planned a focus group discussion lasting 90 min. with eight participants, you might need 15 min. for the introduction and the concluding summary. This means you have 75 min. for asking questions, and if you have four questions, this allows a total of 18 min. of speaking time for each question. If all eight respondents participate in the discussion, this boils down to about two minutes of speaking time per respondent per question.

How can I use new media to collect qualitative data?

New media are increasingly used for collecting qualitative data, for example, through online observations, online interviews and focus group discussions, and in analysis of online sources. Data can be collected synchronously or asynchronously, with text messaging, video conferences, video calls or immersive virtual worlds or games, etcetera. Qualitative research moves from ‘virtual’ to ‘digital’. Virtual means those approaches that import traditional data collection methods into the online environment and digital means those approaches take advantage of the unique characteristics and capabilities of the Internet for research [ 10 ]. New media can also be applied. See Box 3 for further reading on interview and focus group discussion.

Can I wait with my analysis until all data have been collected?

You cannot wait with the analysis, because an iterative approach and emerging design are at the heart of qualitative research. This involves a process whereby you move back and forth between sampling, data collection and data analysis to accumulate rich data and interesting findings. The principle is that what emerges from data analysis will shape subsequent sampling decisions. Immediately after the very first observation, interview or focus group discussion, you have to start the analysis and prepare your field notes.

Why is a good transcript so important?

First, transcripts of audiotaped interviews and focus group discussions and your field notes constitute your major data sources. Trained and well-instructed transcribers preferably make transcripts. Usually, e.g., in ethnography, phenomenology, grounded theory, and content analysis, data are transcribed verbatim, which means that recordings are fully typed out, and the transcripts are accurate and reflect the interview or focus group discussion experience. Most important aspects of transcribing are the focus on the participants’ words, transcribing all parts of the audiotape, and carefully revisiting the tape and rereading the transcript. In conversation analysis non-verbal actions such as coughing, the lengths of pausing and emphasizing, tone of voice need to be described in detail using a formal transcription system (best known are G. Jefferson’s symbols).

To facilitate analysis, it is essential that you ensure and check that transcripts are accurate and reflect the totality of the interview, including pauses, punctuation and non-verbal data. To be able to make sense of qualitative data, you need to immerse yourself in the data and ‘live’ the data. In this process of incubation, you search the transcripts for meaning and essential patterns, and you try to collect legitimate and insightful findings. You familiarize yourself with the data by reading and rereading transcripts carefully and conscientiously, in search for deeper understanding.

Are there differences between the analyses in ethnography, phenomenology, grounded theory, and content analysis?

Ethnography, phenomenology, and grounded theory each have different analytical approaches, and you should be aware that each of these approaches has different schools of thought, which may also have integrated the analytical methods from other schools ( Box 4 ). When you opt for a particular approach, it is best to use a handbook describing its analytical methods, as it is better to use one approach consistently than to ‘mix up’ different schools.

In general, qualitative analysis begins with organizing data. Large amounts of data need to be stored in smaller and manageable units, which can be retrieved and reviewed easily. To obtain a sense of the whole, analysis starts with reading and rereading the data, looking at themes, emotions and the unexpected, taking into account the overall picture. You immerse yourself in the data. The most widely used procedure is to develop an inductive coding scheme based on actual data [ 11 ]. This is a process of open coding, creating categories and abstraction. In most cases, you do not start with a predefined coding scheme. You describe what is going on in the data. You ask yourself, what is this? What does it stand for? What else is like this? What is this distinct from? Based on this close examination of what emerges from the data you make as many labels as needed. Then, you make a coding sheet, in which you collect the labels and, based on your interpretation, cluster them in preliminary categories. The next step is to order similar or dissimilar categories into broader higher order categories. Each category is named using content-characteristic words. Then, you use abstraction by formulating a general description of the phenomenon under study: subcategories with similar events and information are grouped together as categories and categories are grouped as main categories. During the analysis process, you identify ‘missing analytical information’ and you continue data collection. You reread, recode, re-analyse and re-collect data until your findings provide breadth and depth.

Throughout the qualitative study, you reflect on what you see or do not see in the data. It is common to write ‘analytic memos’ [ 3 ], write-ups or mini-analyses about what you think you are learning during the course of your study, from designing to publishing. They can be a few sentences or pages, whatever is needed to reflect upon: open codes, categories, concepts, and patterns that might be emerging in the data. Memos can contain summaries of major findings and comments and reflections on particular aspects.

In ethnography, analysis begins from the moment that the researcher sets foot in the field. The analysis involves continually looking for patterns in the behaviours and thoughts of the participants in everyday life, in order to obtain an understanding of the culture under study. When comparing one pattern with another and analysing many patterns simultaneously, you may use maps, flow charts, organizational charts and matrices to illustrate the comparisons graphically. The outcome of an ethnographic study is a narrative description of a culture.

In phenomenology, analysis aims to describe and interpret the meaning of an experience, often by identifying essential subordinate and major themes. You search for common themes featuring within an interview and across interviews, sometimes involving the study participants or other experts in the analysis process. The outcome of a phenomenological study is a detailed description of themes that capture the essential meaning of a ‘lived’ experience.

Grounded theory generates a theory that explains how a basic social problem that emerged from the data is processed in a social setting. Grounded theory uses the ‘constant comparison’ method, which involves comparing elements that are present in one data source (e.g., an interview) with elements in another source, to identify commonalities. The steps in the analysis are known as open, axial and selective coding. Throughout the analysis, you document your ideas about the data in methodological and theoretical memos. The outcome of a grounded theory study is a theory.

Descriptive generic qualitative research is defined as research designed to produce a low inference description of a phenomenon [ 12 ]. Although Sandelowski maintains that all research involves interpretation, she has also suggested that qualitative description attempts to minimize inferences made in order to remain ‘closer’ to the original data [ 12 ]. Descriptive generic qualitative research often applies content analysis. Descriptive content analysis studies are not based on a specific qualitative tradition and are varied in their methods of analysis. The analysis of the content aims to identify themes, and patterns within and among these themes. An inductive content analysis [ 11 ] involves breaking down the data into smaller units, coding and naming the units according to the content they present, and grouping the coded material based on shared concepts. They can be represented by clustering in treelike diagrams. A deductive content analysis [ 11 ] uses a theory, theoretical framework or conceptual model to analyse the data by operationalizing them in a coding matrix. An inductive content analysis might use several techniques from grounded theory, such as open and axial coding and constant comparison. However, note that your findings are merely a summary of categories, not a grounded theory.

Analysis software can support you to manage your data, for example by helping to store, annotate and retrieve texts, to locate words, phrases and segments of data, to name and label, to sort and organize, to identify data units, to prepare diagrams and to extract quotes. Still, as a researcher you would do the analytical work by looking at what is in the data, and making decisions about assigning codes, and identifying categories, concepts and patterns. The computer assisted qualitative data analysis (CAQDAS) website provides support to make informed choices between analytical software and courses: http://www.surrey.ac.uk/sociology/research/researchcentres/caqdas/support/choosing . See Box 5 for further reading on qualitative analysis.

The next and final article in this series, Part 4, will focus on trustworthiness and publishing qualitative research [ 13 ].

Acknowledgements

The authors thank the following junior researchers who have been participating for the last few years in the so-called ‘Think tank on qualitative research’ project, a collaborative project between Zuyd University of Applied Sciences and Maastricht University, for their pertinent questions: Erica Baarends, Jerome van Dongen, Jolanda Friesen-Storms, Steffy Lenzen, Ankie Hoefnagels, Barbara Piskur, Claudia van Putten-Gamel, Wilma Savelberg, Steffy Stans, and Anita Stevens. The authors are grateful to Isabel van Helmond, Joyce Molenaar and Darcy Ummels for proofreading our manuscripts and providing valuable feedback from the ‘novice perspective’.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

• Open access
• Published: 24 April 2024

Disaster literacy in disaster emergency response: a national qualitative study among nurses

• Di Zhang 1 ,
• Li-Yan Zhang 1 , 2 ,
• Ke Zhang 3 ,
• Han Zhang 4 ,
• Huan-fang Zhang 5 &
• Kai Zhao 6  

BMC Nursing volume  23 , Article number:  267 ( 2024 ) Cite this article

Metrics details

As the largest group of healthcare professionals, nurses play an indispensable and crucial role in disaster response. The enhancement of nurses’ disaster literacy is imperative for effective disaster emergency management. However, there is currently a lack of knowledge regarding nurses’ disaster literacy. This study represents the first attempt to explore the key components and characteristics of disaster literacy among nurses.

A qualitative descriptive design was employed, and the reporting followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines (refer to File S1). The purposive sampling method was utilized. Thirty-one rescue nurses from 31 medical institutions across 25 provinces and regions in China were recruited to participate in the study. The respondents were requested to share their experiences and insights regarding disaster rescue operations. Inductive content analysis was employed for data examination.

The results indicated that rescue nurses universally recognized that there was a pressing need to enhance the level of disaster literacy among nurses. The disaster literacy of nurses encompasses nine dimensions: physical and mental quality, disaster rescue general knowledge, professional and technical competence, professional ethics, teamwork, emotional ability, information literacy, leadership, and knowledge transformation.

Conclusions

To ensure national sustainability, government departments, healthcare organizations, and hospital administrators can accurately evaluate the disaster literacy of individual clinical nurses, groups, and the workforce as a whole through nine dimensions, which also can provide evidence to support the development of precision strategies to strengthen the disaster literacy of nurses.

Peer Review reports

Disaster prevention has long been a priority of the international healthcare system [ 1 ]. Effective disaster risk management is intricately intertwined with the attainment of the Global Sustainable Development Goals [ 2 ]. In 2020, for instance, the unforeseen proliferation of COVID-19 impeded global endeavors to accomplish the Sustainable Development Goals worldwide [ 3 ]. Nevertheless, this pandemic has also engendered an unparalleled surge in media and public attention towards nursing [ 4 ], along with a global discourse regarding the pivotal role played by nursing professionals in national disaster response and public safety.

Nurses are the largest group of healthcare professionals globally and serve as the primary responders during disaster rescue operations [ 5 ]. Enhancing disaster literacy within this extensive group can significantly enhance treatment efficiency, an aspect that is often overlooked [ 6 ]. Disasters frequently occur unexpectedly, resulting in chaotic and intricate environments at rescue sites, which starkly contrasts with structured clinical settings comprising fixed clinical departments and medical staff. Consequently, experienced or trained nurses are indispensable for managing the complexities associated with such situations. The demanding treatment environment characterized by inadequate resources, scarcity of supplies and medications, urgent tasks, and psychological stress places heightened demands on nurses engaged in disaster rescue efforts. According to the State of the World’s Nursing Report 2020, advancing disaster nursing disciplines will play a pivotal role in shaping the future of global nursing [ 7 ]. Consequently, adapting traditional first aid structures, nursing skills, and theoretical frameworks to suit disaster scenarios has proven challenging.

Despite this, not every nurse is adequately prepared to confront these situations. Studies have confirmed that nurses’ knowledge, skills, and abilities in disaster emergency response are insufficient to deal with such circumstances [ 8 – 9 ]. Furthermore, it should be noted that the concepts of knowledge, skill, ability, and literacy are distinct and cannot be equated. In the context of disaster rescue operations, saving lives is a crucial ability, life first is the value of faith, and dedication is the necessary character. The disaster rescue scene serves as a litmus test for nurses’ emergency response capabilities, however, possessing the necessary ability does not necessarily imply having literacy in this domain. According to the Organisation for Economic Co-operation and Development (OECD), literacy encompasses not only knowledge and skills but also the capacity to utilize psychosocial resources effectively in complex situations [ 10 ]. Literacy possesses multiple dimensions, extending beyond the mere acquisition of knowledge or skills, with a greater emphasis on their practical application for problem-solving during critical incidents. Consequently, disaster literacy aims at enhancing nurses’ disaster nursing abilities by integrating and promoting their knowledge and skills, processes and methods, emotional attitudes, as well as values [ 11 ]. The development of disaster literacy proves advantageous for nurses when confronted with diverse emergencies that arise from local conditions within a disaster scenario.

However, there is currently a lack of global studies examining the conceptual connotation of disaster literacy in professional groups, specifically focusing on nurses. Furthermore, existing research indicates that nurses may be inadequately prepared to effectively respond to disasters [ 12 – 13 ]. Therefore, it is imperative to discuss the significance of disaster literacy among nurses and elucidate the characteristics that nurses should possess.

The qualitative and descriptive design was used in this study to determine the disaster literacy characteristics that nurses should have from the perspective of rescue nurses. The present study employed a qualitative and descriptive design to ascertain the disaster literacy characteristics that nurses should possess from the perspective of rescue nurses. Utilizing a qualitative descriptive design is considered the most effective approach for directly gathering information from survey participants [ 14 ]. Qualitative descriptive research aims to provide comprehensive accounts of experiences in authentic settings using straightforward language, thereby enabling detailed descriptions of otherwise unknown occurrences [ 15 ]. Consequently, employing a qualitative descriptive study design ensures that data analysis remains faithful to participants’ descriptions and facilitates transparency in researchers’ judgments.

To ensure the interviews remain focused on the topic, this study developed an interview outline based on the STAR tool [ 16 ]. The STAR method is a commonly employed technique by interviewees to effectively respond to behavioral interview questions. STAR stands for Situation, Task, Action, and Result. Through utilizing the STAR method, interviewees articulate their job-related scenarios eloquently, describe their responses comprehensively, and provide detailed outcomes when addressing behavior-based inquiries. Thus, the utilization of the STAR method guarantees that interviewees are capable of delivering concise and persuasive answers. The formal interview outline is finalized after thorough review and modification by experts in the qualitative research field within the project team as presented in Table  1 .

Setting and participants

The purposive sampling method was employed to recruit participants. The selection criteria for participants are as follows: (1) Licensed registered nurses from medical and healthcare institutions nationwide; (2) Participation in at least two out of the four major disaster types, including natural disasters (earthquakes, floods, snowstorms, etc.), accident disaster (mining accidents, traffic accidents, accidents at public facilities and equipment, etc.), public health events (SARS, Avian Influenza, New Crown Pneumonia Pandemic, etc.), and social security events (mass incidents, terrorist attacks, emergencies affecting market stability, particularly significant foreign-related incidents, etc.); (3) Willingness to be interviewed. Recruitment and selection encompass China’s seven administrative geographic regions. The exclusion criteria are as follows: (1) Involvement in fewer than two disaster rescue events; (2) Incomplete provision of personal and disaster relief information during formal interviews leading to unanalyzable data; (3) Insufficient interview time available for the participant.

Data collection

The recruitment notice was disseminated to all provincial disaster nursing professional committees through the Disaster Nursing Professional Committee of the Chinese Nursing Association in this study. Rescue nurses who met the inclusion criteria were contacted via email or phone as stated in the recruitment notice, and they provided us with their personal contact information. Before conducting pre-interviews and formal interviews, we communicated with each individual by phone or email and sent them an informed consent form, which they signed and returned to our research team. The qualitative descriptive design was employed to collect individual interview data from July to September 2021. Due to the influence of epidemic prevention and control measures during that period, telephone interviews were conducted for this study. Before the formal interviews, two participants were selected by the interview team for pre-interviews to identify and address any issues that may arise during the interviews, ensuring their effectiveness. The formal interviews commenced by adhering to the interview outline and requirements. The researchers meticulously recorded each interview, capturing nuances such as tone of voice, intonation, pauses, etc., and appropriately labeling them. Each interview was transcribed verbatim upon initial recording. The duration of these interviews ranged from 30 to 77 min with an average of 47 min.

Data analysis

This report adheres to the EQUATOR Guidelines for Research Reporting as well as the Comprehensive Criteria for Reporting Qualitative Research (COREQ), which comprises a set of 32 items suitable for individual interviews [ 17 ] (refer to File S1). In China, data collection and analysis were conducted concurrently. The data underwent six steps of inductive content analysis [ 18 ]. Each step was meticulously validated by the researchers to ensure the quality and credibility of the analysis [ 19 ]. Two researchers listened to the recordings several times, independently analyzed the texts, and subsequently engaged in discussions until reaching a consensus.

We employed the qualitative research methodology developed by Graneheim et al. to enhance the credibility, reliability, verifiability, transferability, and authenticity of our study [ 20 ]. During the recruitment phase, we established inclusion and exclusion criteria to identify participants with extensive experience in disaster rescue operations and their ability to effectively articulate those experiences. Considering that content analysis emphasizes variations in content, diversity, and differences across different types of disasters, we conducted purposive sampling to recruit participants from various regions across the country for interviews. To develop an interview outline, we sought guidance from esteemed experts in disaster response and qualitative research. Before the interviews, researchers underwent comprehensive training in systematic qualitative research and content analysis to acquire relevant knowledge and refine their interviewing skills. In order to fine-tune the interview questions during the process and establish a clear framework for the formal interviews, two pre-interviews were conducted by the interview team. Text analysis was performed independently by two researchers, followed by extensive discussions until a consensus was reached [ 21 ]. Moreover, this study employed a six-step method of qualitative content analysis for category analysis to ensure credibility and authenticity [ 18 ]. Original recordings, transcripts, and coding memos from all participants were retained for auditing purposes as well as cross-verification. Additionally, adherence to the Comprehensive Criteria (COREQ) outlined in the report’s inventory of qualitative studies was strictly observed [ 17 ].

Ethics approval and consent to participate

This study is part of a larger research project, and all phases of this study have received approval from the Medical Ethics Committee of Jiangsu University. All participants were provided with information regarding the purpose of the study, and both verbal and written informed consent was obtained after emphasizing that participation was entirely voluntary. Additionally, all participants were notified about the strict confidentiality measures in place for their interview data. They had the option to withdraw from the study at any time, with the assurance that their interview data would be deleted. Furthermore, all data has been anonymized and de-identified, with restricted access limited to researchers only.

A total of 33 disaster nurses were recruited for interviews in this study, but one could not be reached and one was interviewed for less than 30 min. Consequently, we obtained 31 valid interview materials. Nurse codes were assigned from N1 to N31, using the first letter of each nurse’s name as their code number. Descriptive information for each participant is provided in Table  2 . The average age of the interviewed nurses was (38.45 ± 6.51) years old, with an average RN experience of (16.77 ± 7.50) years. On average, they had participated in disaster rescues (2.87 ± 0.92) times and belonged to a category of disaster rescue with an average rating of (1.87 ± 0.56). The interviews lasted on average for (47.23 ± 12.63) minutes. The demographics are listed in Table  3 .

All interviewed disaster rescue nurses unanimously agreed on the critical importance of studying disaster literacy in nursing and emphasized that government departments and healthcare institutions should promptly enhance education and training programs for nurses, including nursing students, to effectively respond to various potential disasters. Additionally, data from interviews were analyzed and summarized to extract nine essential characteristics of disaster literacy that nurses should possess, as presented in Table  4 .

Physical and mental quality

Most participants concurred that nurses must possess physical fitness and stamina to effectively carry out high-intensity rescue work in extreme environments at disaster sites. Nearly all participants agreed that nurses should have the ability to self-regulate and manage their emotions during the process of disaster response. Additionally, all participants emphasized the significance of nurses promptly recognizing and intervening when a patient or injured individual is undergoing a psychological crisis.

If your physical condition is not optimal, you may become a liability to the team when going out to rescue people. (N31). He suffered a head injury during the earthquake, but as an infant, he was remarkably adorable with plump white cheeks resembling a small meatball… Later on, despite leaving that ward I never wanted to enter again, whenever I think of his chubby figure lying uncomfortably on the hospital bed, it reminds me of the profound psychological impact caused by this experience. (N2).

Disaster rescue general knowledge

The majority of participants emphasized the importance for nurses to possess a comprehensive understanding of the characteristics, nature, and specific circumstances associated with different types of disaster events. Additionally, they should be equipped with general knowledge to effectively safeguard their safety as well as that of others at the disaster site.

After undergoing nearly two months of intensive training, primarily focused on epidemic prevention, isolation protocols, disease nursing techniques, and cultural sensitivities in Africa, as well as language instruction, we must acquire a comprehensive understanding of the highly contagious nature of Ebola before we can effectively assist. (N25). The lack of preparedness was evident during our rescue mission, encompassing ourselves, the supplies we brought, and a significant portion of our management, personnel, and materials. This remains a regrettable oversight. (N20).

Professional and technical competence

The participants unanimously emphasized the importance for nurses to possess a comprehensive understanding of theoretical knowledge in the field of nursing, proficient skills in hospital emergency nursing procedures, and fundamental abilities in on-site rescue nursing before engaging in rescue operations. Additionally, they stressed the necessity for nurses to be well-versed in common pre-hospital emergency nursing knowledge.

…. Subsequently, her blood pressure and vital signs exhibited a decline, necessitating an accelerated administration of fluids while adjusting the patient’s position to manage shock. I am grateful for the invaluable experience gained during my rotation in anesthesiology, particularly in mastering intubation techniques… (N28). When transferring patients, our medical staff should possess not only exceptional professional skills but also a profound understanding of the characteristics of disaster rescue and potential accidents. (N30).

Professional ethics

The majority of participants emphasized the importance for nurses to possess political acumen and maintain strict confidentiality during rescue operations. Additionally, they highlighted the significance of professional dedication, subjective initiative, prioritizing life above all else, and a strong sense of responsibility. Moreover, nurses need to comprehend and apply the utilitarian principle in their ethical practice.

Considering the potential hazards present at disaster sites, it is imperative to foster a spirit of sacrifice. It is crucial to harness the selfless dedication instilled in us during our medical education. For instance, during a pandemic like COVID-19, one must be willing to make personal sacrifices for survival. (N3). The addition I propose is the cultivation of awe, a reverence for life, and unwavering faith. The fundamental purpose of studying medicine should remain unchanged - prioritizing the patient’s well-being and valuing human life above all else. This mindset is crucial as it embodies the spirit of selfless dedication. (N23).

The overwhelming majority of participants emphasized the paramount importance of nurses possessing a robust capacity for medical/nursing collaboration, as well as adeptness in multi-/cross-disciplinary or sectoral integration within rescue scenarios.

The second point is that in the event of an emergency, it is crucial to promptly assemble a highly proficient medical team. (N17). The field of rescue operations necessitates not only intra-unit collaboration but also inter-unit cooperation, thereby demanding specific interdisciplinary collaborative skills. (N24).

Emotional ability

The consensus among all participants was that nurses should possess the ability to effectively communicate with both disaster victims and rescue workers, particularly through perspective-taking and empathy. Furthermore, they should be capable of providing humanistic care during disaster rescue operations.

Communication with disaster victims is also crucial as it plays a vital role in alleviating their fears and facilitating their acceptance of treatment, thus promoting cooperation during the treatment process. (N25). Many patients are experiencing extreme fear and anxiety due to their lack of knowledge about the novel coronavirus, leading them to believe that mere contact with it will result in death. While some patients remain silent, others display visible signs of concern… It is crucial to address the emotional distress experienced by different patients and employ empathy as a means to alleviate their negative emotions. (N9).

Information literacy

The majority of participants emphasized the importance for nurses to possess updated knowledge of rescue resources, emergency plans, policies, and procedures. Additionally, they should be proficient in promptly communicating/reporting priority disaster-related information to superiors or designated personnel at the disaster site and efficiently implementing it. Moreover, fluency in multiple languages is essential for effective communication with both disaster victims and rescue workers. Furthermore, collaboration with disaster leadership teams to develop media information on disaster events is also crucial.

The initial step we took was to break through the English language barrier by identifying and familiarizing ourselves with frequently used sentences and keywords in our processing. Subsequently, we engaged in effective communication with their leaders and translators. (N13). Many departments will request information, including the municipal government, the Health and Construction Commission, the emergency office, and some leaders in charge. How should this information be saved? Who has access to this information? We’d been… I was completely perplexed when I arrived on the scene. (N4).

The majority of participants emphasized the necessity for nurses to possess the ability to contribute to the organization of disaster emergency plans or the development of on-site work processes, as well as demonstrate proficient organizational coordination and management skills while assisting in safeguarding vulnerable populations.

The individual should exhibit decisiveness, demonstrate effective leadership skills, possess contingency planning abilities, and discern between right and wrong actions while articulating the rationale behind choosing the correct course of action. (N9). I believe it is crucial to adopt a disaster management mindset.… There should be an enhancement in the thinking and capabilities related to managing sudden major incidents. (N19).

Knowledge transformation

The significance of nurses’ ability to effectively respond to disasters and integrate disaster information into decision-making was unanimously emphasized by all participants. Concurrently, disaster health education, training, and scientific research can be conducted both during and after the occurrence of a disaster.

As a disaster rescue worker, it is essential to possess adaptability in response to unforeseeable circumstances. This entails the ability to modify work procedures and status based on real-time changes. (N25). Unfortunately, we don’t have a lot of time to research the front lines, which is something that must be done. (N11).

The findings of this study revealed that all participants provided positive feedback regarding the implementation of the disaster literacy study for nurses, as evidenced by the analysis of interview results. They urgently call upon relevant authorities, such as government bodies or healthcare organizations, to prioritize disaster literacy education and training for nurses. Furthermore, through feedback analysis, nine essential characteristics of disaster literacy that nurses should possess have been identified. To our knowledge, this is the first study to establish a comprehensive definition of disaster literacy specifically tailored for nurses. Consequently, it proposed a specific connotation of nurses’ disaster literacy based on their practical rescue experience and significantly contributes to the theoretical development framework within the field of disaster response.

The STAR path was employed in this study to facilitate one-on-one interviews, addressing the time constraints faced by nurses and enabling them to gather data effectively. This approach aided in refining the interview format, guiding participants’ attention toward event details, and encouraging reflection on specific experiences of interest. Thus, interviewers were able to delve into theories and establish characteristic indicators during the interviewing process. As a result, it is recommended that this methodology be widely adopted in future qualitative research endeavors.

The findings of this study are consistent with previous research [ 6 , 22 , 23 , 24 ], which indicates that nurses should prioritize their attention on dimensions such as physical and mental well-being, professional and technical competence, teamwork skills, and emotional resilience in disaster literacy. The majority of the participants in this study reported experiencing chaotic conditions at the disaster scene, encountering challenging tasks, being in suboptimal physical condition, and often being unable to complete rescue missions. Certain natural disasters and accidents tend to occur in harsh environments or regions. Nurses working in high-stress environments must possess robust emotional intelligence, adaptability to dynamic situations, and strong collaborative skills for effective task completion during extreme circumstances. Participants generally agreed that nurses should be capable of psychological and emotional adjustment throughout the process of disaster rescue, while also providing psychological counseling and emotional support to both victims and rescue personnel. As a result, effective psychological first-aid training is critical [ 25 – 26 ]. According to a recent systematic review, cognitive behavioral therapy, psychoeducation, or meditation may assist nurses in overcoming their lack of emotional preparedness [ 27 ]. Furthermore, professional preparedness is essential for effective disaster response. Existing research, however, indicates that nurses are not fully prepared for a disaster emergency [ 28 ]. According to studies, themed game-based training is more effective than traditional scenario simulation and case teaching in improving nurses’ disaster response-ability [ 29 – 30 ]. As a result, managers should establish corresponding disaster training programs to enhance nurses’ disaster literacy.

Another significant finding of this study is that disaster rescue general knowledge, professional ethics, and information literacy are considered crucial dimensions of nurses’ disaster literacy. This aspect has been rarely reported in previous studies, thereby enhancing the development framework of disaster rescue disciplines. Because disaster events occur unexpectedly, nurses must respond effectively and quickly, so nurses must understand the various types and characteristics of disasters. Acquiring such rescue general knowledge will enable nurses to enhance their self-awareness regarding disasters and facilitate quicker and more efficient responses [ 31 ]. Participants in this study emphasized that nurses involved in disaster rescue should possess not only initiative and professionalism but also a profound professional conviction regarding the value of life and a genuine passion for nursing work. This ensures that nurses are willing to provide essential care during such catastrophic events. Moreover, it is crucial to address the severe global nurse shortage [ 32 ], inadequate nursing manpower, and inefficient disaster response systems [ 33 ]. Previous research has demonstrated that organizational support plays a pivotal role in enhancing nurses’ engagement and reinforcing their professional beliefs [ 34 ]. As a result, managers should utilize this data to enhance disaster management policies, increase nursing manpower, and encourage more nurses to volunteer for disaster rescue work. It is worth noting that some study participants mentioned that nurses should have important qualities such as timely follow-up on disaster information, timely reporting of priority information at the disaster site, and if permitted, joint development of media information with managers. Although rarely discussed, these aspects will be the focal point of future research on disaster nursing.

According to this study, enhancing leadership and knowledge transfer skills serves as a crucial indicator of nurses’ disaster literacy, which is reflected in organizational coordination, developing procedures or processes, safeguarding vulnerable groups, critical thinking, integrating information, health education, and scientific research. A disaster is defined as an occurrence that disrupts the normal functioning of a community and requires the utilization of external human and/or material resources for assistance [ 35 ]. Currently, the role of nurses in disaster rescue is not widely debated. Previous studies conducted by Chinese scholars have underscored that nurses’ involvement in disaster emergencies goes beyond being mere clinical nursing providers and encompasses crucial responsibilities such as coordination, problem-solving, and education [ 36 ]. This study confirms these findings. Disaster nursing significantly differs from clinical nursing as it necessitates nurses to handle a myriad of complex emergencies based on local circumstances. As a result, it is critical to strengthen the training of nurses’ transformational learning through daily disaster education and training, which will also be a focal point for future development in the field of disaster nursing discipline and the cultivation of nurses’ disaster literacy.

Limitations

The study was conducted within the same country. The qualitative approach could reflect the picture of disaster literacy from the Chinese context. However, it is important to note that certain in-depth information may only be applicable in specific contexts due to variations in the frequency and magnitude of different types of disasters. Furthermore, given that this study took place during the COVID-19 pandemic in China, caution should be exercised when generalizing the results across all phases of disasters.

This study identifies nine dimensions of disaster literacy that nurses should possess from the perspective of disaster rescue nurses. Including Physical and mental quality, Disaster rescue general knowledge, Professional and technical competence, Professional ethics, Teamwork, Emotional ability, Information literacy, Leadership, and Knowledge transformation. Disaster literacy research and practice among nurses must be promoted urgently by government agencies and medical institutions. Managers can utilize this feedback to enhance disaster management policies and provide continuous support for nursing professionals in their disaster response efforts through education, training, and effective management.

Data availability

The authors confirm that the data supporting the findings of this study are available within the article [and/or its supplementary materials]. All data included in this study are also available by contact with the corresponding author.

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Acknowledgements

We thank all the study participants and their healthcare organizations, and the experts of the Disaster Nursing Professional Committee of the Chinese Nursing Association for their academic support.

This study was supported by Humanity and Social Science Youth Foundation of Ministry of Education of China (21YJC840036), Chinese Association of Degree and Graduate Education Project (2020MSA101), Social Science Foundation Project of Jiangsu Province (23JYD011), 2023 Jiangsu Province Higher Education Teaching Reform Research Projects(2023JSJG257), General Program of Humanities and Social Sciences of Soochow University (23XM1004).

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ZD and ZLY designed the current study. ZD, ZK, and ZH collected and analyzed the data. ZD and ZHF wrote the first manuscript, and ZK revised the manuscript. All authors read and approved the final manuscript for submission.

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This study is part of a larger research project., and all phases of this study have received approval from the Medical Ethics Committee of Jiangsu University. All participants were informed of the study’s purpose, and both verbal and written informed consent was obtained after it was emphasized that participation was completely voluntary. Furthermore, all participants were informed that the interview data would be kept strictly confidential. They had the option to withdraw from the study at any time, with their interview data being promptly deleted. Furthermore, all data has been anonymized and de-identified, with exclusive access granted solely to researchers.

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Zhang, D., Zhang, LY., Zhang, K. et al. Disaster literacy in disaster emergency response: a national qualitative study among nurses. BMC Nurs 23 , 267 (2024). https://doi.org/10.1186/s12912-024-01911-2

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DOI : https://doi.org/10.1186/s12912-024-01911-2

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