Development and validation of the Humanitarian Aid Difficulty Scale for Japanese healthcare workers

Abstract

Few studies have investigated deployment-related experiences of healthcare workers dispatched for medical humanitarian aid or attempted to assess their difficult living and working environments. This is the first study to develop and validate a scale to measure these kinds of difficulties, in 264 Japanese healthcare workers. The Humanitarian Aid Difficulty Scale was developed in three stages. First, an item pool was generated based on literature and expert reviews. The scale was then tested in a pilot study. Reliability and validity were identified through exploratory and confirmatory factor analysis and Cronbach's alpha. The scale consisted of 23 items across five factors based on exploratory factor analysis (cooperation, health status, infrastructure, culture and customs, and supplies and equipment). The total variance explained was 60.7%. Reliability of the five factors was acceptable and validity was supported by confirmatory factor analysis. Cronbach's alpha for the scale was 0.87. The scale may enable evaluation of the level of difficulty of the living and working environments of Japanese healthcare workers in medical humanitarian aid who are at a greater risk of distress.

Deployment-related difficulties of Japanese disaster relief workers by mission duration: a cross-sectional study

“…The participants and methods used in this HADS study are described in detail in a separate article (Noguchi, Inoue, Shimanoe, & Shinchi, 2016b). In brief, this study implemented a cross-sectional design that involved completion of a self-administered questionnaire between August and December 2015.…”

“…However, it is notable that the Humanitarian Aid Difficulty Scale (HADS) has now been developed, allowing for easier assessment of dispatched disaster relief workers' feelings when performing on-site relief and reconstruction (Noguchi, Inoue, Shimanoe, & Shinchi, 2016b). In the HADS, "difficulty" is defined as the negative experience of healthcare workers, and the events or circumstances representing chronic irritations and pressures that occur with respect to disaster relief activities.…”

Difficulties faced by Korean disaster relief workers while providing humanitarian aid: A descriptive study

“…Higher scores indicate greater difficulties faced during deployment. The item reliability (Cronbach's α) of the original tool was .87 (Noguchi et al, ), and that of the Korean version used in the study was .92. For the factors, cooperation was .83, health status was .82, infrastructure was .82, culture and customs was .68, and supplies and equipment was .81.…”

“…The tool used to measure the difficulties experienced by KDRT members during their overseas deployment was based on the HADS (5 factors, 23 items), which was initially developed by Noguchi et al (). The factors include cooperation, consisting of five items (international agency, local arrangement, local organization, home country, team member); health status, consisting of six items (climate, sleep, meals, shape, appetite, accommodation); infrastructure, consisting of four items (sanitization, water, electricity, bathroom); culture and customs, consisting of four items (disease prevention, treatment options, hygiene, sense of time); and supplies and equipment, consisting of four items (troublesome, shortage, unfamiliarity, insufficiency).…”

“…In this regard, the International Federation of the Red Cross (IFRC, ) emphasizes the importance of the accountability of donor countries by a code of conduct during humanitarian aid, while also stating that the disaster‐affected country should eliminate any unnecessary red tape. While humanitarian aid includes volunteering based on humanitarian spirit, relief workers are frequently faced with the emotional burden and responsibility of having to achieve the task at hand in the context of cultural differences and an uneasy working environment (Noguchi, Inoue, Shimanoe, & Shinchi, ). Studies have reported that work‐related and non‐work‐related difficulties can be experienced by overseas emergency relief workers during their deployment and can cause stress (Brooks et al, ; Lee, Lee, Park, & Lee, ; Nilsson, Sjöberg, Kallenberg, & Larsson, ), which can contribute to challenges when returning to their normal work, and increase the risk of mental health issues (Cardozo et al, ; Eriksson et al, ; Stevens, Byrne, Raphael, & Ollerton, ).…”