F RAMEWORK OF R AD /N UC D ISASTER PSB R ESPONSE.
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Transcript of F RAMEWORK OF R AD /N UC D ISASTER PSB R ESPONSE.
● Conceptual elements:Structure of the framework: problems,
goals, and strategies
● Applications:Using the framework for different
populations and time frames
OVERVIEW OF RAD/NUC DISASTER PSB
RESPONSE FRAMEWORK
Presenting problems: what's happening?
Goals: what needs to be accomplished?
Practical strategies: how do you do it?- includes techniques & procedures
CONCEPTUAL ELEMENTS OF FRAMEWORK
● Target group: who?General public
Disaster workers
● Time frame: when?Crisis phase
Longer term
FRAMEWORK APPLICATIONS
Emotional, psychiatric, and behavioral responses
● Fear (eg, of exposure/contamination, of decon process)
● Emotional distress and grief
● Psychiatric illness – largely pre-existing
● Disorganized, disruptive, inappropriate, and harmful behaviors- eg, inappropriate evacuation when sheltering in place is safer
● Concerned treatment and information seekers can overwhelm medical and information providers (surge)
- eg, demand for medical assessment, potassium iodide
GENERAL PUBLIC / CRISIS PHASE
PSB PROBLEM THEMES
Social responses & attitudes● Rumors & misinformation● Distrust of authorities and institutions● Resistance to health authority measures
- eg, decon (eg, modesty/fear), antidotes
● Stigma 1987 Goiania, Brazil cesium-137 incident (medical equipment dismantled and
radioactive material shared around the community)- People avoided the area – tourist and trade industries tanked- Agricultural products would not sell- Hotels and some airline pilots refused to serve Goiania residents- Cars with Goiania license plates were stoned
GENERAL PUBLIC / CRISIS PHASE
PSB PROBLEM THEMES
General public (crisis phase)Presenting problem Goals Strategies
Fear Reduce fear, reassure Risk communication, PFA
Disorganized, disruptive, inappropriate, harmful behaviors Restore calm, keep people safe Risk communication, de-escalation, crowd
containment, redirection, conflict resolution
Surge of unexposed fearful people – overwhelming medical and information providers
Direct to appropriate medical care and information
Risk communication, crowd management, rapid assessment, triage
Rumors & misinformation Disseminate accurate and helpful information Risk communication
Distrust of and resistance to health authorities
Restore trust, persuade, achieve cooperation Risk communication
Emotional distress and grief Relieve distress PFA
Social stigma Change beliefs/attitudes Risk communication, public education
Psychiatric illness Provide acute care Rapid assessment, triage to crisis MH services
● Fear & apprehension- eg, of cancer, birth defects, long term health effects, mortality
● Emotional distress and grief
● Psychiatric illness – pre-existing and post-traumatic
● Misinformation & contamination stigma
● Social responses: spread of rumors & misinformation, distrust of authorities and institutions, anger and blame
● Responses to massive community & infrastructure disruption: helplessness, hopelessness, discouragement, demoralization, disillusionment, nihilism
GENERAL PUBLIC / LONGER TERM
PSB PROBLEM THEMES
General public (longer term)
Presenting problem Goals Strategies
Worry & apprehension Reduce worry, reassure Risk communication, PFA
Misinformation & contamination stigma Disseminate correct information, persuasion Risk communication
Emotional distress and grief Relieve distress PFA
Psychiatric illness TreatmentRebuild treatment infrastructures; ensure long term MH services; identify cases and connect to services
Community and infrastructure disruption, discouragement and demoralization Build community resilience
Public service announcements, commemorations, town hall meetings, social & faith-based community projects
● Fear for safety/wellbeing of self and family
● Distress, fatigue, "compassion fatigue," overwhelmed by suffering and destruction
● Interpersonal conflict among workers
● Disaster performance anxiety
● Unwillingness to report for duty or remain on post
● Neglect of self care
DISASTER WORKERS / CRISIS PHASE
PSB PROBLEM THEMES
Disaster workers (crisis phase)
Presenting problem Goals StrategiesFear for safety/wellbeing of self and family
Personal family assessment & decision-making
Information and problem-solving, personal pre-disaster planning
Distress, fatigue, "compassion fatigue," overwhelmed
Assess/address physical and emotional fatigue & distress
Self-awareness & care training; emotional and physical relief via Incident Command
Interpersonal conflict among workers Reduce conflict Incident Command, de-escalation, conflict resolution
Disaster performance anxiety Address performance anxiety Training, PFA
Unwillingness to report for duty or remain on post
Promote willingness to report for duty and remain
Deployment planning, training, risk communication, PFA, communication with family
Neglect of self care Assess/address own and coworkers’ needs for self care PFA self-care; relief via Incident Command