Validity of a Questionnaire Assessing Preparedness and Self-Reported Confidence of Lebanese Emergency Department Personnel in Managing Ophthalmic Emergencies and Mass Ocular Trauma.

Abstract

Background: Ophthalmic emergencies constitute a significant portion of emergency department (ED) visits; yet, many non-ophthalmologists report feeling underprepared for their management. In Lebanon, mass-casualty events like the 2020 Beirut Port Blast have further highlighted the critical need for structured assessment of personnel preparedness in managing ocular trauma. This study aimed to evaluate the validity and reliability of a novel questionnaire designed to measure the self-reported preparedness and confidence of ED personnel and first responders in managing acute ocular emergencies.

Methods: A cross-sectional validation study was conducted among 431 Lebanese ED healthcare providers and first-line responders, primarily paramedics (69.6%). The 10-item Likert scale instrument underwent expert review for content validity. Psychometric evaluation included internal consistency reliability (Cronbach's α and McDonald's ω) and construct validity via exploratory factor analysis (EFA).

Results: The instrument demonstrated high internal consistency (Cronbach's α = 0.922; McDonald's = 0.924) and strong sampling adequacy (KMO = 0.910). EFA supported a clinically interpretable two-factor structure: "Trauma-Specific Stabilization and Escalation Confidence" and "General Emergency Preparedness in Ophthalmology". Participants reported the lowest confidence in medication indications (mean = 2.53) and training adequacy (mean = 2.62).

Conclusion: The questionnaire is a valid and reliable tool for assessing self-reported preparedness in ophthalmic emergency management. It can serve as a standardized benchmarking instrument to identify educational gaps and guide training interventions in high-throughput, resource-constrained acute care settings.