Navigating Challenges and Building Resilience: Qualitative Insights into Disaster Nursing Preparedness in Chinese Non-First-Tier Cities.

Objectives: This qualitative study aimed to explore the lived experiences, challenges, and perceptions of nurses regarding disaster preparedness in non-first-tier (inland) cities in China. Building upon our previous quantitative findings, we sought to understand the psychological, professional, and organizational factors that influence nurses' disaster response capabilities in resource-limited settings.

Methods: A descriptive phenomenological approach was employed. Semistructured in-depth interviews were conducted with 12 nurses from four comprehensive hospitals at or above the second level in Yongcheng City, Henan Province, China, between September and December 2023. Participants were purposively selected based on their involvement in disaster response activities. Interviews were audio-recorded, transcribed verbatim, and analyzed using Colaizzi's 7-step method.

Results: Five major themes emerged from the analysis: (1) Psychological Stress and Emotional Adaptation, (2) Disaster Emergency Response Capacity and Management, (3) Communication and Collaboration, (4) Challenges in Disaster Nursing Capacity Development, and (5) Impact of Disaster Relief Participation. Key findings revealed that nurses experienced significant psychological pressure during disaster response, struggled with limited specialized training opportunities, faced challenges in team coordination, and identified institutional barriers to disaster preparedness enhancement. Despite these challenges, participants demonstrated strong professional commitment and developed personal coping strategies.

Conclusions: This study provides critical insights into the lived experiences of nurses during disaster response in Chinese non-first-tier cities. The findings highlight the need for systematic psychological support mechanisms, specialized disaster nursing training programs tailored to local contexts, enhanced interhospital collaboration networks, and stronger institutional commitment to disaster preparedness. These insights complement our previous quantitative findings and offer a comprehensive foundation for developing targeted interventions to enhance disaster nursing capabilities in resource-limited settings.