Disasters and humanitarian crises pose significant public health challenges worldwide, with their frequency and intensity increasing over time. (1) The United Nations Office for Disaster Risk Reduction (UNDRR) defines a hazard as a “process, phenomenon, or human activity that may cause loss of life, injury, or other health impacts, property damage, social and economic disruption, or environmental degradation” (2) Hazards can be categorized into natural, anthropogenic, and socio-natural types, with the Sendai Framework for Disaster Risk Reduction 2015-2030 further specifying various categories: biological, environmental, geophysical, hydrometeorological, technological, and multi-hazard events. (3)

A disaster occurs when hazardous events interact with vulnerable communities, resulting in significant losses such as fatalities, economic damage, and social disruption. These events are often classified into slow-onset (e.g., epidemics) or sudden-onset (e.g., chemical explosions) disasters. (4)

The Coronavirus disease – 2019 (COVID-19) pandemic, which caused nearly 3 million deaths (5) and economic losses of $210 billion (6) in 2020, highlights the global scale of such crises. Disasters tend to disproportionately affect low- and middle-income countries (LMICs), where limited resources and healthcare system weaknesses exacerbate their impact. (7) For example, 91% of deaths from climate-related hazards occur in developing countries. (8)

Lebanon, situated in the Eastern Mediterranean Region (EMR), is a country that endured 16 years of civil war and ongoing political instability. (7) Moreover, it is still confronting a deepening humanitarian crisis driven by the overlapping impacts of several major challenges. The nation is experiencing a profound economic collapse, which was triggered by the political protests in October 2019 and the subsequent wave of nationwide unrest. (7) In addition to that, Lebanon faces increased vulnerability due to political instability, economic collapse, and the presence of over 1.5 million displaced Syrian refugees fleeing the war for almost 11 years, making it the country with the highest number of displaced Syrian refugees per capita and per Km2 in the world. (9)

The healthcare system in Lebanon, already under strain, was further overwhelmed by the COVID-19 pandemic. The ultimate blow that almost destroyed it, was the Port Explosion on August 4 2020 which heavily affected Beirut-located medical institutions, resulting in around 240 deaths, 6,500 injuries, and widespread displacement. (9) A year after the initial tragedy, a fuel tanker explosion in Akkar, northern Lebanon, claimed at least 33 lives. Survivors were sent to local hospitals and burn treatment centers in Beirut, as detailed in the Lebanon Crisis Response Plan. (9) In addition, ongoing economic crises have led to a mass exodus of healthcare professionals (HCPs), with nearly 40% of doctors and 30% of nurses leaving the country. (10)

Building on those points, it is crucial to strengthen disaster preparedness (11), particularly in healthcare systems, through multi-sectoral engagement and capacity building endorsed by the Sendai Framework for Disaster Risk Reduction 2015-2030 policy. (12) Although studies have explored HCPs Knowledge, Attitude, and readiness to Practice (KArP) facing disasters, (13–15) most of which were conducted in developed countries such as Europe, (16–18) Australia, (19–22) and North American countries (23–28)  there is limited research on HCPs in the Eastern Mediterranean. Particularly, very little is known about Lebanese HCPs KArP towards disasters and humanitarian crises response preparedness.

In addition, several studies following Severe Acute Respiratory Syndrome SARS (11), Ebolavirus Disease (Ebola) (29), and COVID-19 (30) outbreaks reported serious psychiatric symptoms like Post Traumatic Stress Disorder (PTSD), anxiety and depression in HCPs. Yet in EMR disaster-prone regions, such as Lebanon, mental health needs of HCPs facing disasters remains underexplored.

Aim of the Study

Given Lebanon's worsening financial, political, and social crises—exemplified by the Beirut port blast and Akkar explosion—the ongoing refugee burden, and strained healthcare systems during emergencies like COVID-19, Lebanese HCPs face extraordinary challenges. In light of that, this study aims to assess the KArP of Lebanese HCPs, including physicians, pharmacists, and nurses, regarding disaster and humanitarian crises, after validating relevant scales. As a secondary objective, this study evaluates the mental health status of these professionals following exposure to such events.

Study Design

A cross-sectional, survey-based study was conducted using a questionnaire to assess Lebanese HCPs’ KArP regarding disaster and humanitarian crisis management. This study employed a quantitative approach with predefined questions formatted in standardized questionnaires, providing access to both quantitative and qualitative information. The study was descriptive in nature, designed to document the current status of KArP among Lebanese HCPs facing such events.

Study Population

The targeted population consisted of Lebanese physicians, nurses, and pharmacists residing and practicing in Lebanon. No exclusion criteria were applied. The snowball sampling technique was used to recruit participants from all five governorates of Lebanon: Beirut, Beqaa, Mount Lebanon, South Lebanon, and North Lebanon.

Sample Size Calculation

The sample size was calculated using G-Power Software and the Epi-Info tool. Based on an effect size of f2 = 1%, an alpha error of 5%, and a power of 80%, the final sample size required was 380 participants.

Questionnaire Development and Distribution

The questionnaire was developed after an extensive review of the literature. A pre-validated questionnaire (14,31), was used to assess KArP (Additional file 1). The questionnaire was self-administered and available in both French and English to accommodate participants' preferences, with forward and back translations checked with two different translators. The questionnaire was distributed via an online Google Form. Data collection spanned three months, from May to July 2022. A pilot study was conducted beforehand, and minor adjustments were made based on participant feedback to ensure the survey's appropriateness. The final questionnaire consisted of five sections:

Section 1: Sociodemographic Data and General Questions

This section collected sociodemographic information including gender, age, profession, syndicate subscription, region of practice, and nature of workplace. It also contained questions about prior exposure to disasters and relevant disaster training participants had received in their careers.

Section 2 : Knowledge

This section assessed participants’ knowledge of disaster management with 22 closed-ended binary questions. After factor analysis, 15 items were included in the final knowledge score, which could range from 0 to 15. Scores were categorized into low, moderate, and high knowledge levels based on the 25th, 25-75th, and >75th percentiles, respectively.

Section 3 : Attitudes

This section included 17 Likert scale questions (strongly agree = 5, agree = 4, neither agree nor disagree = 3, disagree = 2, strongly disagree = 1). The maximum score was 85 points, and the minimum score was 17 points. Attitudes were categorized into low, moderate, and high levels using the 25th, 25-75th, and >75th percentiles.

Section 4 : Readiness to Practice

This section measured readiness to practice with 11 Likert scale questions (strongly agree = 5, agree = 4, neither agree nor disagree = 3, disagree = 2, strongly disagree = 1). Scores ranged from 11 to 55 points, and readiness levels were categorized similarly to knowledge and attitudes using the 25th, 25-75th, and >75th percentiles.

Section 5 : Mental Health Assessment

This section evaluated participants' mental health using a pre-validated scale : Screening Questionnaire for Disaster Mental Health (SQD) (32), which assesses depression or PTSD symptoms following disaster exposure. (Additional file 1)

Ethical Considerations

The study was not considered a medical experiment. It was approved by the Ethics and Scientific Research Committee of the Lebanese University (in November 2021). The first page of the questionnaire contained an informed consent form, which participants had to approve before proceeding. The form detailed the study’s purpose, the voluntary nature of participation, and a guarantee of confidentiality and secure data storage. The questionnaire was anonymous.

Data Analysis

Data analysis was carried out using SPSS version 26 (IBM Corp. Released 2018. IBM SPSS Statistics for Windows, Version 26.0. Armonk, NY, USA). To assess validity and reliability of the KArP scales, factor analyses, and internal consistency were used. The relevant factor analysis allowed for evaluation of the internal structure of the scales and the removal of unnecessary items, leading to the final number of items to be used in calculating the KArP scores. The internal consistency of the questionnaire and each sub-scale derived from the construct validity was tested using Cronbach’s alpha coefficient. This coefficient ranges from 0 to 1. Large Cronbach’s alpha values indicate a high consistency of the questions that the sub-scale consists of. The questionnaire’s reliability was also assessed by calculating the Intra-class Correlation Coefficient (ICC), which takes values between -1 and +1. The values proximate (+1) show high repeatability of the questionnaire. The results are shown as ICC (95% confidence interval [CI]) (Additional files 2,3,4).

Afterwards, descriptive statistics, including frequency (%) for categorical variables, were used, whereas the mean or median for continuous variables. The Kolmogorov-Smirnov test was applied to check the normality of the continuous variables. Then, a bivariate analysis was carried out for knowledge, attitudes, and readiness to practice scores as dependent variables with all other variables. If normality was not found, non-parametric tests (i.e., Kruskal-Wallis and Mann-Whitney) were applied. Pearson or Spearman correlation tests were also used to find the correlation between the three parameters (K, A, rP). Finally, multivariable linear regression models and a generalized linear model were performed to explore factors associated with the K,A,rP, scores as dependent variables and taking all variables that showed a p < 0.1 in the bivariate analysis as independent variables.

Sociodemographic and Other Characteristics of the Participants

The study included a total of 265 participants from across Lebanon, with a relatively even distribution of professions: 30.2% were medical doctors, 29.4% were nurses, and 34.7% were pharmacists. The results indicated that the mean age of participants was 35.8 ± 9.3 years, with an average work experience of 11.43 ± 8.3 years. The majority of participants were practicing in the capital, Beirut (43.4%), and in Mount Lebanon (31.7%). Most participants reported prior exposure to hazards (91.3%) and had received previous training in emergency and crisis preparedness, as well as humanitarian aid (95.1%). More than three-quarters of the participants (83.8%) expressed the need for mental health counseling following exposure to significant events such as the Beirut Blast, the Akkar Explosion, or the COVID pandemic. In terms of mental health assessments, nearly one-third (32.5%) of participants were found to be at an increased risk of depression, while more than half (57.4%) were assessed as moderately or severely affected based on their PTSD scores. The sociodemographic and other characteristics of the participants are summarized in Table 1.

Table 1. Sociodemographic and other characteristics of the participants

Descriptive of the KArP Scores

Knowledge Score

The results revealed that the mean knowledge score was 8.33 ± 3.3 (median = 8; minimum = 0; maximum = 15). When categorizing the scores into three groups, 93 participants (35.1%) had poor knowledge (score ≤6), 117 participants (44.2%) had moderate knowledge (scores between 7 and 11), and 55 participants (20.8%) had high knowledge (score of 12 or above), as shown in Figure 1.

Figure 1: Categories of Knowledge Score

In terms of percentage relative to the maximum possible score, the average knowledge score was low, with a value of 55.6/100.

Table 2 . below summarizes the respondents' knowledge perspectives. The views agreed upon by the  majority of respondents were: 1) Lebanon is at risk of disasters (natural or human-made) (95.8%);  2) disasters come in various forms (95.8%); 3) disaster medicine is inherently a systems-oriented specialty involving multiple responding agencies (90.6%); 4) and realistic on-scene training is crucial for an effective and efficient disaster medicine plan (87.5%). However, 84.2% of participants felt that there is insufficient support from local officials at the governance level, and 60.8% stated they were unfamiliar with the organizational logistics and roles of local and national agencies in disaster medicine response (e.g., decision-making and implementation). Additional perspectives are provided below in table 2.

Table 2. Knowledge assessment of the respondents regarding disaster medicine preparedness, N (%) a: Items included in the final Knowledge score scale after factor analysis. Each item counts for 1 point if answered “yes”.

Attitudes Score

The results indicated that the mean attitudes score was 64.75 ± 7.33 (median = 65.00; IQR = 23.50; minimum = 21.00, maximum = 85.00). When categorizing the scores into three groups, 66 participants (24.9%) had poor attitudes (score ≤ 53.00), 127 participants (47.9%) had moderate attitudes (scores between 54.00 and 76.00), and 72 participants (27.2%) had high attitudes (score of 77 or above) as shown in

Figure 2: Categories of Attitudes Score

In terms of percentage relative to the maximum possible score, the average attitudes score was considered good at 76.18/100. Table 3 below outlines respondents’ attitudes regarding preparedness for medicine-related disasters. The four most strongly agreed-upon viewpoints were: 1) 96.2% expressed interest in educational classes on medicine-related disaster preparedness tailored to the country’s situation; 2) 80.7% indicated willingness to be a future member of a healthcare response team in the event of a medicine-related disaster; 3) 95.4% acknowledged the need for more workshops and simulated training to enhance readiness for disaster medicine; and 4) 76.6% of healthcare professionals expressed confidence in their abilities as future healthcare providers and first responders in disaster medicine situations.

Table 3. Attitude assessment of the respondents regarding disaster medicine preparedness

^b: Items included in the final Attitudes score scale after factor analysis.

Readiness to Practice Score

The results revealed that the mean practice score was 39.86 ± 7.32 (median = 39; minimum = 25; maximum = 55). When categorizing the scores into three groups, 73 participants (27.5%) had poor practice (score ≤ 34), 123 participants (46.4%) had moderate practice (scores between 35 and 44), and 69 participants (26.0%) had high practice (score of 45 or above) as shown by Figure 3. .

Figure 3: Categories of Readiness to Practice Score

In terms of percentage relative to the maximum possible score, the average readiness to practice score was considered good at 72.5/100. Table 4 below outlines respondents’ practice perspectives. Among the three highest agreement standpoints were: 1) 92.4% expressed willingness to attend emergency medicine education as part of the continuous professional education program; 2) 90.1% acknowledged the need for more training on providing patient-centered care in disaster medicine situations; and 3) 85.7% recognized that preparing for disaster medicine requires significant effort and time.

Table 4. Readiness to practice assessment of the respondents regarding disaster medicine preparedness

c: Items included in the final readiness to Practice score scale after factor analysis.

KArP Scale Validity and Reliability

Construct Validity

The sample was deemed adequate for factor extraction. The knowledge sub-scale met the criteria for factor analysis, as indicated by a Kaiser-Meyer-Olkin (KMO) test result of 0.836 and a significant Bartlett test of sphericity (χ2 = 765.110, p < 0.001). Four potential factors were identified, explaining 51.502% of the variance, with all factor loadings exceeding 0.4. The factor loadings for each item are listed in Additional file 2.

Similarly, the attitudes sub-scale met the criteria for factor analysis, with KMO and Bartlett test results of 0.940 and χ2 = 3729.934 (p < 0.001), respectively. Two potential factors were identified, explaining 65.211% of the variance, with all factor loadings exceeding 0.5. The factor loadings for each item are listed in Additional file 3.

Regarding the readiness to practice sub-scale, the KMO and Bartlett test results (0.838 and χ2 = 1179.406, p < 0.000, respectively) confirmed that the data met the criteria for factor analysis.

Reliability - Internal Consistency

Cronbach's alpha measures indicated that the knowledge domain had a coefficient of 0.796, the attitude domain had a coefficient of 0.951, and the readiness to practice domain had a coefficient of 0.829. Additionally, the ICCs were also very good, indicating an appropriate stability of the questionnaire and sufficient reliability (Additional files 2,3,4).

Bivariate Analysis

Knowledge

The results of the bivariate analysis revealed significant differences in knowledge scores among participants as detailed in Table 5. Specifically, men scored higher than women (8.96 vs 7.94, p-value=0.016). Nurses also demonstrated higher knowledge scores compared to other profession categories (9.58, p<0.001). Additionally, age and work experience were positively correlated with knowledge scores (0.127, p=0.038; and 0.134, p=0.029). Participants with previous exposure to hazards and past training also showed significantly higher knowledge scores (8.63, p<0.001; and 8.56, p<0.001, respectively).

Attitudes

The analysis showed that males exhibited higher attitude scores than females (67.12 vs 63.22 p=0.031). Similarly, nurses scored higher than other profession categories as highlighted in Table 5 (69.37, p=0.001). Significant associations were found between higher attitude scores and age (0.173, p=0.005), work experience (0.217, p<0.001), past exposure to hazards (65.35, p=0.026), past training (65.22, p=0.049), and needing counsel (67.29, p<0.001). Furthermore, a strong positive correlation was observed between attitude and knowledge scores (r = 0.594, p<0.001).

Readiness to Practice

The bivariate analysis revealed significant differences in practice scores among participants. Specifically, males scored higher than females (41.56 vs 38.77 p=0.002), while nurses outperformed other profession categories (43.17, p<0.001) (see Table 5). Significant associations were also found between higher practice scores and age (0.203, p=0.001), work experience (0.230, p<0.001), needing counsel (40.85, p<0.001), past training(40.14, p=0.001), and past exposure to hazards(40.25, p=0.005). Furthermore, a strong positive correlation was observed between knowledge and practice scores (r = 0.585, p < 0.001), and between attitude and practice scores (r = 0.711, p < 0.001).

Table 5. Bivariate analysis of factors associated with the knowledge, attitudes, and practice scores

HCP: Healthcare professional          2PTSD: Post traumatic stress disorder                          **: Kruskal-Wallis test

†: Independent t-test                         §: ANOVA                                                        *: Pearson correlation coefficient

¥: Adjusted t-test                               ‡: Mann-Whitney test

Multivariable Analysis

The results of the multivariable analysis provided further insight into the factors influencing knowledge, attitudes, and practice scores.

Knowledge Score: A multiple linear regression model revealed that age (b=0.119), being a nurse (b=2.44) and having previous experience dealing with disasters (b=2.34) and past training (b=4.07) were significantly associated with higher knowledge scores. In contrast, female gender (b= - 1.38) was associated with lower knowledge scores (see Table 6, Model 1).

Attitudes Score: A generalized linear model showed that higher knowledge scores (b=2.19) and needing counsel (b=13.51) were significantly associated with higher attitudes scores (see Table 6, Model 2).

Practice Score: A multiple linear regression model revealed that age (b=0.20), higher knowledge scores (b=0.43), higher attitude scores (b=0.24), being a nurse (b=3.60) and having moderate PTSD (b=1.75), were significantly associated with higher practice scores (see Table 6, Model 3).

Table 6. Multivariable analysis

This study assessed the KArP of HCPs in Lebanon regarding disaster preparedness. The results showed suboptimal KArP levels, with half of the participants demonstrating moderate scores and one-quarter to one-third exhibiting poor levels. Knowledge scores were a significant predictor of both attitude scores and readiness to practice.

A large majority (95.8%) of participants believed Lebanon is at risk for both natural and human-made disasters, which aligns with findings from Yemen (33). The World Health Organization (WHO) stresses that HCPs play a key role in disaster response (34). They must be prepared to face various challenges (35), and their knowledge, attitudes, and practices regarding disaster response must be optimal. Communities expect healthcare workers to be available to provide care during catastrophic events. In such situations, healthcare workers may serve as responders, victims, or both. Therefore, their ability and willingness to work are critical (36).

However, in this study, 68.7% of participants reported that accessing relevant information on disaster medicine preparedness tailored to the country’s specific needs is a major obstacle to their level of preparedness. This figure is considerably higher than the 28.0% reported in Jordan—a country with a profile similar to Lebanon’s (37).

The findings of this paper revealed that the knowledge score, with a standardized mean of 55.60 out of 100, is relatively low—likely reflecting the limited availability of formal training programs. Indeed, emergency and disaster medicine programs remain scarce in Lebanon.

It was observed that nurses demonstrated significantly higher knowledge scores compared to other healthcare professionals—a result consistent with findings from Saudi Arabia (38), where knowledge levels among both physicians and nurses were found to be satisfactory. However, this result may be influenced by information bias.

Additionally, a positive association was found between higher knowledge scores and both age and work experience, a trend similarly reported in a study conducted in Iran (39).

Regarding attitudes, although the standardized mean attitude score was 76.18 out of 100—considered moderately good—96.2% of respondents expressed interest in attending educational courses on disaster preparedness specifically tailored to the country's context. Additionally, 95.4% indicated a need for more workshops and simulation-based training to adequately prepare for disaster medicine scenarios. These figures are significantly higher than those reported in Jordan (37) and Pakistan (13), highlighting a strong perception of existing gaps that must be addressed.

This research revealed that a more favorable attitude score was significantly associated with participants expressing a need for psychological counseling and mental health support. This finding underscores the psychological distress experienced by HCPs during disasters and catastrophic events, emphasizing the critical importance of prioritizing their mental health and well-being  (36,40–43)

The level of readiness to practice among the respondents was also moderate, with a standardized mean score of 72.50 out of 100. This result is consistent with findings from studies conducted in Saudi Arabia (38), Iran (39), Jordan (37), Malaysia (44), and Pakistan (13).

This analysis showed that past training, previous experience in managing disaster situations, and the need for psychological counseling were all significantly associated with higher readiness to practice scores. Additionally, both higher knowledge and more positive attitudes were significantly correlated with improved readiness to practice. These findings collectively reinforce the critical role of education and training in enhancing HCPs’ preparedness for disaster situations.

Finally, the study was able to identify key predictors of KArP scores. Higher knowledge scores were significantly associated with being a nurse, having received prior training, and possessing previous experience in managing disasters. Similarly, higher attitude scores were influenced by greater knowledge levels and the expressed need for psychological counseling. Lastly, readiness to practice was positively associated with higher knowledge and attitude scores, as well as with being a nurse. The correlations among KArP were also observed in comparable studies involving students in Pakistan (13) and Qatar (40), highlighting the importance of fostering positive attitudes and strengthening competencies to enhance effective response readiness during disasters.

Another focus of this research was the impact of disasters and humanitarian crises on the mental health of healthcare workers. Since the onset of the COVID-19 pandemic, numerous studies have examined its mental health implications (20).  While earlier studies primarily focused on the mental health of the general population, the pandemic highlighted the crucial role of the medical sector in disaster management. Natural disasters, pandemics, and their aftermath create periods of intense distress for medical doctors, nurses, and frontline workers. These professionals are expected to deliver care to patients affected by such events while simultaneously managing their own internal struggles, fears, and stress. This situation often results in significant psychological and physical strain that exceeds the demands of their formal training and education.

The findings of this study indicated that one-third (32.5%) of HCPs were more likely to experience depression, and over half (57.4%) were found to be moderately or severely affected by PTSD. These results are consistent with numerous studies worldwide examining the mental well-being of HCPs. During the severe SARS outbreak, 20% of healthcare workers exhibited stress-related reactions (45). Similarly, surveys conducted on disaster workers 2 to 3 weeks after the 9/11 tragedy revealed that 15% had acute stress disorder, and 26% had probable depression (46). PTSD is the most common long-term consequence of disaster exposure among first responders and HCPs. First responders continued to experience PTSD 13 months after the 9/11 disaster (47) and 24.2% of the Turkish Red Crescent Disaster Relief Team experienced PTSD one month after assisting with the Asian tsunami (48).

The COVID-19 pandemic has notably affected the mental health of HCPs, leading to increased rates of anxiety, burnout, stress, and PTSD (49–51). In Lebanon, the combination of the Beirut port explosion, the COVID-19 pandemic, and the economic collapse created an exceptionally stressful environment for HCPs, contributing to burnout, diminished job performance, and compromised patient safety (52,53). PTSD in affected personnel can also impair readiness to practice, as demonstrated in this study (p = 0.017). This may be attributed to fears of performing poorly and risking patient health.

An important and often overlooked concept to consider, especially in the aftermath of global healthcare system strains, is moral injury. It is defined as "morally injurious events, such as perpetrating, failing to prevent, or bearing witness to acts that transgress deeply held moral beliefs and expectations" (54). This is particularly mentally taxing for HCPs who have witnessed patients in life-or-death situations and were unable to assist, or who were required to allocate limited resources to maximize patient outcomes (55). Moral injury can arise when HCPs, bound by their oath to "do no harm," are forced to prioritize patients with the highest chance of survival rather than treat every patient equally, as their oath demands (56). This often leads to statements such as, "We did our best with the staff and resources available, but it wasn’t enough," which reflect the root of moral injury (57). Given the toll of the COVID-19 pandemic and the traumatic events like the Beirut port blast and the Akkar fuel tank explosion, the moral injury suffered by the Lebanese healthcare sector is likely profound. Further research is needed to assess the long-term psychological effects of these experiences on healthcare workers.

While this study provides important insights, there are several limitations. The small sample size may introduce selection bias, as participants were impacted by the challenging conditions in Lebanon, including the increasing emigration of healthcare professionals. Additionally, self-reported data may lead to information bias, and residual confounding factors could have influenced the results. The unique cultural, environmental, and educational context of Lebanon also limits the generalizability of the findings to other LMICs.

Nonetheless this research sheds the light on the importance of integrating training into university curricula and continuous education programs, focusing on both theoretical and practical aspects, including operational simulations and the availability of essential medicines during emergencies (38,39,44). Mental health support, including strategies like mindfulness and accessible behavioral health resources, is essential for managing stress during crises (58,59). Addressing moral injury through programs like Pastoral Narrative Disclosure can also help HCPs cope with trauma and restore their sense of purpose (60).

In conclusion, this study revealed that HCPs in Lebanon exhibit suboptimal levels of KArP regarding disasters and humanitarian crises. A clear need for enhanced educational resources and ongoing training in disaster preparedness was identified. Additionally, there is a significant lack of awareness regarding the Lebanese health system’s emergency response plans. Knowledge was found to be a key predictor of attitudes, with both knowledge and attitudes strongly influencing readiness to practice. medical institutions, educators, and policymakers are called to develop comprehensive curricula in disaster medicine management to better prepare future HCPs. Furthermore, the study highlighted the importance of addressing HCPs’ mental health. These findings call for further research with larger sample sizes, particularly in a country facing financial hardships, where healthcare workers continue to endure significant challenges while striving to uphold their mission of protecting public health and human dignity.

5. Conclusion

In conclusion, this study revealed that HCPs in Lebanon exhibit suboptimal levels of KArP regarding disasters and humanitarian crises. A clear need for enhanced educational resources and ongoing training in disaster preparedness was identified. Additionally, there is a significant lack of awareness regarding the Lebanese health system’s emergency response plans. Knowledge was found to be a key predictor of attitudes, with both knowledge and attitudes strongly influencing readiness to practice. medical institutions, educators, and policymakers are called to develop comprehensive curricula in disaster medicine management to better prepare future HCPs. Furthermore, the study highlighted the importance of addressing HCPs’ mental health. These findings call for further research with larger sample sizes, particularly in a country facing financial hardships, where healthcare workers continue to endure significant challenges while striving to uphold their mission of protecting public health and human dignity.

List of Abbreviations

ACLS: Advanced Cardiac Life Support

A: Attitude

BLS: Basic Life Support

CI: Confidence Interval

COVID-19: Coronavirus disease - 2019

Ebola: Ebolavirus Disease

EMR: Eastern Mediterranean Region

HCP: HealthCare Professionals

IBM: International Business Machines Corporation

ICC: IntraClass Correlation

IQR: InterQuartile Range

K: Knowledge

KMO: Kaiser-Meyer-Olkin

LMIC: Low- Middle-Income Countries

NY: New York

rP: readiness to Practice

PTSD: Post Traumatic Stress Disease

SARS: Severe Acute Respiratory Syndrome

SPSS: Statistical Product and Service Solutions

SQD: Screening Questionnaire for Disaster Mental Health

UNDRR: United Nations Office for Disaster Risk Reduction

USA: United States of America

WHO: World Health Organisation

Declarations

• Ethics approval and consent to participate
• The study was not considered a medical experiment. It was approved by the Ethics and Scientific Research Committee of the Lebanese University. The first page of the questionnaire contained an informed consent form, which participants had to approve before proceeding. The form detailed the study’s purpose, the voluntary nature of participation, and a guarantee of confidentiality and secure data storage. The questionnaire was anonymous.
• Consent for publication
• Not applicable.
• Availability of data and materials
• The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.
• Competing interests
• The authors declare that they have no competing interests.
• Funding
• This research received no specific grant or funding.
• Authors’ contributions
• All authors contributed to the design of the study. MH and MH collected the data, conducted the full statistical analysis, and drafted the article. PS reviewed the final article. All authors approved the final manuscript.
• Acknowledgments

Not applicable.

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