Nurses’ readiness for disaster response has assumed front and center-stage in recent years, due to the heightened number of natural and human-induced disasters across the globe. Scientific literature affirms that without nurses’ personal and professional readiness for disaster situations, patient and public health outcomes will likely decline. Three research manuscripts presented in this dissertation portfolio targeted this significant, but overlooked public health issue. First, a quantitative pilot study addressing nurses’ personal preparedness for disaster response was considered. Findings from the study not only justified personal readiness as a significant concept, but also prompted review of the scientific literature to further explore the effects of personal barriers to disaster response. While a variety of issues emerged for consideration, duty to care was identified as reoccurring concept still uncharted and unmeasured by nursing scholars. This resulted in a psychometric study describing the development, testing, and measurement qualities of the Nash Duty to Care Scale, the second manuscript in this portfolio. While the instrument was psychometrically sound, the study sample maintained limitations. Therefore, the third manuscript reexamined the concept of duty to care among nurses from the United States and Taiwan, while also considering the effects of cultural values on nurses’ perceived duty to care for disasters. Results from the 229 member sample demonstrated that while nurses’ cultural values were characteristic of their native traditions, general duty to care did not differ significantly between the two countries. Limited internal consistency reliability of the duty to care scale will require follow-up retesting and revisions.

Date of publication

Spring 4-24-2017

Document Type




Persistent identifier


Committee members

Danita Alfred, PhD, RN (Committee Chair); Susan Yarbrough, PhD, RN; Jenifer Chilton, PhD, RN; Jacqueline Owens, PhD, RN; Yu-Yun Alice Hsu, PhD, RN


Doctor of Philosophy in Nursing