# Fundamentals of Care in a 1997 Azorean Disaster: A Multiple-Case Study

## TL;DR

This study explores nursing care during a 1997 disaster in the Azores, highlighting how care evolved from physiological to psychosocial needs over time.

## Contribution

The study provides empirical evidence of nursing interventions during disaster response and recovery phases, emphasizing person-centred care.

## Key findings

- Nursing interventions initially focused on physiological needs during the acute phase of the disaster.
- Care later expanded to include psychosocial support and patient autonomy during prolonged hospitalizations.
- The study emphasizes the integration of technical skills with relational care in disaster nursing.

## Abstract

Background/Objectives: Disasters have a substantial impact on health systems and populations worldwide, with increasing frequency, mortality, and economic losses associated with natural hazards. The United Nations emphasises that disasters result from the interaction between hazards, exposure, and vulnerability, requiring integrated, people-centred health responses aligned with the 2030 Agenda. However, empirical evidence describing specific nursing interventions, particularly during response and recovery phases, is limited. This study aims to analyse the fundamental nursing care interventions provided to disaster victims in the Autonomous Region of Azores, Portugal. Methods: A qualitative multiple case study was conducted using documentary analysis of the nursing records from two disaster survivors with different clinical trajectories. Data were collected between August 2023 and May 2024 through complete transcription of nursing documentation contained in the clinical files. Data analysis followed Yin’s case study methodology and was theoretically supported by the Fundamentals of Care Framework. Results: The findings indicated a predominance of interventions addressing physiological needs during the acute phase, which progressively evolved to maintenance, psychosocial support, and adaptation needs during prolonged hospitalizations. Nursing care integrates advanced technical skills with relational and person-centred interventions, including emotional support, therapeutic communication, and promotion of patient autonomy. Conclusions: Nursing practice in disaster situations should be conceptualised as integrative, person-centred care grounded in international nursing frameworks. Strengthening disaster-specific nursing education, developing phase-adapted care protocols, and promoting multicentre longitudinal research appear to play a critical role for advancing nursing care models and informing health policies in disaster-prone regions.