Chronic Illness and Disasters: Development of a Theoretical Framework

In a disaster, individuals with chronic illnesses risk poor outcomes. This grounded theory study sought to develop a framework that describes how these individuals manage health-related challenges during disasters. The five phases of disaster response (non-disaster, pre-disaster, impact, emergency, reconstruction) and the individual, local, state, and federal level model served as conceptual frameworks. Using purposive sampling, 30 individuals with chronic illnesses and 10 lay caregivers were recruited from Florida and New Orleans. Data sources included interviews and media data. Constant comparative analysis techniques were used to build the theoretical framework. Transcript analysis suggested that participants used four unique ways to shift priorities from illness to disaster-related challenges. Each way related to media impact, evacuation, preparation, attention, and recovery. If evacuated over a week, many could address some health-related concerns from afar. Those remaining home were more apt to ignore health-related concerns to deal with home and family issues