Terrorist attacks are one of the human problems that affect many countries, leaving behind a huge toll of disabilities and deaths. The aim of this study was to use a mixed-method analysis to design and validate an evaluation tool for pre-hospital emergency medical services for terrorist attacks. The present study is a mixed-method (qualitative and quantitative) study that was conducted in two phases. In the qualitative phase (item generation), semi-structured interviews were conducted with 34 Iranian emergency medical technicians who were selected through a purposive sampling method and a scoping literature review was conducted to generate an item pool for the preparedness evaluation of Emergency Medical Services (EMS) in terrorist attacks. In the quantitative phase (item reduction), for validity of tool face, content and construct validity, were performed; for tool reliability, the test and retest and intra-class correlation coefficient were evaluated. At the first stage, 7 main categories and 16 subcategories were extracted from the data, the main categories including “Policy and Planning”, “Education and Exercise “,“ Surge Capacity”, “Safety and Security”, “Command, Control and Coordination”, “Information and Communication Management “and “Response Operations Management”. The initial item pool included 160 items that were reduced to 110 after assessment of validity (face, content and construct). intra-class correlation coefficient (ICC = 0.71) examination and Pearson correlation test (r = 0.81) indicated that the tool was also reliable. The research findings provide a new perspective to understand the preparedness of pre-hospital emergency medical services for terrorist attacks. The existing 110-item tool can evaluate preparedness of pre-hospital emergency medical services for terrorist attacks through collecting data with appropriate validity and reliability.

中文翻译：

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恐怖袭击院前急救医疗服务准备评估工具的设计与验证：混合方法研究

恐怖袭击是影响许多国家的人类问题之一，造成了巨大的残疾和死亡人数。本研究的目的是使用混合方法分析来设计和验证针对恐怖袭击的院前紧急医疗服务的评估工具。本研究是一项混合方法（定性和定量）研究，分两个阶段进行。在定性阶段（项目生成），对通过有目的抽样方法选择的 34 名伊朗紧急医疗技术人员进行了半结构化访谈，并进行了范围界定的文献审查，以生成用于紧急医疗服务准备情况评估的项目池（ EMS）在恐怖袭击中。在量化阶段（项目减少），对于工具面效度、内容效度和结构效度，进行了；对于工具可靠性，评估了测试和再测试以及类内相关系数。第一阶段从数据中提取出7个大类和16个小类，主要类别包括“政策与规划”、“教育与演习”、“应急能力”、“安全与安保”、“指挥、控制与协调” ”、“信息和通信管理”和“响应操作管理”。最初的项目池包括 160 个项目，在评估有效性（面部、内容和结构）后减少到 110 个。类内相关系数 (ICC = 0.71) 检查和 Pearson 相关性检验 (r = 0.81) 表明该工具也是可靠的。研究结果为了解院前紧急医疗服务对恐怖袭击的准备情况提供了新的视角。