{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T10:16:14Z","timestamp":1785406574991,"version":"3.56.0"},"reference-count":28,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"unspecified","delay-in-days":201,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"funder":[{"DOI":"10.13039\/501100010298","name":"Yuumi Memorial Foundation for Home Health Care","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100010298","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Disaster med. public health prep."],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S1935789326103486_sec1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Floods are increasing with climate change, and evacuating medically vulnerable people receiving home healthcare remains challenging. Patients dependent on medical devices and long-term care face complex challenges throughout the evacuation process. However, key factors influencing successful evacuation and effective support strategies remain underexamined. This study aimed to identify such factors and essential support measures across evacuation phases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1935789326103486_sec2\" sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Semi-structured interviews were conducted with 13 participants\u2014family caregivers, healthcare providers, and municipal officials\u2014from July 2022 to March 2023 in 3 Japanese regions. Snowball sampling was used via medical administrative institutions. Thematic analysis followed COREQ guidelines, focusing on three phases: preparation, evacuation, and post-evacuation. Ethics approval was obtained (MG2022-01).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1935789326103486_sec3\" sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Preparation showed heterogeneous readiness: some services had hazard maps and manuals\/BCPs, whereas household engagement was limited and operationalization was constrained by resources. During evacuation, participants described transport and staffing limitations, difficulty in moving medical equipment, and uncertainty about feasible options, with occasional consideration of vertical evacuation. Post-evacuation challenges centered on shelter sanitation and supplies, continuity of medical support, and coordination of support systems.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1935789326103486_sec4\" sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A three-phase, multi-stakeholder perspective clarifies how constraints accumulate and informs coordinated planning among municipalities, home-care teams, and families. Limitations include a small, region-specific sample and no direct patient interviews.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/dmp.2026.10348","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T08:08:38Z","timestamp":1784621318000},"source":"Crossref","is-referenced-by-count":0,"title":["Evacuation Challenges for Home Medical Care Patients During Floods: A Three-Phase Qualitative Analysis"],"prefix":"10.1017","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3091-9910","authenticated-orcid":false,"given":"Hirotomo","family":"Miyatake","sequence":"first","affiliation":[{"name":"Yushoukai Medical Corporation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Kosaka","sequence":"additional","affiliation":[{"name":"Orange Home-Care Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhiro","family":"Kotera","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01ee9ar58","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Nottingham"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4415-9657","authenticated-orcid":false,"given":"Akihiko","family":"Ozaki","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/00njwz164","id-type":"ROR","asserted-by":"publisher"}],"name":"Jyoban Hospital of Tokiwa Foundation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Beniya","sequence":"additional","affiliation":[{"name":"Orange Home-Care Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,7,21]]},"reference":[{"key":"S1935789326103486_r10","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0199252"},{"key":"S1935789326103486_r11","unstructured":"11. Cabinet Office GoJ. Status of Disaster Management Measures in Japan Available: https:\/\/www.bousai.go.jp\/en\/documentation\/white_paper\/pdf\/2024\/03_Chapter1.pdf. Accessed February 22, 2026."},{"key":"S1935789326103486_r5","unstructured":"5. Zane, R , Biddinger, P , Hassol, A , et al. Hospital Evacuation Decision Guide. Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2010:1\u201355."},{"key":"S1935789326103486_r15","doi-asserted-by":"publisher","DOI":"10.1159\/000494971"},{"key":"S1935789326103486_r20","doi-asserted-by":"publisher","DOI":"10.1017\/S1049023X15000229"},{"key":"S1935789326103486_r24","doi-asserted-by":"publisher","DOI":"10.1016\/j.pdisas.2022.100218"},{"key":"S1935789326103486_r26","doi-asserted-by":"publisher","DOI":"10.1002\/ccr3.3727"},{"key":"S1935789326103486_r25","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijdrr.2024.104762"},{"key":"S1935789326103486_r6","first-page":"359","article-title":"Hospital evacuation assistance from public and private resources: Lessons learned from the 2018 Western Japan Floods","volume":"74","author":"Inaba","year":"2020","journal-title":"Acta Med Okayama."},{"key":"S1935789326103486_r23","doi-asserted-by":"publisher","DOI":"10.5055\/ajdm.2014.0180"},{"key":"S1935789326103486_r1","first-page":"55","article-title":"Beyond the hazard vulnerability analysis: Preparing health systems for climate change","volume":"104","author":"Baugh","year":"2021","journal-title":"R I Med J"},{"key":"S1935789326103486_r8","doi-asserted-by":"publisher","DOI":"10.20965\/jdr.2018.p0978"},{"key":"S1935789326103486_r7","doi-asserted-by":"publisher","DOI":"10.9734\/BJMMR\/2014\/5059"},{"key":"S1935789326103486_r2","doi-asserted-by":"publisher","DOI":"10.1007\/s11069-008-9227-5"},{"key":"S1935789326103486_r18","doi-asserted-by":"publisher","DOI":"10.1177\/1049732315617444"},{"key":"S1935789326103486_r17","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzm042"},{"key":"S1935789326103486_r19","doi-asserted-by":"publisher","DOI":"10.1191\/1478088706qp063oa"},{"key":"S1935789326103486_r27","doi-asserted-by":"publisher","DOI":"10.1017\/dmp.2021.99"},{"key":"S1935789326103486_r13","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph192215356"},{"key":"S1935789326103486_r28","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000039428"},{"key":"S1935789326103486_r9","unstructured":"9. Ministry of Land I, Transport and Tourism. Anti-inundation Measures for Medical Facilities Accepting Patients Who Need Special Care. Available: https:\/\/www.mlit.go.jp\/river\/bousai\/main\/saigai\/jouhou\/jieisuibou\/bousai-gensai-suibou02.html. Accessed March 5, 2026."},{"key":"S1935789326103486_r14","doi-asserted-by":"publisher","DOI":"10.1177\/1084822314567536"},{"key":"S1935789326103486_r21","unstructured":"21. Cabinet Office GoJ. White Paper on Disaster Management 2022 (English), Chapter\/Section on individual evacuation plans. Available: https:\/\/www.bousai.go.jp\/en\/documentation\/white_paper\/pdf\/2022\/SF3-1.pdf?utm_source=chatgpt.com. Accessed March 1, 2026."},{"key":"S1935789326103486_r12","doi-asserted-by":"publisher","DOI":"10.7189\/jogh.11.03108"},{"key":"S1935789326103486_r16","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00149111"},{"key":"S1935789326103486_r22","doi-asserted-by":"publisher","DOI":"10.9734\/BJMMR\/2014\/5059"},{"key":"S1935789326103486_r4","doi-asserted-by":"publisher","DOI":"10.1002\/emp2.12632"},{"key":"S1935789326103486_r3","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph16142466"}],"container-title":["Disaster Medicine and Public Health Preparedness"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1935789326103486","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T08:08:43Z","timestamp":1784621323000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1935789326103486\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":28,"alternative-id":["S1935789326103486"],"URL":"https:\/\/doi.org\/10.1017\/dmp.2026.10348","relation":{},"ISSN":["1935-7893","1938-744X"],"issn-type":[{"value":"1935-7893","type":"print"},{"value":"1938-744X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026]]},"article-number":"e85"}}