Clinical Experiences of Registered Nurses and Healthcare Professionals on Disaster Preparedness, Response, and Delivery of Care During the Hajj Mass Gatherings in Saudi Arabia.

Abstract

Background: The Hajj pilgrimage is one of the largest annual mass gatherings in the world, drawing millions of pilgrims from diverse cultural and linguistic backgrounds. This event presents complex and unique challenges for healthcare systems, including the need to manage high patient volumes, prevent disease outbreaks, and respond to emergencies in overcrowded conditions. Ensuring effective healthcare delivery during the Hajj requires comprehensive disaster preparedness, culturally competent care, and robust interagency coordination. Healthcare professionals must be equipped to address both routine and critical care needs in a rapidly changing environment. A well-structured and collaborative healthcare strategy is essential to protect both pilgrims and healthcare professionals alike. Objective: This study aimed to explore the experiences and challenges faced by registered nurses and healthcare professionals during the Hajj mass gathering, with a focus on disaster preparedness, response, and healthcare delivery. Methods: A qualitative exploratory design was adopted in this research. Semi-structured interviews were conducted with 27 healthcare professionals, comprising ten registered nurses, six paramedics, six practical educators, and five physicians from the cities of Taif and Makkah in Saudi Arabia. All interviews were audio-recorded, transcribed verbatim, where necessary, and translated into English to ensure consistency and clarity. Data were then analysed using reflexive thematic analysis, allowing for the identification of core themes grounded in participants’ narratives. NVivo software was used to support the coding process and facilitate efficient data organisation and management. Ethical approval for this study was obtained from the Ministry of Health in Saudi Arabia and confirmed by Queen’s University Belfast. Findings: This study integrated evidence from a systematic literature review and primary qualitative interviews to provide a comprehensive understanding of disaster preparedness and response among healthcare professionals during the Hajj. The systematic review identified three main themes: (1) Disaster Preparedness, with sub-themes of Mass Gatherings and Hajj Disaster Preparedness, Disaster Preparedness in Non-Mass Gathering Contexts, and Awareness of Disaster Policies and Protocols; (2) Experiences and Challenges in Disaster Response, with the sub-theme Experiences and Challenges in Disaster Response; and (3) Educa on and Training, with sub-themes of Learning and Development Needs in Disaster Care and Content of Disaster xii Care in Nursing Curricula. These findings highlight the critical need for structured planning, policy awareness, and targeted training to support healthcare professionals in both mass-gathering and general disaster contexts. The qualitative interviews with registered nurses, paramedics, practice educators, and physicians complemented the systematic review by providing practical, Hajj-specific insights. Individual analyses of each participant group were synthesised to identify five overarching themes: Hajj preparedness, disaster management, patient care management, communication and coordination, and psychological and physical strains. Together, the systematic review and qualitative findings underscore the importance of technical expertise, emotional resilience, cultural sensitivity, interprofessional teamwork, advanced technologies, strong leadership, and collaborative systems to ensure effective disaster response and optimal patient outcomes during the Hajj. Conclusion: The findings offer an in-depth understanding of the operational and emotional demands on healthcare professionals during the Hajj. They suggest the need for enhanced training, mental health support, and systemic coordination to strengthen healthcare delivery during mass gatherings. These insights can inform policy and planning to improve preparedness and resilience in similar high-density settings.