Backgrounds of public health nurses who encounter difficulties caused by cultural differences when providing maternal and child health services to foreign residents in a metropolitan area of Japan / 国際保健医療

Introduction   Recently, the number of foreign residents residing in Japan has increased. The purpose of this study was to describe the backgrounds of public health nurses (PHNs) who encounter the cultural differences and their resultant difficulties while providing maternal and child health (MCH) services to foreign residents in a metropolitan area of Japan.Methods   Questionnaires were administered to PHNs working at local health centers in a metropolitan area. Information about the backgrounds and working areas of the PHNs were extracted from descriptive statistics. The χ2- test, Fisher’s exact test, and the Mann-Whitney U test were conducted to analyze their experiences of and difficulties caused by cultural differences.Results   A total of 265 PHNs completed the survey (response rate: 17.7%), among whom, 246 (92.8%) responded that they had encountered difficulties due to cultural differences while providing MCH services to foreign residents, and 212 (80.0%) responded that they had faced difficulties caused by cultural differences in general. Significant differences were found in experiences of cultural differences, the length of each PHN’s professional career and his or her MCH activities, the presence of continual concerns from foreign residents, and the list of MCH activities that required English or another language, as well as the accurate interpretation of these languages. The size of the foreign residents population was a significant cause of difficulties resulting from different cultural experiences. Few PHNs were able to interpret languages effectively at any time (10.6%), and only 3.0% were able to implement the training provided by their center.Conclusions  PHNs who work in areas with a high proportion of foreign residents face significant difficulties. However, it is possible that all PHNs face difficulties irrespective of their language ability and overseas experiences.

Number of public health nurses and COVID-19 incidence rate by variant type: an ecological study of 47 prefectures in Japan

BACKGROUND@#Community health activities by public health nurses (PHNs) are known to improve lifestyle habits of local residents, and may encourage the practice of infectious disease prevention behaviors during the COVID-19 pandemic. We investigated the association between prefecture-level COVID-19 incidence rate and the number of PHNs per population in Japan, by the COVID-19 variant type.@*METHODS@#Our data were based on government surveys where prefectural-level data are accessible to the public. The outcome variable was the COVID-19 incidence rate (i.e., the cumulative number of COVID-19 cases per 100,000 population for each variant type in 47 prefectures). The explanatory variable was the number of PHNs per 100,000 population by prefecture. Covariates included socioeconomic factors, regional characteristics, healthcare resources, and health behaviors. The generalized estimating equations of the multivariable Poisson regression models were used to estimate adjusted incidence rate ratio (IRR) and 95% confidence interval (CI) for the COVID-19 cases. We performed stratified analyses by variant type (i.e., wild type, alpha variant, and delta variant).@*RESULTS@#A total of 1,705,224 confirmed COVID-19 cases (1351.6 per 100,000 population) in Japan were reported as of September 30, 2021. The number of PHNs per 100,000 population in Japan was 41.9. Multivariable Poisson regression models showed that a lower number of PHNs per population was associated with higher IRR of COVID-19. Among all COVID-19 cases, compared to the highest quintile group of the number of PHNs per population, the adjusted IRR of the lowest quintile group was consistently significant in the models adjusting for socioeconomic factors (IRR: 3.76, 95% CI: 2.55-5.54), regional characteristics (1.73, 1.28-2.34), healthcare resources (3.88, 2.45-6.16), and health behaviors (2.17, 1.39-3.37). These significant associations were unaffected by the variant type of COVID-19.@*CONCLUSION@#We found that the COVID-19 incidence rate was higher in prefectures with fewer PHNs per population, regardless of the COVID-19 variant type. By increasing the number of PHNs, it may be possible to contain the spread of COVID-19 in Japan and provide an effective human resource to combat emerging infectious diseases in the future.

Mediating Effects of Self-leadership in the Relationship between Public Health Nurses' Organizational Culture and Their Job Performance

PURPOSE: The purpose of this research is to enhance organizational competitiveness of health centers as well as private medical institutions serving as public health and medical institutions. It tries to help them to cope with the requirements from health consumers, to enhance public health nurses' job performance. METHODS: After verifying the reliability of the tool, confirmatory factor analysis was used to detect a model, in which valid path coefficients exist among variables. The detected model was then selected as the subject and its validity was verified. Finally, a structural equation model was applied to verify whether the estimate was suitable for the purpose of this research. RESULTS: As for the nursing organizational culture, the public health nurses considered relation-oriented culture the most desirable. As for the self-leadership, they considered self-compensation the most desirable. It was found that mediating effects of self-leadership was partially significant. CONCLUSION: To enhance job performance, it is necessary to make a transition from the organizational culture to the relation-oriented culture and it is also necessary to develop a program capable of reinforcing self-leadership. In addition, it is necessary to conduct a research to verify whether such a developed self-leadership program is influential on job performance enhancement.

The current situation and issues in the maternal and child health services provided by public health nurses to foreigners residing in Japan / 国際保健医療

<B>Introduction</B><BR>Compared to Japanese nationals, foreigners residing in Japan have a poor rate of maternal and child mortality and utilization of maternal and child health services. In this study, we examine the maternal and child health services provided by public health nurses to foreigners residing in Japan.<BR><B>Methods</B><BR>Questionnaires were administered to public health nurses working at local health centers in Aichi prefecture.<BR><B>Results</B><BR>Among the respondents, 4.5% were satisfied with the support system offered to foreigners residing in Japan, and 41.5% had offered their services to foreigners residing in Japan with various ideas. The following factors significantly affected satisfaction in public health nurses: acceptance by foreigners residing in Japan of the home of a newborn and maternal and child health check-ups (P=0.037, P=0.001, respectively), utilization of translators (P=0.002), and adopting a positive attitude towards providing health care services to foreigners residing in Japan (P=0.028).<BR><B>Conclusions</B><BR>Public health nurses in Japan are not satisfied with the health care services they offer foreigners residing in Japan. The results of this study suggest that it is important to provide them with multilingual materials and help them develop a positive attitude towards offering health care services to foreigners residing in Japan.

Concept Analysis of Health Promotion Competence in Public Health Nurses

PURPOSE: The purpose of this study was to define and clarify the concept of health promotion 'competence' in public health nurses (PHNs). METHODS: A hybrid model was used to develop the concept of competence. The model included a field study carried out in Seoul, Korea. The participants in this study were 20 PHNs who were working in the health promotion area. RESULTS: The concept of health promotion competence was found to be a complex phenomenon having a meaning in two dimensions: personal-relationship and environmental-relationship. Four attributes and eight indicators were defined. CONCLUSION: Health promotion competence was defined as the ability to have understanding and flexibility in practicing (personal-relationship dimension) and to have capacity for uniqueness and leadership in planning (environmental-relationship dimension). Therefore, PHNs who work in the health promotion area should be equipped with attributes and indicators of health promotion competence to enhance their competence in health promotion.

Public Health Nurses' Experiences of Public Health Services for the Aged / 성인간호학회지

PURPOSE: The purpose of this study was to describe public health services for the aged in public health centers from the perspective of public health nurses. METHODS: The interview data were collected from 11 public health nurses and analyzed by using Colazzi's (1978) descriptive phenomenology. The procedural steps was that described the phenomenon of interest, collected participants' descriptions of the phenomenon, extracted the meaning of significant statement, organized the meanings into theme clusters, wrote exhaustive descriptions and then incorporated data into an exhaustive description. RESULTS: The results included 291 re-statements, 49 constructed meanings, 27 themes, 12 theme clusters, and 5 categories were deduced. The five categories were 'perception of obstacles for elderly health system', 'sense of burden in services of health', 'planning about diverse elderly health services', 'elderly clients-focused performance', and 'solidify community ground of elderly health services'. Despite obstacles, participants tried to diverse health services for elderly. CONCLUSION: This study has described public health nurses' experiences about public health services for the aged. These findings have important implication for the practice of public health services for the aged and must be considered to develop program for planning and practice of public health nurses for the aged.

Analysis of Working Time of Nurses in Urban Public Health Center Branches in South Korea.: Focused on Nurses for Visiting Health Service and Chronic Disease Management

PURPOSE: The purpose of this study is to investigate working time of nurses in urban public health center branch, especially for nurses for visiting health service and chronic disease management. METHOD: Daily note, which was developed by this research team, was distributed to nurses at 7 urban public health center branches to be filled out them for 2 weeks during 2 month from June 2007 to August 2007. We analyzed 121 daily notes recorded by visiting nurses and 65 daily notes written by chronic disease management nurses were analyzed. RESULTS: The total working time for visiting nurses at urban public health center branches was 589.85 minutes per day on the average. They spent 147.13 min in actual visiting nursing services, 149.36 min in documenting, 66.94 in preparing, 77.69 min in transferring, and 11.84 min in referring. The total working time for chronic disease management nurses at urban public health center branches was 582.92 minutes per day on the average. They spent 148.77 min in actual chronic disease management services, 120.62 min in documenting, 42.46 min in group education, 37.38 in preparing, and 10.38 min in referring. CONCLUSION: Based on the results of this study, it is recommended to improve documenting systems and to increase community resources linkage were recommended through the results of this study. The results of this study are expected to be used to plan staffing at urban public health center branches in the future.

An examination of the Integrated Curriculum of nursing training schools / 医学教育

1) In Japan, an integrated curriculum for public health professionals and nurses was enacted in April 1997, as was as integrated curriculum for midwives and nurses. By April 2006, ten schools had been established to provide the former curriculum, but no schools had been established to provide the latter.<BR>2) In the integrated curriculum for midwives and nurses, there are few community health nursing units, and the very concept of the integration is problematic in that midwifery does not tend to involve illness or old age.<BR>3) The integrated curriculum seems to have been enacted without due thought as to its practicability. However, it may be desirable to use the system as a way to address the chronic shortage of midwives in Japan today.

Analysis of the Nursing Interventions Performed by Public Health Nurses in Health Centers Using the NIC / 간호학회지

PURPOSE: The purpose of this study was to identify nursing interventions performed by public health nurses in health centers. METHOD: Data was collected by the taxonomy of Nursing Intervention Classification (NIC 3rd: 486 nursing interventions) from 131 public health nurses in health centers and analyzed using descriptive statistics. RESULT: As its result, more than 50% of public health nurses performed 137 nursing interventions at least monthly. The most frequently used intervention class was 'activity and exercise management', followed by 'physical comfort promotion', 'community health promotion', 'life span care', 'coping assistance', 'Self care facilitation', 'information management', 'nutrition support', 'community risk management' and 'patient education'. One hundred twenty nursing interventions were rarely performed by 90% or more of the nurses. Most of them were the physical complex domain. CONCLUSION: In conclusion, 137 interventions were performed by public health nurses at least monthly. NIC is helpful to build a standardized language for public health nursing.

A Study on Developing Strategies for Expanding the Roles of Public Health Nurses / 간호학회지

PURPOSE: This study was to identify activities and related problems on health promotion of public health nurses, and to investigate basic data proposed to revise strategies of Health Promotion Nurse Specialists (HPNS). METHOD: The subjects of this study were 787 public health nurses sampled by clustering of the entire nation of Korea. Data were collected by focus group studies and cross-sectional survey during April to October of 1999. Results: 13.3% of public health nurses took responsibility for health promotion projects and 45.9% were involved in health promotion work with in home care or other routine activities. Also, the factors public health nurses perceived as barriers to implement activities for health promotion were time limitation, lack of ability for planning projects, insufficient time for specialties, inadequate understanding about health promotion project. CONCLUSION: According to the study, they need to have special education and further technical support. These results have important implications for the establishment for the role of Health Promotion Nurse Specialist. Also, in developing systems and curriculums for Health Promotion Nurse Specialist, the major factors described above need to be considered carefully.