Depression and anxiety symptoms among Vietnamese migrants in Japan during the COVID-19 pandemic.

This study aimed to examine the mental health status and related factors among Vietnamese migrants in Japan during the COVID-19 pandemic. We conducted an online cross-sectional survey between September 21 and October 21, 2021. Along with Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder 7-item (GAD-7) scores, we collected data on demographics, changes in socioeconomic status due to the pandemic, language proficiency, social support, and health conditions. Multivariate logistic regression was performed to identify factors related to symptoms of depression and anxiety. Among 621 participants who completed the questionnaire, moderate-to-severe symptoms of depression (PHQ-9 score ≥ 10 points) and mild-to-severe symptoms of anxiety (GAD-7 score ≥ 5 points) were observed in 203 (32.7%) and 285 (45.9%) individuals, respectively. Factors related to depressive symptoms were age (95% confidence interval [CI]=0.89-0.99), pre-existing health conditions (95% [CI]=1.61-3.76), and a low subjective socioeconomic status (95% [CI]=1.64-3.71). Factors related to anxiety symptoms were being single (95% [CI]=1.01-2.93), having pre-existing health conditions (95% [CI]=1.63-3.88), subjective socioeconomic status (95% [CI]=1.87-3.97), and absence of a partner to discuss one's health with (95% [CI]=1.11-2.47). Vietnamese migrants in Japan experienced a decrease in income, worsening working conditions, and poor mental health status during the COVID-19 pandemic. Further investigations are necessary to find an effective way to increase their social support and mitigate socioeconomic adversities.

Developing a Theory of Community Caring for Public Health Nursing.

Nursing theories focus on individual and community care and human relationships in unique contexts. One of these contexts is the community in which a theory-based systematic nursing practice process is warranted. This article describes a theory of Community Caring for Public Health Nursing (CCPHN), which is grounded in four nursing metaparadigms by Fawcett: persons, environment, health, and nursing. This theory has three assumptions: (1) community caring fosters care demonstrations in nursing, (2) caring communities comprise members with community attachments united by their common values rather than rigid customs, and (3) community caring is expressed competently in mutual-care practices. From these assumptions, a nursing perspective supporting the community caring process is exhibited as the expression of caring by public health nurses toward supportive and promotive nursing processes that enhance a caring community. Nurses play critical roles in leading the establishment of caring communities. In future research, it is critical to verify whether building a caring community by public health nursing practices based on this theory of CCPHN contributes to the health and well-being of the people in the community.

A cross-sectional survey of material deprivation and suicide-related ideation among Vietnamese technical interns in Japan.

Background: The economic struggles faced by many technical intern trainees in Japan include the necessity to remit money to their home country, debts owed to intermediaries facilitating their arrival, and reduced working hours due to the COVID-19 pandemic. Furthermore, there is concern that the pandemic may contribute to mental instability resulting from the significant life changes experienced by the trainees. This study examined the experience of material deprivation among Vietnamese intern trainees in Japan and explored the correlation between material deprivation and suicidal ideation. Methods: A cross-sectional study was conducted between September and October 2021, involving 310 Vietnamese technical intern trainees. Data from 200 participants were analyzed. The questionnaire included gender, age, duration of residence in Japan, proficiency in the Japanese language, income changes due to the COVID-19 pandemic, material deprivation status, and suicidal ideation. Suicidal ideation was assessed using the ninth item of the Patient Health Questionnaire-9. Logistic regression analysis was performed to investigate the relationship between material deprivation items and suicidal ideation. Results: The mean age of the respondents was 26.0 ± 5.1 years, with 62.0% (n = 124) being male. Among the material deprivation items, 74.0% (n = 148) reported food deprivation, 59.0% (n = 118) reported cellphone bill deprivation, and 55.0% (n = 110) reported medical expense deprivation. Suicidal ideation was reported by 23.0% (n = 46) of the respondents. The prevalence of suicidal ideation was associated with age (p = 0.031, odds ratio [OR] = 0.889, 95% confidence interval [CI] = 0.799-0.990), deprivation of food expenses (p = 0.003, OR = 3.897, 95% CI = 1.597-9.511), and deprivation of cellphone usage (p = 0.021, OR = 3.671, 95% CI = 1.217-11.075). Conclusion: Vietnamese technical intern trainees in Japan faced various forms of material deprivation, which correlated with a high prevalence of significant psychological issues. Suicidal ideation was influenced by factors such as age, deprivation of food expenses, and inability to pay cellphone bills. The experience of material deprivation could have intensified the mental health challenges faced by Vietnamese trainees, particularly in the demanding circumstances of the COVID-19 pandemic.

Dietary Intake Quality Is Affected by Knowledge and Dietary Intake Frequency among Pregnant Women in Muntinlupa, Philippines: A Cross-Sectional Study.

Improving the nutrition of pregnant women is essential in reducing maternal and child mortality, which is one of the global nutritional goals of 2025. This study evaluated the factors related to the quality of dietary intake among pregnant women in Muntinlupa, Philippines. We conducted a cross-sectional study of 280 pregnant women at a hospital in Muntinlupa from March 2019 to August 2019 using questionnaires. After the primary aggregation, multivariate logistic regression analysis was used to identify factors associated with the quality of dietary intake in pregnant women. Approximately half of the women (46.4%, n = 130) had a low dietary diversity during pregnancy. Less than 30% of the respondents consumed beans, soybean products, and nuts. In the logistic regression analysis, poor maternal knowledge of nutritional sources to prevent anemia (odds ratio (OR) 4.25, 95% confidence interval (CI) 1.47-12.32, p = 0.01) and less frequent meal consumption (OR 2.15, 95% CI 1.08-4.29, p = 0.03) were significantly associated with poor dietary diversity. Our findings are crucial because they suggest that increasing the knowledge of pregnant women about good nutrition and ensuring that dietary intake is frequent and adequate through antenatal care can improve the nutrition of pregnant women.

Maternal Knowledge Associated with the Prevalence of Iron and Folic Acid Supplementation Among Pregnant Women in Muntinlupa, Philippines: A Cross-Sectional Study.

PURPOSE: The World Health Organization advocates that all pregnant women in areas where anemia is prevalent receive supplements of iron and folic acid. However, owing to a myriad of factors, the uptake of iron and folic acid supplementation (IFAS) is still low in many countries. Therefore, this study was conducted to assess the prevalence of IFAS and its associated factors among pregnant women. PATIENTS AND METHODS: A cross-sectional study was conducted at a hospital in Muntinlupa, Philippines, between March and August 2019 among 280 pregnant women. A systematic random sampling technique was used to select participants. Data were collected using interviewer-administered questionnaires. Multivariable logistic regression analyses were employed to identify factors associated with the prevalence of IFAS among pregnant women. RESULTS: Among 280 pregnant women, a majority (85.6%, n= 238) took IFAS during pregnancy. Among the respondents, 128 (45.9%) women had knowledge about signs and symptoms of anemia, 126 (45.3%) had knowledge of the benefits associated with IFAS, and 42 (15.4%) had knowledge about side effects associated with IFAS. The main sources of information about IFAS were health care providers (41.8%), followed by community health workers (CHWs) (14.6%). Maternal knowledge concerning IFAS benefits (OR = 2.50, CI = 1.04-5.97, p=0.04) was positively associated with the prevalence of IFAS. CONCLUSION: Maternal knowledge about the benefits of taking IFAS was significantly associated with the prevalence of IFAS among pregnant women in Muntinlupa, Philippines. There is a pressing need to improve health education on the benefits of IFAS among pregnant women to increase its prevalence. This emphasizes the necessity of increased involvement of health care providers and CHWs to increase women's knowledge of IFAS benefits and support them through pregnancy.

Knowledge and risk perception of radiation for Japanese nursing students after the Fukushima Nuclear Power Plant disaster.

BACKGROUND: The Japanese have had three experiences of radiation disasters: the atomic bombs dropped on Hiroshima and Nagasaki in 1945, and the 2011 Fukushima Nuclear Power Plant disaster. The former two experiences have been covered in compulsory education programs. In light of these incidents, a strong fear of radiation has pervaded people of several generations. In such a situation, the role of nurses is important. When nurses treat residents, their attitudes change depending on how they understand and feel about radiation. The foundations of these attitudes are formed through student education. Hence, it is necessary to explore nursing students' understanding and risk perception of radiation, and the nature of radiation education received. OBJECTIVES: To assess the levels of understanding and risk perception of nursing students regarding radiation. DESIGN: Cross-sectional survey. METHODS: A questionnaire survey was administered to all students (74 first-year, 79 second-year, 65 third-year, and 69 fourth-year students) in the nursing department of a Japanese national university. The response rate was 84%. Respondents were asked to rate their level of understanding of 50 phrases chosen from two supplementary texts about radiation for elementary school students and for middle and high school students, prepared by the Japanese Ministry. Further, they were asked to rate their risk perception for 30 events, and to answer six questions about radiation. RESULTS: It was found that knowledge about radiation among Japanese nursing students was poor, because sufficient radiation education had not been provided. Hence, they displayed a greater fear of X-rays as compared to American students and members of the League of Woman Voters. However, it was also found that an increase in understanding might decrease risk perception. CONCLUSIONS: It was concluded that nursing students require adequate education about radiation, in order to reduce their fear of X-rays and to mitigate their risk perception.

Effectiveness of simulation learning program for mastering public health nursing skills to enhance strength of community: A quasi-experimental design.

PURPOSE: The purpose of this study is to develop a simulation learning program for mastering public health nursing skills to enhance strength of community, and to verify its effectiveness. METHODS: The program is one-day session to master the skills from three exercises. This study adopts a quasi-experimental design. We selected unbiased 34 participants in intervention group and 30 participants in control group, and conducted self-administered questionnaire surveys at three points in time: pre, post 1 and post 2. Three tools were used to measure the required outcome. For the outcome evaluation, we calculated the changes in the mean value of each tool between pre and post 1 and between pre and post 2, and compared them between the two groups. RESULTS: The change of intervention group in the total score at the post 1 stage from the pre stage was significantly higher than control group regarding each of the scales (P < .05). CONCLUSIONS: The program was found to be effective in upgrading the skills of less-experienced public health nurses to enhance strength of community.

[Development of an action scale to show the necessity of healthcare activities].

OBJECTIVES: In order to promote high-quality healthcare activities, public health professionals such as public health nurses must improve their ability to systematically show health needs based on evidence and to lead decision making of superior officers and facility inhabitants for improved planning. This study developed and investigated its reliability and validity of an action scale to show the necessity of healthcare activities (SNH). METHODS: The items in the SNH were originally selected based on previous studies and refined by researchers; they were subsequently adjusted after a pilot survey. The subjects were full-time public health nurses (PHNs) working at prefectural public health centers or randomly chosen municipal health centers. Questionnaires were distributed by mail. We explained the ethical considerations in writing and those who returned completed questionnaire forms were considered to have given their consent to participate in the study. The study plan was approved by the university Domestic Ethics Committee. RESULTS: Among 1,615 questionnaire recipients, 1,088 (67.4%) responded; of these, 1,035 (64.1%) responses were valid. Nineteen of 20 items were selected based on results of item analysis, and exploratory and confirmatory factor analyses showed that the SNH consisted of four factors: show existence of health needs, show evidence for the necessity of addressing health needs, show actual conditions requiring solution, and show priority for resolution. Cronbach's alpha, an SNH reliability coefficient, was 0.948, and individual factor scores were over 0.85, supporting the internal consistency of SNH. The correlation coefficient between SNH and the three other scales including related concepts was 0.6-0.8, with significant differences between scales, supporting the criterion-related validity of SNH. The score increased with increasing PHN experience and job seniority, which were used as the known-group, with significant differences between the lowest group and the top two groups. CONCLUSION: The results confirmed that SNH is a reliable and valid scale to show the necessity of healthcare activities.

Identifying Residents' Health Issues Six Weeks after the Great East Japan Earthquake.

OBJECTIVE: The aim of this study was to identify the characteristics and health issues of residents in need of assistance in a town affected by the Great East Japan Earthquake, six weeks after the disaster, through an outreach initiative. DESIGN AND SAMPLE: A cross-sectional qualitative design was used. Public health nurses conducted comprehensive semi-structured interviews during home visits with residents. A total of 5,082 residents from the affected town. MEASURES: These included demographic information, public records of the extent of the damages, and qualitative interview data to determine the urgency of the necessary interventions. RESULTS: A total of 281 residents needed some kind of assistance and were identified as "requiring early intervention (within two weeks)" or "requiring assistance (within 12 weeks)." The most common health issue requiring early intervention was "interruption of treatment" (25.0%), followed by "need for mental care." The most frequent health issue requiring assistance within 12 weeks was the "need for mental health care" (39.7%), followed by "interruption of treatment," and "need for nursing care." CONCLUSIONS: During a disaster, it is imperative to identify cases requiring early intervention. Home-visit interviews were necessary to identify existing health concerns to prevent the development of more serious health problems.

The tsunami's impact on mortality in a town severely damaged by the 2011 Great East Japan Earthquake.

This study identifies the relationship between tsunami damage and mortality through a demographic pyramid of a town severely damaged by the tsunami following the Great East Japan Earthquake of 11 March 2011. It uses cross-sectional data collection. Volunteers visited all households, including shelters, and asked residents about the whereabouts of family members and neighbours. The information was collated with lists of evacuees and the dead to confirm the whereabouts of all residents about 50 days after the disaster. Demographic pyramids for the whole population based on pre- and post-disaster data were drawn. In all, 1,412 (8.8 per cent) were dead or missing, 60.2 per cent of whom were aged 65 and over and 37.5 per cent aged 75 and over, suggesting that the very old should be located beyond the reach of tsunamis. The mortality rate of children was lower than that in other studies, which may indicate the efficacy of disaster evacuation drills.

[Development of a learning outcome creation program to enhance the competence of public health nurses part of action research to contribute to the local community].

OBJECTIVES: In recent years, accompanying the increased diversification and growing seriousness of public health concerns, the duties demanded of nurses have been expanding and becoming more sophisticated. The objective of this research project was to assess a study achievement creation program to enhance the competence of public health nurses, etc., carried out in the curriculum for the first half of a graduate school doctorate course. METHODS: The program was developed undergoing a process of two test trials and corrections. The program's concept was "what I learn will contribute to tomorrow," and the program was composed of five group sessions during a four-month period and four individual interviews conducted between the group sessions. During this period, the participants clearly defined the problems seen in the field and their own themes of study to resolve them, and then worked toward attainment of achievement targets that they themselves had selected. The researchers, acting as study supporters, assisted to maximize the participants' study achievements. The targeted students were eight public health nurses who were enrolled in the program for the three semesters from October 2008 to March 2010, and included four graduate students and four others registered to complete the course. The program's outcome was assessed by measuring competence before and after program implementation, and process evaluation was conducted by ascertaining whether the participants had passed through three essential stages in their study: 1) awareness of the actual conditions and of the problems concerned; 2) implementation of an improvement plan; 3) confirmation of improvements. RESULTS: As a result of implementing the program, a certain degree of success, as indicated below, was verified. In the before-and-after outcome assessment, participant A exhibited a significant degree of advancement. Furthermore, the degree of satisfaction scores of the participants after program implementation were sufficiently high to conclude that results worthy of the costs expended were obtained. In addition, it was ascertained that the essential stages of passage, as indicated in the methodology, featured in the study process of the participants. CONCLUSION: In the future, this program may find application in graduate school education and for active service public health nurses by municipal governments or companies working in cooperation with universities and associations for public health nurses. Hereafter, areas that must be tackled in order to enrich the program include establishment of study support methods in response to diverse circumstances, development of educational materials and qualitative evaluation indicators and establishment of systems to train study supporters.

[Creation of a professional development scale for public health nurses and investigation of its reliability and validity].

PURPOSE: To contribute to public benefit, each professional is required to improve his/her specific skills and to acquire competencies that affect his/her professional development. The purpose of this study was to develop a Professional Development Scale (PDS) for Public Health Nurses (PHNs) and to investigate its reliability and validity. METHODS: The subjects were full-time PHNs working at 135 prefectural public health centers and 115 municipal health centers that were randomly chosen. Questionnaires were distributed by mail. The item pool of the PDS was selected from previous studies and refined by the present researchers. RESULT: Of a total of 250 health centers, 184 (73.6%) returned questionnaires; a total of 1261 (70.1%) PHNs responded, and 1112 responses were valid. Item and factor analyses showed the PDS to consist of 4 factors and 16 items. The factors were: "Competency development by self-responsibility", "Competency development by learning from others/resources", "Succession and improvement of one's specialty", and "Behavior according to professional principles". Cronbach's alpha values ranged from 0.77 to 0.93; hence, reliability was proven. The correlation coefficient between the PDS score and external variables was 0.7. CONCLUSION: The results obtained proved the reliability and validity of a PDS containing 4 factors. The PDS could thus be used for self-evaluation and setting of learning goals by PHNs.

[Development of competency measurement concerning the creation of projects/social resources for public health nurses: investigation of reliability and validity].

PURPOSE: To develop a 'Competency Measurement of Creativity' (CMC) for public health nurses (PHNs) we earlier identified relevant items. In the present study, we aimed to assess the reliability and validity of the resultant CMC. METHODS: Questionnaires were distributed via mail. The subjects were full-time PHNs working at 135 prefectural public health centers and 115 municipal health centers; the centers were randomly selected. The questionnaire contained items related to self-evaluation of CMC, external variables concerning the creation of projects/social resources, basic personal information, and experience in attending seminars. To prove the validity of the CMC, item and factor analyses were conducted and correlation coefficients were calculated. To prove reliability of CMC, Cronbach's alpha and split-halves were calculated. In addition, the relevance of CMC scores was tested using basic personal information and experience in attending seminars. RESULTS: A total of 1,261 (70.1%) PHNs responded, and 1,112 (61.8%) responses were valid. The average response for each item in the CMC ranged from 1.97 to 3.44. Item and factor analyses showed the CMC to consist of 3 factors and 16 items. The factors were termed "defining the necessity of creativity" "promoting and incarnating creativity" and "collaborating for creativity". Cronbach's alpha and split-half values ranged from 0.76 to 0.95; hence reliability was proved. The correlation coefficients between CMC scores and external variables were in the range of 0.50-0.69. Significant links were noted with regard to years of experience, attending facility, job title, and experience in attending seminars. CONCLUSIONS: The results thus obtained proved the reliability and validity of a CMC that contains 3 factors and 16 items. The CMC score was found to be relevant in terms of basic personal information and experience in attending seminars and this result is in agreement with existing knowledge. CMC could be used for self-evaluation, for example, in pre- and post- tests at seminars dealing with the creation of projects/social resources.

[Development and evaluation of the reliability and validity of a scale for basic actions relevant to public health].

PURPOSE: The purpose of this study was to develop a Scale for Basic Action for Public Health (hereinafter referred to as the BAPH scale) to assess and improve the ability of public health nurses (PHNs) to contribute to the health and well-being of Japanese people. The present study was carried out to assess the reliability and validity of the BAPH scale. METHODS: One hundred and thirty-five prefectural public health centers and 115 municipal health centers in Japan were randomly chosen. Full-time PHNs working at the selected health centers were selected as the subjects of this study. Questionnaires were sent to the directors of the health centers and then distributed to the subjects. The questionnaire survey included some provisional questions formulated taking into account the assessment items derived from the existing literature as well as questions related to the respondent's age, years of experience as a PHN, academic background, and job title. RESULTS: Of a total of 250 health centers, 184 (73.6%) responded. The questionnaire was completed and returned by 1,261 (70.1%) PHNs, 1,112 of whom provided valid responses and were thus included in the analysis. 1) Based on the results obtained from the factor analysis performed on the 18 provisional BAPH questions, 12 BAPH scale items were chosen for inclusion in the scale. These items consisted of three sub-scales, namely "promotion of accessibility and fairness" (five items), "assessment of quality and quantity of service" (four items), and "prevention action for health risk" (three items). 2) The Cronbach's coefficient alpha for the BAPH scale and its three sub-scales were 0.91, 0.84, 0.86, and 0.82, respectively. 3) As respondents experience become longer, their scores on the BAPH scale become higher. In addition, respondents who had given either presentations or speeches at academic conferences and those who subscribed to academic journals were significantly more likely than others to score high on the scale. CONCLUSIONS: The results of the present study revealed that the BAPH scale is a reliable and valid method to evaluate the ability of PHNs to contribute to the health and well-being of people. Hitherto, there has been no method that can be used to evaluate the job performance of PHNs. The use of the BAPH scale to assess the effectiveness of basic education and in-service training for PHNs may not only improve the content of training/education offered but also help them fulfill their duties as providers of health care and welfare services.

Relationship of experience and the place of work to the level of competency among public health nurses in Japan.

AIM: To examine the actual competencies of public health nurses (PHNs) working in public organizations in Japan in order to clarify the relationship between the level of competency and the number of years of experience and the place of work. METHODS: The subjects were 1799 full-time PHNs working at 135 prefectural public health centers and 115 municipal health centers, which were randomly selected. Each subject received a questionnaire in the mail, requesting basic personal information and a self-evaluation of six levels of achievement in 11 topics in five categories of competencies. RESULTS: The number of respondents was 1261 (70.1%), with a total of 1184 valid responses (65.8%). In terms of the level of competency, the average score was >3 for all items and the number of PHNs who achieved Ladders 5 and 6 was low, with very few achieving Ladder 6, despite having more years of experience. Furthermore, the level of achievement depended on the workplace, position, and academic background. CONCLUSION: The tasks regarding the education of PHNs in Japan are to establish achievement goals clearly and incrementally and to develop methods and systems that consistently and systematically increase competencies, not only in basic undergraduate education, but also for employed PHNs, through specialized education. In particular, educational methods that lead to high-quality experiences need to be selected in order to develop competencies.