Prevalence of symptoms of pelvic floor dysfunction and related factors among Japanese female healthcare workers.

OBJECTIVES: Women working in the medical field may be at risk for pelvic floor dysfunction due to high physical activity levels leading to increased abdominal pressure; however, the actual situation remains unknown. This study aimed to clarify the prevalence of symptoms of pelvic floor dysfunction and its associated factors among Japanese women working in the medical field. METHODS: A cross-sectional study was conducted among female employees at a public hospital in Japan from July to August 2020. Participants answered a web-based questionnaire. Three types of symptoms related to pelvic floor dysfunction were assessed based on one or more subscale scores in the Pelvic Floor Distress Inventory-Short Form 20 (PFDI-20). RESULTS: Out of 466 female employees in the hospital, 294 responded (response rate 63.1%). The mean age was 42.8 ± 10.3 years old and 221 (73.5%) were nurses. The prevalence of at least one type of symptom was 63.9%. The prevalence of recto-anal symptoms (45.9%) was highest, followed by lower urinary tract (37.1%) and pelvic organ prolapse symptoms (22.8%). The total PFDI-20 score was associated with constipation (ß = .254), body mass index (ß = .136), and part-time work (ß = .167) after adjusting for other variables. CONCLUSION: This study showed a high prevalence of symptoms related to pelvic floor dysfunction among women working in the medical field. Lifestyle management to prevent constipation and obesity is a promising strategy to improve symptoms of pelvic floor dysfunction.

[Effectiveness of a program promoting community activities for the prevention of frailty using a community assessment].

AIM: We developed a program to promote community activities for preventing frailty using the Community-as-Partner model. We aimed to clarify whether or not participants' extent of practice relating to frailty prevention activities increased after the classroom, as well as the effectiveness of the program for preventing frailty. METHODS: The participants were recruited from among pre-frailty and frailty individuals in a cohort study of community-dwelling older adults. Thirty-two participants completed the classroom intervention. Thereafter, every three months, through a telephone survey, the participants were asked about the extent of practice regarding their frailty prevention activities. The Kihon Checklist and Japanese version of the Cardiovascular Health Study (J-CHS) frailty index were surveyed as outcome measures during the cohort study conducted six months before the classroom (baseline [BL]) as well as approximately one year after this intervention (follow-up [FL]). The changes in the outcome measures between the BL and FL in the intervention group were compared to those in the control group matched by the propensity score. RESULTS: The frailty prevention activities saw a maximum increase around six to nine months after the classroom. The J-CHS frailty index showed a group × time-of-survey significant interaction (F = 6.531, p=0.012) and significantly decreased from 1.3 at BL to 0.8 at FL in the intervention group (p=0.009). CONCLUSIONS: The practice of activities relating to frailty prevention increased after the classroom, and the participants also showed improvements in their physical frailty. The present program seems likely to be effective preventing frailty.

[An implementation study of a program supporting frailty-prevention community activities using the "Community-as-Partner" model].

Objectives　We hypothesized that the motivation for improving physical function could be increased by increasing the awareness of social role expectations among frail community-dwelling older adults through an intervention based on the Community-as-Partner (CAP) model. We also developed a program for supporting community activities to prevent frailty, utilizing the CAP model. Program feasibility was assessed by implementing it under the local government's frailty prevention service.Methods　The CAP-based program consisted of a "learning period," a "regional issue extraction period," and a "practice period," scheduled once a week for four months. Public health nurses and/or physical therapists assisted with the program. The intervention was conducted with a cohort study of community-dwelling older adults. About 160 participants identified as frail and pre-frail on the Kihon Checklist were recruited. Program feasibility was assessed through participation rate, number of pre-frail and frail individuals, and drop-out rate; scores of a pre-post intervention questionnaire assessing the understanding of frailty and regional resources; and behavioral change stage on frailty prevention.Results　A total of 42 participants were recruited (participation rate=26.3%; 25 were pre-frail and 17 were frail). The drop-out rate was 23.8% (n=10). The scores on four out of five items and six out of eleven items on the understanding of frailty and regional resources, respectively, improved significantly after the intervention. Regarding the behavioral change stage, 26 participants (81.2%) maintained or improved.Conclusion　The participation rate was approximately 30%, similar to conventional programs with direct professional intervention. Conversely, a higher drop-out rate compared to conventional programs suggested the importance of explaining the workshop in the program introduction and publicizing the workshop. The results indicated that the program improved the understanding of frailty and regional resources, and led to behavioral change for frailty prevention.

The evaluation of public health nursing students' skill achievement levels by educational improvement.

OBJECTIVE: This study aimed to evaluate the educational improvement outcomes after introducing undergraduate public health nursing electives from the perspective of students, teachers, and public health nurses. DESIGN AND SAMPLE: Post-test design with control group was used. We surveyed three groups of participants on the relevance of achieved skill items. These groups were as follows: fourth-year students, teaching staff from seven universities, and public health nurses from special districts of Tokyo who had pioneered the introduction of public health nursing electives. MEASURES: The three participant groups were surveyed in 2013 and 2014 to compare the students' levels of achievement in the 98 skill items presented by the Japanese Ministry of Health, Labour, and Welfare. Practical training introduced educational reform in 2014. Anonymous self-administrated questionnaires were used. RESULTS: The mean achievement rates of the 98 items in 2013 and 2014 were 67.9% and 72.6%, respectively, for students; 40.9% and 59.7% for teachers; and 44.4% and 59.4% for PHNs. A significant difference was observed between ratios of 2013 and 2014 in all three groups. CONCLUSIONS: The results demonstrated that the introduction of educational reform increased the achievement rates of students through the electives.

Evaluation of skill achievement levels and practical experiences of public health nursing students before and after the introduction of the public health nursing course as an elective.

Objective To equip public health nurses (PHNs) with higher qualifications, PHN education is shifting from an integrated curriculum for PHNs and registered nurses to a specific elective system of undergraduate or postgraduate programs. Most colleges in the special wards of Tokyo introduced the elective system in 2014 before the remaining areas. The outcomes of this must be evaluated. This study aimed to evaluate the achievement levels and practical experiences of PHN students at seven colleges in the special wards before and after introduction of the PHN course as an elective.Method Self-administered, anonymous questionnaires were completed by senior PHN students at seven colleges in the special wards who underwent training in 2013, the last year of an integrated curriculum, and in 2014, the first year of the elective system. The target numbers of participants were 663 in 2013 and 136 in 2014 with 20 students from each school exposed to the elective system. Our study focused on whether they achieved the 98 "technical items of PHN training and achievement levels at the time of graduation" required by the Ministry of Health, Labour and Welfare. The study also determined whether participants obtained practical experience in 15 items developed by the special wards based on the standards set for training.Results In 2013, there were 348 total responses (52.5%) and 310 valid responses. In 2014, there were 136 total responses (88.2%) and 120 valid responses. The average achievement rate at which the student answered, "I was able to arrive at it," at an arrival degree level for the 98 technical items was 72.6% in 2014, an increase compared to the 67.9% obtained in 2013. Moreover, the average practical experience rate at which the student answered, "I was able to have an experience," regarding the 15 items was 85.7% in 2014, which constituted an increase compared to 70.5% attained in 2013. However, the number of items with an achievement rate of more than 80% remained at 31 (31.6%) in 2014.Conclusion Increasing percentages of average achievement and experience rate suggest that the lecture and training have improved, and highly motivated students could have been selected in the PHN program. However, students did not achieve the target rate for many of the items. Thus, there was a time limit to experience the technical item/the experience item.