Public health nurses' descriptions of "healthcare targets and results".

Objectives　This study examined the sentences that public health nurses (PHNs) use to describe "healthcare targets and results"; how they use the four components-target, result, term, and achievement degree-necessary for explaining, for example, a plan for healthcare activities; and what kind of contents they describe.Methods　The participants were full-time PHNs working at randomly chosen prefectural public health centers or municipal health centers. Questionnaires were distributed by mail, and the subjects were asked to give a sentence describing "healthcare targets and results." The contents of the sentences were examined, four components were extracted, and the sentences were classified by their contents. Depending on the number of components, the sentences were classified into five groups: 4, 3, 2, 1, and 0. We ascertained the ratio of each component and group, and the combinations of components in sentences. Related factor measures were years of PHN experience and municipality.Results　Of the 1,615 participants, 1,088 (67.4%) responded, and 961 (59.5%) responses were valid. The ratio of sentences expressing "target" was 81.0%, "result" was 58.8%, "term" was 3.4%, and "achievement degree" was 18.5%. Most of the answers for "target" expressed attributes. The answers for "result" expressed not only specific indicators of activity or health, but also a general vision or output (not the results like outcome) of the process of PHNs' healthcare activities. The answers for "term" expressed the time limit of the evaluation, and those for "achievement degree" expressed a specific rate, ratio, or number. Within each component group, the sentences were classified as follows: Group 4 (2.4%), Group 3 (15.6%), Group 2 (33.8%), Group 1 (37.7%), and Group 0 (10.5%), which were found to lack the component "term," "achievement degree," "result," and "target" respectively. The ratio of Group 4 increased with more years of PHN experience and larger municipality, but there were no significant differences.Conclusion　A few of the PHNs' sentences described all the components of "healthcare targets and results," and the fewest described "term" and "achievement degree." In addition, these sentences expressed abstract contents or the process of PHNs' healthcare activities. PHNs should be able to describe the target's specific health issue, the time limit for solution, and numerical target results.

[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.