[A two-year program to promote participatory workplace environmental improvements at small enterprises with fewer than ten employees].

OBJECTIVE: This study aimed to determine the influence of participatory workplace environmental improvement program on reducing job stress and workers' psychological distress at small enterprises (i.e., less than 10 employees). Furthermore, this study aimed to clarify important factors for success of this program as well. METHODS: The model program was tested in a small enterprise with eight employees between October 2014 and January 2017. Moreover, five employees participated in the annual work environment improvement workshops for two consecutive years. During both years, the New Brief Job Stress Questionnaire (80-item version) was used to measure work-related stress before (baseline) and after (post-three months and post-12 months) the workshops. To assess the extent of an intervention effect, the questionnaire data were analyzed using the Friedman test and the multiple comparison test annually. In addition, continuous data were analyzed during the two years. The statistical significance of the differences across time was determined at the p < .10 cutoff value because the number of participants was small. The effect size was also calculated. The participants were interviewed regularly. RESULTS: For both years, the employees implemented action plans within one month of completing the workshops. In the first year, the data for the Friedman test indicated a significant change in role conflict, job resources (workgroup-level), respect for individuals, fair personnel evaluations, work-self balance (positive), workplace social capital, and job satisfaction. In the multiple comparison test, significant changes manifested in role conflict and workplace social capital. In the second year, significant changes were found regarding role conflict and fair personnel evaluations for the Friedman test, demonstrating significant changes in role conflict in the multiple comparison test. As per the two-year survey results, the Friedman test indicated significant changes in role conflict, respect for individuals, and fair personnel evaluations, while the multiple comparison test demonstrated no significant changes. Over time, favorable changes were found regarding role conflict in the first year; however, undesirable changes were found regarding the other statistically significant items. The interviews revealed both positive and negative opinions. CONCLUSIONS: This study found the effects of the participatory workplace environment improvement program to be limited. Thus, the program should be improved to reduce its adverse effects as well as the participants' negative opinions.

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.