A country's efforts toward creating an advanced practice nurse in public health.

AIM: The study goal was to inform the creation of a blueprint for an advanced practice nurse (APN) in public health. BACKGROUND: No internationally accepted standard for an APN in public health exists. Activities of public health nurses (PHN) traditionally have centered on health promotion and disease prevention, but many have added other population-based activities such as chronic and acute disease treatment. INTRODUCTION: An APN in public health is needed to address the global challenges threatening the physical, social, and mental health of populations worldwide. METHODS: This qualitative study was comprised of six focus groups, each containing a different group of stakeholders (n = 40). Study results followed the requirements of the consolidated criteria for reporting qualitative research (COREQ). FINDINGS: Two major themes emerged: the APN role in public health and core expectations. From the APN role theme, four subthemes emerged on APN domains of public health practice and functions. From the core expectations theme, nine subthemes emerged on the APN's qualifications and behaviors. DISCUSSION: Agreement among stakeholders was found in the nine core expectations; however, among the four different visions of an APN in public health, two fit a population-based model rather than the traditional PHN model. CONCLUSIONS: A single APN role in public health is insufficient to address the breadth and complexity of today's global challenges as detailed by the sustainable development goals. Due to the interaction between health and the biopsychosocial environments, we need APNs with different areas of expertise. IMPLICATION FOR NURSING POLICY: Nurses working at universities, in public health services, and as healthcare policymakers are needed to create a multistage strategy that gradually introduces several different types of APNs in public health.

Organizational commitment and quality of life at work among public health nurses in Israel.

OBJECTIVE: To test the relationship between job satisfaction, professional self-image, work environment, organizational commitment (OC), and quality of life at work (QoLW) among public health nurses in Israel. To determine which variables can predict OC and QoLW among public health nurses. DESIGN AND SAMPLE: One hundred and thirty-two public health nurses participated in this cross-sectional study with a structured self-administered questionnaire that examined OC, professional self-image, job satisfaction, nursing work environment, and QoLW. Pearson correlation tested correlations between variables and multiple regression was conducted to predict OC and QoLW. MEASUREMENTS: The five measurements (job satisfaction, professional self-image, work environment, OC, and QoLW) based on validity questionnaires with high internal confident. RESULTS: All five variables showed a significant positive correlation. Job satisfaction (t = 5.77, p < 0.001) and nursing work environment (t = 4.55, p < 0.001), contributed significantly to the explanation of OC and QoLW variance. Nursing work environment (t = 6.42, p < 0.01) and job satisfaction (t = 2.99, p < 0.01) were the variables that predicted QoLW. CONCLUSIONS: Nursing managers should be proactive and create a professional environment for nurses to encourage their OC and QoLW as factors that may influence public health nurses.

Family Health Clinics as a Source of Social Capital.

PURPOSE: To examine the extent to which Family Health Clinics (FHCs) contribute to the formation of social capital among mothers, and determine whether it is influenced by socioeconomic factors. In FHCs, social capital can be gained by relationships between mothers (bonding social capital), by relationships between mothers and FHCs team, or between mothers of different origins/culture (bridging social capital) and health services institutional bodies (linking social capital). DESIGN: This is a mixed method study. For the quantitative part, data were collected from 673 mothers using a questionnaire. The qualitative part was conducted with six focus groups. RESULTS: The FHC constitutes a source of social capital in all dimensions. Bridging social capital was most prominent and is formed by interactions between mothers and FHC nurses. The factors that explain the formation of social capital were: mothers' spoken language being Arabic, participation in group training, and lower level of education. The focus groups revealed that participation in group training increased the social capital. Mothers noted that FHC nurses supplied updated information about their children's care. Regarding linking social capital, mothers perceive FHC nurses as mediators between them and the local and national health services. CONCLUSIONS: FHC clinics are a source for gaining social capital. The FHC services should be adapted to mother's needs. IMPLICATIONS: FHC nurses should try to create conditions for mothers to meet to create bonding social capital, relate to mother's needs for the creation of bridging social capital, and provide culturally adapted care for the formation of linking social capital.

Public Health Nurses in Israel: A Case Study on a Quality Improvement Project of Nurse's Work Life.

Public health nurses (PHNs) working in Well Baby Clinic in Israel's Haifa district were voicing great distress to inspectors-the impossibility of meeting their workload, feeling overwhelmed, poor physical, and technological conditions. They were feeling tired and frustrated and burn-out was rising. The district's nursing management took the decision, together with Tel Aviv University's nursing research unit, to conduct a quality improvement project based on issues that arose from meetings with focus groups on the nurses' difficulties. This paper is a case study of a quality improvement project targeting nurses daily working life. One of its chief contributions is as a study of meeting PHNs' frustration by integrating focus groups and round-table brainstorming (involving nurses, clinic managers and nursing inspectors) in order to identify targets for practical intervention. This strategy has been very successful. It has provided the district's nursing management a battery of forcefully argued and realistically grounded proposals for making the work of Well Baby clinics more relevant to their communities and giving nurses (a) the conditions to meet their assignments and (b) greater professional self-respect.

Trust and the demand for autonomy may explain the low rates of immunizations among nurses.

Rates of vaccinations of healthcare workers with recommended vaccines are generally low in the developed countries. Our goals were to identify attitudes associated with self-reported vaccinations against pertussis and seasonal influenza among Israeli nurses in Mother and Child Healthcare Centers (MCHC) in the Haifa District. Over 100 nurses answered a self-administered questionnaire. Forty two percent of the nurses reported receiving the pertussis vaccine in the last five years and 44% reported receiving the influenza vaccine during the previous year. Attitudes toward the importance of vaccinating nurses, trust in the public health authorities and demand for autonomy were associated with receiving the pertussis vaccine. Attitudes toward the importance of vaccinating nurses and trust were associated with receiving the influenza vaccine in a bivariant analysis. However, in the logistic regression models only attitudes toward the importance of vaccinating nurses were associated with vaccinations [odds ratio (OR)- 3.66, 95% confidence interval (CI)- 1.4-9.6 for pertussis and OR- 4.53, CI-1.6-13.0 for influenza]. Jewish nurses reported more often receiving the influenza vaccine compared with the Arab nurses, whereas there was no difference between them in receiving the pertussis vaccine. Low levels of positive attitudes toward the importance of vaccinating nurses may inhibit nurses in MCHC from receiving vaccines. The demand for autonomy and low levels of trust may, in part, form these low levels of positive attitudes toward the importance of vaccinating nurses.