Critical consciousness of public health nurses: A descriptive, comparative survey.

BACKGROUND: Public Health Nurses (PHN) caring for vulnerable populations amid systemic inequality must navigate complex situations, and consequently they may experience serious moral distress known to be detrimental to PHN wellbeing. OBJECTIVE: Given PHN awareness of social inequities, the study aimed to determine if PHNs were motivated to enact social change and engage in social and political action to address inequality. DESIGN AND SAMPLE: A survey of 173 PHNs was conducted in fall 2022. The convenience sample was mainly female (96.5%), White (85%), had associate/bachelor's degrees (71.7%), and worked in governmental public health settings (70.7%). MEASURE: The study employed the Short Critical Consciousness Scales' subscales: Critical Reflection, Critical Motivation, and Critical Action. RESULTS: PHNs were highly motivated to address inequities (Critical Motivation = 20.83; SD = 3.16), with similarly high awareness (Critical Reflection = 17.89; SD = 5.18). However, social and political action scores were much lower (Critical Action = 7.13; SD = 2.63). A subgroup of PHNs with strong agreement regarding the impact of poverty were more likely to be younger (p = .039) and work in a community setting (p = .003); with higher scores across subscales (p < .001). CONCLUSIONS: High critical reflection and motivation among PHNs aligned with literature. Lower Critical Action scores warrant investigation into validity for PHNs, and possible role constraints.

How do public health nurses in Norwegian school health services support siblings of children with complex care needs?

AIMS: There is a paucity of data regarding the care and support provided by Norwegian school health services to siblings of children with complex care needs. Public health nurses are an integral part of these universal services, which focus on health promotion and disease prevention in primary and secondary schools. This study aimed to explore health promotion interventions by public health nurses for siblings in Norwegian schools and to identify regional differences. METHODS: An online national questionnaire was distributed to Norwegian public health nurses and leaders of public health nursing services (N = 487). The questions were related to how the nurses support siblings of children with complex care needs. The quantitative data were analysed using descriptive statistics. An inductive thematic analysis of free-text comments was conducted. ETHICAL APPROVAL: The study was approved by the Norwegian Centre for Research Data. RESULTS: The majority of public health nursing leaders (67%) reported that the services in their municipality had no system to identify siblings or to provide them with routine care. However, 26% of public health nurses reported that routine support was provided to siblings. Regional differences were identified. STUDY LIMITATIONS: This study included responses from 487 PHNs from all four health regions in Norway. The study design is limited and gives a brief outline of the current situation. Further data are needed to provide in-depth knowledge. CONCLUSIONS: This survey provides important knowledge for health authorities and professionals working with siblings, about inadequate support and regional differences in care provided to siblings by school health services.

Public health nursing workforce and learning needs: A national sample survey analysis.

OBJECTIVES: Generate national estimates of the public health nursing workforce's (1) demographic and work characteristics and (2) continuing education learning needs in the United States. DESIGN: Secondary data analysis of the 2018 National Sample Survey of Registered Nurses. SAMPLE: Total 7352 of the 50,273 survey respondents were categorized as public health nurses (PHNs), representing an estimated 467,271 national workforce. MEASUREMENTS: Survey items for demographics, practice setting, training topics, and language(s) spoken fluently were analyzed. RESULTS: Workforce demographic characteristics are included. Mental health training was the most frequently endorsed topic by PHNs, followed by patient-centered care and evidence-based care. Training topic needs vary by practice setting. CONCLUSIONS: Results here can be used as a needs assessment for national public health nursing professional development and education initiatives. Further research is needed to refine and survey a nationally representative sample in a manner meaningful to public health nursing practice.

The nurse as peacebuilder: Intersections of health and peace.

The purpose of this review is to examine peacebuilding as a concept relevant to nursing practice. A historical view of Lilian Wald's contribution to public health nursing sets the stage for nursing's commitment to the ethics of social justice and responsibility to address the social determinants of health as root causes to health inequities. The interweaving of health and peace are highlighted through exploration of works from leading organizations in health and nursing, nationally and globally. Finally examples of current peacebuilding in public health nursing are highlighted.

Creating safe relational space: Public health nurses work with mothering refugee women.

OBJECTIVE: Exploring how public health nurses (PHNs) provide community-based support to women who are refugees and mothering. DESIGN: A constructivist grounded theory (CGT) design was used where intersectionality as an analytical tool was applied. Varying data collection approaches including focus groups were used. SAMPLE: Twelve PHNs from four public health units in Western Canada participated in this study. RESULTS: Participants in this study described an overall process of creating safe relational space to address a basic social problem of establishing trust while managing structural forces. This overarching process was expressed through burning with passion, connecting while looking beyond, protecting from re-traumatization, and fostering independence. Findings reveal strategies PHNs used to enhance health equity. This study extends critical caring theory to include sociopolitical and economic influences on public health nursing practice. Consequences of these influences on the mothering refugee women population are also revealed. Implications include structural integration of trauma-and-violence-informed principles to support public health nursing practice. CONCLUSIONS: This study adds to an emerging body of knowledge on PHNs work with complex populations. Innovative application of intersectionality is demonstrated as an effective approach to analyzing impacts of broad sociopolitical priorities on communities that are systemically marginalized.

"Not everybody approaches it that way": Nurse-trained health department directors' leadership strategies and skills in public health.

Evidence points to nurses as possessing particular skills which are important for public health leadership; in particular, investigators have found that a nurse public health director is strongly associated with positive health department performance. To better understand this association and to guide the effective deployment of nurse leaders, researchers sought to explore the specific leadership strategies used by nurse public health directors, using a critical thematic analysis approach to examine these leadership strategies in the context of certain ideologies, power differentials, and social hierarchies. Data were collected via semistructured interviews conducted from July to September 2020 with 13 nurse public health directors from across the United States. Major themes illustrate a distinct picture of the nursing approach to public health leadership: (a) approaching their work with an other-focused lens, (b) applying theoretical knowledge, (c) navigating the political side of their role, and (d) leveraging their nursing identity. Findings articulate the nurse public health director's distinctive combination of skills which reflect the interprofessional nature of public health nursing practice. Such skills demonstrate a specialized approach that may set nurse leaders apart from other types of leaders in carrying out significant public health work.

A holistic health determinants model for public health nursing education and practice.

Baccalaureate nursing graduates (BSNs) in the 21st century need to be prepared to manage the population health needs of diverse populations across the lifespan and take actions to improve health equity. A need for a Holistic Health Determinants Model that included the Social Determinants of Health was identified. A model incorporating the Healthy People 2020 Health Determinants Model and the Healthy People 2030 Social Determinants of Health Model was developed. Two theoretical approaches provided a foundation for the model. Social ecological theory stresses the lived experience in an ever-changing environment from the micro to the macro biological, behavioral, social and physical environmental levels. Public health intersectionality added the construct of constant interactions among the health determinants that resulted in different levels of health status among individuals and groups. This Holistic Health Determinants Model is a tool to use in teaching nursing students how to address the needs of individuals/families, diverse populations, and communities. It also facilitates integration of the new AACN Population Health Competencies across the curriculum. The model facilitates the preparation of BSN graduates to address the factors that shape health status and to take actions to improve health equity.

Reproductive justice and black lives: A concept analysis for public health nursing.

BACKGROUND: Inequities in maternal mortality in the United States are a form of structural violence against Black women. The concept of reproductive justice has been employed in the social sciences for almost 30 years, yet nursing has been slow to adopt this concept in promoting maternal-child health. OBJECTIVE: To analyze the concept of reproductive justice as used in peer-reviewed publications with the aim of reframing black maternal health in public health nursing scholarship, research, practice, and advocacy. DESIGN: We conducted a systematic review of the social science literature. We analyzed selected articles though a principle-based concept analysis focusing on epistemological, pragmatic, linguistic, and logical principles. SAMPLE: Eight articles were selected from a pool of 377. RESULTS: Race was identified as a source of power for understanding reproductive justice through individual knowledge, collective knowledge, and praxis. Pragmatically, reproductive justice is a social justice-oriented platform that bridges the pro-choice/pro-life divide; aids coalition building; and promotes inclusion. Linguistically, the concept is distinct from both reproductive health and reproductive rights. Reproductive justice is logically situated within intersectionality theory and the cumulative embodiment of oppressions Black women experience based on race, class, and gender. CONCLUSION: Reproductive justice reframes public health nursing actions for Black women by focusing on uncovering systems of oppression, recognizing past historical injustices, and advancing cultural safety in health promotion. Multilevel interventions are needed to simultaneously address these injustices particularly in the areas of preconception health, maternal health, infant and child health, and Black family well-being across the reproductive lifespan.

Factors associated with the utilization of community assessment models among Japanese nurses.

OBJECTIVES: This study aimed to identify factors related to the practical utilization of community health needs assessment (CHNA) models that public health nurses (PHNs) learned in their fundamental education. DESIGN: A nationwide questionnaire survey was conducted via postal mail. SAMPLE: We randomly selected 630 public health institutes in Japan. The participants were 3397 full-time novice and mid-level PHNs. MEASUREMENTS: The questionnaire included the participants' basic personal information, six items regarding the perception of CHNA with a 4-point Likert scale, learned models in their undergraduate education, their utilization in practical settings, and the reasons for their answer in narrative form. RESULTS: There were 951 valid responses. The results of logistic regression showed that the significant positively factors with model utilization were perception of CHNA as "not troublesome" or "not impossible as they learned," continuing education with 5 years of experience, and identification of the learned model in continuing education. Furthermore, the results of text mining showed the reasons for non-utilization of the model included being "busy" and having a lack of "opportunity." CONCLUSIONS: This study showed the associated factors with rare utilization of a learned model for PHNs. These findings may suggest improvement of continuing education and development of an appropriate assessment model.

Culturally and linguistically diverse mothers accessing public health nursing: A narrative review.

BACKGROUND: Culturally and linguistically diverse (CALD) families with young children are less likely to seek out healthcare services in comparison with the mainstream population. A lack of appropriate access and engagement with public health nursing (PHN) service contributes to major health disparities for CALD mothers. AIM: To describe and synthesize the available literature on the factors that promote or hinder CALD mothers' access to and engagement with PHN services and in particular sustained nurse home-visiting (SNHV) programs. This paper identifies gaps and new areas of needed research inquiry to support best provision of PHN for CALD mothers. METHOD: A narrative review of the literature was conducted. Databases searched included PubMed, CINAHL, MEDLINE, Cochrane, and Scopus with year of publication between 2000 and 2020. RESULTS: Of 463 total articles, 12 met inclusion criteria. The key barriers and facilitators identified were grouped in three major themes. These include mother-related issues, experiences with interpreters, and program and program delivery related issues. DISCUSSION: The review demonstrates that CALD mothers with limited English proficiency (LEP) are experiencing multiple challenges in accessing and engaging with PHN and SNHV services. More research is needed to understand nurse-mother-interpreter relationships and policy and practice issues.

People deprived of their freedom: nursing diagnoses in the light of Horta's Theory / Personas privadas de libertad: diagnóstico de enfermería a la luz de la Teoría de Horta / Pessoas privadas de liberdade: diagnóstico de enfermagem à luz da Teoria de Horta

ABSTRACT Objective: to identify the Nursing diagnoses in men deprived of their freedom, based on the Basic Human Needs framework. Methods: a descriptive and exploratory study with a qualitative approach conducted by means of the Theory of Basic Human Needs framework. Data collection took place from June to November 2019, with individual interviews carried out with 220 men deprived of their freedom. The data were submitted to thematic and content analysis directed to NANDA International Taxonomy II. All ethical aspects were respected. Results: 12 Nursing diagnoses belonging to the categories of health problems and potential risks were identified, grouped and interpreted according to the theoretical framework. Sedentary lifestyle, obesity, overweight, risk-prone health behavior, and ineffective health control are factors that have been related to the psychobiological needs. Involvement in recreational activities, anxiety, ineffective coping, risk of violence directed toward others, disrupted family processes, and risk of ineffective relationships were related to the psychosocial needs, while the risk of impaired religiosity was related to the psychospiritual needs. Conclusion: the absence of Nursing diagnoses in the health promotion category signals the need for actions that provide quality of life to these people.

RESUMEN Objetivo: identificar diagnósticos de Enfermería en hombres privados de su libertad, sobre la base del marco referencial de las Necesidades Humanas Básicas. Métodos: estudio exploratorio y descriptivo con enfoque cualitativo realizado de conformidad con el marco referencial de la Teoría de las Necesidades Humanas Básicas. La recolección de datos tuvo lugar entre junio y noviembre de 2019, por medio de entrevistas individuales realizadas con 220 hombres privados de su libertad. Los datos se sometieron a análisis temático y de contenido dirigido a la taxonomía II de NANDA Internacional. Se respetaron todos los aspectos éticos. Resultados: se identificaron 12 diagnósticos de Enfermería pertenecientes a las categorías de problemas de salud y riesgos potenciales, agrupados e interpretados de acuerdo con el referencial teórico. Estilo de vida sedentario, obesidad, sobrepeso, conductas de salud propensas a riesgo y control ineficaz de la salud fueron factores que se relacionaron con las necesidades psicobiológicas. A su vez, menor participación en actividades de recreación, ansiedad, estrategias de enfrentamiento ineficaces, riesgo de violencia hacia otras personas, procesos familiares interrumpidos y riesgo de vinculación ineficaz se mostraron relacionados con las necesidades psicosociales, en tanto que el riesgo de religiosidad perjudicada presentó una relación con las necesidades psicoespirituales. Conclusión: la ausencia de diagnósticos de Enfermería de la categoría de promoción de la salud indica la necesidad de implementar acciones que propicien la calidad de vida de estas personas.

RESUMO Objetivo: identificar os diagnósticos de enfermagem em homens privados de liberdade, com ancoragem no referencial das Necessidades Humanas Básicas. Métodos: estudo exploratório descritivo de abordagem qualitativa conduzido pelo referencial da Teoria das Necessidades Humanas Básicas. A coleta de dados ocorreu nos meses de junho a novembro de 2019, com entrevistas individuais realizadas com 220 homens privados de liberdade. Os dados foram submetidos à análise temática e de conteúdo dirigida à taxonomia II da NANDA Internacional. Todos os aspectos éticos foram respeitados. Resultados: foram identificados 12 diagnósticos de enfermagem pertencentes às categorias de problemas de saúde e riscos potenciais, agrupados e interpretados conforme o referencial teórico. Estilo de vida sedentário, obesidade, sobrepeso, comportamento de saúde propenso a risco e controle ineficaz da saúde são fatores que se relacionaram às necessidades psicobiológicas. Já o envolvimento em atividades de recreação diminuído, ansiedade, enfrentamento ineficaz, risco de violência direcionada a outros, processos familiares interrompidos e risco de relacionamento ineficaz se mostraram relacionados às necessidades psicossociais, ao passo que o risco de religiosidade prejudicada apresentou relação com as necessidades psicoespirituais. Conclusão: a ausência de diagnósticos de enfermagem da categoria de promoção da saúde sinaliza a necessidade de ações que propiciem qualidade de vida a essas pessoas.

Organizational Support for Social Justice in Public Health Nursing Practice: A Conceptual Framework.

Notwithstanding the significant representation of social justice as a theoretical ideal of public health nursing (PHN), there is little agreement about how the concept is applied in PHN practice and supported by nurse leaders and organizations. A framework for social justice praxis in PHN was developed after a critical review of the literature to advance the ability of nurse leaders and healthcare administrators to support social justice praxis in PHN. This conceptual framework provides a foundation from which nursing leaders can launch meaningful conversations and make specific efforts toward achieving social justice to improve health equity.

Enfrentamento da sífilis a partir da ampliação da clínica do enfermeiro / Fighting syphilis from the widening of nurse ́s clinical skills / Abordar la sífilis desde la expansión de la clínica de enfermeras

Objetivo: relatar a vivência de enfermeiros da Atenção Primária à Saúde, na implantação do Protocolo de ampliação da clínica para o enfrentamento da sífilis. Método: estudo descritivo, do tipo relato de experiência, desenvolvido junto aos Centros de Saúde da Secretaria Municipal de Saúde de Florianópolis - Santa Catarina, Brasil. Resultados: a vivência profissional no processo de implantação do Protocolo de Enfermagem no enfrentamento da sífilis ­ Volume II ­ seguiu as seguintes etapas: revisão das evidências científicas sobre a aplicação da penicilina na Atenção Primária à Saúde; capacitação dos enfermeiros da rede municipal de saúde; acompanhamento e educação permanente dos profissionais; e monitoramento e avaliação de todo o processo. Conclusão: observou-se que no período de três anos desde a publicação do Protocolo Clínico de Enfermagem houve importante aumento na participação clínica do enfermeiro em atendimentos individuais. Tal documento representou um marco na assistência de enfermagem do município, não só pela autonomia proporcionada, mas também pelo importante papel desempenhado na segurança profissional e do paciente. (AU)

Objetive: To report nurses' experience in Primary Health Care, in the implementation of the clinic expansion protocol to fight syphilis. Methods: Descriptive study of the experience report type, developed at the Health Centers of the Municipal Health Department of Florianópolis - Santa Catarina, Brazil. Results: The professional experience in the process of implementing the Nursing Protocol in coping with syphilis ­ Volume II ­ followed the following steps: review of scientific evidence on the application of penicillin in Primary Health Care; training of nurses in the municipal health network; monitoring and continuing education of professionals; and monitoring and evaluation of the entire process. Conclusion: It was observed that in the three year period since the publication of the Clinical Nursing Protocol, there was an important increase in the clinical participation of nurses in individual care. This document represented a milestone in the municipality's nursing care, not only because of the autonomy it provides, but also because of the important role it plays in professional and patient safety. (AU)

Objetivo: Reportar la experiencia de enfermeras de Atención Primaria de Salud, en la implementación del protocolo de ampliación de la clínica para el tratamiento de la sífilis. Métodos: Estudio descriptivo del tipo relato de experiencia, desarrollado en los Centros de Salud del Departamento Municipal de Salud de Florianópolis - Santa Catarina, Brasil. Resultados: La experiencia profesional en el proceso de implementación del Protocolo de Enfermería en el afrontamiento de la sífilis - Volumen II - siguió los siguientes pasos: revisión de la evidencia científica sobre la aplicación de penicilina en Atención Primaria de Salud; formación de enfermeras en la red municipal de salud; seguimiento y formación continua de profesionales; y seguimiento y evaluación de todo el proceso. Conclusión: Se observó que en el trienio transcurrido desde la publicación del Protocolo de Enfermería Clínica, hubo un aumento importante en la participación clínica de los enfermeros en la atención individual. Este documento representó un hito en la atención de enfermería del municipio, no solo por la autonomía que brinda, sino también por el importante papel que juega en la seguridad profesional y del paciente. (AU)

The Nursing Situation in the Region of the Americas

This infographic presents the nursing situation in the Region of the Americas in a concise way. It contains sex-disaggregated data and percentages reflecting the situation of the nursing professionals compared with that of the health workers in all countries. The information is based on the State of the world's nursing 2020: investing in education, jobs and leadership, published by the World Health Organization. It is addressed to governments, ministries of health, universities, professionals, students, and other interested parties.

[Gaining consensus on key terms in community health activities: A national survey using the Delphi method].

Objectives　The purpose of this study was to define the terminology used in community health activities by systematically establishing agreement among public health nurses and related professionals, to aid them in effectively cooperating with other professionals.Methods　We extracted the major terms described in "Guidelines for Public Health Nurses' Activities in the Region," which was issued by the Director of Health Bureau, Ministry of Health, Labor and Welfare; and conducted 2 iterations on the proposed definition of the terms using the Delphi method. The survey targeted 800 stakeholders from the following 4 professions: public health nurses in managerial positions in local governments, clerical staff in local governments, public health nursing professors at educational institutions, and social welfare council staff. Respondents indicated their degree of agreement with the definition of the terms using a 4-point Likert scale. We tallied the answers indicating "I agree" or "Mostly agree." A 70% term agreement was considered "conformed." A free text box for each proposed definition was also available so that respondents could share their opinions and offer alternatives.Results　The first survey received 231 responses. The conformity of their definitions ranged from 83.9%-96.9% (mean=91.5%). Although all definitions exceeded the consensus level, we examined their adequacy with reference to the definitions and opinions from the free text. Various opinions were obtained from those engaged in each occupation. The second round included 117 consenting stakeholders from the first survey, yielding 90 responses. Their degree of conformity ranged from 86.7%-98.9% (mean=94.6%). Therefore, we determined the definitions had reached a robust agreement. We revised the definitions of some terms with reference to the opinions from the free texts and finalized the definitions. Finally, we defined 23 terms-such as region, community diagnosis, and policy.Conclusion　All terms had a conformity of more than 85%, thus bringing into alignment those community health terms that had varying interpretations among related occupations earlier. By including the opinions of those from the related occupations who collaborate with public health nurses, the definitions of these terms could be established and shared. These definitions can be used in public health nursing practice, education, service, and research-among those in involved these related occupations.

Nurse contribution to the construction of health policy in the state of Bahia (1925-1930).

OBJECTIVE: to analyze the contribution of nurses to the construction of health policy in the state of Bahia, from 1925 to 1930. METHODS: qualitative research, from a historical nature. Data were retrieved from five public archives, organized in a documentary corpus, and analyzed based on the health political analysis and the social control concepts, health policy and public health. RESULTS: from 1925 to 1930, the State seized the work of the woman/nurse and established it in public health. This fact enabled the nurse's contribution to the construction of the health policy of the state of Bahia, which took place by the implementation of sanitary education actions, home visits and hygienic surveillance. FINAL CONSIDERATIONS: the female nurse's work made the health policy of the state of Bahia viable and was an ideal instrument to access homes and instruct/advise people in their daily lives to adopt behaviors that prevent the occurrence and, above all, the spread of diseases.

Does it make a difference? Exploring the value of combining public health and nursing education.

BACKGROUND: Within the evolving United States healthcare system, there is a need to strengthen the public health nursing workforce. Historical and more recent trends within nursing education have demonstrated this need. Nurses who obtain a Master of Public Health (MPH) contribute to this workforce's development. PURPOSE: This study aimed to describe nurses' educational and professional experiences with an MPH and better understand how professionals use this combination in practice. METHODS: This study utilized a phenomenological, qualitative research method. Researchers interviewed 11 nurses with an MPH via the telephone. The researchers independently coded the interview transcripts and developed a codebook. Qualitative analysis facilitated the emergence of subsequent themes. RESULTS: Four themes emerged: (1) educational pathway decisions, (2) education experience, (3) role in the workforce, and (4) nursing and public health in practice. Participants worked in a variety of settings, including primary care, academia, and administration. All participants reported utilizing their nursing and public health skills and described the actual integration of these skills in the workplace. CONCLUSION: These findings suggest that nurses with an MPH value the education and report being better equipped to promote health on both the individual and community levels.

Civic engagement: School-based health centers and public health nursing.

OBJECTIVES: To understand how the events of the 1996 formation of a school-based health center (SBHC) both illustrate the concept of civic engagement and embody historic aspects of public health nursing practice. DESIGN: Case study design. SAMPLE: Interviews, documents, epidemiologic records, and field observations. RESULTS: The three themes discovered were collaboration to achieve public good, equity and social justice, creation of a long-term partnership, and demonstration of leadership using grassroots advocacy. CONCLUSION: The SBHC case serves as a contemporary example of public health nurses' leadership in the current practice arena. The experience of nurse leadership evokes the historic mission and practice of public health nursing.

Motivação dos homens na busca por assistência prestada pelas estratégias de saúde da família / Motivation of men in search of assistance provided by the family health strategy / Motivación de hombres en la busca de ayuda proporcionada por las estrategias de salud de la familia

Objetivo: investigar a motivação dos homens na busca por assistência prestada pela Estratégia Saúde da Família. Método: estudo descritivo, exploratório, com abordagem quantitativa, realizada em uma equipe de saúde da família, de modo que a amostra compreendeu 30 homens cadastrados na área de abrangência. Foi utilizado um questionário semiestruturado cujos dados foram analisados conforme epidemiologia descritiva. Resultados: trata-se de homens entre 20 e 74 anos; casados; Ensino Fundamental; predomínio da profissão de pedreiro os quais 67% trabalham no período diurno. Dos serviços procurados, 68% correspondem à Medicina cuja motivação da procura foi por consultas e exames. Quanto aos fatores dificultadores, destaca-se a resistência dos homens; a falta de tempo decorrente da dedicação ao trabalho; e ao comodismo. Conclusão: a motivação dos homens pela procura ao serviço ocorreu por ações de cunho curativo com predomínio de queixas agudas na qual as práticas preventivas não fazem parte do cotidiano.(AU)

Objective: to investigate the motivation of men in search of assistance provided by the Family Health Strategy. Method: a descriptive study, exploratory, with a quantitative approach, performed in a family health team in which the sample included 30 men registered in the coverage area. A semi-structured questionnaire was used in which the data were analyzed according to descriptive epidemiology. Results: these are men between 20-74 years; married; elementary school; predominance mason profession in which 67% work in the daytime. Of popular services, 68% correspond to medicine whose motivation demand was for consultations and exam. As for complicating factors, there is the strength of men; lack of time due to the hard work; and convenience. Conclusion: the motivation of men by demand service occurred curative nature of actions with a predominance of acute complaints where preventive practices are not part of everyday life.(AU)

Objetivo: investigar la motivación masculina en busca de asistencia en la Estrategia Salud de la Familia. Método: estudio descriptivo, exploratorio, con abordaje cuantitativo, realizado en un equipo de salud de la familia, la muestra incluía 30 hombres registrados en el área. Se utilizó un cuestionario semiestructurado en el que se analizaron los datos por medio de epidemiología descriptiva. Resultados: hombres entre 20-74 años; casado; enseñanza fundamental; predominio de albañilesque trabajan durante el día. De los servicios buscados, 68% corresponde a la medicina cuya motivación fue las consultas y exámenes. Cuanto a los factores de complicación, se destaca la resistenciamasculina; la falta de tiempo debido a dedicación del trabajo; y la comodidad. Conclusión: la motivación masculina por la demanda del servicio se produjo la naturaleza curativa de las acciones con un predominio de las quejas agudas en las que las prácticas preventivas no son parte de la vida cotidiana.(AU)

Developing sustainable public health care systems for responding to COVID-19 in Japan.

OBJECTIVE: Despite having prevented public health center (PHC) dysfunction in response to COVID-19 during the first wave, public health nurses (PHNs) who play a central role in preventing COVID-19 and supporting community people were unable to share practical knowledge with other PHNs immediately. This report aims to introduce the development of novel sustainable public health care systems with regard to COVID-19 in Japan: task sharing, securing staff, and task shifting. METHODS: A descriptive study. The Japan Ministry of Health, Labour, and Welfare enlisted good practices regarding resource allocation and developing full readiness for sustainable public health care systems in September 2020. RESULTS: Public health center developed systems for office support, infection control, hospital coordination, and outsourced inventory control. To reduce the workload of PHNs, a support team of three to four office workers developed a response manual for residents and a format for telephone consultations regarding COVID-19. Developing an infection control team and web-based system for hospital coordination decreased the workload of PHCs in each community to prepare for the pandemic. CONCLUSION: Public health center should consider managing limited human resources and focus on providing specialized care for COVID-19 patients. Task sharing, securing staff, and task shifting are crucial strategies for developing sustainable public health care systems.