Experiences of municipal public health nurses following Japan's earthquake, tsunami, and nuclear disaster.

OBJECTIVE: The purpose of this study was to explore the experiences of municipal public health nurses in the wake of the March 2011 massive earthquake and tsunami and resulting nuclear accident in Fukushima, Japan, from the time of the disaster until December 2013. DESIGN AND SAMPLE: Thirty-two public health nurses working in three cities in Fukushima prefecture were divided into four focus groups and took part in interviews, which were analyzed using a qualitative descriptive method. RESULTS: Two major themes were extracted: (1) experiences of difficulties and dilemmas, and (2) professional challenges and the meaning of excellence as a public health nurse. Subjects recounted their experiences based on the timeline of events. The process of overcoming various dilemmas--between prescribed roles and actual needs on the ground, being both civil servants and private citizens with families, and having to be publicly accountable while lacking adequate information--caused participants to reexamine the meaning of excellence in the practice of public health. CONCLUSION: The strenuous and complex demands of extended disaster management caused subjects to grow professionally. Helping them process their emotions should also help these nurses give focus to their posttraumatic growth, and strengthen their sense of professionalism.

Health support program for family members with hospitalized child.

In 2001, we began conducting Health Support Programs on the pediatric ward of Miyazaki Medical College Hospital. The program is designed to help family members who accompany and care for their children who are ill and hospitalized to practice some physical movements for their own benefit. An interview survey was undertaken to clarify the effects and the purpose of the program by evaluating subjective data from program participants, as well as by evaluating changes in participants' blood pressure rates. Findings indicate that the program's effects include "reduction of stress and/or lack of exercise," "refreshing effect," "comfort and/or exhilaration," "relaxation," and "alleviation of physical symptoms." We also have noted that mothers become more aware of their own health issues and that the program offers an opportunity to reexamine their health conditions. Furtherrnore, we have learned that for parents and children who participate together, the program offers a fun environment, and that, on occasion, mothers are the ones who are cared for in the program.

[Mental health status and effects on daily life of patients of a large outbreak of Legionnaires Disease].

OBJECTIVES: The aim of this study was to survey mental health status among patients of a large outbreak of Legionnaires Disease (LD) occurring at a public bath in Hyuga City, Miyazaki Prefecture, from June through July, 2002. It also aimed to provide a basis for establishing a mental health care support system for persons suffering from ill health. METHODS: Some 295 patients were reported by medical institutions to public health centers as being infected with LD or having suspected infection after using a hot springs bath, where hygiene was assumed to be maintained by regular water circulation, from 6/20 through 7/23, 2002 in Hyuga City, Miyazaki Prefecture. A total of 153 subjects consented to interviews after being informed of the objectives. They were visited and interviewed with a questionnaire from 10/12 through 12/5, 2002. Questions about mental health were written to identify "feeling stressed", based on diagnostic criteria for Post Traumatic Stress Disorder (PTSD) as noted in the DSM-IV. The Japanese version of the General Health Questionnaire (GHQ28) was used to identify high risk subjects for mental disorder, as well as the following four symptoms: "somatic symptoms", "anxiety and insomnia", "social dysfunction", and "severe depression". Factors associated with these were assessed with regard to knowledge and/or information about LD and its effects on daily life. RESULTS: Regarding mental health, 27 (17.6%) were "feeling stressed". High risk patients for mental disorder numbered 39 (25.5%) according to the GHQ28. Patients with "somatic symptoms" numbered 44 (28.8%), those with "anxiety and insomnia" 21 (13.7%), those with "social dysfunction" 18 (11.8%) and with "severe depression" 5 (3.3%). Among the effects on daily life, "changes of human relationships" was related with "feeling stressed" in those suspected of LD infections (P = 0.022). High risk was related to "economic support" (P = 0.009) in LD, and also to "cause and survey" (P = 0.035) in those cases suspected of LD. CONCLUSIONS: At 3 to 4 months after the outbreak, the patients still exhibited mental health problems. Therefore we should provide health and social support that deals with the factors identified on a longer-term or continuous basis.