ABSTRACT
Background: Improving breast cancer screening rates is crucial for early detection. However, factors hindering regular screening among working women remain unclear. This study aimed to clarify screening behavior among working women in Japan and associated discouraging factors. Methods: Surveys were conducted from April to May 2019 among women aged 40-60 at public offices and companies in Tottori Prefecture. We used two surveys: the "Basic Attributes Questionnaire" and the "Structural Questionnaire on Rejecting Screening." Data analysis involved chi-squared tests, logistic regression analysis, factor analysis, and nonparametric tests. Results: Completed questionnaires analyzed were 668 out of 825 collected (response rate: 81.0%). Most participants were part-time employees with an average age of 51 years. Over 60% reported undergoing regular screening. Logistic regression analysis identified part-time employment, lack of children, a discouraging workplace atmosphere, and absence of personal connections to breast cancer patients as factors associated with avoiding breast cancer screening. Factor analysis identified five factors and 16 items as reasons for not undergoing regular screening. Women who had no spouse, no children or felt that their workplace was not encouraging breast screening felt difficulty in scheduling screening most strongly. Conclusion: Individuals who had part-time employment and had no children, did not know a breast cancer patient, or considered that their workplace environment was not supportive were more likely to avoid undergoing regular breast cancer screening. Also, women who did not undergo regular screening experienced difficulty in scheduling. In the future, the challenge lies in disseminating accurate knowledge about breast cancer to foster awareness without excessive anxiety.
ABSTRACT
BACKGROUND: The majority of nurses are employed at medical institutions and acquire clinical competency through their work within their organization. Hands-on experience in the clinical setting is essential to enhance a nurse's clinical competence. The objective of this study was to determine the impact of commitment to the practical skills of nurses within Tottori prefecture. METHODS: We studied data from 916 nurses employed at 7 publicly-funded medical facilities (national and other public institutions). Data on basic information, clinical nursing competence, and commitment were collected via an anonymous self-administered questionnaire. RESULTS: A total of 672 valid questionnaires were analyzed. Mean clinical nursing competence scores showed a tendency to increase with years of experience. Scores increased from years 1 to 4, and then tended to plateau or decrease slightly thereafter up to around year 9. Mean commitment scores decreased from 1 to 2 years of experience to 3 to 4 years of experience. Other than "normative factors," mean scores tended to increase after 5 to 10 years of experience. Multiple regression analysis showed that "job involvement" at 1 to 2 years; "overall job satisfaction" at 5 to 9 years; "career commitment" at 10 to 19 years; and "job involvement" and "career commitment" at ≥ 20 years impacted results. No factors appeared to have an influence on nurses in their 3rd to 4th year of experience. CONCLUSION: Based on the concepts described above, self-assessment of nursing competence scores tended to improve with years of experience. Mean commitment scores tended to decrease after 3 to 4 years of experience and thereafter plateaued or increased. Organizational commitment has not clearly been shown to affect nursing competency, but the factors that affect this parameter changed with the length of experience. Results suggest support is needed in the 1st and 2nd years to help nurses adapt to the organization while in years 5 through 9, support that takes work-life balance into consideration is needed. This indicates support should change to meet the needs of each stage in a nurse's career. In years 3 to 4, it was suspected that the nurses' relationship with the organization weakened. Helping nurses forge a good relationship with their organization is believed to be effective in improving clinical competency in nurses with 5 or more years of experience.
ABSTRACT
BACKGROUND: Self-care agency is an important determinant of self-care behavior. The purpose of this study was to identify the causal relationship between self-care agency and healthy behavior, and to construct a conceptual model of healthy behavior among older people living in a rural community. METHODS: This study was conducted as a cross-sectional survey at the Hino, a town in western Tottori Prefecture, Japan. Participants who were enrolled in the Good Ageing and Intervention against Nursing Care and Activity Decline (GAINA) study from 2014 to 2018 (467 new participants) were initially investigated. Of 398 participants aged ≥ 65 years, 5 were excluded due to missing data, and thus 393 were analyzed. Nurse researchers conducted face-to-face interviews with participants to check the accuracy of data obtained from a self-administered questionnaire, which included demographic information, physical condition (comorbidities, knee pain, low back pain, and locomotive syndrome), healthy behavior, and self-care agency. Correlations among variables were investigated by Pearson's correlation coefficient analysis, and path analysis was performed to assess causal relationships. RESULTS: A total of 393 persons (160 men and 233 women) were investigated, ranging in age from 65 to 92 years, with a mean age of 75.1 years (SD: 6.9 years). Path analysis revealed poor fit of a model in which pain and locomotive syndrome were factors inhibiting healthy behavior. When the model included only self-care agency, the indices of model fit were almost satisfactory (Goodness-of-fit index = 0.967, Adjusted goodness-of-fit index = 0.900, Comparative fit index = 0.951, and Root mean square error of approximation = 0.088), and the coefficient of determination (R2) was 0.38. The self-care agency items with the greatest influence on healthy behavior were the ability to "grasp the techniques/tips needed to maintain health," and the ability to "persist with healthy behavior." CONCLUSION: Self-care agency can promote healthy behavior among community-dwelling older people. Regardless of physical problems such as pain and locomotive syndrome, older people have the potential to adopt positive healthy behavior if they acquire self-care agency.