Cases of intervention refusal encountered by public health nurses in Japan and characteristics of their support- qualitative analysis of described mother-child and elderly cases.

BACKGROUND: The purpose of this study is to clarify the actual situation of the cases and the characteristics of support, focusing on mothers and their children, and elderly persons among the cases of intervention refusal encountered by public health nurses (PHNs) in Japan. METHODS: The data were descriptions of intervention refusal cases that were freely described by PHNs working for prefectural and municipal governments in questionnaire surveys nationwide. The characteristics of the cases and the support were categorized according to the situation of the case, and the number of descriptions was summarized and interpreted. RESULTS: The results revealed that interventions involving mothers and children were refused in most of by mother or parents. The refusals were related to child abuse, parental mental illness, obsessiveness, and complex backgrounds. The actual status of intervention refusal in elderly persons, interventions are frequently refused by elderly persons themselves in the case of self-neglect and by family members living with the elderly in the case of abuse. The refusals were related to mental disorders or dementia and living alone. In both cases, PHNs provided support in collaboration with multi-disciplinary and multi-agencies, and attempts were made to alleviate the situation of refusal to intervene, from detecting cases through contact during home visits and in other settings, and by coordinating with appropriate team members as required. CONCLUSIONS: It is suggested that PHNs need to acquire practical skills depending on the characteristics of the case to cope with critical situations throughout the process of engagement.

Development of a prenatal smoking cessation counseling scale for public health nurses in Japan.

INTRODUCTION: This study aimed to develop a scale to measure prenatal smoking cessation counseling for Japanese public health nurses (PHNs). METHODS: A cross-sectional study was conducted via an anonymous, self-administered questionnaire. The sample included 1933 PHNs working in 424 municipal health centers nationwide, which were randomly selected. We created the draft scale based on semi-structured interviews, previous studies, and preliminary survey. Additionally, we conducted back translation for English version of the draft scale to be applicable in English countries. The analytic strategy consisted of item analysis, exploratory factor analysis, and differentiation by 'known groups'. RESULTS: A total of 550 responses (28.5%) were included in the analysis. Most of the respondents were female (98.2%) and the mean age was 37.5±9.37 years. In the exploratory factor analysis, two factors were extracted and the factor loadings for all items were greater than 0.40. The first factor with eleven items was named as 'basic counseling' and the second factor with seven items was named as 'advanced counseling'. The Cronbach's alpha of the scale was 0.918, and the cumulative contribution was 44.908%. Multiple comparisons by experience years working as a PHN revealed significant differences in the scale and two factors. CONCLUSIONS: In this study, we initially developed the prenatal smoking cessation counseling scale for Japanese PHNs, and the reliability and validity of the scale were considered to be acceptable.

Factors Associated with Nursing Interventions for Smoking Cessation: A Narrative Review.

The purpose of this narrative review is to synthesize the factors that are associated with smoking cessation intervention among nurses. We conducted a systematic search of the literature published from database inception through to 22 April 2020, in five electronic databases including Pubmed, CINAHL Plus, Scopus, Web of science, and ProQuest. The search was limited to articles written in English and published in scientific journals. The reference lists of papers identified as being relevant in the above electronic searches were also hand searched. The initial database search yielded 2039 articles and 11 articles were obtained through a manual search. Finally, 24 articles were included in the analysis. Of the 24 included studies, 46 different factors were identified to be significantly associated with nursing interventions for smoking cessation. The identified factors were grouped into the following four conceptually similar categories: (1) socioeconomic factors, (2) smoking-related factors, (3) motivational factors, and (4) enabling factors and barriers. In the future, nursing interventions for smoking cessation will need to be improved based on the identified factors.

Factors Associated with Prenatal Smoking Cessation Interventions among Public Health Nurses in Japan.

This study aimed to identify the factors associated with prenatal smoking cessation interventions based on the 5As model among public health nurses (PHNs) in Japan. A nationwide cross-sectional study was conducted from December 2019 to February 2020 via a self-administered questionnaire. The study subjects were 1988 PHNs working in 431 health centers of municipalities and special wards across the country. Of the 1988 questionnaires mailed, 521 responses (26.2%) were included in the analysis. Of the 521 responses, most of the respondents were female (98.1%) and the mean age was 37.5 years. There were statistically significant differences on age, work regions, experience years working as a PHN and smoking cessation training after becoming a PHN in implementing the 5As. Self-efficacy, professional development competency, research utilization competency, age and experience years working as a PHN were positively associated with the 5As. Social nicotine dependence was negatively associated with the 5As. Furthermore, self-efficacy mediated the relationship between the 5As and professional development competency, research utilization competency, social nicotine dependence, age and experience years working as a PHN. In the future, smoking cessation intervention training should be widely implemented to improve self-efficacy and prenatal smoking cessation interventions among Japanese PHNs.

Effectiveness of simulation learning program for mastering public health nursing skills to enhance strength of community: A quasi-experimental design.

PURPOSE: The purpose of this study is to develop a simulation learning program for mastering public health nursing skills to enhance strength of community, and to verify its effectiveness. METHODS: The program is one-day session to master the skills from three exercises. This study adopts a quasi-experimental design. We selected unbiased 34 participants in intervention group and 30 participants in control group, and conducted self-administered questionnaire surveys at three points in time: pre, post 1 and post 2. Three tools were used to measure the required outcome. For the outcome evaluation, we calculated the changes in the mean value of each tool between pre and post 1 and between pre and post 2, and compared them between the two groups. RESULTS: The change of intervention group in the total score at the post 1 stage from the pre stage was significantly higher than control group regarding each of the scales (P < .05). CONCLUSIONS: The program was found to be effective in upgrading the skills of less-experienced public health nurses to enhance strength of community.

The status and future directions of comprehensive tobacco control policies for the 2020 Tokyo Olympic Games: A review.

INTRODUCTION: This review aims to clarify the status and future directions of comprehensive tobacco control policies for the 2020 Tokyo Olympic Games based on a comparison with seventeen countries that hosted the Olympic Games. METHODS: Seventeen countries that hosted the Olympic Games from 1988 to 2018 were identified by searching the website of IOC. A comparison of the contents was carried out by six themes (Monitor, Protect, Offer, Warn, Enforcement and Raise) in accordance with the MPOWER package for implementation of the FCTC. The comparison items and data were obtained from Global Health Observatory (GHO) data, Japanese government websites, and the literature. Based on the MPOWER scale, the 17 countries were ranked by total score, and a correlation between smoking prevalence and MPOWER total scores was established. RESULTS: The following three results were clarified: 1) Compared to the 17 countries that hosted the Olympic Games, smoking prevalence in Japan at 22.5% is at a moderate level and male smoking prevalence (33.7%) is still higher than other developed countries such as UK (24.7%) and Australia (16.5%); 2) Japanese tobacco control policies were far behind other countries that hosted the Olympic Games, especially in protecting people from tobacco smoke, warning about the dangers of tobacco, anti-tobacco mass media campaigns and enforcing bans on tobacco advertising, promotion, and sponsorship; and 3) The better practice in MPOWER was able to reduce total and male smoking prevalence in the study countries. CONCLUSIONS: Japanese tobacco control policies are far behind other countries that hosted the Olympic Games. In order to successfully hold the 2020 Tokyo Olympic Games, it will be necessary to strengthen tobacco control policies, based on the FCTC, in the future.