Strategies for tobacco-free survivorship after breast cancer: The possible weaving of preoperative care and public health policies

Among smoker women with breast cancer quitting smoking has been shown to increase survival and surgical outcomes. Where surgery is indicated, the preoperative seems to be a crucial moment for smoking cessation interventions as it enhances recovery after surgery and motivates prolonged tobacco abstinence. Timing and frequency of preoperative quitting conversations were variables associated with quitting. An early, multidisciplinary, and personalized approach is recommended. A solid integration between primary care services and specialized care is challenging but feasible, implementing prehabilitation pathways that include tobacco treatment routinely as an integral part of breast cancer care. Smoking cessation programs before surgical procedures impact recidivism prevention, survivorship improvement, public health, and cost savings. The contribution of healthcare professionals can make a difference in tobacco control, collaborating with organizations, public health, and nursing research. Integrated solutions in oncological clinical care pathways might help patients build and maintain tobacco abstinence after breast cancer. Future research shall study when patients should abstain from smoking before oncological breast surgery.

The development and challenges of public health nursing education in China from 1912 to 1949: A historical study

OBJECTIVE

To examine the development and challenges of public health nursing education in China during the period of the Republic of China (1912-1949).

METHODS

This study utilized a historical research design that combined a social framework and a policy framework to explore the early history of public health nursing education in China. Historical data were collected from periodicals, newspapers, archives, books and other sources.

RESULTS

Public health was integrated into the nursing school curriculum for the first time during the period of the Republic of China, and health facilities and nursing schools conducted early explorations of public health nurse training. However, public health nursing education faced difficulties in terms of the curriculum, personnel training, and the localization of education.

CONCLUSIONS

The achievements and difficulties associated with public health nursing education in China during the period of the Republic of China provide a historical reference for the integration of public health into current basic nursing education and the compatibility between the training of public health nurses and practical needs. Comparative studies of early public health nursing education across countries are expected to offer a better understanding of current public health nursing education.

The four stages of neighborhood trust: Classic grounded theory

INTRODUCTION

Neighborhoods are often overlooked as a determinant of health. Among recent research, the focus on "place-based effects," due to prolonged residential environmental exposure, has been of particular interest. These studies' purpose is to identify and examine how a healthy neighborhood is intentionally created to describe a transferable process-driven theory.

METHOD

A classic grounded theory approach was used in these studies. Data sources include individual in-depth interviews, historical documents, and a member-checking focus group, collected over 3-years.

RESULTS

Analysis generated the Four Stages of Neighborhood Trust Model, which is nested within the context of perceived neighborhood safety. The theory outlines a social process of four stages of neighborhood trust: (a) rules-based agreements, (b) shared values, (c) cooperation, and (d) neighborhood belonging.

CONCLUSIONS

We present the development of a process-driven theory that may be useful for public health nurses as they engage neighborhoods in health promotion activities. The stage of trust development will aid the nurse in identifying what is needed to move to the next stage in a healthy neighborhood process.

Bridging the gap: Innovating undergraduate public health nursing education through a service-learning health fair project

Amidst a critical shortage of registered nurses, nursing schools are aiming to expand enrollment while working with ongoing resource constraints. Service-learning clinical activities can enhance nursing education by improving clinical quality, addressing faculty and clinical site shortages, and meeting increasing enrollment demands. This paper describes a health fair experience that served as a service-learning clinical experience within an undergraduate public health nursing course. The experience bridged theoretical knowledge with real-world application, fostering competency-based learning and addressing community health needs, resulting in a positive impact on students, faculty, and the community.

Nurses' mental workload and public health emergency response capacity in COVID-19 pandemic: A cross-sectional study

AIMS

The aim of this study was to assess the level of mental workload of Chinese nurses through a latent profile analysis and to explore its relationship with public health emergency response capacity.

DESIGN

A cross-sectional design with a convenience sample.

METHODS

A convenience sample of nurses from five tertiary hospitals in Chengdu between May and December 2022. Demographic, work-related information, Nurse's version of NASA's Task Load Index Scale and Nurse's Public Health Emergency Response Capacity Scale were used in this study.

RESULTS

The mean scores for mental workload and emergency response capacity for nurses were (57.19 ± 15.67) and (3.58 ± 0.77) respectively. We found that the mental workload of nurses fell into three potential categories. In addition, there were differences in psychological training and supply of epidemic prevention materials in the department among nurses with different mental workload subtypes. There was a moderate negative correlation between nurses' mental workload and public health emergency response capacity.

CONCLUSION

Our results show that there is still a strong mental workload on a proportion of nurses, and enhanced psychological training and material supply support are beneficial in relieving nurses' mental workload. The better the nurses' capacity to cope with public health emergencies, the lower their mental workload.

IMPACT

Nursing managers should pay ongoing attention to the mental workload status of nurses in the latter stages of a pandemic and individual differences in nurses' mental workload. In addition, nursing managers should be aware of the impact of public health emergency response capacity on nurses' mental workload. They can intervene in nurses mental workload from a new perspective.

PATIENT OR PUBLIC CONTRIBUTION

560 registered nurses participated in this study.

Evidence of validity of the Smoking Cessation Counseling scale - Brazilian version

OBJECTIVE

to evaluate the evidence of validity of the internal structure and reliability of the Brazilian version of the Smoking Cessation Counseling instrument.

METHOD

psychometric study of confirmatory factor analysis and reliability carried out on 250 nurses in clinical practice. For the analysis of the convergent validity of the factor model, Average Variance Extracted values were calculated, and discriminant analysis was carried out using the Fornell-Larcker criterion. Reliability was examined using Cronbach's alpha coefficient and composite reliability.

RESULTS

it was necessary to exclude seven items from the Advanced Counseling domain and one item from the Basic Counseling domain in order to properly obtain the Average Variance Extracted values and the Fornell-Larcker criterion. The composite reliability ranged from 0.76 to 0.86 and the overall Cronbach`s alpha coefficient was 0.86, ranging from 0.53 to 0.84 depending on the domain assessed. The final version of the instrument was made up of 16 items divided into 4 domains.

CONCLUSION

the Brazilian version of Smoking Cessation Counseling obtained adequate psychometric evidence of validity and reliability. Further studies are needed to refine the instrument.

BACKGROUND

(1) Instrument shows adequate internal consistency and validity.

BACKGROUND

(2) Evaluate counseling practices and their impact on patient care.

BACKGROUND

(3) Instrument for evaluating smoking cessation counseling.

BACKGROUND

(4) Provides important information for planning nursing care.

Predictors of parenting difficulties at the 18-month health checkups: A retrospective study using administrative data from infant health checkups

OBJECTIVE

This study aimed to identify predictors of parenting difficulties at 18 months from the results of the 4-, 6-7-, and 9-10-month infant health checkups among caregivers who had not experienced difficulties at 4 months.

DESIGN AND SAMPLES

This retrospective study used data from infant health checkups conducted in a city in Tokyo from November 2019 to October 2021. The participants were caregiver-child dyads of children who had undergone four checkups. Low birthweight, preterm, and multiple birth infants, and caregivers who experienced difficulties at 4 months were excluded.

MEASUREMENTS

Data included caregiver, child-rearing environment, and child factors at the 4-, 6-7-, and 9-10-month checkups and caregivers' self-reported parenting difficulties at the 18-month checkup.

RESULTS

Of the 555 caregivers, 48 (8.6%) experienced parenting difficulties at 18 months. Logistic regression analyses showed that mothers' physical condition (4 months), children being male, abnormal child growth (4 months), less than 10th percentile for children's height (6-7 and 9-10 months), and abnormal examination results (6-7 months) were significantly associated with parenting difficulties at 18 months.

CONCLUSIONS

To prevent child abuse, public health nurses should consider the identified factors to detect and support caregivers with emerging parenting difficulties.

Prediction of drinking water quality with machine learning models: A public health nursing approach

OBJECTIVE

The aim of this study is to use machine learning models to predict drinking water quality from a public health nursing approach.

DESIGN

Machine learning study.

SAMPLE

"Water Quality Dataset" was used in the study. The dataset contains physical and chemical measurements of water quality for 2400 different water bodies. The process consists of four stages: Data processing with Synthetic Minority Oversampling Technique, hyperparameter tuning with 10-fold cross-validation, modeling and comparative analysis. 80% of the dataset is allocated as training data and 20% as test data. ML models logistic regression, K-nearest neighbor, support vector machine, random forest, XGBoost, AdaBoost Classifier, Decision Tree algorithms were used for water quality prediction. Accuracy, precision, recall, F1 score and AUC performance metrics of ML models were compared. To evaluate the performance of the models, 10-fold cross-validation was used and a comparative analysis was performed. The p-values of the models were also compared.

RESULTS

N this study, where drinking water quality was predicted with seven different ML algorithms, it can be said that XGBoost and Random Forest are the best classification models in all performance metrics. There is a significant difference in all ML algorithms according to the p-value. The H0 hypothesis is accepted for these algorithms. According to the H0 hypothesis, there is no difference between actual values and predicted values.

CONCLUSION

In conclusion, the use of ML models in the prediction of drinking water quality can help nurses greatly improve access to clean water, a human right, be more knowledgeable about water quality, and protect the health of individuals.

The needs of multiple birth families during the first 1001 critical days: A rapid review with a systematic literature search and narrative synthesis

OBJECTIVE

Supporting families during the first 1001 days from conception to the age of two is vital for setting the emotional, cognitive, and physical building blocks for children's futures. Families with twins, triplets, or higher order multiples (multiple birth families) have unique challenges due to caring for more than one baby at the same time. Therefore, identifying the needs of multiple birth families is necessary to provide optimum support during the first 1001 critical days.

DESIGN

A rapid review was undertaken to synthesize knowledge of the needs of multiple birth families in the United Kingdom (UK) during the first 1001 critical days. Findings from five databases (MEDLINE, APA PsycArticles, APA PsycInfo, CINAHL, and Web of Science) for peer-reviewed studies and grey literature published between 2012 and 2022 were synthesized. Fifteen studies were reviewed using narrative synthesis.

RESULTS

Multiple birth families have unique and complex emotional and practical needs across the first 1001 critical days, and in particular, the first-year post birth, impacted further by complicated pregnancies and prematurity. Needs were identified within the four key themes: high risk pregnancy and birth; transformed reality of raising multiples; inadequate support; and positively affecting experiences. Health professional support was inconsistent and particularly lacking in intrapartum, postnatal, and community care including transition.

CONCLUSION

Multiple birth families' needs should be considered in the design and delivery of care within the first 1001 critical days, especially within the first year after birth. Multiples specific advice across the first 1001 critical days is needed and training for health professionals to adapt universal advice for this population is one way to achieve this. Further research is needed to ensure this advice is evidence based and effective.

A qualitative study of public health nurses' experiences detecting and preventing child maltreatment in primary care settings

AIM

To explore how public health nurses in child and family health centres experience detecting and preventing child maltreatment.

DESIGN

Qualitative study.

METHODS

Fourteen semi-structured individual interviews with public health nurses who worked in 11 different child and family health centres were conducted. The interviews were analysed using thematic analysis.

RESULTS

Three themes were identified: (i) integrating knowledge to prevent child maltreatment as part of their everyday job, (ii) striving hard to detect child maltreatment and (iii) experiencing the assignment to be complex and demanding.

CONCLUSION

Despite extensive experience, knowledge and following the guidelines, public health nurses in this study had difficulties finding children exposed to child maltreatment in child and family health centres. Public health nurses called for mutual multidisciplinary cooperation with other services and organizational facilitation, such as enough time and clear guidelines to effectively address this issue.

IMPLICATIONS FOR PRACTICE

This study provides knowledge about how public health nurses work with child maltreatment at the Child and Family Health Center, which can serve as valuable foundation for further research as well for collaborating services.

REPORTING METHOD

EQUATOR guidelines were followed, using the COREQ checklist.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Public health nurse reflections on implementing the New Families home visiting programme: A qualitative study

AIM

To investigate reflections of public health nurses (PHNs) on implementing the New Families programme, a supplement to the usual Norwegian child health centre programme. It involves user-led decisions on the content and number of home visits offered by the family's PHN from pregnancy week 28 until the child is 2 years.

DESIGN

An interpretive description approach.

METHODS

Altogether 206 anonymized, undated reflection notes by PHNs becoming familiar with the programme were collected in 2017-2020. NVivo 12 and inductive content analysis were used to convert the data into manageable segments.

RESULTS

Focusing on childhood experiences and parental role expectations among prospective parents during home visits was seen as a major shift in the nurses' counselling strategy. Providing relevant information to the parents-to-be ahead of a meeting was important. Given sufficient staff and guidance, the programme was considered a good basis for building a relationship with the family.

[Comparison and clarification of public health and public health nursing competencies: A report of the Committee on Public Health Nursing (2017-2018)]

Objectives　The Committee on Public Health Nursing (2017-2018) of the Japanese Society of Public Health aimed to elucidate the competencies of public health and public health nursing to provide basic materials for public health, public health nursing education, practice, and research.Methods　We studied the core competencies of public health professionals and public health nursing in the United States and examined similarities to and differences from those in Japan.Results　The United States and Japan shared similar public health and public health nursing competencies in that they targeted populations, identified health problems, and clarified health challenges for effective actions. However, differences were noted in the understanding of target groups, perspectives for identifying health problems and overcoming health challenges, and conceptualization of individuals in populations. In public health, the target population practiced clear boundaries, such as residing in certain geographical areas and ethnic groups, among others. In health challenges, the top-down approach was employed to resolve health problems in certain populations. The individual was recognized as a part of a population composed of a certain group. In public health nursing, target population (e.g., from individuals/families to groups/communities/social groups) were understood in a continuous and multilayered manner. Individual/family health problems were associated with the characteristics of groups, communities, and social groups that encompass the continuum. Moreover, health challenges were addressed in a manner oriented toward the transformation of social groups as a whole. Public health nursing competencies in both countries, which share many similarities, were developed to achieve the objectives of public health. In the United States, the competencies and skills considered necessary, such as analytical/assessment and cultural competency skills, were clearly expressed and constructed in line with the core competencies of public health professionals. However, in Japan, skills and abilities necessary as competencies in public health nursing mentioned above were not specified.Conclusion　Elucidating the core competencies of public health professionals in Japan is essential to develop human resources that can contribute to effective practices in public health and public health nursing. Toward this end, skills and abilities necessary as competencies in public health nursing in Japan, which were not previously verbalized, should be described in detail.

Menstrual hygiene access and practices in Latin America: scoping review

OBJECTIVE

to synthesize available evidence related to menstrual hygiene access and practices in Latin America and the Caribbean.

METHOD

literature scoping review with research protocol registered in the Open Science Framework, carried out in the bibliographic databases: PubMed, Scopus, Web of Science and Portal Regional da Biblioteca Virtual em Saúde. Data were analyzed using simple descriptive statistics and thematic analysis.

RESULTS

15 publications were included, the majority of which addressed adolescents in Brazil: 12 articles, two technical reports and a course conclusion monograph. As recurring themes in the publications, the following stand out: Access to dignified conditions for managing menstrual hygiene; Need for access to information on menstrual hygiene management; and Practices for managing menstrual hygiene.

CONCLUSION

adolescents report difficulties in accessing toilets, water and absorbent materials, and lack of information about menstrual health, including in schools, leading to school absenteeism. Thus, gaps in the Latin American scientific literature reveal inequalities and diversity in menstrual experiences intersected by categories such as gender, social class and ethnicity.

HIGHLIGHTS

(1) Lack of access to hygiene products, toilets and water for personal hygiene. (2) Invisibility of the problem of period poverty in Latin America. (3) Lack of physical structure in schools aggravates and leads to school absenteeism. (4) Menstrual health literacy was insufficient for the demands of adolescents. (5) Primary studies on menstrual hygiene in Latin America are scarce.

Public health nursing: Challenges and innovations for health literacy in rural area

Health literacy is a critical component of public health nursing, particularly in rural areas where access to health services is severely limited. As it relates to quality of care, cost of care, safety of care, and appropriate decision-making in general public health, health literacy can also be seen as an important public policy issue. Several challenges that can be found in rural communities in terms of access to health literacy, such as limited access to healthcare services, limited resources, low literacy rate, cultural and language barriers, financial constraints, and digital divide. Based on these challenges, several innovations can be pursued such as community-based health education, health literacy training among healthcare professionals, digital health technology, partnerships with community-based organizations, health literacy radio programs, and community health ambassadors. This reflection highlights the challenges and innovations that nurses can do to overcome the problem of low-health literacy in rural communities. In the future, the development of community empowerment and technology will be needed to refine the progress made so that a gradual increase in health literacy in rural communities can be seen.

Integrative literature review: Ethylene oxide exposure signs and symptoms

BACKGROUND

Although ethylene oxide (EtO) gas is designated as a human carcinogen, extant literature reports mixed findings on the health effects of exposure. The disparate findings may reflect industry bias as many studies were funded by a large chemical industry lobby.

OBJECTIVE

To conduct an integrative review of studies free from industry bias to facilitate compilation of a comprehensive list of reported signs and symptoms of EtO exposure.

METHODS

We reviewed 1887 papers of which 42 articles met inclusion criteria. The authors conducted this review in accordance with PRISMA guidelines. The presence of bias was assessed using Joanna Briggs Institute checklists.

RESULTS

Non-industry biased literature confirmed serious adverse health effects associated with EtO exposure at the occupational, hospital, and community level. EtO represents a carcinogen, neurotoxin, and respiratory irritant.

CONCLUSION

After removal of industry-biased studies, EtO was unequivocally found to pose a threat to human health. There remains a gap in the number of studies examining community-level exposure, which is essential to understanding the impact of EtO. Given that EtO-emitting facilities are concentrated in diverse and disadvantaged communities, further study of EtO exposure health effects is warranted to inform public policy on toxic air emissions.

A crosswalk of foundational BSN population health documents and the AACN essentials

To guide the development of entry-level nursing education, the American Association of Colleges of Nursing (AACN) published the Essentials document in 2021 with a broadened scope of competencies. Community, population, and public health (CPPH) nurse educators use a number of foundational documents to crosswalk for gaps in the AACN principles, highlighting the need of including these contemporary documents within the baccalaureate CPPH nursing curriculum. In this crosswalk, the authors highlight important capabilities and knowledge exclusive to these fundamental documents and tools, as well as the relevance of these competencies and knowledge to CPPH baccalaureate nursing education.

A qualitative study of school nurses' moral distress related to COVID-19

OBJECTIVE

To understand school nurses' perceptions and experiences of moral distress related to COVID-19 case management in the school systems.

DESIGN

A descriptive qualitative study guided by Braun and Clarke's reflexive thematic analysis.

SAMPLE

Twelve school nurses practicing in Colorado from December 2021 to January 2022.

MEASUREMENTS

Semi-structured interviews about school nurses' experiences of COVID-19. Investigators utilized an iterative reflexive thematic analysis process engaging the participants' and researchers' subjective experiences.

RESULTS

Four themes were created: (1) keeping kids and the community safe, (2) caught in the middle of the "tug of war" between health and politics, (3) distress amid an ocean of COVID-19 uncertainty, and (4) visibility as a bright spot shining through the COVID-19 cloud.

CONCLUSIONS

Two research questions examined school nurses' experiences of moral distress and their role and scope of practice that affected their relationships in the educational and public health systems. The results of this study confirm the important role of school nurses and interprofessional case management in school environments in the fight against infectious diseases and pandemics. Building stronger relationships between school nurses and public health is imperative for future collaborative and cohesive public health responses to pandemics.

Influence of occupational exposure to antineoplastic agents on adverse pregnancy outcomes among nurses: A meta-analysis

AIM

This study aimed to explore the relationship between nurses' occupational exposure to antineoplastic agents and adverse pregnancy outcomes.

DESIGN

Meta-analysis.

METHODS

Data were retrieved from studies published before April 2022 in PubMed, the Cochrane Library, the Web of Science, Embase databases, the China National Knowledge Infrastructure (CNKI), China Biology Medicine disc (CBM), China Science and Technology Journal databases (VIP) and Wan Fang databases (WF). Stata MP (Version 17.0) was used to conduct this meta-analysis.

RESULTS

The current evidence shows that occupational exposure to antineoplastic agents increases nurses' risk of spontaneous abortions, stillbirths, and congenital abnormalities. It is necessary to pay attention to occupational exposures caused by antineoplastic agents, especially for female nurses of reproductive age. Managers should take timely and effective countermeasures to ensure their occupational safety and reduce the risk of adverse pregnancy outcomes.

Tailored Nurse Support Program Promoting Positive Parenting and Family Preservation

BACKGROUND

Public health nurse home visiting is a promising approach for addressing the complex needs of families at risk of child maltreatment. The Colorado Nurse Support Program advances service provision by using evidence-based practices to provide tailored assessment and intervention to low-income, primiparous, and multiparous families with children under 18 years of age identified as high risk by county human service systems.

OBJECTIVES

This study aimed to test the effects of the Nurse Support Program on child protective services case characteristics between Nurse Support Program families and a demographically comparable reference group of families and evaluate changes in parenting outcomes from pre- to postprogram involvement for Nurse Support Program families.

METHODS

We used a matched comparison group quasi-experimental design in which families in the Nurse Support Program ( n = 48) were compared to families ( n = 150) who were identified using administrative data from Colorado's Comprehensive Child Welfare Information System. Outcomes were child protective case characteristics (child protection referrals, open assessments, founded assessments, open cases, and children's placement in out-of-home care) and parenting outcomes.

RESULTS

Nurse Support Program families were less likely to have a child protection case opened or have their child placed in out-of-home care. There were no significant between-group differences in child protection referrals, open assessments, or founded assessments. Families in the Nurse Support Program showed improvements in parenting outcomes over time.

DISCUSSION

Findings suggest that the Nurse Support Program is a successful public health nurse home-visiting approach to promote positive parenting and family preservation among families with complex needs. Implementing tailored public health nurse home-visiting programs, such as the Nurse Support Program, should continue to be evaluated and supported to mitigate the public health risk of child maltreatment.

New Web-Based System for Recording Public Health Nursing Practices and Determining Best Practices: Protocol of an Exploratory Sequential Design

BACKGROUND

Digitalization and information and communication technology (ICT) promote effective, efficient individual and community care. Clinical terminology or taxonomy and its framework visualize individual patients' and nursing interventions' classifications to improve their outcomes and care quality. Public health nurses (PHNs) provide lifelong individual care and community-based activities while developing projects to promote community health. The linkage between these practices and clinical assessment remains tacit. Owing to Japan's lagging digitalization, supervisory PHNs face difficulties in monitoring each department's activities and staff members' performances and competencies. Randomly selected prefectural or municipal PHNs collect data on daily activities and required hours every 3 years. No study has adopted these data for public health nursing care management. PHNs need ICTs to manage their work and improve care quality; it may help identify health needs and suggest best public health nursing practices.

OBJECTIVE

We aim to develop and validate an electronic recording and management system for evaluating different public health nursing practice needs, including individual care, community-based activities, and project development, and for determining their best practices.

METHODS

We used a 2-phase exploratory sequential design (in Japan) comprising 2 phases. In phase 1, we developed the system's architectural framework and a hypothetical algorithm to determine the need for practice review through a literature review and a panel discussion. We designed a cloud-based practice recording system, including a daily record system and a termly review system. The panels included 3 supervisors who were prior PHNs at the prefectural or municipal government, and 1 was the executive director of the Japanese Nursing Association. The panels agreed that the draft architectural framework and hypothetical algorithm were reasonable. The system was not linked to electronic nursing records to protect patient privacy. Phase 2 validated each item through interviews with supervisory PHNs using a web-based meeting system. A nationwide survey was distributed to supervisory and midcareer PHNs across local governments.

RESULTS

This study was funded in March 2022 and approved by all ethics review boards from July to September and November 2022. Data collection was completed in January 2023. Five PHNs participated in the interviews. In the nationwide survey, responses were obtained from 177 local governments of supervisory PHNs and 196 midcareer ones.

CONCLUSIONS

This study will reveal PHNs' tacit knowledge about their practices, assess needs for different approaches, and determine best practices. Additionally, this study will promote ICT-based practices in public health nursing. The system will enable PHNs to record their daily activities and share them with their supervisors to reflect on and improve their performance, and the quality of care to promote health equity in community settings. The system will support supervisory PHNs in creating performance benchmarks for their staff and departments to promote evidence-based human resource development and management.

TRIAL REGISTRATION

UMIN-ICDR UMIN000049411; https://tinyurl.com/yfvxscfm.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/45342.

Associations between sleep and overweight/obesity in adolescents vary by race/ethnicity and socioeconomic status

AIM

To examine the interaction between sleep and social determinants of health (SDOH) [race/ethnicity and socioeconomic status (SES)] on overweight/obesity in adolescents.

DESIGN

Cross-sectional.

METHODS

We conducted a secondary analysis using the 2017-2018 National Survey of Children's Health data. We included adolescents (10-17 years old) who had sleep and body mass index (BMI) data available (n = 24,337) in analyses (samples with BMI <5th percentile excluded). Parents reported children's sleep duration and regularity. High BMI (≥85th percentile) for age defines overweight/obesity. We selected SDOH (race/ethnicity, family income, primary caregiver education and neighbourhood condition) and covariates (age, sex, smoking, exercise and depression) using a hierarchical model-building approach. Accounting for complex survey design, logistic regression estimated the interaction between sleep and SDOH.

RESULTS

There were significant interactions between sleep duration and SDOH. The association between increasing sleep and decreasing odds of overweight/obesity only showed in the following subgroups: White, family income ≥400% federal poverty level (FPL) or primary caregiver' education ≥ high school. Compared with these subgroups, Hispanic adolescents and adolescents whose family income was below 100% FPL and whose caregiver education was below high school had weakened and reversed associations. Sleep regularity was not associated with overweight/obesity.

CONCLUSIONS

Increasing sleep duration was associated with a decreased risk of overweight/obesity, but the association was not present in adolescents from racial/ethnic minority groups (i.e. Hispanic) and those with low SES.

IMPACT

The study findings suggest that associations between sleep and overweight/obesity vary by race and SES. Identification of additional mechanisms for obesity is needed for racial/ethnic minority groups and those from families with low SES. Also, the complexity of these relationships underscores the importance of community-based needs assessment in the design of targeted and meaningful interventions to address complex health conditions such as poor sleep and obesity.

Characteristics of Public Health Registered Nurses and Advanced Practice Registered Nurses: Lessons Learned From the 2018 National Sample Survey of Registered Nurses

OBJECTIVES

Little research has compared the demographic and practice characteristics of registered nurses (RNs) who work in public health (PH RNs) with other RNs and advanced practice registered nurses (APRNs) who work in public health (PH APRNs) with other APRNs. We examined differences in characteristics between PH RNs and other RNs and between PH APRNs and other APRNs.

METHODS

Using the 2018 National Sample Survey of Registered Nurses (N = 43 960), we examined demographic and practice characteristics, training needs, job satisfaction, and wages of PH RNs compared with other RNs and PH APRNs compared with other APRNs. We used independent sample t tests to determine significant differences between PH RNs and other RNs and between PH APRNs and other APRNs.

RESULTS

On average, PH RNs and PH APRNs earned significantly less than other RNs ($7082 difference) and APRNs ($16 362 difference) (both P < .001). However, their job satisfaction was comparable. PH RNs and PH APRNs were also significantly more likely than other RNs and APRNs to report the need for more training in social determinants of health (20 [P < .001] and 9 [P = .04] percentage points higher, respectively), working in medically underserved communities (25 and 23 percentage points higher, respectively [P < .001 for both]), population-based health (23 and 20 percentage points higher, respectively [P < .001 for both]), and mental health (13 and 8 percentage points higher, respectively [P < .001 for both]).

CONCLUSIONS

Efforts that expand public health infrastructure and workforce development must consider the value of a diverse public health nursing workforce to protect community health. Future studies should include more detailed analyses of PH RNs and PH APRNs and their roles.

The effect of a non-congregate, integrated care shelter on health: A qualitative study

OBJECTIVE

To describe the experiences of unstably housed, medically vulnerable residents living at the Haven, a novel, non-congregate integrated care shelter operating in a historic hotel during the COVID-19 pandemic.

DESIGN

A qualitative descriptive design.

SAMPLE/MEASUREMENT

Semi-structured qualitative interviews were conducted in February and March 2022 with a purposive sample of 20 residents living in the integrated care shelter. Data were analyzed in May and June 2022 using the thematic analysis methods described by Braun and Clarke.

RESULTS

Six women and 14 men, ages 23-71 (M = 50, SD = 14), were interviewed. Lengths of stay at the time of the interview ranged from 74 to 536 days (M = 311 days). Medical co-morbidities and substance use details were collected at baseline. Three themes were identified: (1) Autonomy, (2) supportive environments, and (3) stability and the need for permanent housing. Participants characterized the integrated care, non-congregate model as having multiple advantages over traditional shelter systems. Participants emphasized the role of nurses and case managers in providing a respectful, caring environment in the integrated shelter model.

CONCLUSION

Participants described acute physical and mental health needs which were largely met by the innovative integrated shelter care model. The effect of homelessness and housing insecurity on health is well documented, but few solutions exist that promote autonomy. Participants in this qualitative study emphasized the benefits of living in a non-congregate integrated care shelter and the services which promoted their self-management of chronic diseases.

PATIENT OR PUBLIC CONTRIBUTION

Patients were the participants in the study, but were not involved in the design, analysis of interpretation of the data, or preparation of the manuscript. Due to this project's small scope, we could not involve patients or the public after the study concluded data collection.

Algorithm development to improve intervention effectiveness for parents with mental health signs and symptoms

OBJECTIVES

In this study we aimed to describe and compare groups formed by a rules-based algorithm to prospectively identify clients at risk of poor outcomes in order to guide tailored public health nursing (PHN) intervention approaches.

DESIGN

Data-driven methods using standardized Omaha System PHN documentation.

SAMPLE

Clients ages 13-40 who received PHN home visiting services for both the Caretaking/parenting and Mental health problems (N = 4109).

MEASUREMENT

We applied a theory-based algorithm consisting of six rules using existing Omaha System data. We examined the groups formed by the algorithm using standard descriptive, inferential statistics, and Latent Class Analysis.

RESULTS

Clients (N = 4109) were 25.1 (SD = 5.9) years old and had an average of 7.3 (SD = 3.2) problems, 250 (SD = 319) total interventions, and 32 (SD = 44) Mental health interventions. Overall outcomes improved after PHN interventions (p < .001 for all) and having more Mental health signs/symptoms was negatively associated with outcome scores (p < .001 for all).

CONCLUSIONS

This algorithm may be helpful in identifying high-risk clients during a baseline assessment who may benefit from more intensive mental health interventions. Findings show there is value using the Omaha System for PHN documentation and algorithm clinical decision support development. Future research should focus on algorithm implementation in PHN clinical practice.

Building consensus in defining and conceptualizing acceptability of healthcare: A Delphi study

BACKGROUND

The concept of healthcare acceptability is important for nursing staff spending most of their time with patients. Nevertheless, acceptability remains confusing without a collective definition in existing literature.

OBJECTIVE

This study aimed to create a consensus among experts on definition and conceptual framework of healthcare acceptability.

METHODS

We conducted two rounds of Delphi surveys to collect opinions from experts on definition and conceptual framework of healthcare acceptability proposed following thematic content analysis. We calculated the consensus among experts using the modified Appraisal of Guidelines for Research & Evaluation II (AGREE II) instrument and followed the guidance on conducting and reporting Delphi studies (CREDES) best practices.

RESULTS

A total of 34 experts completed two rounds of Delphi survey. The definition was validated through consensus as: "a multi-construct concept describing the nonlinear cumulative combination in parts or in whole of experienced or anticipated specific healthcare from the relevant patients/participants, communities, providers/researchers or healthcare systems' managers and policy makers' perspectives in a given context." The overall quality rating was 92.6% and 95.1% for the proposed definition and conceptual framework respectively.

CONCLUSION

Opinions collected from experts provided significant insights to build a consensus on healthcare acceptability advancing public health nursing.

Relationship between the fear of COVID-19 and social isolation and depression in elderly individuals

BACKGROUND

The COVID-19 pandemic has seriously affected elderly individuals and it has been associated with high morbidity and mortality rates. This study was conducted to examine the relationship between fear of COVID-19, social isolation and depression in elderly individuals.

METHODS

The study is a descriptive type. The sample consisted of 362 elderly people. The study data were collected using the Introductory Information Form, the Fear of COVID-19 Scale, the Nottingham Health Profile Social Isolation Scale and the Geriatric Depression Scale-Short Form.

RESULTS

It was determined there was a positive and moderate relationship between fear of COVID-19 and depression and social isolation, and a positive and high relationship between social isolation and depression, and the results were statistically significant (P < 0.001).

CONCLUSIONS

Public health nurses, during epidemic periods, should help elderly individuals manage their fears about the disease. In addition, they should lead the practices that can sustain social participation and prevent depression in the elderly.

Instagram, risky drinking and main health effects in Spanish adolescents in the COVID-19 pandemic. A qualitative study

INTRODUCTION

The aim of this study was to analyze the relationship between Instagram, alcohol consumption and the impact on adolescent health during the COVID-19 pandemic.

DESIGN AND SAMPLE

A qualitative study was carried out with 13 focus groups, involving 38 interviews. The fieldwork was conducted between January and December 2021 using a semi-structured script with three main categories. The research was carried out by a team specialized in adolescent risks and qualitative research.

RESULTS

Three main categories were established: (1) The COVID-19 pandemic, Instagram and Risky Drinking, (2) Risk prevention and control strategies and (3) Effects on health. The participants (n = 118) reported greater alcohol consumption among Instagram users, either because this social media platform was used to spread the practice of alcohol consumption, or because they were affected by the content posted by digital marketers, Instagrammers, and/or contacts on Instagram. More than half of the sample (67.8%) had health problems (loss of control, headaches, difficulty in breathing, trembling, anxiety attacks, vomiting, tiredness, blackouts, and absence seizures), of whom 35% required urgent attention from their parents and/or the health services.

CONCLUSIONS

Further research is needed to prevent risky drinking related to the use of social networking sites (SNSs) and its main health effects.

Introducing Norwegian parents to the Circle of Security Parenting program during the postpartum period: A qualitative descriptive study

OBJECTIVE

Public health nurses in Norway provide a range of health promotion and primary prevention services to families in the postpartum period. The study objectives were to describe parents' experiences of: 1) being introduced to the Circle of Security Parenting program during a home visit and 2) participating in a parent group meeting.

DESIGN

Qualitative descriptive study.

SAMPLE

A purposeful sample of 24 caregivers (n = 15 mothers, n = 9 fathers) parenting an infant.

MEASURES

In-depth, semi-structured interviews were conducted to document participants experiences. Content analysis was used to code and categorize the data.

FINDINGS

Three main categories with seven subcategories reflected the parents' experiences: 1) Confidence-building home visit, 2) Awareness-raising parental group, 3) Dissemination of knowledge.

CONCLUSIONS

The parents experienced the home visit as being on their family's terms and reassuring. The parental group session started a reflection process which made them aware of the importance of being present for their child, how to modify their communication and have a common understanding of childrearing. The parents thought the group was a great way to introduce the Circle of Security Parenting program and experienced it as a continuation of the information presented at the home visit. The introduction provided them with new knowledge.

Community Resilience After Hurricanes: Can Neuman's Systems Theory Guide Public Health Nursing?

Objective: Examination of community resilience after Hurricane Harvey and -applicability of Neuman's systems model to the role of public health nurses in applying primary, secondary, and tertiary prevention strategies to communities susceptible to natural disasters. Design: Descriptive, exploratory study. Sample: A convenience sample (N = 1,470). Measurements: Hurricane Harvey Survey. Results: Respondents from seven counties in southeast Texas report previously experiencing a hurricane (80%) with no weather-related flooding (79%), adequate preparation (54%), failure to comprehend the potential severity of Hurricane Harvey (62%), damage to their homes (45%), and a 68% loss of personal belongings. Anxiety, frustration, disbelief, determination, and hopefulness were rated highest after the storm. Residents received updates from family and friends, social media, and online news reports regarding rising water, even though, in many cases, a mandatory evacuation was not officially announced. Only 35% of respondents reported being aware of resources available, possibly due to flooding or inaccessibility of typical resources (e.g., hospitals, shelters). Communicating through social networks (social media, family, and friends) provided avenues for arranging evacuations and assistance. Respondents report giving assistance to others and receiving assistance from family, friends, and their faith community. The majority of respondents reported that the community provided adequate services during the hurricane (59%), and they plan to stay in southeast Texas (70%). Conclusions: Southeast Texas residents demonstrated individual and community resilience which may be further supported with primary, secondary, and tertiary nursing interventions as illustrated by Neuman's systems model. The rise in positive emotional response traits demonstrates positive coping, which is consistent with resilience. Effective and timely communication through social networks provides an additional line of resistance to protect and promote the resilience of the community. The lack of medical resources indicates a break in the normal line of defense and an area for potential improvement with the utilization of mobile medical units to provide healthcare for areas not easily accessible during a disaster. Public health nurses are strategically positioned in the international community to lead prevention and recovery efforts by applying theory-based community interventions.

School nursing: New ways of working with children and young people during the Covid-19 pandemic: A scoping review

AIM

To examine how school nurse practice evolved as a result of the Covid-19 pandemic.

DESIGN

A scoping review of international literature, conducted and reported in line with Arksey and O'Malley's (2005) framework.

DATA SOURCES

Searches were conducted in September 2021. Ten databases were searched: The British Nursing Database, CINAHL, Cochrane Library, Consumer Health Database, Health and Medicine, Nursing and Allied Health, Public Health, PsycINFO, PubMed and Web of Science. Relevant grey literature was identified through hand searching.

REVIEW METHODS

A minimum of three reviewers independently screened articles and two reviewers independently undertook data extraction, with any decisions made collaboratively with the wider team. Much of the literature was not empirical work and so it was not possible to apply a traditional quality appraisal framework.

RESULTS

Searches identified 554 papers (after deduplication) which were screened against title and abstract. Following the full-text review, 38 articles underwent data extraction and analysis. The review findings highlighted that school nurses adapted their practice to ensure they were able to continue providing their formal and informal school health offer to children, young people and their families and continued working closely with the multidisciplinary team. In addition, the expanded public health role generated by Covid-19 for school nurses' work was considerable, multi-layered and added to their routine workload. School nurses displayed resilience, adaptability and creativity in their response to delivering services during Covid-19.

CONCLUSION

School nurses took on a leading public health role during the Covid-19 pandemic. Some developments and practices were highlighted as beneficial to continue beyond the pandemic. However, formal evaluation is needed to identify which practices may merit integration into routine practice. Continued investment in staff and infrastructure will be essential to ensuring school nurses continue to expand their practice and influence as public health experts.

Transitions from jail to rural community for adults with mental illness

OBJECTIVES

Describe the facilitators and inhibitors of accessing healthcare services for adults with mental illness transitioning from a rural jail to a rural community.

DESIGN/SAMPLE/MEASUREMENTS

A qualitative descriptive approach was used to conduct this study in a rural southwest county. Purposive sampling was used to recruit eight adults. Data were collected using semi-structured telephonic interviews and analyzed using open coding and thematic analysis with clustering of emergent data.

RESULTS

The overarching theme, "Out of Jail, but No Freedom," is supported by four domains: Situational Transition Facilitators; Situational Transition Inhibitors; Health-Illness Transition Facilitators; and Health-Illness Transition Inhibitors.

CONCLUSIONS

Transitions from the rural jail to the community were facilitated by friends, family, and peer navigators. Systemic inequality endemic within the justice system and exacerbated by rurality creates an environment in which marginalization is ubiquitous for persons with mental illness and inhibits their transition from jail to the rural community. Nurses are well positioned to lead systematic reform in public policy, guiding healthcare funding, and jail utilization.

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.

Post-migration psychosocial experiences and challenges amongst LGBTQ+ forced migrants: A meta-synthesis of qualitative reports

AIMS

Synthesize qualitative research to illuminate the post-migration psychosocial experiences amongst LGBTQ+ forced migrants.

DESIGN

Meta-synthesis of qualitative reports.

DATA SOURCES

Systematic searches in seven databases and manual screenings were performed in July 2021 (21,049 entries screened in total). The final sample included 29 English-language reports containing empirical qualitative findings about post-migration experiences and published 10 years prior to the searches, based on migrants as the primary source.

REVIEW METHODS

Methodological quality was appraised using the CASP and JBI checklists. Through a collaborative process involving nurse-midwife researchers and experienced clinical professionals, reports were analysed with a two-stage qualitative meta-synthesis including an inductive qualitative content analysis.

RESULTS

The methodological quality was high and the reports included 636 participants in total. Two themes were identified through the meta-synthesis. The first theme illustrates the psychological distress and numerous challenges and stressors forced migrants face after arrival, including challenges encountered as an LGBTQ+ forced migrant, psychological reactions and manifestations, and practical issues related to resettlement and living conditions. The second theme highlights the resilience and strength they find through various internal processes and external resources, including resilience and strengthening resources, identity formation and establishing and maintaining social relationships.

CONCLUSION

After arrival in the host country, forced migrants identifying as LGBTQ+ face numerous societal and personal challenges whilst being at risk of experiencing significant psychological distress. These migrants utilize a wide range of resources that may strengthen their resilience. Peer support stands out as a highly appreciated and promising resource that needs further attention in experimental research.

IMPACT

Forced migrants identifying as LGBTQ+ need access to adequate and sufficient support. The findings emphasize several strength-building resources that may inform nurses, midwives, researchers and other professionals when providing psychosocial support for these persons.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Effectiveness of non-pharmacological community-based nursing interventions for smoking cessation in adults: A systematic review

OBJECTIVE

The purpose of this systematic review was to determine the effectiveness of non-pharmacological community-based nursing interventions for smoking cessation in adults.

METHOD

Studies published between January 1, 2008 and December 31, 2017 were comprehensively searched to 14 databases. Quality Assessment Tool for Quantitative Studies was used to examine the methodological quality of the included studies. The obtained studies were listed on a code table by title, summary, and author/s' name. A narrative synthesis was used interpreting the data. This study was registered to PROSPERO (ID: CRD42018088007).

RESULTS

Strong-quality rated three randomized controlled studies were included. Nurses were found to perform intensive behavioral support, brief-advice and mTobacco cessation interventions. These were effective on changing knowledge, belief and attitudes. No sufficient evidence on the cessation rate and the non-relapse rate was found.

DISCUSSION

This review puts forward that non-pharmacological community-based smoking cessation interventions by nurses has an impact on changing knowledge, belief and attitudes in adult smokers. Findings can encourage public health nurses to use their counsellor role more actively. Improving the health literacy of the adult smokers via these findings can facilitate their intention to behavior change. Findings can be a useful resource for policy makers and governments in controlling the smoking epidemic.

It's what the community demands: Results of community-based emergency opioid overdose trainings

OBJECTIVES

In response to a surge of drug overdoses involving polysubstance use among Atlanta service industry workers that resulted in the deaths of five people in the Atlanta area in the summer of 2021, a local community of harm reductionists and nurses organized opioid education and naloxone distribution (OEND) training sessions specifically customized for service industry workers in Atlanta. After the sessions, the nurses and harm reductionists asked attendants to participate in a study concerning their response to overdoses. The reason nurses and harm reductionists conducted the study was to determine the efficacy of OEND training adapted for those working in the service industries as well as to evaluate and possibly modify the training sessions for future use. This pre-post study examined if and how participants' knowledge and attitudes toward an opioid-involved overdose changed after engaging with the OEND training. If the study determined that the sessions were successful in teaching service industry workers how to mitigate the immediate and devastating effects of overdose, we recommend expanding and implementing both adaptable training sessions like the OEND training referenced, as well as accompanying studies to improve the training sessions' effectiveness.

DESIGN

The pre-post study used convenience sampling to recruit participants in emergent OEND training. Participants completed an abbreviated version the Opioid Overdose Attitudes Scale (OOAS) which measured how, and to what degree, they changed their attitudes towards overdoses and their responses to them. Participants also completed an abbreviated version of the Opioid Overdose Knowledge Scale (OOKS) which measured how effectively the OEND increased their knowledge when it came to properly responding to an overdose, which included implementing naloxone as part of immediate rehabilitation treatment. Paired nonparametric tests assessed changes in participants' OOAS/OOKS scores.

RESULTS

A total of 161 individuals attended, and 72 consented to be in the study. The sample predominately consisted of white (76.4%) and female (66.7%) adults whose age averaged 34.3 years. Attitude and knowledge score improvements were statistically significant: approximately 11 points (p < .001) and 3 points (p < .001), respectively.

CONCLUSIONS

This rapidly implemented training was associated with improving attitudes and knowledge about responding to an opioid-involved overdose. We recommend expanding the scope of studies like these in order to develop and examine effective, dynamic, and targeted OEND training tailored towards specific community groups and situations, such as polysubstance overdose among service industry workers. As the opioid epidemic worsens, it is critical to equip community members themselves with the skills and tools to recognize and respond to opioid overdoses as a frontline prevention to overdose deaths.

(1878-1971): Her historical legacy and lessons for contemporary public health nursing education

Sally Lucas Jean, RN (1878-1971) pioneered health education in the United States and globally. At the time of her death in 1971, aged 93, her legacy included serving on boards of leading American health associations, spearheading public health projects worldwide and transforming thinking on contemporary public health education. Sally Lucas Jean's influence continues today, from her input on educational children's television programs, policies on child health and her involvement in developing the early foundations of health communication. In this historical reflection, we examine her role in defining health education and communication, alongside influencing and applying strategies to improve public health nursing.

A Comparison of the Contents of Disaster Nursing Practices and Perceived Difficulties among Nurses Working at Welfare Evacuation Shelters during Natural Disasters and Multiple Disasters: A Qualitative Study

In this study, we compared the disaster relief practices of nurses who worked in welfare shelters in Iwate and Miyagi Prefectures, areas in which only natural disasters occurred, and nurses who worked in Fukushima Prefecture, an area in which both nuclear and natural disasters occurred during the Great East Japan Earthquake in 2011, in order to identify commonalities and differences between them. We conducted semi-structured interviews with two nurses from each prefecture. The results revealed that "nursing practice with minimal available materials and personnel" and "nursing practice based on knowledge and experience as a nurse" were common themes in the content of nursing practices, whereas "securing human resources during disasters and considering ideal welfare evacuation centers" and "recording the difficulties in dealing with nuclear disasters" were uncommon themes. The findings confirmed that even in Fukushima Prefecture, in which the nuclear disaster occurred, participants did not talk about their concerns regarding radiation exposure while working at welfare evacuation shelters where people with special requirements were evacuated, and that they were expected to respond in the same way as they would in natural disasters. However, participants reported several difficulties relating to nuclear disasters that should be considered in future disaster support.

The Need for a Preparedness Training Model on Disaster Risk Reduction Based on Culturally Sensitive Public Health Nursing (PHN)

The Indonesian Disaster Risk Index (IRBI) in 2018 found that 52.33% of districts or cities in Indonesia were at high risk of natural disasters and the others were at moderate risk. The World Risk Index places Indonesia at number 33 in the very high-risk category. The policy direction of the Implementation of Disaster Management in Indonesia in 2020-2024 is to increase disaster resilience toward sustainable prosperity for sustainable development.

PURPOSE

This study aims to identify the various needs for a culturally sensitive PHN-based disaster risk-reduction preparedness training model.

METHODS

This study used a descriptive qualitative research design. Data collection was done through in-depth interviews, Focus Group Discussions (FGDs), and expert panel stages in the Indonesian language. Samples involved in the research included 4 experts and 11 informants.

RESULTS

There were 10 themes generated from the results. The analysis results revealed that the level of knowledge, attitudes, and skills of the community is still low. Almost all of the people of Mekar Mukti Village stated that they had never received community-based disaster management training.

CONCLUSIONS

The study findings highlighted the importance of the Disaster Risk-Reduction Preparedness Model Based on Culturally Sensitive Public Health Nursing for the community.

"Talking on the Phone Is Very Cold"-Primary Health Care Nurses' Approach to Enabling Patient Participation in the Context of Chronic Diseases during the COVID-19 Pandemic

Strengthening patient participation is considered a crucial element of primary health care (PHC) nurses' practice when working with chronically ill patients. The COVID-19 pandemic had extraordinary effects on PHC nursing routines and how chronically ill patients' could be involved in their own care. This study investigates the adaptation of Spanish PHC nurses' approaches to supporting the participation of patients living with chronic illness during the COVID-19 pandemic. To reach this goal, we interviewed 13 PHC nurses who practiced in PHC centers in Spain. The interviews were analyzed using thematic coding. Three themes emerged from the descriptions of the nurses: (1) High COVID-19-related workload, decreasing health promotion, and chronic care, (2) Emphasis on patients' and families' self-responsibility, (3) Expanded digital and telephone communication with fewer in-person consultations. Nurses felt especially challenged to uphold the support for vulnerable groups, such as older people or patients without family support. Future research should focus on how the participation of the most vulnerable chronic patients can be supported in the context of the growing relevance of remote care.

Public health in undergraduate nursing education and workforce readiness

Student engagement with the community is a cornerstone of undergraduate nursing education in Canada. Working with community from perspectives of social justice, health equity, advocacy, and political action are essential for workforce readiness. We suggest that the erosion of public health theory and clinical courses in baccalaureate nursing programs undermines the potential capability of nurses to address the intersectionality of the social determinants of health. The impact of the COVID-19 pandemic on populations further demonstrates inequities, particularly among marginalized populations. Public health nursing education supports students' understanding about the health impacts of social injustice, how systemic racism is embedded in colonial and Eurocentric structures, and practices of superiority and privileges.We, as a national group of public health nursing educators, set out to investigate how existing guidelines and competencies support public health in undergraduate education across Canada. Results from a national questionnaire of educators, and of PHN leaders on new graduate practice readiness are presented. Questionnaire responses confirm an erosion of PHN theory and practice in baccalaureate nursing education (BNE) curricula. The results of the questionnaires combined with evidence of PHN since the global pandemic provide educators and practitioners more insight to inform future directions to respond to workforce readiness.

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.

Hypothetical model for on-the-job training through case conferences of public health nurses

Public health nurses (PHNs) face difficulties supporting vulnerable individuals and families. On-the-job training (OJT) is essential for improving nurses' competencies. However, PHN managers lack the knowledge to systematically implement OJT. The aim of this study was to develop a hypothetical model to systematically promote OJT for PHNs through case conferences (CC). Literature review, based on an integrative approach, has three stages: (1) theoretical framework development, (2) literature review, and (3) modeling. Literature review from five databases (MEDLINE, CINAHL, PsycInfo, Cochrane Central Register of Controlled Trials, Japan Medical Abstract Society) was conducted to identify the OJT process, its outcomes, and the conditions associated with OJT according to the theoretical framework. Based on 18 articles, this model progressed from "OJT process through CC," comprising the CC design, implementation, and evaluation to OJT produced "outcomes through CC." Outcomes included staff perception and behavior changes, improvements in client's condition, and staff turnover reductions. The OJT model involved "conditions for implementing CC as OJT" and "individual and organizational conditions." Future research should incorporate the social, political, and historical contexts of specific practice situations into the hypothetical model to help refine the model to be used in practice.

Evaluation of public health nurse-led health counseling programs for the prevention of cardiovascular diseases in Amagasaki City, Japan

OBJECTIVE

We evaluated whether Amagasaki health counseling programs led by public health nurses (PHNs) are contribute to improving cardiovascular disease (CVD) risk factors and CVD mortality among adult residents.

DESIGN AND SAMPLE

This cross-sectional study used a before-and-after comparative design. We evaluated data from health checkups and mortality before and after Amagasaki health promotion programs.

MEASUREMENTS

Population levels of CVD risk factors body mass index (BMI), waist circumference, systolic and diastolic blood pressure, fasting blood glucose, hemoglobin A1c, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, Triglyceride, aspartate aminotransferase (AST), alanine aminotransferase (ALT), uric acid, γ-glut amyl trans peptidase (γ-GTP), serum creatinine, estimated glomerular filtration rate (eGFR) were compared between 2008 and 2012 when the intervention with the Amagasaki health counseling program started from 2008. In addition, standardized mortality ratio (SMR) of acute myocardial infarction (AMI) were compared between 2003-2007 and 2008-2012.

RESULTS

Mean value of most CVD risk factors improved and the SMR for AMI declined, which could be attributable in part to the effort of intensive health education and counseling.

Nurse visit utilization and blood pressure control: A multi-cohort study in New Zealand

OBJECTIVE

This study aimed to retrospectively examine the contribution of nurses to population health outcomes with reference to nurse visits and blood pressure measurement in primary health settings.

DESIGN

A retrospective study was conducted using New Zealand Health Survey (NZHS) from 2012 to 2017.

SAMPLE

Adult population who are 18 years old and over living in New Zealand.

MEASUREMENTS

Age, gender, and ethnicity, the service utilization of primary health care nurse visit and blood pressure measurement were extracted from the NZHS (2012-2017) to compare with the service utilization of primary health care nurses by different demographic groups.

RESULTS

Females who have treated hypertension shows higher utilization of nurse visit than males. From 2015 to 2017, the participants in this cohort have visited a primary health care nurse at least more than once within a year. With blood pressure control, the overall pooled results show the impact of visiting primary health nurses on systolic and diastolic blood pressure control.

CONCLUSION

Our study at a national scale, demonstrated the impact of nurse's contribution to population health outcomes among people living with hypertension in New Zealand. Nurses are key to improving population health outcomes and to achieve universal health coverage.

Barriers and enablers to postpartum depression and anxiety screening: A qualitative study of Victorian maternal and child health nurses' practices

In Victoria, Australia, Maternal and Child Health nurses (MCHNs) play a key role in facilitating the timely identification of Postnatal Depression and Anxiety (PNDA). Understanding MCHNs' screening practices, and the factors which impact them, is central to ensuring that future screening policy agendas are evidence-based and able to support MCHNs in carrying out this critical work. Yet, little is known about this subject. The purpose of this study was to gain an in-depth understanding of MCHNs' screening practices, and the factors which impact them. Qualitative descriptive design with semi-structured interviews were used. Participants were MCHNs who had been practicing for a minimum of 6 months and regularly saw new mothers. Purposeful sampling was used to facilitate diversity across participant characteristics. Twelve MCHNs were interviewed between March and May 2021. Thematic analysis was conducted to identify patterns across our data. Qualitative content analysis was then used to identify issues which were most emphasised by MCHNs. Two themes were identified. Theme one, 'variations in screening practices', pertained to MCHNs' various screening practices (i.e., who, when, how) and the factors which influence them. Theme two, 'systemic barriers hinder equitable screening', pertained to factors which hindered equitable screening practices. Results indicate that systemic barriers contribute to inconsistent and inequitable screening practices, with women from culturally and linguistically diverse backgrounds less likely to be screened in line with best practice. Our findings emphasise an urgent need for MCHNs to be allocated with the resources required to screen all women equally, regardless of their cultural background.

Factors associated with risk related to the use of psychoactive substances by men deprived of their liberty

Objective:

to evaluate the factors associated with risk related to the use of psychoactive substances in male inmates of a prison in a city in the South of Brazil.

Method:

a cross-sectional data from 220 men deprived of liberty, inmates of a provisional custody institution in the State of Paraná, collected with a screening instrument and questionnaire. Binary logistic regression and odds ratio analysis were used to verify associations between risk related to substance use and socio-demographic characteristics of living conditions before incarceration and current incarceration.

Results:

the adjusted model revealed association of consumption with skin color brown/black and yellow, those who had only one parent responsible until age 15, age at first arrest 18 or older, professing religion, working before arrest, owning their own house, living alone, receiving visitors in prison.

Conclusion:

the identified factors are useful to insert effective treatment proposals and reduce the gaps and social vulnerability existing in prison.

Association between public health nurses' involvement in local healthcare planning and the corresponding off-the-job training

OBJECTIVE

This study investigated the association between receiving off-the-job training and the involvement of public health nurses in local healthcare planning.

DESIGN

A nationwide, cross-sectional study design.

METHODS

We sent self-report questionnaires to 2,185 public health nurses with experience in developing local healthcare plans in Japan since 2013 and collected information related to three main categories: demographic data, involvement in local healthcare planning and strategies for healthcare planning.

RESULTS

We received 1,281 responses (return rate of 58.6%), of which 231 did not meet the inclusion criteria. Thus, we analysed 1,050 valid responses. Among the 1,050 respondents, 496 (47.2%) had received off-the-job training in healthcare planning. A subsequent logistic regression analysis revealed that the following factors were associated with this achievement: holding a managerial position, receiving healthcare planning education at the undergraduate level, having mentors regarding the promotion of it, partially conducting cross-sectional coordination and conducting groupwork with community-dwelling residents.

Valuing tacit nursing knowledge during the COVID-19 pandemic

Public health nurses in Ontario, Canada, support the healthy growth and development of children across the province through a variety of programs including home visits for pregnant individuals and families with young children. During the COVID-19 global pandemic the needs of families increased while access to health and social services decreased. During this time, home visiting teams closely involved in supporting families also experienced staff redeployment to support pandemic efforts (e.g., case and contact management, vaccinations) and changes to the nature of home visiting work, including shifts to remote or virtual service delivery. To support nursing practice in this new and evolving context, a framework for capturing and sharing the tacit or how-to knowledge of public health nurses was developed. A valuing of this type of knowledge for informing future public health nursing practice - well beyond the pandemic response - was recognized as a pandemic silver lining when reflecting on two years of supporting home visiting teams in our province.

A qualitative study of effective collaboration among nurse home visitors, healthcare providers and community support services in the United States

Collaboration across sectors is needed to improve community health, but little is known about collaborative activities among public health prevention programs. Using the Nurse-Family Partnership® (NFP) home visiting program as context, this qualitative study aimed to describe effective collaboration among nurse home visitors, healthcare providers and community support services to serve families experiencing social and economic adversities. We used grounded theory to characterise collaboration with six purposively sampled NFP sites in the United States through in-depth interviews. We interviewed 73 participants between 2017 and 2019: 50 NFP staff, 18 healthcare providers and 5 other service providers. Interviews were recorded, transcribed, validated and analysed in NVivo 11. Validation steps included inter-coder consistency checks and expert review. Thematic memos were synthesised across sites. Most participants perceived collaboration to be important when serving families with complex needs, but substantial variation existed in the degree to which NFP nurses collaborate with providers dependent on provider type and community context. Factors that contributed to effective collaboration were relational in nature, including leadership commitment and provider champions, shared perceptions of trust, respect and value, and referral partnerships and outreach; organisational in terms of mission congruence between providers; and structural such as policy and system integration that facilitated data sharing and communication channels. These findings provide greater insights into effective cross-sector collaboration and care coordination for families experiencing adversities. Collaboration across sectors to promote health among families experiencing adversities requires intentional efforts by all inter-professional providers and continued commitment among all levels of leadership to coordinate services.

Experiences of stress among West Africa-born immigrant women with hypertension in Washington DC area

OBJECTIVE

To report a study that explored hypertension (HTN) stress and coping experiences of West-Africa-born immigrant (WABI) women in Washington DC Metropolitan area of the United States.

DESIGN AND SAMPLE

This qualitative study conducted from December 2017 to May 2018 involved WABI women (n = 15) in Washington Metropolitan area that self-reported diagnosis of HTN. The transactional model of stress and coping (TMSC) provided the conceptual framework. Data collection was through semi-structured one-on-one interviews.  Data analysis was done through manual open-hand coding of themes.

RESULTS

Three themes emerged from the analysis: Perceived Stressors, Sources of Stress, and Coping Measures. Participants perceived that their HTN diagnosis contributed to their stress; reported other financial, school, work, trauma, household and marriage-related stressors, and coping measures that include faith-based and other recreational leisure activities.

CONCLUSION

Participants mentioned stressors related to lack of support with domestic house chores and described various religious practices as coping strategies. These findings provide additional insights relevant to several ongoing public health nursing conversations on acute and chronic stress management in different parts of the globe. Public health nurses need to utilize these findings when assessing stressors and considering safe coping measures that appeal to WABI women experiencing HTN or chronic illness.