Public Health Nursing最新文献

Background: LGBTQIA+ individuals in Brazil face persistent inequities in accessing Primary Health Care (PHC), largely due to structural barriers, institutional discrimination, and limited professional training. Despite the existence of the National Policy for Integral LGBT Health, significant challenges remain in ensuring inclusive and equitable care.

Objective: To map the available scientific evidence regarding the access of the LGBTQIA+ population to Brazilian public PHC services, identifying barriers, facilitators, and research gaps.

Method: This scoping review followed the JBI framework and PRISMA-ScR guidelines. Searches were conducted in MEDLINE/PubMed, Embase, Scopus, CINAHL, SciELO, LILACS for studies published between 2018 and 2023.

Results: A total of 19 studies were included, predominantly qualitative (84.2%) and concentrated in the Northeast and Southeast regions, with no studies from the Central-West. Most investigations prioritized healthcare professionals' perspectives, particularly nurses and physicians, while the experiences of LGBTQIA+ users remained underrepresented. Barriers to access included institutional prejudice, lack of professional preparedness, and a narrow biomedical focus on HIV/aids. Facilitators involved social support networks, and the search for inclusive spaces. Research gaps persist, particularly regarding dissident gender identities.

Conclusion: Strengthening inclusive policies, diversifying scientific production, and integrating sexual and gender diversity into professional training are essential to promoting equity and improving health outcomes.

Objective: This study identified variables influencing caregiving burden and health outcomes using data from a national caregiving database.

Design: A predictive study design was employed, guided by the Caregiving Preparedness framework.

Sample: The dataset comprised 1446 family caregivers providing in-home care to individuals aged 50 and older (Mean = 76.26 years, SD = 12.24, Mode = 80), with diverse health conditions.

Measurement and analysis: Structural Equation Modeling (SEM) was utilized to examine the relationships among caregiver stress (emotional, physical, and financial), care recipients' health status and daily needs, and caregiver outcomes. Mediating variables were also assessed.

Results: SEM analysis revealed significant direct and indirect effects on caregiving burden and health. Three mediating variables were identified: caregivers' sense of meaning in life, presence of a personal healthcare plan, and perceived social connectedness.

Conclusion: The analysis of a national database with SEM offers a robust analytical approach. Findings underscore the importance of supporting caregivers in maintaining personal health, addressing loneliness, and fostering meaning in their lives. These insights can inform policy, practice, and future research aimed at enhancing caregiving and aging services.

Background: Rotavirus is a leading cause of severe diarrhea in children and continues to contribute significantly to childhood morbidity and mortality. While significant research has been conducted on the epidemiology and vaccination of rotavirus, the contributions of nursing to its prevention, management, and family-centered care are insufficiently documented. This study analyzes global research trends to identify gaps in nursing scholarship and emerging opportunities related to rotavirus.

Methods: A bibliometric analysis was performed using Web of Science and Scopus (1966-2024). Co-occurrence, co-citation, and thematic mapping techniques were applied to examine research productivity, influential contributors, collaboration patterns, and thematic evolution.

Results: The analysis included 210 publications from 146 sources authored by 1170 researchers. The most productive countries were the United States (18.7%), China (7%), and Canada (5.7%), while Brazil, India, and Australia demonstrated strong international collaboration. The dominant themes were immunization, infection control, and epidemiology. Emerging areas focused on zoonotic transmission and gut microbiota. Despite their importance in caregiver education, hydration management, and community prevention, nursing-led interventions were markedly underrepresented.

Conclusions: Rotavirus research continues to grow, yet nursing contributions remain limited within the broader scientific landscape. Despite their importance in caregiver education, hydration management, and community-level prevention, nursing-led interventions remain markedly underrepresented in the global literature. Advancing nursing-led preventive strategies, vaccine advocacy, and community-based interventions represent a critical opportunity to strengthen public health responses to rotavirus.

Clinical trial registration: No clinical trial number is required.

Objective: Vaccine hesitancy among parents is a significant threat to global health, contributing to the resurgence of vaccine-preventable diseases. Understanding the global epidemiology of childhood vaccine hesitancy is crucial for developing effective strategies to address the sustainable development of immunity systems. In this study, our scientometric analysis provides a comprehensive overview of childhood vaccine hesitancy research in Turkey from 2014 to 2024.

Methods: The PubMed, Scopus, and Web of Science databases were used to retrieve all related publications. The bibliometrix R-package, CiteSpace, and VOSviewer were applied to collect information on annual citations and publications, notable journals and authors, the most productive countries and organizations, popular topics, and keywords.

Results: A total of 1850 publications were retrieved. The publication output showed a gradual upward trend from 2014 to 202. The most-cited paper was a review article that was published in 2021. According to the analysis results, Turkey was the most prolific contributor to this research area. The closest collaboration was observed between Turkish institutions and international organizations. The journal "Journal of Pediatric Vaccines and Immunization" published the most papers. The most frequently used keywords were "vaccine hesitancy," "childhood vaccines," "immunization," "parental attitudes," and so on.

Conclusion: Childhood vaccine hesitancy significantly impacts public health efforts in Turkey. However, many studies focus on theoretical aspects, with fewer empirical studies addressing practical interventions. The scientometric analysis offers researchers a clear picture of the current state of research and emerging trends in this field. From our study, researchers may identify key areas that merit further investigation and development.

Objectives: This study examined healthcare professionals' perceptions of the climate crisis's impact on patients' mental health.

Background: The global climate crisis poses significant challenges to mental health, influencing individuals' psychological well-being and their ability to adapt to changing environmental conditions.

Materials and methods: A phenomenological research approach was adopted, employing a qualitative design. In-depth semi-structured interviews were conducted with 15 healthcare professionals working in various regions of Türkiye. Participants were recruited through snowball sampling, and interviews continued until data saturation was achieved. All sessions were audio-recorded, transcribed verbatim, and analyzed using thematic analysis. The study adhered to the COREQ checklist for reporting qualitative research.

Results: Analysis revealed three main themes: the effects of climate change on healthcare professionals' mental health, patients' perceptions of climate change's impact on mental health, and the reflections of the global climate crisis on patient care. Seven sub-themes were also identified: direct, indirect, social, psychological, and physical effects. Findings indicated that both healthcare professionals and their patients experience negative mental health outcomes related to climate change.

Conclusion: The study highlights that the global climate crisis adversely affects the mental health of healthcare providers and patients. These findings underscore the need for health policies and interventions that address the psychological consequences of climate change within healthcare settings.

Objective: The complex relationship between poverty, health-seeking behavior, and access to health services is critical to understanding health inequalities. This study aimed to deepen our understanding of this field by examining the relationships between poverty, health-seeking behavior, and access to health services with a mixed-methods approach.

Methods: Between December 2023 and March 2024, a mixed-methods design (QUAN-QUAL) was employed using a convergent (sequential) approach. The quantitative phase adopted a cross-sectional research approach, while the qualitative part embraced a phenomenological approach. The quantitative stage involved 384 participants, and the qualitative stage involved 11 individuals. Quantitative data were collected using the Health Seeking Behavior Scale and the Healthcare Demand Procrastination Scale. In contrast, qualitative data were gathered through in-depth individual interviews using a semi-structured interview guide.

Results: As household income levels increase, health-seeking behavior (r = 0.141, p < 0.001) and healthcare demand procrastination (r = 0.143, p < 0.001; β = 0.132, p = 0.003) significantly increase. Health-seeking behavior rises among individuals who perceive their general health status as good (F = 7.111, p < 0.001; β = 0.143, p = 0.004). In contrast, low income levels (t = 3.797, p < 0.001; β = -0.147, p = 0.004) and low education levels (F = 4.791, p < 0.001; β = -0.145, p = 0.004) are significantly associated with decreases in health-seeking behavior. Procrastination of healthcare demand is more common among workers (β = 0.176, p < 0.001). On the other hand, higher income levels and the distribution of health expenditures appear to reduce this tendency (β = -0.121, p = 0.015; β = -0.116, p = 0.021). The synthesis of interviews revealed two main themes: utilization of health services, and access to health services and inequalities. Within the theme of "challenges in accessing health services," the qualitative thematic analysis highlighted key difficulties such as transportation problems, long waiting times, and insufficient personnel.

Conclusion: Findings indicate that socioeconomic factors such as income level and education were determinants of health-seeking behavior and that healthcare demands procrastination behavior. Among the challenges encountered in accessing health services, transportation issues, long waiting times, and inadequate staff were prominent.

Objective: To evaluate midwifery students' knowledge and concerns about climate change, especially how it affects maternal and child health.

Design: The study is cross-sectional descriptive.

Sample: The sample included all 103 4th-year midwifery students without selection.

Measurements: The Introductory Information Form, Climate Change Anxiety Scale (CCAS) and Climate Change Knowledge Test (CCKT) were applied to gather data. Descriptive statistics and Kruskal-Wallis tests were used to perform comparisons, setting significance levels at p < 0.05.

Results: Students were asked questions about how climate change affects maternal and child health. Students who thought that climate change causes heat-related illnesses had significantly higher CCAS anxiety subscale scores (KW = 10.778, p < 0.05). Students who thought that droughts, storms, floods, and fires caused physical or psychological problems had significantly higher CCAS and helplessness subscale scores (KW = 10.237, p < 0.05; KW = 10.172, p < 0.05). Students who thought that illnesses were caused by UV radiation and poor air quality had significantly higher CCAS scores (KW = 10.236, p < 0.05).

Conclusions: Midwifery students recognize climate change impacts on maternal-child health while experiencing significant anxiety and helplessness about future implications. Preparing students for climate change roles and responsibilities and creating awareness-raising activities are important for their future professional success.

Aim: To evaluate the post-traumatic change and chronic disease self-management in individuals with chronic illness who experienced the earthquake and determine the relationship between these dimensions.

Background: The earthquake, the disaster of the century, had a traumatic effect on all individuals, especially those with chronic diseases.

Methods: This descriptive, correlational study included 463 individuals with a chronic disease diagnosed at least 1 year before the earthquake. Data were collected between March and July 2024, using a Personal Information Form, the Post-Trauma Change Scale (PTCS), and the Chronic Illness Self-Management Scale (CISMS). Mann-Whitney U test, Pearson correlation, and multivariate linear regression analyses were used in the analyses. The STROBE checklist was used.

Results: A negative correlation was determined between PTCS and the CISMS subscales of Self-Stigma and Treatment Adherence. A positive correlation was determined between PTCS and the CISMS subscales of Coping with Self-Stigma and Healthcare Efficacy. The CISMS subscale of Self-Stigma explained 9% of the PTCS Self-Confidence, Awareness, and Social Adaptability subscale total points. The CISMS subscale of Coping with Stigma explained 13% of the PTCS Self-Confidence and Awareness subscale total points. The Healthcare Efficacy subscale of the CISMS explained 13% of the PTCS Self-Confidence subscale total points. The CISMS Treatment Adherence subscale explained 4% of the PTCS Awareness subscale.

Conclusion: The study results demonstrated that there was a neutral change in levels after the trauma, and chronic disease self-management was insufficient in the study participants. A negative correlation was determined between the PTCS and the CISMS subscales of Self-Stigma and Treatment Adherence. A positive correlation was determined between the PTCS and the CISMS subscales of Coping with Stigma and Healthcare Efficacy.

Implications for nursing policy and health policy: According to our results, increasing self-confidence, awareness, and social adaptability will enable patients to achieve control of the traumatic event and chronic disease self-management in the long term. In traumatic events such as earthquakes, nurses should take an active role in the care, education, and guidance of individuals with chronic diseases who are in the vulnerable group. In addition, emergency health action plans should be determined in detail by health policy makers for individuals with chronic diseases, especially in risky regions.

Background: Gender identity documentation is an important component of gender-affirming care, particularly for LGBTQIA+ adolescents who may be hesitant to disclose their gender identities due to fear of rejection or discrimination. Without family support, these adolescents face higher rates of suicide, depression, and anxiety. Despite both clinical relevance and the importance of providing inclusive health care services, currently, there is no national standard for collecting gender identity information within clinical settings.

Aim: This program evaluation assessed gender identity documentation practices for adolescents in a rural mental health clinic and examined compliance with the American Academy of Pediatrics (AAP) recommendations for inclusive care.

Methods: A retrospective chart review of 151 patients aged 4-18 was conducted from 2020-2023 to evaluate baseline and longitudinal documentation of gender identity and pronouns.

Results: Gender identity documentation improved from 0% in 2020 to 95% in 2023. Pronoun documentation remained inconsistent, and identity was assessed only at intake, limiting the ability to support adolescents with gender identities evolving over time. A case example of a transgender adolescent illustrated how gaps in documentation can contribute to distress and unmet mental health needs.

Conclusion: Systematic gender identity documentation is feasible in a rural outpatient clinic and provides a replicable model for inclusive practice. These findings can guide public health nurses in reducing disparities, influencing policy, and supporting multi-step efforts to improve care of gender-diverse youth.