Public Health Nursing最新文献

Objectives: To examine nurses' adoption and use of digital technologies across six countries during the COVID-19 pandemic and identify lessons to strengthen preparedness for future public health crises.

Methods: Nurses in Australia, Finland, New Zealand, Switzerland, the United Kingdom and the United States completed an international cross-sectional survey in 2022-2023. Recruitment used snowball sampling via professional networks, associations and social media. The 41-item questionnaire captured information on technologies adopted during the pandemic, their perceived usability and contextual factors influencing their implementation.

Results: In total, 1,423 nurses reported on 1,128 technologies. Usability varied across countries and technology categories, with average System Usability Scale (SUS) scores at the benchmark for average usability. Some countries reported higher usability than others, suggesting differences in digital infrastructure maturity and workflow integration. Across settings, respondents described challenges related to digital literacy and skills, technical barriers and connectivity, organizational readiness, training, usability and accessibility, as well as dependency on technology. These influenced adoption and effective use during the pandemic.

Conclusions: Nurses' experiences revealed variations in usability and implementation challenges, demonstrating that nurses were underprepared for rapid digital transformation. Strengthening digital literacy, technical infrastructure and organizational readiness supports safe and effective technology integration in future public health crises.

Objective: This study aimed to evaluate the impact of Turkey's 2020 policy shift from school-based to family physician-based individual vaccination for the adolescent Tetanus-Diphtheria (Td) vaccine and to assess the effectiveness of a multi-component intervention (education, reminders, and on-site vaccination) in improving vaccine uptake among initially unvaccinated adolescents.

Methods: The study consisted of two phases: first, a cross-sectional analysis comparing Td vaccination coverage rates from 2018 to 2024 before and after the policy change; second, a quasi-experimental intervention involving 1007 high school students in Haliliye district during the 2023-2024 academic year. The intervention included structured educational sessions, monthly reminders, and on-site vaccination services. Data were analyzed using descriptive statistics, Cochran's Q test, and McNemar tests.

Results: Following the shift to family physician-based individual vaccination in 2020, Td coverage initially decreased from 71.3% to 64.3% but increased gradually to 79.3% by 2024. The multi-component intervention increased vaccination coverage from 77.8% to 98.4% (p < 0.001). Major barriers overcome included lack of awareness (51.3%) and reluctance or time constraints (27.7%).

Conclusion: Transitioning from school-based to family physician-based individual vaccination increased coverage gradually but left many adolescents unvaccinated. A multi-component intervention significantly improved vaccine uptake, supporting a hybrid school- and physician-based model.

Aim: To identify the effects of a 12-week brain health services (BHS) program on improving the knowledge, beliefs, and behaviors of dementia prevention among middle-aged and older Chinese community residents.

Design: A randomized controlled trial was conducted in five communities in Chongqing, China, between October 2021 and October 2022.

Measurements: The outcomes in this study were the participants' scores of the Healthy Lifestyle Score, MCLHB-DRR, and DKAS.

Intervention: The control group received community routine services and the "resident brain health guidance manual" the same as the intervention group. And an extra 12-week BHS program was adapted in the intervention group.

Results: There were significant interaction effects between time × group factors in primary outcome (Healthy Lifestyle Score) of the two groups (F = 6.140, p = 0.003, η² = 0.07) and the same in secondary outcomes (MCLHB-DRR and DKAS) (F = 6.604, p = 0.002, η² = 0.142) (F = 6.236, p = 0.003, η² = 0.135).

Conclusion: The BHS program promoted participants to form positive dementia prevention beliefs and effectively changed the lifestyle of the participants, especially in terms of healthy diet and regular physical activity. The BHS program can be applied to primary health services in Chinese communities.

Trial registration: Chinese Clinical Trial Registry identifier: ChiCTR2200059665.

Objective: To estimate vaccination coverage (VC) and analyze the factors associated with the incomplete vaccination schedule (IVS) in children under 5 years of age in two Basic Health Units in the Federal District of Brazil.

Design: A cross-sectional study.

Sample: The study included 162 children in two Basic Health Units; 54.94% were male, and all were under 5 years of age.

Measurements: Guardians were interviewed using a structured questionnaire, and their vaccination booklets were photographed. VC was estimated and prevalence ratios (PR) were calculated using Poisson regression analysis.

Results: Twenty percent of the children had an IVS. None of the vaccines evaluated reached the VC considered correct in terms of age and interval between doses. Factors associated with IVS were age under 2 years (adjusted PR: 2.55; 95% CI: 1.53-4.24), difficulties arising from the COVID-19 pandemic (adjusted PR: 2.71; 95% CI: 1.51-4.86) and a negative response when asked whether all vaccines were administered in the same location (adjusted PR: 1.97; 95% CI: 1.13-3.44).

Conclusions: A high proportion of children presented IVS, associated with factors such as age, lack of continuity of vaccination in the same location and difficulties caused by the COVID-19 pandemic.

Objective: This study explored barriers to cardiovascular rehabilitation (CR) participation among individuals with cardiovascular disease (CVD) and risk factors in a rural, low-resource setting.

Design: A qualitative study using focus groups.

Sample: 21 individuals (76% women, 71% with CVD risk factors, 48% with incomplete elementary education) were recruited from a public health system.

Measurements: Data were collected through six focus groups and analyzed using thematic analysis.

Intervention: None.

Results: Six overarching themes emerged. Participants had limited awareness of CR, with lack of knowledge being the primary barrier. Technological challenges hindered engagement with telerehabilitation programs. Medication was the most common treatment strategy, but patients expressed a need for more information. While physical exercise was recognized as important, barriers such as lack of time and motivation prevented participation. Perceptions of health status varied, with some reporting improvements and others experiencing deterioration. Family support and access to virtual programs were identified as facilitators of CR participation.

Conclusions: Strategies to improve CR awareness, enhance virtual access, and strengthen patient education are needed to increase participation in rural populations.

Objective: The aim of this study was to investigate the experiences of school nurses working with refugee children from Ukraine.

Design: This research was conducted as a qualitative interview study, using an inductive approach and a semi-structured interview guide.

Sample: School nurses (n = 8) from different parts of Sweden were interviewed, and the data were analyzed through a qualitative content analysis. The COREQ guidelines were followed for reporting study findings.

Results: Four categories were identified in the analysis: (1) Initial health conversations with the Ukrainian refugee children, (2) Experience of challenges during the health visits, (3) The impact of war on the Ukrainian refugee children, and (4) To have a health-promoting everyday life.

Conclusion: The present study shows that the school nurse has an important function in promoting the health of Ukrainian refugee children, and describes the health conversation as a significant part of the meeting with these children. The work of public health nurses in schools in supporting Ukrainian refugee children can be optimized through increased cultural awareness, which can help promote the children's overall health.

Patient or public contribution: The study question was identified in discussion with school nurses.

Public health nursing plays a crucial role in advancing health equity and social justice. This is despite a lack of investment and recognition in public health nursing. This editorial argues that in order for public health nursing to optimise opportunities to pursue and advocate for health equity, it will require solid investment in the workforce and leadership and changes in health care design, organisation and delivery. It will also need to recruit and support a diverse workforce that mirrors the population it serves.

Objective: This scoping review evaluates the effectiveness of community-based interventions addressing frailty's multidimensional impacts (physical, nutritional, and psychosocial) in older adults, emphasizing nurses' roles in crisis-responsive care during pandemics.

Design: A scoping review was conducted using Arksey & O'Malley's framework and PRISMA-ScR guidelines.

Sample: Thirty-one studies were from 2019 to 2023, sourced from PubMed and Scopus, spanning five continents.

Measurements: Study quality was assessed with the Newcastle-Ottawa Scale; outcomes included frailty reduction and quality-of-life metrics.

Intervention: Interventions included physical rehabilitation (e.g., Otago Exercise Program), nutritional optimization, psychosocial support, technology-enhanced models (e.g., telemedicine), and social engagement.

Results: Multicomponent interventions outperformed single-domain approaches, improving gait speed, reducing frailty progression, and mitigating depression. Telemedicine maintained 78% care continuity during lockdowns. Asian family-centered models excelled, but 84% of evidence came from high-income countries, highlighting low- and middle-income country (LMIC) gaps.

Conclusions: Gerontological nurses are pivotal in delivering culturally adapted care by coordinating interprofessional home-based teams, integrating gerotechnology in resource-limited settings, and advocating for policy reforms to bridge urban-rural disparities. These findings underscore nursing's role in equitable, resilient frailty management.

Objectives: This study aimed to evaluate nursing students' knowledge, attitudes, and self-efficacy regarding chemical, biological, radiological, and nuclear (CBRN) threats.

Methods: A descriptive, cross-sectional design was employed between January and May 2025 with 432 nursing students. Data were collected using an information form, the CBRN Knowledge Test, the CBRN Attitude Scale, and the CBRN Self-Efficacy Scale.

Results: The mean scores were 19.47 ± 2.76 for knowledge, 3.59 ± 1.27 for attitude, and 3.44 ± 0.73 for self-efficacy. Female students demonstrated significantly higher knowledge and self-efficacy scores than males (p < 0.005). Knowledge, attitude, and self-efficacy scores differed significantly across academic years (p < 0.001), with fourth-year students showing the highest knowledge levels. Students who had received CBRN training reported higher knowledge and attitude scores (p < 0.001). Similarly, students expressing a desire for CBRN training had significantly higher knowledge, attitude, and self-efficacy scores (p < 0.005).

Conclusions: The findings indicate that nursing students have notable gaps in practice-oriented domains such as triage, radiation safety, personal protective equipment use, and decontamination. These results underscore the importance of integrating structured, simulation-based CBRN training into undergraduate nursing education to enhance preparedness and practical competence.

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.