Public Health Nursing最新文献

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.

Background: Climate change is intensifying the spread of vector-borne diseases through rising temperatures, changing rainfall patterns, and the potential release of ancient pathogens from melting polar ice. Community health nurses (CHNs) play a vital role in helping communities adapt to these evolving health threats. This study aims to synthesize evidence on the link between climate change and vector-borne disease outbreaks and to propose a theoretical framework, the Climate Change Adaptation Theory (CCAT), that supports CHNs in leading community adaptation strategies.

Methods: An umbrella review was conducted by systematically searching PubMed, Scopus, Web of Science, and Embase databases for relevant systematic review articles. Selected studies were analyzed to identify key themes related to vector-borne diseases and climate change.

Results: Of the total 2420 retrieved articles, 44 reviews were received, of which, after reviewing the full text of the articles, 18 articles met the inclusion criteria. Four main concepts were identified in the reviews around climate change: human activities facilitating disease emergence; global warming and the El Niño phenomenon; melting polar ice caps and pandemic risk; and the critical role of CHNs in climate change adaptation.

Conclusion: CCAT integrates existing health education models and highlights the leadership role of CHNs in effectively educating communities on climate change adaptation, thus mitigating risks associated with vector-borne diseases.

Background: Health disparities, particularly among racial and ethnic minority populations, were exacerbated by the COVID-19 pandemic due to factors like social determinants of health, vaccine hesitancy, and pre-existing health conditions. Local government leaders within an urban city received federal funds to address these disparities by improving health literacy and engaging in culturally responsive outreach and education among Black and Latinx communities within a mid-sized city in the southeastern United States.

Objective: To identify facilitators and barriers to implementing public health strategies aimed at addressing COVID-19 health disparities in a community guided by the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework.

Design: The research team conducted qualitative, semi-structured interviews via telephone, Zoom, or in person between March 20th and April 12th, 2024.

Participants/setting: Fifteen participants, including local governmental health office staff (e.g., nurse navigators, administrative staff) and employees from community center partner sites, were included in the study.

Analysis: Two coders applied both a priori codes guided by the RE-AIM framework and data-driven inductive codes to transcripts in NVivo 14. A final interrater reliability measurement, Cohen's kappa coefficient (k = 0.74), was calculated, indicating a moderate level of agreement between coders. NVivo 14 data visualization tools (e.g., coding matrices) were used to inform thematic content analysis.

Results: Themes were identified within each RE-AIM dimension, highlighting various facilitators and barriers to implementing the selected public health strategies. Working in synergy with community center staff and other community partners to create tailored services and resources was vital for successful implementation. Transparency and timely communication, additional full-time program implementers (i.e., nurse navigators), and sustainable funding sources were identified as key elements to enhance effective implementation.

Conclusions: Insights from the local governmental health office and community center staff's experiences in this study highlight recommendations for effective implementation of locally tailored public health strategies to address COVID-19 health disparities in similar community-based settings. Future research should capture the perceptions and experiences of community members to better understand acceptability, accessibility, and utilization in similar initiatives.

Objective: To analyze the current situation of knowledge, behavior, and willingness of elderly nursing workers to participate in training among patients who cannot take care of themselves.

Methods: From October to December 2023, a simple random sampling method was adopted to conduct a questionnaire survey on 155 elderly care workers. The basic information was collected, and the knowledge, belief, and action scale was used to evaluate the knowledge, belief, and action of patients who could not take care of themselves, and the training situation and training willingness were investigated.

Results: Among the 155 respondents, 40-50 years old accounted for a relatively high proportion, the education level was mainly concentrated in high school and technical secondary school, 65.16% had no professional title, and the monthly salary was mainly concentrated in 7000-8000 yuan, accounting for 69.03%; The average score of Facts of Aging Quiz (FAQ) was (12.05 ± 2.11), and the pass rate was 15.48%. The overall average score of Kogan's Attitudes Toward Old People Scale (KAOPS) was (108.63 ± 12.65), the positive coping dimension of Simplified Coping Style Questionnaire (SCSQ) was (21.77 ± 0.56), and the negative coping dimension was (21.15 ± 0.31). The results indicated that despite a positive attitude, nursing staff have insufficient knowledge of elderly care. There were differences in the level of positive scores among different levels of education, with high school or vocational school > junior high school > undergraduate or associate degree or above (t = -2.527, p = 0.013). There was a difference in the total score of SCSQ between the population with and without units, and the score of the population with units was lower than that of the population without units (F = 3.671, p = 0.028). The proportion of respondents who like to receive part-time training is the highest, 41.94%. 65.81% need to learn the training of nursing content for patients who are unable to take care of themselves, and 98.71% are willing to participate in the training.

Conclusion: Elderly care workers have a strong training willingness, and most of them have learning needs for nursing content of patients who can't take care of themselves, which can be paid attention to in the training.

Objective: This study aimed to examine the relationship between parents' e-health literacy and attitudes toward childhood vaccination.

Design: A descriptive-correlational study.

Sample: The study included 396 parents of children aged 0 to 72 months, recruited between May and December 2022.

Measurements: Data were collected using the Demographic Information Form, the E-Health Literacy Scale (E-HLS), and the Caregiver Vaccination Attitudes Scale (CVAS). Analyses were performed using SPSS (version 24).

Results: The mean age of the parents was 30.13 ± 5.22 years. E-HLS scores differed significantly by education level (F = 6.914, p < 0.001, η² = 0.034), with higher scores among university-educated parents (29.72 ± 5.99) compared to those with secondary (26.86 ± 6.64) or primary education (27.48 ± 5.98). Economic status also showed significant differences in E-HLS (KW = 6.982, p = 0.03, ε² = 0.012); parents with good economic status (29.54 ± 5.89) scored higher than those with poor status (26.35 ± 4.32). A statistically significant but weak positive correlation was found between CVAS and E-HLS (r = 0.172, p < 0.001), indicating a small effect size.

Conclusions: This study showed that parents with higher e-health literacy tend to have more positive attitudes toward childhood vaccination. However, the relationship between these two variables was weak, suggesting only a limited association between e-health literacy and vaccination attitudes. In addition, parents with higher education and better economic status had higher e-health literacy scores. Due to the weak correlation observed, it is important for nurses to understand that increasing e-health literacy alone is unlikely to produce significant improvements in parental vaccination attitudes. Despite the weak correlation, these results may help guide future research exploring the broader context of vaccine attitudes among parents.

Objectives: To develop and implement a nurse-led mobile health clinic affiliated with an academic college of nursing to improve access to care in underserved communities and support workforce development through experiential nursing and interprofessional education.

Design: A descriptive, community-based quality improvement initiative detailing the operationalization of a nurse-led mobile health unit (MHU) serving underserved communities.

Sample: The first 200 patients served by the MHU across five high-need community locations were identified using census data and the social vulnerability index.

Measurements: Patient demographic data, visit type, and satisfaction were collected. Additional process measures included clinic staffing, services delivered, and student involvement.

Intervention: The Mo-Bull Nurse Medical Clinic delivered free primary care services while serving as a training site for undergraduate and graduate nursing students and interprofessional learners.

Results: Among 200 patients, 175 were adults (mean age 48), and 25 were children (mean age 9.2). Adults were 43.5% female, 51.5% White, 20.5% Hispanic, and 18% Black. Most children sought school/sports physicals (88%). Common adult visits included well-care (16%), hypertension (13.1%), and alcohol abuse remission (9.7%). Over 99% reported high satisfaction.

Conclusions: Nurse-led mobile clinics are a scalable, equity-driven model that expands access to care and supports hands-on workforce development in underserved communities.

Objectives: Misinformation, conspiracy theories, and myths rapidly spreading through social media and various news outlets can play a significant role in the increase of community-based vaccine hesitancy and refusal. This study, conducted after the conclusion of COVID-19 vaccination efforts, aimed to determine the potential impact of circulating COVID-19 vaccine myths and conspiracy theories in various news sources on vaccine hesitancy and refusal in the Turkish society during a future pandemic.

Study design: Descriptive cross-sectional study.

Methods: In this study 1010 adult individuals responded to an online survey published on social media platforms between November 2023 and March 2024. Data were collected using a Socio-Demographic Information Form, the COVID-19 Vaccine Myths and Conspiracy Theories Survey in Turkey, and the Vaccine Hesitancy Scale in Pandemics.

Results: The study found that the mean total score of the Vaccine Hesitancy Scale in Pandemics was 31.54 ± 5.55. The most widely accepted vaccine myths and conspiracy theories among the Turkish population were, in order: "Vaccines are definitely not safe because they were developed too quickly," "vaccines are not safe for pregnant and breastfeeding women," and "vaccines have increased deaths due to heart attacks." The statement "microchips were implanted in people via vaccines" was the least accepted belief. Among those who believed that vaccines are not safe because they were developed too quickly, 63.9% reported that they would not get vaccinated in a new COVID-19 pandemic, and 50.2% stated that they would not get vaccinated in a pandemic caused by a different agent.

Conclusions: The resurgence of anti-vaccine movements and misinformation following COVID-19 vaccinations, which has led to increased vaccine hesitancy and refusal, urgently necessitates that health policy makers develop strategies and that healthcare providers implement effective interventions promptly.

Objective: To define the effect of environmental and child health education given to midwives and nurses working in primary health care services.

Design: The quasi-experimental study with the pretest-post-test.

Sample: Forty-two midwives/nurses.

Measurements: The Environmental Health Awareness Form, Knowledge Test, and Training Evaluation Form.

Intervention: The face-to-face 2-day training.

Results: The participants got an average score of 20.29 ± 5.69 in the pretest and 31.07 ± 0.68 (95% confidence interval difference: lower: -12.61, upper: -8.962) in the post-test. The mean knowledge scores increased significantly (t = 11.949, p < 0.001). The mean score of the evaluation of the training content by the participants was 4.69 ± 0.60 (min: 3, max: 5).

Conclusions: It has been determined that the awareness of midwives and nurses working in primary health care services can be increased by improving their knowledge of the relationship between child health and the environment, and participants have expressed their need for training in this area. It can be recommended that work be initiated to spread these trainings throughout the country through online training within the Ministry of Health of the Republic of Türkiye, and that these programs be organized under the leadership of public health nurses.

Objectives: This study demonstrated the usability of a co-designed benchmarking dashboard for supervisory public health nurses (PHNs) and their staff and identified supervisory PHNs' management challenges and strategies for system use.

Design: Descriptive case study.

Sample: Fifty-seven PHNs from three municipalities participated in the study using snowball sampling.

Measurements: Feedback was collected before, during, and after the dashboard development on the Kintone app. Participant attrition and System Usability Scale (SUS) scores were used to evaluate the dashboard's feasibility and usability using descriptive statistics. Content analysis was conducted to identify supervisory PHNs' management challenges and strategies for system use.

Results: There were no dropouts. The dashboard achieved an SUS score of 67.5, slightly higher than that of the existing system (66.0). Management challenges included human resource development, managing numerous individual cases, and conducting communityased activities. Dashboard use strategies included advancing evidence-based human resource development and strengthening data-driven management.

Conclusions: Per the findings, strategies for developing the benchmarking dashboard supported evidence-based workforce management and promoted reflective practices, suggesting that dashboard systems can enhance supervisory PHNs' leadership and improve the quality and equity of community health services.

Trial registration: University Hospital Medical Information Network (UMIN) Clinical Trials Registry: UMIN000051509 [https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000058761].