Aim: Nurses must develop good problem-solving skills (PSS) to work in the complex health care environment. This study explored PHNs’ use of analogy in PSS development. The purposes of the study were to clarify how PS...Aim: Nurses must develop good problem-solving skills (PSS) to work in the complex health care environment. This study explored PHNs’ use of analogy in PSS development. The purposes of the study were to clarify how PSS developed in one area (i.e., mental health) could be applied to another area (i.e., maternal health) and whether new PSS could develop in response to PSS gained in another area. Methods: A multiple case study was conducted using interviews. We interviewed 27 consultations from eight Japanese PHNs who consulted in mental health departments before transferring to maternal health departments. The data on how PHNs applied PSS in the selection, mapping, evaluation, and learning stages of the analogy process were extracted from transcribed interviewed data and compared. Results: PHNs provided 59 PSS used in 27 consultations. All PHNs applied past mental health PSS to solve new problems in maternal health. They tended to select past PSS based on structural similarity and to apply PSS via low-level abstraction in serious situations or preventively to avoid causing the current situation to worsen. Notably, PHNs developed maternal health PSS by using past mental health PSS;these new PSS were derived through analogy from various failures and successes. Conclusions: PSS developed in one area can be applied in another area, and new PSS can develop through applying these previous PSS. Identification of structural similarities and preventive analogies must be included in nursing education, especially for nurses working in public health fields.展开更多
An adequate approach to reducing school absenteeism should focus on medical absenteeism as this is the most prevalent form of school absenteeism. The objective of this study is to explore the health condition of pre-v...An adequate approach to reducing school absenteeism should focus on medical absenteeism as this is the most prevalent form of school absenteeism. The objective of this study is to explore the health condition of pre-vocational secondary students with extensive medical absenteeism from a biopsychosocial perspective. Data were obtained from medical assessments and Strengths and Difficulties Questionnaires (SDQs) of students with medical absence above threshold criteria (i.e. reported sick four times in 12 school weeks or more than six consecutive school days) who were referred to a youth health care physician. The results showed that the students had a mean absence rate of 14% in 12 school weeks. Of all students, 43.5% had a diagnosed disease and 81.5% had problems such as physical complaints not yet diagnosed, psychosocial problems, lifestyle problems and sleeping difficulties. Four groups could be distinguished: 13.4% with a diagnosed disease and no problem, 30.1% with a diagnosed disease and a problem, 51.5% with a problem and no diagnosed disease and 5.1% without a diagnosed disease or problem. Significantly higher scores of the Total difficulties-scale on the SDQ were found (mean 10.5;SD 5.8) in the study group, compared to a reference group (mean 9.1;SD 4.9). In conclusion, this study shows that when using the aforementioned criteria for extensive medical absenteeism to intervene with the absence, students with a mean absence rate of 14% in 12 school weeks are identified. If there was a diagnosed disease, it was accompanied by problems about twice as often. More than half of the students’ absence was caused by problems rather than a disease. The great diversity of these problems calls for a personalized approach. A broad perspective, including medical expertise, is needed to distinguish between emerging mental and physical diseases, psychosocial and lifestyle problems.展开更多
文摘Aim: Nurses must develop good problem-solving skills (PSS) to work in the complex health care environment. This study explored PHNs’ use of analogy in PSS development. The purposes of the study were to clarify how PSS developed in one area (i.e., mental health) could be applied to another area (i.e., maternal health) and whether new PSS could develop in response to PSS gained in another area. Methods: A multiple case study was conducted using interviews. We interviewed 27 consultations from eight Japanese PHNs who consulted in mental health departments before transferring to maternal health departments. The data on how PHNs applied PSS in the selection, mapping, evaluation, and learning stages of the analogy process were extracted from transcribed interviewed data and compared. Results: PHNs provided 59 PSS used in 27 consultations. All PHNs applied past mental health PSS to solve new problems in maternal health. They tended to select past PSS based on structural similarity and to apply PSS via low-level abstraction in serious situations or preventively to avoid causing the current situation to worsen. Notably, PHNs developed maternal health PSS by using past mental health PSS;these new PSS were derived through analogy from various failures and successes. Conclusions: PSS developed in one area can be applied in another area, and new PSS can develop through applying these previous PSS. Identification of structural similarities and preventive analogies must be included in nursing education, especially for nurses working in public health fields.
文摘An adequate approach to reducing school absenteeism should focus on medical absenteeism as this is the most prevalent form of school absenteeism. The objective of this study is to explore the health condition of pre-vocational secondary students with extensive medical absenteeism from a biopsychosocial perspective. Data were obtained from medical assessments and Strengths and Difficulties Questionnaires (SDQs) of students with medical absence above threshold criteria (i.e. reported sick four times in 12 school weeks or more than six consecutive school days) who were referred to a youth health care physician. The results showed that the students had a mean absence rate of 14% in 12 school weeks. Of all students, 43.5% had a diagnosed disease and 81.5% had problems such as physical complaints not yet diagnosed, psychosocial problems, lifestyle problems and sleeping difficulties. Four groups could be distinguished: 13.4% with a diagnosed disease and no problem, 30.1% with a diagnosed disease and a problem, 51.5% with a problem and no diagnosed disease and 5.1% without a diagnosed disease or problem. Significantly higher scores of the Total difficulties-scale on the SDQ were found (mean 10.5;SD 5.8) in the study group, compared to a reference group (mean 9.1;SD 4.9). In conclusion, this study shows that when using the aforementioned criteria for extensive medical absenteeism to intervene with the absence, students with a mean absence rate of 14% in 12 school weeks are identified. If there was a diagnosed disease, it was accompanied by problems about twice as often. More than half of the students’ absence was caused by problems rather than a disease. The great diversity of these problems calls for a personalized approach. A broad perspective, including medical expertise, is needed to distinguish between emerging mental and physical diseases, psychosocial and lifestyle problems.
