Realities of Reflective Practice Skill among Public Health Nurses in Japan and Related Learning and Lifestyle Factors

Background: According to the diversification of the health needs and the expansion of health disparities, it is necessary to raise their reflective practice skills so that PHNs present more appropriate activities. The purpose of this study was to elucidate the realities of reflective practice skills among public health nurses in Japan and identify related factors. Methods: This study covered 1725 public health nurses in the Chugoku/Shikoku area. We conducted an anonymous self-completed questionnaire survey. As reflective practice skills (RPS), we adopted the six components of the six cycles of the Gibbs reflective model. We used the 20 criteria of the Scale for Practical Competence (SPC). We set 25 learning history/daily lifestyle items. The study plan was approved by the Ethics Committee of Okayama University. Results: We analyzed the 962 (55.8%) valid responses. Although years of experience as a public health nurse was highly correlated with practical skills as measured by SPC, with a correlation coefficient of 0.627, it was not closely related with RPS, with a correlation coefficient as low as 0.129. A logistic regression analysis of the eight learning history items and six daily lifestyle items associated with RPS, with the introduction of the high/low RPS groups as dependent variables, showed a convergence to five factors (odds ratio of 1.38 - 2.29). Conclusions: Going forward, we will need to consider how to accumulate learning on a daily basis and how to include positive health practice in PHN education, in connection with exploring the curriculum and method of training.

Perceived Difficulties Regarding HIV/AIDS Services among Public Health Nurses in the Kinki Region of Western Japan: Implications for Public Health Nursing Education in Japan

Objective: To determine the perceived difficulties in providing HIV/AIDS services among public health nurses and to identify their correlates, we carried out a cross-sectional study in the Kinki region of western Japan. Methods: Structured self-administered questionnaires were distributed to all public health nurses in the region, and 1535 valid questionnaires were retrieved (valid response rate 78.7%). Results: More than half of the participants (52.8%) reported difficulties with HIV/AIDS services. The factors associated with perceived difficulties were having a negative attitude towards consultations on sexual matters (adjusted odds ratio [AOR] 2.2, p p = 0.002 and AOR 1.8, p p p = 0.016), and low permissiveness of the diversity of sexual behavior (AOR 2.0, p Conclusions: Overall, our results suggest that nursing and public health nursing education in Japan should cover sexual issues and HIV/AIDS in a more systematic way.

Chagas Disease: Proposal of Health Education for Community Health Workers in the City of Petrolina, Pernambuco, Brazil

The Education for Health at PET Work Program (PET-Health) is focused on education as a pre-supposition. Actions are directed towards to the integration of service-learning and community. Interdisciplinary principle is directed from fusion of work of graduate students, academics and professionals of health services for the benefit of strengthening primary care and health surveillance. This work aimed to carry out educational activities with Community Health Agents (ACS) of the health facilities of PET-health, with the theme of Chagas disease. This descriptive cross-sectional study was carried out from January to May 2013, and the sample consisted of 25 active ACS in six Basic Health Units in the city of Petrolina, Brazil. In spite of actuation of ACS in primary care for over 10 years, a limited knowledge has been developed about this pathology. The health education workshops developed by the PET group clarified the ACS on Chagas disease allowing them to have an expansion of knowledge about the vector, habitat Barber, transmission, clinical manifestations… After the workshop, it was found that the ACS expanded their knowledge about the disease cycle, expanding the possibilities for action in the prevention of this pathology in their respective coverage areas. This work shows an important form of integration between education, service and community that can govern the new direction of health education.

Sociodemographic,biological,and psychosocial correlates of light-and moderate-to-vigorous-intensity physical activity during school time,recesses,and physical education classes

Background: Identifying factors associated with physical activity(PA) is useful in planning interventions and policies. The aim of this study was to identify sociodemographic, biological, and psychosocial factors associated with PA performed in school settings.Methods: Data collected for the present study included gender, age, socioeconomic status, body fat percentage, aerobic fitness, self-efficacy, attitudes,peer and parental support, and perception of school environment. Dependent variables were light-intensity PA(LPA) and moderate-to-vigorousintensity PA(MVPA) performed during school time, recesses, and physical education(PE) classes. Multiple regression analyses were performed.Results: Participating adolescents(n = 567, 53% female, 12.9 ± 5.3 years) spent 5% of school time in MVPA and 27% in LPA, 15% of recesses in MVPA and 44% in LPA, and 16% of PE classes in MVPA and 41% in LPA. Boys engaged in more MVPA in all categories. Age was inversely related with MVPA and LPA in all periods, whereas body fat percentage was inversely related with MVPA in school time and PE classes. Attitude was inversely related with MVPA in all periods and with LPA in recesses. Considering PA to be good and enjoyable was positively associated with MVPA in school time.Conclusion: Adolescents spent little time in PA during school. Future interventions should implement enjoyable activities at school.

Community Education Challenges in Young Adults of South Western Uganda

The aim of this study was to identify the major challenges to community education and any health problem in Bushenyi district of South Western Uganda. Data collection was done through questionnaire and participants were randomly selected. This was a cross-sectional study carried out for a period of three months in 2012. A questionnaire was used to collect data and using onsite observations the responses were validated. A total of 260 participants from 65 homesteads were included in the study from 52 households. 144 were females and 116 males, of which 52.4% of the children were female and the rest male. The mean ± SEM age of females and males was 36 ± 8.6 and 29 ± 8.6 years respectively. In all the homesteads, 71% were headed by an adult male and only 29% were found to be headed by an adult female while none was headed by children. Inferential analysis showed (P = 0.02) that there are more females than male in the homesteads. Majority of the homesteads are being taken care of by women instead of men probably as a result of the high mortalities due to HIV/AIDS in the past decade and above all the movement of most men to urban centers in search of better sources of employment to support their families. Among school going age participant’s i.e. children and adolescents, only 59.6% were found to be attending school. There was no statistical significance (P = 0.16) between school attendance and age. Family responsibilities such as cooking for younger siblings by female participants, obligations on open market days are thought to be secondary limiting factors for community development and livelihood amongst young persons;thus a follow up study would be conducted to assess their associations in this community as this would raise major child abuse concerns which would need to be reported to the legal authorities for follow up.

Use of Analogy by Public Health Nurses in Problem Solving for Individual Consultations in Japan: A Multiple Case Study

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.

Factors influencing self-efficacy in breastfeeding support among public health nurses in Japan

This study investigated self-efficacy in breastfeeding support among public health nurses (PHNs) working at maternal and child health (MCH) services in Japanese municipalities, and its related factors such as education, working experience, breastfeeding experience, and postgraduate/continuous education. Directors of the MCH divisions were requested to select one PHN to answer the self-report questionnaires sent. The questionnaires were collected from October 2010 to January 2011. Of the 1750 questionnaires sent, 831 were returned (response rate: 47.5%);102 were excluded from analysis because of missing data (valid response rate: 41.7%). After adjusting the weights of PHN sampling and collection rates by prefecture and population size, Model 1 of the multiple regression analysis showed that the self-efficacy in breastfeeding support was significantly higher in large/urban municipalities (β = 0.13) and in the Kanto district. Model 2 revealed that self-efficacy was significantly associated with working experience (β = 0.13) and breastfeeding experience (β = 0.22) but not with educational background. Model 3 showed that self-efficacy was significantly associated with postgraduate education (β = 0.14) and continuous education (β = 0.12). This suggested that PHNs’ self-efficacy increased through self-enrichment. It is necessary to create training opportunities about breastfeeding support for PHNs—especially those working in remote and/or small municipalities— and to provide them with new and important information.

Mixed methods evaluation of a randomized control pilot trial targeting sugar-sweetened beverage behaviors

This Excessive sugar-sweetened beverage (SSB) consumption and low health literacy skills have emerged as two public health concerns in the United States (US);however, there is limited research on how to effectively address these issues among adults. As guided by health literacy concepts and the Theory of Planned Behavior (TPB), this randomized controlled pilot trial applied the RE-AIM framework and a mixed methods approach to examine a sugar-sweetened beverage (SSB) intervention (SipSmartER), as compared to a matched-contact control intervention targeting physical activity (Move-More). Both 5-week interventions included two interactive group sessions and three support telephone calls. Executing a patient-centered developmental process, the primary aim of this paper was to evaluate patient feedback on intervention content and structure. The secondary aim was to understand the potential reach (i.e., proportion enrolled, representativeness) and effectiveness (i.e. health behaviors, theorized mediating variables, quality of life) of SipS- martER. Twenty-five participants were randomized to SipSmartER (n = 14) or MoveMore (n = 11). Participants’ intervention feedback was positive, ranging from 4.2 - 5.0 on a 5-point scale. Qualitative assessments reavealed several opportuneties to improve clarity of learning materials, enhance instructions and communication, and refine research protocols. Although SSB consumption decreased more among the SipS-martER participants (?256.9 ± 622.6 kcals), there were no significant group differences when compared to control participants (?199.7 ± 404.6 kcals). Across both groups, there were significant improvements for SSB attitudes, SSB behavioral intentions, and two media literacy constructs. The value of using a patient-centered approach in the developmental phases of this intervention was apparent, and pilot findings suggest decreased SSB may be achieved through targeted health literacy and TPB strategies. Future efforts are needed to examine the potential public health impact of a large-scale trial to address health literacy and reduce SSB.

Prevention of Children Obesity: A Nutrition Education Intervention Model on Dietary Habits in Basic Schools in Chile

The objective of this study is to describe the process and results of a three-year project designed to create a nutrition education intervention model that promotes healthy dietary habits among teachers, students and their families. The methodology consisted in surveys, focus groups and Delphi method to assess teachers’, students’ and parents’ dietary habits, followed by an intervention for parents, and a participative nutritional education intervention with information and communication technologies applied to teachers, with the purpose to transfer nutritional knowledge and habits to school children and their families. Qualitative results were measured in all the phases of the project with positive results, and quantitative results demonstrated significant changes in food knowledge and healthy dietary habits in parents, teachers and students, compared with the control groups, without changes in students’ nutritional status during the short period of the intervention. With the results, an integral school nutrition education model in healthy eating was developed with children, parents, teachers and support for school management. This model should be applied in the educational sector to address the problem of unhealthy diet and childhood obesity that affects Chile and the world.

Free Media as the Social Determinants of Health: The Case of Oromia Regional State in Ethiopia

Background: For over a hundred thirty years, consecutive Ethiopian regimes have denied the Oromo people the right to develop free media. In this paper I explore how this denial has affected the development of public health conditions in Oromia. Methods: Using the “upstream” public health metaphor as the framework of thinking, in this paper I explore how the denial of free media has hindered the development of better public health conditions. Finding: Although media and public health are distinct social organizations, many of their functions overlap, with the former significantly supporting the development of the latter. Media informs, educates, entertains, molds opinion, advocates, provides a framework of thinking, connects people and ideas, and records events. The foundation of public health rests on the study of risks to population health and identifying health promotion as well as disease prevention (primary, secondary and tertiary) tools. Media facilitates knowledge construction and its dissemination. It supports the efforts societies make in establishing and maintaining the social conditions that will ensure the best public health outcomes possible. Conclusion: Since media facilitates knowledge construction and knowledge dissemination, it can help produce knowledgeable and critical citizens who are equipped with problem-solving skills. Denying the Oromo people the right to develop their own free media is hindering them from having people with skills who are critically needed in transforming their society and developing better public health conditions.

No change of attitude toward forensic psychiatry: 5 years after the Medical Treatment and Supervision Act in Japan

Objective: The forensic mental health system in Japan changed dramatically with the enforcement of the “Act on Medical Care and Treatment for the Persons Who Had Caused Serious Cases under the Condition of Insanity” or MTS Act, in 2005. The aim of this study is to evaluate the changes in attitude and behavior of general psychiatrists, towards forensic psychiatry. Methods: We conducted a questionnaire survey in 2010 on forensic psychiatry for Japanese psychiatrists, mirroring a previous study from 2007. Results: Comparing the results from both questionnaires, it is not evident that awareness of forensic mental health has improved among psychiatrists in the intervening three years. Conclusion: Further education about forensic mental health needs to be considered inJapan.

The Social Determinants of Health in Relation to Sexually Transmitted Infections in Maricopa County Arizona

Based on the information that was collected on the County Health Rankings website [1], one of the top health concerns for Maricopa County was sexually transmitted infections or STIs. A big concern with STIs is this is not a common subject explored in educational settings or addressed socially. There are many organizations, including the CDC, that have access to materials, there is limited distribution of the educational content. Therefore, the public is not well informed and lacks the information to make educated decisions. The areas with insufficiencies are knowledge of the disease processes, prevention, and treatment.

Raising Awareness about Water Issues:The Role of Water Symbolism and Proverbs

Sustainable water management is one of the global grand challenges of our time. Tackling this challenge through corrective actions would require the participation of the general public, a public with sound awareness of the challenge and commitment. One such awareness raising intervention could be through the use of water symbolism and proverbs, targeted to particular society. Water has the different symbolism and levels of importance to people, depending of their personal characteristics and socio-demographic factors (e.g. gender, age, occupation, residence). Similarly, water proverbs can also demonstrate attitudes towards water among communities, ethnic groups and whole nations. Such meanings and symbolism could help determine attitude and be a powerful tool towards education. In this context, we describe and propose a psychological Health Belief Model (HBM) as a way to explain behaviour and stimulate sustainable water management practice.

Virtual patient education for hypertension: The truth about behavioral change

Anti-hypertensive education is an important public health intervention to decrease the mortality and burden of the disease.Using digital technologies for education as a part of preventive measures for hypertension is a cost-effective approach and helps low-income communities and vulnerable populations overcome barriers to healthcare access.The coronavirus disease 19 pandemic further highlighted the need of new health interventions to address health inequalities.Virtual education is helpful to improve awareness,knowledge,and attitude toward hypertension.However,given the complexity of behavioral change,educational approaches do not always provide a change in behavior.Some of the obstacles in online hypertensive education could be time limitations,not being tailored to individual needs and not including the different elements of behavioral models to enhance behavior change.Studies regarding virtual education should be encouraged and involve lifestyle modifications emphasizing the importance of Dietary Approaches to Stop Hypertension diet,salt restriction,and exercise and should be used adjunct to in-person visits for the management of hypertension.Additionally,to stratify patients according to hypertension type(essential or secondary)would be useful to create specific educational materials.Virtual hypertension education is promising to increase awareness regarding risk factors and most importantly motivate patients to be more compliant with management helping to decrease hypertension related complications and hospitalizations.

中美健康传播学的起源、跨文化流动与体系建构

学科史“常识”一般将健康传播认定为传播学的一个分支,于21世纪初由美国引入我国。这种对于健康传播学起源的误解不仅低估了中美两国公共卫生领域的学术贡献,也直接影响了我国健康传播研究的学术视野、方法取径和评价体系。通过知识考古,重访以罗杰斯及其“创新扩散”理论为主要动力的美国健康传播学的创立过程,重估20世纪80年代我国公共卫生领域研究者们的本土健康传播学构想,可以发现,健康传播学学科建设与研究应植根于我国政治经济制度和社会历史发展现实,重视中华人民共和国成立以来公共卫生领域的健康教育实践,并在促进健康传播与公共卫生的对话与合作中重建健康传播的问题意识与知识体系。

护理实习生突发公共卫生事件应对能力培养路径的质性研究

目的探究急诊科护理实习生和临床带教教师双方视角下突发公共卫生事件(以下简称突发事件)应对能力培养实践过程中的潜在问题及限制性因素,为护理实习生突发事件应对培训策略发展提供参考资料。方法2022年12月—2023年10月选取北京市某三级甲等医院急诊科护理实习生、临床带教教师作为研究对象,进行半结构式访谈,使用Colaizzi7步分析法提炼主题。结果护理实习生突发事件应对能力培养可归纳为3个主题:突发事件应对及培训经历、突发事件应对的能力培养、突发事件应对能力的培养策略。结论医学院校和临床协作在提升临床带教教师突发事件应对能力的同时,建议明确定位护理实习生对突发事件应对的培养目标及能力要求,结合急诊科临床实习环境,多方协调形成突发事件应对培养路径。

面向国家公共卫生安全的药学专业课程思政体系的构建

在新冠疫情暴发的背景下,成都大学药学专业提出“弘扬三线精神、牢记川抗使命,培养家国情怀;面向公卫安全、面向科技前沿、培养创新精神”思政教育目标。通过挖掘川抗思政元素、运行“院所合一”机制、实施“链上德育”教学模式等措施,构建了“课程-导学-实践”三位一体的药学专业思政体系;通过建立激励考核-综合评价-持续改进的思政保障体系,形成了专业课程思政教育OBE闭环体系,切实提升了专业思政水平和学生培养成效。

突发公共卫生事件影响下医学生医学职业精神认知现状研究

目的调查分析上海高校医学生对医学职业精神的理解和认知现状。方法选取上海市部分医学院校的全日制在读医学生574名,采用自行设计的问卷开展调查,并根据参与志愿者工作或抗疫一线工作经历将医学生分为参与组(362名)和未参与组(212名),进一步分析相关工作经历对医学职业精神内涵重要性认同度的影响。结果不同学历医学生对《医师宣言》和《中国医师宣言》的认知情况比较,差异有统计学意义(P<0.05)。46.2%的医学生认为疫情的发生并没有影响个人职业规划,37.3%的医学生在经历疫情之后更坚定了学医的决心,准备为医学事业献身;37.6%的医学生认为疫情对个人职业精神影响很大,加深了对医学职业精神的直观感受,并将付诸实践;46.5%医学生意识到医学职业精神对医学教育、卫生健康事业发展的重要性。医学生认为医学职业精神最重要的前3项是“尊重患者”(87.1%)、“在困难时保持镇定”(87.3%)和“解决自己知识和技能上的差距”(86.2%),而排名末3项则是“代表患者发声”(58.9%)、“对待患者,随叫随到”(47.9%)和“为满足患者,接受对自己不便的要求”(41.5%)。参与组对医学职业精神内涵重要性的认同度显著高于未参与组,差异有统计学意义(P<0.01)。结论医学生对医学职业精神的认识目前仍存在不足,且利他主义精神相对缺乏,但大部分医学生能认识到医学职业精神在自身成长、发展与职业实践中的重要性。

基于微信公众平台开展医学微生物学课程思政与健康融合教育的实践意义

研究表明微信公众平台能显著提高大学生健康教育和课程思政教育的效果。通过医学微生物学课程思政与健康融合教育微信公众平台,将课程思政与校园健康教育有机统一起来,以提高医学生的健康、人文素养和医学微生物学课程的学习效果。微信公众平台作为校园思政、健康与课程融合教育创新模式,对完善课程思政与健康的融合、协同式教育的长效机制,形成人人都积极参与建设“健康中国”的校园和社会合力,共同促进新时代医学教育事业的改革与创新,建设中国特色社会主义和实现中华民族伟大复兴的目标等都具有重要实践意义。

突发公共卫生事件下的检验技术本科教学改革思考

近年来,在对不确定且影响范围较大的突发公共卫生事件处置中,检验专业发挥了重要的作用,同时也对检验技师在生物安全规范、检测技术整合及参与临床诊断上提出更高的要求.如何培养拥有更全面的理论及实践能力的检验专业人才显得尤为重要.本文从新型冠状病毒感染疫情带给检验专业的挑战及机遇出发,立足本科教育,通过对本科学生在校理论课程设置与临床实习两方面的改革,以期构建顺应突发公共卫生事件要求的检验本科教学体系.