Abstract
Purpose : This study aimed to describe the methods used by public health nurses (PHNs) to provide culturally sensitive health counseling to prevent lifestyle-related diseases in residents of suburban Japan. Methods : Seven PHNs from two cities were observed during health counseling sessions and semi-structured interviews were conducted by the authors. Responses to the following research questions were analyzed qualitatively: a) What cultural themes did PHNs consider during health counseling? And b) How did PHNs use those cultural themes to enhance behavioral change? Results : The cultural themes were categorized into seven groups. Furthermore, six methods of applying these cultural themes by the PHNs were identified as follows: encouraging counselees to talk freely by talking about their interests or by matching their tone, assessing the risks of lifestyle-related diseases with regard to the suburban lifestyle, accepting practices favored by the counselees even when they may be risk factors for lifestyle-related disease, creating awareness of health risks in the daily lives of the counselees, encouraging self-care methods that can be easily incorporated into their daily lives, and proposing behavioral changes based on the interests or abilities of the counselees. Discussion : PHNs are required to understand the counselees' meaning of living in the suburbs and offer viable lifestyle options, taking into account suburban culture. This method supports a lifestyle option that reflects the counselees' values and attitudes and also nurtures love for their home town. It is suggested that PHNs understand that people are not only influenced by culture but also create new culture.
