Purpose: This study aimed to clarify the structure of the strategies used by public health nurses（PHNs）in developing public health programs.
Methods: Municipal PHNs were encouraged to respond by mail to a self-administered questionnaire directing them to select one of several cases and then answer questions regarding their experience in developing appropriate health programs. Based on the results, the structure of strategies took the form of a causal model related to PHNs’ activities and their outcomes, and was verified by a covariance structure analysis.
Results: The questionnaire was returned by 885 participants. The strategies for developing health programs consisted of two parts: an activity part and an outcome part, each of which contained five factors. The causal model consisted of a structure with three phases. The degrees of relevance of the main survey were as follows: GFI = 0.931, AGEI = 0.916, CFI = 0.942, and RMSEA = 0.042. Phase 1 consisted of “supporting subjects for voluntary participation,” “forming consensus for implementation,” “sharing all processes among planning members,” “attractive contents of programs” and “understanding subjects.” Phase 2 consisted of “advancing to more superior measures,” “strengthening collaborative systems,” and “autonomous changes by subjects.” Phase 3 consisted of “results corresponding to aims” and “improvement of expertise.”
Discussion: Our results revealed that PHNs require two particular strategy types to develop public health programs: a strategy to encourage residents’ autonomy and a strategy to enforce residents’ support systems in order to realize more superior measures.
Objective: To clarify the process of avoiding radiation exposure of mothers who had children under 6 years old at the time of the Fukushima Daiichi Nuclear Power Stations（FDNPS）accident.
Methods: A semi-structured interview was conducted with the twenty-one mothers and the data analysis was conducted by the trajectory equifinality approach（TEA）．
Results: The mothers had gathered negative information about the FDNPS accident from the internet. Because of this negative information, they began to connect this information to the negative events they were experiencing in their daily life. Therefore, they began to draught the information by the Japanese government that said there would be no harmful effects from the radiation caused by the accident. The mothers thought that if they continued to live in the disaster area instead of evacuating, their children may experience health issues that were attributable to their radiation exposure. Because of this, they began to consider evacuating the disaster area with their children. In addition to considering whether to evacuate the disaster area with their children, the mothers also had to think deeply about how this choice would affect their family members, especially their husbands. However, while negotiating whether or not to evacuate the disaster area with their husbands, many mothers decided to give priority to their role as a mother. As a result, they decided to evacuate from the disaster area in order to provide a good life for their children.
Discussion: When working as a regional nurse and providing support to the mothers, it is important to understand that the mothers had to endure suffering and conflict prior to their evacuation of the disaster area.
Aims: Specialized support provided by public health nurses to mothers with children having identified traits of developmental disorders was investigated by examining those mothers’ child-rearing experiences from the point of the identification of traits to the receiving of continuous support from specialized agencies.
Methods: Semi-structured interviews were conducted with mothers（N ＝ 7）of children with developmental disorders, living in A city, on the concrete aspects of their child-rearing. The results were analyzed qualitatively and inductively.
Results: Nine categories of mothers’ child-rearing experiences were developed. （1）Feeling despair when informed about their child’s traits indicating developmental disorders, （2）depression before the diagnosis, （3）feeling isolated, anxious and alone, （4）feeling remorse for their ways of rearing children, （5）mental and physical exhaustion through difficulties in dealing with the traits of a developmental disorder, （6）distress about not being able to accept their child, （7）positive thoughts about facing the disorder, （8）feeling relieved by receiving support from specialized agencies, （9）gaining confidence in child-rearing through their child’s development.
Discussion: Mothers experienced despair when the traits of developmental disorder were identified in their children, which had negative effects on the development of mother-child attachment. It is important to build a trusting relationship with mothers after the traits are identified and to provide continuous support, as well as to help mothers acquire skills to cope with their children. It is expected that mothers’ distress and loneliness, as well as inhibition in developing mother-child attachment, would be reduced through such support.
Objective: To clarify the public health nurses’（PHNs’）support in terms of the viability among residents with schizophrenia in the local community, who are untreated or with interrupted treatment.
Methods: Semi-structured interviews were conducted with 10 PHNs experienced in mental health and welfare counseling at municipal public health centers: transcripts of the interviews were analyzed qualitatively.
Results: Nine categories and 42 subcategories were extracted as PHNs’ support in terms of viability. The PHNs identified the viability in the context of relationships built in the following categories: “Being a person who residents can consult peacefully,” “sensing crisis of family members,” “persistently dealing with problems,” and “accepting the existence of psychiatric symptoms.” The PHNs also “identified residents’ ability to live their lives” by continuously engaging with residents in their own environment. Moreover, the PHNs actively expanded the scope of residents’ lifestyle and connected them with treatment after ascertaining their viability by “courteously introducing them to medical services,” “arranging treatment systems to enable them to lead stable lives at home,” “maintaining PHNs’ involvement with residents,” and “coordinating with the next supporters to help rebuild residents’ lifestyles” in a manner suited to their viability.
Discussion: The present findings suggest that the support for the schizophrenia residents who are untreated or with interrupted treatment focused on viability: “identifying the ability of residents to live their lives.” This viability is considered to be important for them to live in a local community.
Objectives: We inquired into and described the support of local communities for families who had experienced a loved one’s death.
Methods: Data came from semi-structured interview for qualitative descriptive research; participants comprised locally active persons in city ‘A’ who had consulted or provided support regarding a neighbor’s death, or were publicly employed. A content analysis of the interview was performed.
Results: Thirteen individuals, mean age 69.7 years, participated. Support of local communities for families who had experienced a loved one’s death were: “create relationships in a local community so they can ask one another for help”; “interacting with others hoping for their happiness”. Then, they supported a family from patient’s daily life to one’s death: “support a family caring for a patient” ; “support a family left behind when the patient passes”. Support provided shortly after someone’s death included: “look after the families and lives after loss”; “take feelings into consideration when interacting with the family.”
Discussion: In local communities, the long-term neighborhood relationship transforms into one based on trust and interaction, allowing people to look out for each other after a neighbor’s death. Connections are forged as people watch out for their neighbors during the patient’s illness and funeral. In the future, it is important to engage key persons involved in citizens’ and community activities and ask them to assist in the edification and nurturing of a community that supports neighbors during the loss of a loved one.
Objective: To assess the “face-to-face relationship” among hospital nurses and home visiting station nurses（ST）and explore the various factors affecting that relationship in a future community comprehensive health care system.
Method: There were 556 subjects in this study, comprising 230 nurses belonging to 230 hospitals with home care coordination departments, in the capital city region of prefecture A and 326 ST belonging to 326 ST in the same prefecture.An anonymous questionnaire delivered by mail was completed by the subjects. The dependent variable was the “face-to-face relationship” and the independent variables were the subjects’ basic characteristics and the nurses’ teamwork competencies.
Results: There were 234 valid questionnaire replies（hospital: 83; visiting nurse ST: 151）. The valid response rate was 98.3％（hospital: 97.6％ ; ST: 98.7％）. The average age was 44.0 ± 8.5 years for all subjects; 45.8 ± 8.6 years for hospital nurses and 43.1 ± 8.4 years for ST. The total scores for the face-to-face relationship assessment were 69.7 ± 11.9 points for all subjects: 70.8 ± 13.6 points for hospital nurses and 69.1 ± 10.8 points for ST. For all subjects, the variable that showed a correlation with the face-to-face relationship assessment score was the total score for the 11 factors under teamwork competencies（all subjects: p ＝ 0.01, hospital nurses: p ＝ 0.04, ST: p ＝ 0.03）. Among these factors, some of the results were: “Asserting one’s own thoughts, judgments, or actions to influence others”（all subjects: p ＝ 0.06, hospital nurses: p ＝ 0.05, ST: p ＝ 0.03）; “Effective use of others’ abilities”（all subjects: p ＝ 0.07, hospital nurses: p ＝ 0.06, ST: p ＝ 0.03）; and “Participation in collaborative activities with other nurses”（p ＝ 0.02）.
Conclusions: It was clarified that attention should be paid to shared individual competency and environmental factors, transcending hospitals and ST, to promote collaboration among nurses in a future community comprehensive health care system.
Purpose: The aim of this study was to clarify the subjective awareness of mothers raising pre-school children regarding their own upbringing experiences, with a focus on attachment experiences during the mothers’ childhoods.
Methods: Semi-structured interviews were conducted with 13 mothers raising pre-school children, and data were analyzed qualitatively and descriptively.
Results: Subjective awareness of each mother regarding her own upbringing experiences fell into two main categories: “Sense of security in being watched over and accepted” and “Dissatisfaction from one’s expectations not being met”．The first category included “The attention of parents who did things to please their child”，“Affirmation of encouragement through praise”，“Experiences of being raised with a sense of security from parents”，“Trust from being watched over and receiving help in difficulties”，and “Parents with a positive attitude toward childrearing”．The second category included “Resignation that one’s uncomfortable feelings were not noticed”，“Feeling that one was always being scolded”，“Failure of the parents to match their child’s pace”，“Sense of unfairness from attitudes towards siblings”．
Discussion: Mothers have recognized that they have related to forming attachment and parenting experiences on both sides of satisfaction and feeling of being unfulfilled. Recognizing the feeling of satisfaction with their parenting experience encourages mothers in their positive involvement and love affirmation. Regarding parental support, it can be expected that positive personal upbringing experiences as well as attachment experiences would improve self-affirmation in mothers’ practice of rearing their own children.