Objectives The Japanese government has supported public health nurses’ systematic career development and preceptors’ learning. Previous studies on precepting public health nurses indicated the value of precepting for career development. However, assessment scales for preceptor learning were not found. The purpose of this study was to develop the “PHN Precepting Experiential Learning Scale” (PHN-PELS) based on Kolb's experiential learning theory.
Methods This study included three phases of questionnaire development. First, the preliminary qualitative pilot study resulted in the PHN-PELS. The second pilot study was a questionnaire survey, returned by 52 (54.2%) public health nurses (PHNs) who had examined the validity and modified the items. Finally, a nation-wide questionnaire survey was conducted for PHNs who precepted novice PHNs in public health units from 2012 to 2016.
Results Of the 868 questionnaires mailed to 86 public health units, 438 (59.4%) were returned with 378 (43.5%) valid responses. PHN-PELS has 20 items forming four sub-scales, with confirmed content validity, construct validity, and reliability (α>.7). Sub-scales were: “Role Performance of Fostering Novice PHN,” “Self-development as a PHN,” “Sharing to Foster Novice PHN,” and “Improving Career Development Environment.”
Conclusion Scale development of the PHN-PELS resulted in four sub-scales with 20 items; its validity and reliability were supported. The PHN-PELS measures experiential learning in precepting novice PHNs, therefore, its usability is recommended for preceptors to evaluate their experiential learning and for preceptor training program in selecting sub-scales as appropriate.
Objectives Chronic insomnia is common in late adulthood. A non-pharmacological approach should take priority in the treatment of insomnia for the elderly. Many studies have shown the efficacy of Cognitive Behavioral Therapy for Insomnia (CBT-I) for elderly diagnosed with insomnia. However the effect of CBT-I on mild insomnia among older adults in community settings has not been ascertained. We conducted a randomized controlled trial to evaluate the effectiveness of a brief CBT-I delivered by nurses, which is feasible in community settings, to improve sleep quality and decrease the dose of hypnotics use for older adults.
Methods Participants aged 60 years and over were enrolled in this study. The participants in the intervention group were administrated the brief CBT-I consisting of a group session (60 min) and an individual session (30 min). The primary outcomes were the score differences in the Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI). The secondary outcomes were the change in the proportion of people diagnosed with insomnia and the dose of hypnotics used. The follow-up period was 3 months.
Results The score on PSQI in the intervention group (n=41) significantly decreased compared to the control group (n=38). The effect size (Cohen's d) was 0.56 (95% Confidence interval [CI], 0.07 to 1.05). The score on ISI also decreased significantly and Cohen's d was 0.77 (95%CI, 0.27 to 1.26). According to subgroup analysis, Number Needed to Treat (NNT) for improvement of insomnia was 2.8 (95%CI, 1.5-17.2) and NNT for decreasing of dose of hypnotics use was 2.8 (95%CI, 1.5-45.1).
Conclusion The present results have demonstrated that the brief CBT-I significantly improved subjective evaluation of sleep quality and insomnia symptoms among the elderly. In addition, the brief CBT-I decreased the usage of hypnotics. Further studies are needed in terms of the procedure and the effects of brief CBT-I for older adults living in a community.
Objective The objective of this study was to examine the influence of environmental factors on eating behaviors of children.
Method The participants were the caregivers of 1,678 children attending nursery schools or kindergartens in two different cities of a prefecture. We distributed several self-administered questionnaires to the caregivers in conjunction with collaborating organizations. The participants returned the questionnaires either to collection boxes placed at the collaborating organizations facilities or by mailing them. The questionnaires included assessment of the child's basic attributes, caregiver assessments of eating behaviors, the Social Responsiveness Scale (SRS) measure of autistic traits, the Japanese Sensory Inventory-Revised (JSI-R), and the Index of Child Care Environment (ICCE). We conducted a chi-square (χ2) test, Fisher's exact test, and a multiple regression analysis.
Results We received responses from 843 participants (response rate=50.4%), and of those, 583 were considered valid (34.7%). The mean number of problematic eating behaviors for each child as perceived by the caregivers was 2.43±2.26. In general, caregivers thought that about 40% of the children had an unbalanced diet and about 30% had a problem of “not being able to sit still.” The multiple regression analysis showed that the number of problematic eating behaviors was significantly and positively affected by the SRS T-score total (β=0.188, P<0.001), sense of taste (β=0.319, P<0.001) and auditory sense (β=0.168, P<0.001) in JSI-R. A positive relationship was found between the environmental factors of human stimulation (β=0.096, P=0.010) and social support (β=0.085, P=0.022). A negative relationship was found between sense of smell (β=−0.108, P=0.013), number of siblings (β=−0.100, P=0.005), age (β=−0.077, P=0.029), and sex (β=−0.091, P=0.010).
Conclusion Our study results showed that having an unbalanced diet and “not being able to sit still” were typical features of eating behaviors. The number of problematic eating behaviors was associated with personal factors such as autistic tendency and sensory characteristics, and also with environmental factors, such as human stimulation and social support. Our findings show the importance of evaluating all relevant factors when dietary guidance is provided in the treatment of problematic eating behaviors.