Aim: The purpose of this study is to examine the research hypothesis that there are differences in determinant factors that depend on the income level in seeking medical care of breast cancer patients who delayed getting medical care.

Methods: A cross-sectional survey was carried out at breast clinics in Japan, from February to May, 2016. The survey was conducted among 61 breast cancer patients who delayed seeking care at a hospital for more than 3 months after noticing a breast abnormality. The survey was asked about Problem Definition, Affective Responses, Health service utilization habits, Social Context, Beliefs, and Health services system variables. In the analysis, the annual family income level was classified into two groups, high-income group (≧3,000,000 JPY) and low-income group (＜3,000,000 JPY), and group comparisons were performed.

Results: The lower-income group experienced a significantly higher level of fear (p＝0.001) and anxiety (p＝0.008) compared with the higher-income group, when patients notice a breast abnormality. There were significantly differences between lower and higher-income group among 4 out of 20 items on the Modified J-Delay scale. The percentage of those who answered yes in the following questions were significantly high in the lower-income group : “Choose not to take any action” (p＝0.01), “Nuisance about thinking and acting” (p＝0.003), or “Consideration to people around” (p＝0.046). On the other hand, the percentage of those who answered yes in the following question was significantly high in the higher-income group answered “prioritized attending a hospital examination than other important things” (p＝0.03).

Conclusion: Our finding showed that there were differences in related factors that depend on the income level in seeking medical care of breast cancer patients who delayed getting medical care. Therefore, it was important to consider income level when constructing methods for reducing delayed seeking medical care.

親密なパートナーからの暴力は，社会的，経済的，宗教的あるいは文化的背景に関わらず，公衆衛生上の健康課題となっている．日本においても，他の諸国と比較して低い状況とはいえ，親密なパートナーからの暴力が発生している．本研究では，大学1年生に対して，交際相手からのデートDV被害を受けた経験とその後の援助希求行動について，25の被害経験シナリオを含む無記名自記式質問票を用いて横断研究を行った．371人から回答を得た．男子148人（60.2％）および女子81人（64.8％）が，交際経験があると回答した（χ²＝0.754, df＝1, p＝0.385）．交際経験がある学生中，男子69人（46.6％）および女子49人（60.5％）が，何らかのデートDV被害を受けており，女子の方が統計的有意にデートDV被害を経験していた（χ²＝4.033, df＝1, p＝0.045）．最も回答が多かった被害経験は，「交際相手から『ブス／ブサイク』や『バカ』などと言われたことがある」であり，男子24人（16.2％）および女子26人（31.2％）であった．デートDV被害後，援助希求行動について回答した115人中，19人（16.5％）が相談していたが，相談先としては，19人全員が「友人」，4人が「母親」と回答した．専門職・機関に相談した者はいなかった．自分の意志に反したキスあるいはセックスといった性行為の経験があると回答した11人のうち，誰かに相談した者は4人，またその後交際を解消した者は4人であった．デートDVの予防や早期に適切な相手・機関への援助希求行動を促進するための介入プログラムを講じる際には，性別や文化的要素について考慮する必要性が示唆された．

Objective: The purpose of this study was to identify the attainment targets for graduates of basic public health nurse (PHN) education on practical nursing competencies in school health.

Methods: We conducted an interview survey of eight teachers of basic public health nurse (PHN) education courses incorporating school health practice based on stories told by teachers. An inductive research methodology was used for the analysis.

Results: Our study found the following six types of attainment targets for graduates of basic public health nurse (PHN) training on practical nursing competencies in school health: “Understanding children,” “Understanding children’s health issues,” “Understanding human resources for school health,” “Understanding school health mechanisms and activities,” “ Practice of school nursing skills,” and “Acquisition of professional qualities.”

Discussion: Our findings showed that teachers with experience in school health practice classes recognize that many of the attainment targets identified have been achieved by students through the school health practice training and that they may be categorized within the existing framework of practical nursing competencies. We consider that the targets may be achieved through the practical experience elements deemed es sential by the teachers.

We consider that the targets may be achieved through the practical experience elements deemed essential by the teachers.