Reiko Okamoto

Relationship of experience and the place of work to the level of competency among public health nurses in Japan

AIM To examine the actual competencies of public health nurses (PHNs) working in public organizations in Japan in order to clarify the relationship between the level of competency and the number of years of experience and the place of work. METHODS The subjects were 1799 full-time PHNs working at 135 prefectural public health centers and 115 municipal health centers, which were randomly selected. Each subject received a questionnaire in the mail, requesting basic personal information and a self-evaluation of six levels of achievement in 11 topics in five categories of competencies. RESULTS The number of respondents was 1261 (70.1%), with a total of 1184 valid responses (65.8%). In terms of the level of competency, the average score was >3 for all items and the number of PHNs who achieved Ladders 5 and 6 was low, with very few achieving Ladder 6, despite having more years of experience. Furthermore, the level of achievement depended on the workplace, position, and academic background. CONCLUSION The tasks regarding the education of PHNs in Japan are to establish achievement goals clearly and incrementally and to develop methods and systems that consistently and systematically increase competencies, not only in basic undergraduate education, but also for employed PHNs, through specialized education. In particular, educational methods that lead to high-quality experiences need to be selected in order to develop competencies.

The tsunami's impact on mortality in a town severely damaged by the 2011 Great East Japan Earthquake.

This study identifies the relationship between tsunami damage and mortality through a demographic pyramid of a town severely damaged by the tsunami following the Great East Japan Earthquake of 11 March 2011. It uses cross-sectional data collection. Volunteers visited all households, including shelters, and asked residents about the whereabouts of family members and neighbours. The information was collated with lists of evacuees and the dead to confirm the whereabouts of all residents about 50 days after the disaster. Demographic pyramids for the whole population based on pre- and post-disaster data were drawn. In all, 1,412 (8.8 per cent) were dead or missing, 60.2 per cent of whom were aged 65 and over and 37.5 per cent aged 75 and over, suggesting that the very old should be located beyond the reach of tsunamis. The mortality rate of children was lower than that in other studies, which may indicate the efficacy of disaster evacuation drills.

Relationship between Reflective Practice Skills and Volume of Writing in a Reflective Journal

Background: According to the diversification of the health needs and the expansion of health disparities, public health nurses need to improve their practical capabilities, starting from basic education in graduate and undergraduate courses. And Reflective Practice with using reflective journal is one way of improving practical capabilities. The purpose of this study was to investigate the relationship between the volume of reflective journal and the quality of progress in the reflective cycle. Methods: The participants in this study were 20 junior students majoring in public health nursing (hereinafter “PHN students”) at a university in the Chugoku area, Japan. We asked the participants to answer the questions on Reflective Practice Skills (RPS) composed of six criteria corresponding to the six questions of Gibbs on the reflective cycle before and after they started writing RJ. The volume of reflective writing was measured by the number of characters written by the PHN students in RJ of the reflective practice for three months. The study plan was approved by the Ethics Committee for Nursing Study, Okayama University. Results: Although the average total RPS score showed a change of about 3 points as a result of the 3-month RJ writing exercise, no correlation was observed between the RPS score and the RJ writing volume (r = 0.175). However, we did observe a moderately positive correlation between the RPS score and the RJ writing volume with regard to Items 5 and 6 (r = 0.475 and r = 0.444, respectively). Conclusion: This study indicated that detailed RJ writing helps to complete the reflective cycle all the way to theorization and action planning, and that the volume of writing may serve as a criterion for qualitative evaluation.

Development of an action scale to show the necessity of healthcare activities

OBJECTIVES In order to promote high-quality healthcare activities, public health professionals such as public health nurses must improve their ability to systematically show health needs based on evidence and to lead decision making of superior officers and facility inhabitants for improved planning. This study developed and investigated its reliability and validity of an action scale to show the necessity of healthcare activities (SNH). METHODS The items in the SNH were originally selected based on previous studies and refined by researchers; they were subsequently adjusted after a pilot survey. The subjects were full-time public health nurses (PHNs) working at prefectural public health centers or randomly chosen municipal health centers. Questionnaires were distributed by mail. We explained the ethical considerations in writing and those who returned completed questionnaire forms were considered to have given their consent to participate in the study. The study plan was approved by the university Domestic Ethics Committee. RESULTS Among 1,615 questionnaire recipients, 1,088 (67.4%) responded; of these, 1,035 (64.1%) responses were valid. Nineteen of 20 items were selected based on results of item analysis, and exploratory and confirmatory factor analyses showed that the SNH consisted of four factors: show existence of health needs, show evidence for the necessity of addressing health needs, show actual conditions requiring solution, and show priority for resolution. Cronbachs alpha, an SNH reliability coefficient, was 0.948, and individual factor scores were over 0.85, supporting the internal consistency of SNH. The correlation coefficient between SNH and the three other scales including related concepts was 0.6-0.8, with significant differences between scales, supporting the criterion-related validity of SNH. The score increased with increasing PHN experience and job seniority, which were used as the known-group, with significant differences between the lowest group and the top two groups. CONCLUSION The results confirmed that SNH is a reliable and valid scale to show the necessity of healthcare activities.