Public Health Nurses Research Articles

A qualitative study of public health nurses' experiences detecting and preventing child maltreatment in primary care settings.

To explore how public health nurses in child and family health centres experience detecting and preventing child maltreatment. Qualitative study. Fourteen semi-structured individual interviews with public health nurses who worked in 11 different child and family health centres were conducted. The interviews were analysed using thematic analysis. Three themes were identified: (i) integrating knowledge to prevent child maltreatment as part of their everyday job, (ii) striving hard to detect child maltreatment and (iii) experiencing the assignment to be complex and demanding. Despite extensive experience, knowledge and following the guidelines, public health nurses in this study had difficulties finding children exposed to child maltreatment in child and family health centres. Public health nurses called for mutual multidisciplinary cooperation with other services and organizational facilitation, such as enough time and clear guidelines to effectively address this issue. This study provides knowledge about how public health nurses work with child maltreatment at the Child and Family Health Center, which can serve as valuable foundation for further research as well for collaborating services. EQUATOR guidelines were followed, using the COREQ checklist. No patient or public contribution.

Changing praxis from within - an in-depth qualitative exploration of how home visits affected statutory service at a Child Health Clinic

PurposeThis study aims to define critical domains of salutogenic home visits conducted by public health nurses, and how thevisits can supplement a universal Child Health Clinic. Design and methodA qualitative grounded theory study was conducted among three public health nurses in Stovner district, Oslo, Norway. The nurses were followed for 26 months offering home visits to all first-time parents. Data from focus group discussions, monthly reflection notes and bi-weekly meeting minutes were analysed using qualitative content analysis. ResultsThree critical themes emerged: building trust, prenatal visits and maintaining a salutogenic, strength-based approach. Extended public health nurse autonomy facilitated tailored support based on individual family needs. This promoted proportionate universalism to naturally be the gradient of the home visit intensity and kept actions at a universal level. ConclusionsThe key component of family access and utilizing support was building and maintaining trust. Conducting prenatal visits was an important part of the nurse-family relationship, positively affecting later Child Health Clinic follow-up and continued care. Practice implicationsCritical domains and benefits of practicing home visits emerged in this study and disclosed important aspects necessary for family access and utilizing support. By changing the point of entry from postnatal to prenatal, public health nurses-family relationship gets an important head start, positively affecting later follow-up and continued care. A tailored support to new families without using a predefined agenda and a salutogenic, strength-based philosophy can fit the public health nurses' professional beliefs and extend their autonomy.

New Web-Based System for Recording Public Health Nursing Practices and Determining Best Practices: Protocol of an Exploratory Sequential Design

Background Digitalization and information and communication technology (ICT) promote effective, efficient individual and community care. Clinical terminology or taxonomy and its framework visualize individual patients’ and nursing interventions’ classifications to improve their outcomes and care quality. Public health nurses (PHNs) provide lifelong individual care and community-based activities while developing projects to promote community health. The linkage between these practices and clinical assessment remains tacit. Owing to Japan’s lagging digitalization, supervisory PHNs face difficulties in monitoring each department’s activities and staff members’ performances and competencies. Randomly selected prefectural or municipal PHNs collect data on daily activities and required hours every 3 years. No study has adopted these data for public health nursing care management. PHNs need ICTs to manage their work and improve care quality; it may help identify health needs and suggest best public health nursing practices. Objective We aim to develop and validate an electronic recording and management system for evaluating different public health nursing practice needs, including individual care, community-based activities, and project development, and for determining their best practices. Methods We used a 2-phase exploratory sequential design (in Japan) comprising 2 phases. In phase 1, we developed the system’s architectural framework and a hypothetical algorithm to determine the need for practice review through a literature review and a panel discussion. We designed a cloud-based practice recording system, including a daily record system and a termly review system. The panels included 3 supervisors who were prior PHNs at the prefectural or municipal government, and 1 was the executive director of the Japanese Nursing Association. The panels agreed that the draft architectural framework and hypothetical algorithm were reasonable. The system was not linked to electronic nursing records to protect patient privacy. Phase 2 validated each item through interviews with supervisory PHNs using a web-based meeting system. A nationwide survey was distributed to supervisory and midcareer PHNs across local governments. Results This study was funded in March 2022 and approved by all ethics review boards from July to September and November 2022. Data collection was completed in January 2023. Five PHNs participated in the interviews. In the nationwide survey, responses were obtained from 177 local governments of supervisory PHNs and 196 midcareer ones. Conclusions This study will reveal PHNs’ tacit knowledge about their practices, assess needs for different approaches, and determine best practices. Additionally, this study will promote ICT-based practices in public health nursing. The system will enable PHNs to record their daily activities and share them with their supervisors to reflect on and improve their performance, and the quality of care to promote health equity in community settings. The system will support supervisory PHNs in creating performance benchmarks for their staff and departments to promote evidence-based human resource development and management. Trial Registration UMIN-ICDR UMIN000049411; https://tinyurl.com/yfvxscfm International Registered Report Identifier (IRRID) DERR1-10.2196/45342

Public health nurses' assessment of the background factors of familicide

AbstractThe purpose of this study was to describe public health nurses' assessment of the background factors of familicide, factors that promote or prevent identification of these factors and familicide‐related education. The researchers sought to provide information that would help public health nurses recognise and prevent family tragedies as well as the development of education. Public health nurses (n = 85) working at clinics in Finland were surveyed using an electronic questionnaire. The quantitative data was described through statistics and open questions were analysed using inductive content analysis. Approximately one‐third (33 per cent) of the nurses considered their ability to identify the background factors of familicide as very poor or poor, and most (87 per cent) felt that they needed additional training. The identification of background factors is hindered by a lack of both resources and multiprofessionalism, fragmentation of care conditions, fear, cultural challenges, and education inadequacies.

Her strength: Reflections on nurse home-visiting.

The Nurse-Family Partnership is a targeted parenting intervention designed to improve maternal and child health. In Canada it is delivered exclusively by public health nurses who provide complex care to adolescent girls and young women. A process evaluation was conducted to better understand the experiences of public health nurses delivering the Nurse-Family Partnership program in Canada. Although the traditional qualitative data analysis led to the creation of significant findings and clinical implications, it lacked the "heart" of public health nursing practice. Through a reflective process, and to present an evocative account of the multifaceted nursing care provided by the study participants, direct quotes were used to create a poetic display of nurses' experiences. Through the power of found poetry, the complexities of clients' lives, as well as the challenges and joys of home-visitation nursing, were illuminated.

A culturally informed model to enhance breast, cervical, and colorectal cancer screenings: perspectives of American Indian adults and healthcare providers in rural New Mexico

PurposeAmerican Indian/Alaska Native (AI/AN) populations have some of the lowest cancer screening rates compared to other racial/ethnic populations. Using community-based participatory research methods, we sought to characterize knowledge, attitudes, beliefs, and approaches to enhance breast, colorectal, and cervical cancer screening.MethodsWe conducted 12 focus groups between October 2018 and September 2019 with 96 eligible AI adults and healthcare providers, recruited using non-probability purposive sampling methods from the Zuni Pueblo in rural New Mexico. We used the Multi-level Health Outcomes Framework (MHOF) to conduct a qualitative content analysis identifying mutable systems- and individual- level constructs important for behavior change that we crosslinked with the Community Preventive Services Task Force (CPSTF) recommended evidence-based interventions (EBIs) or approaches.ResultsSalient systems-level factors that limited uptake of cancer screenings included inflexible clinic hours, transportation barriers, no on-demand service and reminder systems, and brief doctor–patient encounters. Individual-level barriers included variable cancer-specific knowledge that translated into fatalistic beliefs, fear, and denial. Interventions to enhance community demand and access for screening should include one-on-one and group education, small media, mailed screening tests, and home visitations by public health nurses. Interventions to enhance provider delivery of screening services should include translation and case management services.ConclusionsThe MHOF constructs crosslinked with CPSTF recommended EBIs or approaches provided a unique perspective to frame barriers and promoters of screening utilization and insights for intervention development. Findings inform the development of culturally tailored, theoretically informed, multi-component interventions concordant with CPSTF recommended EBIs or approaches aimed at improving cancer screening.

The Knowledge and Awareness on Polycystic Ovarian Syndrome among Lady Health Visitors in Public Health Nursing School Lahore

Polycystic Ovarian Syndrome is a common endocrine condition, rises in adolescent girls and young women during their reproductive years. According to the World Health Organization (WHO), 116 million (3.4%) of women worldwide experienced PCOS in 2012. PCOS increases a woman's risk of type 2 diabetes, cardiovascular disease, infertility, anxiety, and depression, as well as a poor quality of life related to their health. Objectives: To assess the knowledge and awareness on polycystic ovarian syndrome among lady health visitors in Public Health Nursing School Lahore. Methods: A Descriptive Cross-Sectional study was conducted at Public Health Nursing School in Lahore. A total of 141 participants were recruited through random sampling technique. Lady health visitor (LHV) students of first year and second year between the age group 17 to 30 year were participated in the study. Data analysis was done using SPSS version-25, the most recent release of the Statistical Package for Social Sciences (SPSS). Results: Results of the study indicated that majority of participants 114 (80.9 %) were of age ranging from 17-20 years and belongs to belongs to urban areas 75(53.2%). The findings revealed that data was normally distributed as p-value is < 0.05. Results indicated that the total knowledge score of participants regarding PCOS was poor. Conclusions: It was shown that the participants knew nothing about PCOS. The participants' understanding of PCOS risk factors, factors connected to PCOS, and consequences from PCOS is noticeably lacking. A successful teaching intervention designed specifically for nurses can greatly improve their understanding of PCOS.

Impact of Educational Intervention on the Knowledge of Polycystic Ovarian Syndrome among Lady Health Visitors

Background: PCOS, a common endocrine disorder, is more common in adolescent girls and young women during their reproductive years. According to the World Health Organization (WHO), 116 million (3.4%) of women worldwide have PCOS in 2012. PCOS increases a woman's risk of type 2 diabetes, cardiovascular disease, infertility, anxiety, and depression, as well as a poor quality of life related to her health. Objectives: To determine the impact of education intervention on the knowledge of poly cystic ovarian disease among lady health visitors in Public Health Nursing School Lahore. Methodology: A Quasi- experiment one group pre-test post-test study design was conducted at Public Health Nursing School in Pakistan. A total of 141 people were recruited through random sampling. First- and second-year lady health visitor (LHV) students aged 17 to 30 participated in the study. It was done with full knowledge and consent. To analyze the data, the most recent version of SPSS 24 was employed. Results: According to the study's findings, the bulk of participants, 114 (80.9%), were between the ages of 17 and 20, with 75 (53.2%) of them living in metropolitan regions. The results showed that the data was normally distributed because the P-value was less than 0.05. The findings showed that, in comparison to their values at the pretest, the mean post intervention knowledge score was significantly higher after educational intervention (p 0.0001). Practical Implications: The midwives and labor and delivery nurses (LHVs) play a key role in the healthcare industry. Women should receive counselling, information, and encouragement related to polycystic ovary syndrome. The long-term advantages of education would help women understand how to adjust their lifestyles according to polycystic ovarian syndrome. Conclusion: It is concluded that the post intervention score of participants was high than pre-intervention. As a result, educational sessions had a positive effect on improving knowledge scores about polycystic ovarian syndrome. Keywords: Polycystic Ovarian Syndrome; Knowledge; Educational Intervention; Lady Health Visitor

How do public health nurses in Norwegian school health services support siblings of children with complex care needs?

There is a paucity of data regarding the care and support provided by Norwegian school health services to siblings of children with complex care needs. Public health nurses are an integral part of these universal services, which focus on health promotion and disease prevention in primary and secondary schools. This study aimed to explore health promotion interventions by public health nurses for siblings in Norwegian schools and to identify regional differences. An online national questionnaire was distributed to Norwegian public health nurses and leaders of public health nursing services (N = 487). The questions were related to how the nurses support siblings of children with complex care needs. The quantitative data were analysed using descriptive statistics. An inductive thematic analysis of free-text comments was conducted. The study was approved by the Norwegian Centre for Research Data. The majority of public health nursing leaders (67%) reported that the services in their municipality had no system to identify siblings or to provide them with routine care. However, 26% of public health nurses reported that routine support was provided to siblings. Regional differences were identified. This study included responses from 487 PHNs from all four health regions in Norway. The study design is limited and gives a brief outline of the current situation. Further data are needed to provide in-depth knowledge. This survey provides important knowledge for health authorities and professionals working with siblings, about inadequate support and regional differences in care provided to siblings by school health services.

The Support Needs and Current Practices of Public Health Nurses in the Republic of Ireland Who Provide Support to Breastfeeding Mothers: A Cross-Sectional Survey.

Breastfeeding continuation rates are low in Ireland. The Breastfeeding Observation and Assessment Tool (BOAT) was developed to assist public health nurses in assessing breastfeeding challenges; however, little is known of its actual usage, the level of training experienced or desired by public health nurses, or their level of confidence in the support they provide to breastfeeding mothers. To identify the current practices and support needs of public health nurses who provide breastfeeding support in Ireland. An online questionnaire was devised to collect respondents' confidence with breastfeeding issues, caseload, and practices. It was distributed to public health nurses with a current child health caseload in one Community Healthcare Organization. Mann Whitney U tests were used to ascertain the relationship between public health nurses' confidence level and those with qualifications in midwifery or as an International Board Certified Lactation Consultant (IBCLC). The survey was completed by 66 public health nurses. Only 14 respondents (21.2%) indicated that they always used the BOAT. The most common reason for not doing so was a lack of education on its use (n = 17, 25.8%). Postholders also certified as IBCLCs were considered by participants to be the most appropriate professionals to resolve certain breastfeeding issues. Confidence levels to manage breastfeeding issues were highest among public health nurses with IBCLC credentialing (U = 12.5, p = .001) while no difference was seen when comparing those with a midwifery degree to those without (U = 184.0, p = .92). Face-to-face workshops and blended-learning approaches were ranked as the preferred formats for breastfeeding education (Median rank = 2). Breastfeeding education incorporating a face-to-face component is needed to support public health nurses who work with breastfeeding mothers, as is prioritization of recruitment in the community of public health nurses with IBCLC credentials.

Public health nurses experience of mental health encounters in the context of primary health care: a constructivist grounded theory study

BackgroundIn primary health care people with mental health needs are often overlooked or masked with physical complaints. It has been suggested that public health nurses lack sufficient knowledge when encountering people with mental health problems. Low levels of mental health literacy among professionals are associated with negative patient outcome. There is a need to understand public health nurses process and strategies used when encountering a person with mental health problems in order to promote mental health. This study aimed to construct a theory that explains the process of public health nurses experience when encountering people with mental health problems based on their knowledge, attitudes, and beliefs about mental health.MethodsA constructivist grounded theory design was used to meet the aim of the study. Interviews were conducted with 13 public health nurses working in primary health care between October 2019 and June 2021, and the data analysis was performed according to the principles of Charmaz.ResultsThe core category, “Public health nurses as a relationship builder – to initiate the dialogue” reflected the process while the main categories “Being on your own”, “Being on top of things- knowing your limits”, and “Professional comfort zone” reflected conditions that were decisive for initiating a dialogue.ConclusionManaging mental health encounters in primary health care was a personal and complex decision-making process that depends on the public health nurses’ professional comfort zone and acquired mental health literacy. Narratives of the public health nurses helped to construct a theory and understand the conditions for recognizing, managing and promoting mental health in primary health care.

Is family social exclusion associated with child motor and socioemotional development delay? A cross-sectional exploratory study.

The objective was to identify if family social exclusion is associated with child motor and social development delay in Southeastern Brazil. A cross-sectional study was conducted using data from a sample of 348 children under 3 years, proportional to the number of children registered in the primary care centres of the municipality. Child development was measured using the "Developmental Surveillance Instrument" which was developed by the Ministry of Health in Brazil and is used for public health nurses and clinicians in their practice. An index was used to evaluate social exclusion. The prevalence of child motor and socioemotional developmental delay was 27.6% and 17.2%, respectively. Children in the most social excluded group were more likely to have delayed motor development (OR = 3.4; 95% CI = 1.14; 10.55) and socioemotional developmental delay (OR = 3.9; 95% CI = 1.05; 9.02) than children in the least social excluded group.

Primary Amoebic Meningoencephalitis and the Naegleria fowleri Freshwater Amoeba: A New Concern for Northern Climates

Naegleria fowleri (N fowleri), the freshwater amoeba known to cause primary amoebic meningoencephalitis (PAM), is historically found in the southern United States and Central America. Increased incidence of this rare, deadly, and often misdiagnosed illness in northern states causes concern that N fowleri is expanding northward due to climate change, posing a greater threat to human health in new regions where PAM has not yet been documented. This case study provides an example of public health nurses incorporating environmental health data into communicable disease investigations, demonstrating how public health professionals, health care providers, and individuals living in northern climates can work together to prevent, detect, and treat N fowleri infection.

Prioritizing nutrition interventions for low-income clients receiving public health nurses' home visiting services: a latent class analysis study of Omaha System data.

This study aimed to identify phenotypes of nutritional needs of home-visited clients with low income, and compare overall changes in knowledge, behavior, and status of nutritional needs before and after home visits by identified phenotypes. Omaha System data collected by public health nurses from 2013 to 2018 were used in this secondary data analysis study. A total of 900 low-income clients were included in the analysis. Latent class analysis (LCA) was used to identify phenotypes of nutrition symptoms or signs. Score changes in knowledge, behavior, and status were compared by phenotype. The five subgroups included Unbalanced Diet, Overweight, Underweight, Hyperglycemia with Adherence, and Hyperglycemia without Adherence. Only the Unbalanced Diet and Underweight groups showed an increase in knowledge. No other changes in behavior and status were observed in any of the phenotypes. This LCA using standardized Omaha System Public Health Nursing data allowed us to identify phenotypes of nutritional needs among home-visited clients with low income and prioritize nutrition areas that public health nurses may focus on as part of public health nursing interventions. The sub-optimal changes in knowledge, behavior, and status suggest a need to re-examine the intervention details by phenotype and develop strategies to tailor public health nursing interventions to effectively meet the diverse nutritional needs of home-visited clients.

The Vital Role of Public Health Nurses in Perinatal HIV Prevention and Elimination.

Perinatal HIV transmission remains a significant public health challenge, with an estimated 160,000 children newly infected with HIV each year. Public health nurses play a critical role in the prevention and elimination of perinatal HIV transmission through targeted interventions such as identification of pregnant women with HIV, referral and linkage to care, provision of antiretroviral therapy, and follow-up and retention in care for both mothers and infants. However, significant barriers to successful implementation exist, including stigma and discrimination, limited access to healthcare services, socioeconomic factors, and limited resources. Addressing these barriers will require a multifaceted approach that includes policy changes, community engagement, and targeted support and resources for affected families. In this review article, we provide an overview of the epidemiology of perinatal HIV transmission, current strategies for prevention and elimination, and the vital role of public health nurses in these efforts. We will also discuss the barriers to the successful implementation of public health nurse interventions and the future directions for research and practice in this field. Ultimately, the goal of perinatal HIV prevention and elimination can only be achieved through a sustained and collaborative effort across multiple sectors and stakeholders, with public health nurses playing a crucial role in this effort.

Perceived importance of interviewees' information when giving health support interviews to former prisoners: a cross-sectional study of public health nurses in charge of lifestyle-related diseases in Japan

Perceived importance of interviewees' information when giving health support interviews to former prisoners: a cross-sectional study of public health nurses in charge of lifestyle-related diseases in Japan

Failure to thrive among asylum-seeking children: A descriptive study from Turkey.

The aim of the study was to determine failure to thrive among asylum-seeking children. The study was a descriptive study. The sample of the study comprised of 187 children who were registered in an Afghan Association. The power of the study was found to be 97% at 0.5% (moderate) effect size and 95% confidence level. The data was collected between November 8, 2021 and January 10, 2022 using a sociodemographic form and the children's anthropometric measurement. 57.2% of children were male and 44.9% were 6-12 years old. It was determined that female and male infants less than 1 year of age were underweight (z-score=-2) and male infants were stunting (z-score ≤-1). Childhood growth and development problems are significant issues among asylum-seeking families. Public health nurses need to develop their roles in organizing the healthcare service for vulnerable and underrepresented groups.

Experience and Resilience of Japanese Public Health Nurses during the COVID-19 Pandemic and Their Impact on Burnout.

Japanese public health nurses (PHNs) at public health centers (PHCs) have played critical roles in infection prevention and control during the COVID-19 pandemic. This study aimed to examine the actual pandemic-related experiences of PHNs and the relation between their experiences, individual resilience, two components of organizational resilience (system and human resilience), and burnout. An analysis of the responses of 351 PHNs revealed that mid-level PHNs scored higher in experience and lower in organizational resilience compared with those in other positions. More than 80% of respondents experienced inappropriate staff allocation. Multiple regression revealed that burnout was positively associated with the components of the experience of PHNs and negatively with individual and human resilience. In hierarchical multiple regression with depersonalization as the dependent variable, the sign of system resilience reversed from negative to positive when human resilience was added. The results highlight the need to prepare for future health crises including establishing a system with enough personnel, promoting human resilience such as collaboration among staff members, and burnout prevention measures, especially among mid-level PHNs. The study also described alternative approaches to comprehend system resilience-namely, a suppression variable of human resilience, promotion of depersonalization, and multicollinearity-and the need for further research on organizational resilience.

The moderating effect of cultural competence educational needs on the relationship between transcultural self-efficacy and cultural competence in Korean public health nurses

BackgroundIn an increasingly multicultural society, cultural competence and transcultural self-efficacy of public health nurses is important for providing culturally congruent care for client from diverse cultural background. To improv this, it is needed tailored and effective educational program based on the cultural competence educational needs. This study investigated the moderating effect of cultural competence educational needs on the relationship between transcultural self-efficacy and cultural competence.MethodsThis cross-sectional study recruited 217 public health nurses in Korea using convenience sampling from August 2018 to January 2019. A direct questionnaire was used to collect data. Study variables were analyzed using descriptive statistics, correlation, and the Hayes PROCESS macro (Model 1) moderation model.ResultsThe mean scores for transcultural self-efficacy, cultural competence educational needs, and cultural competence were 62.33 ± 11.08, 58.19 ± 15.08, and 97.96 ± 17.09, respectively. Transcultural self-efficacy and cultural competence educational needs were positively associated with cultural competence. In the tested model, cultural competence educational needs had a conditional moderating effect on the relationship between transcultural self-efficacy and cultural competence. The positive association between transcultural self-efficacy and cultural competence was significant at low, medium, and high levels of cultural competence educational needs and stronger for those with high needs.ConclusionsCultural competence educational needs may be an important determinant of cultural competence among public health nurses. To effectively increase cultural competence, transcultural self-efficacy should be increased by education programs tailored by cultural competence educational needs.

Mpox in the United States: Current implications for public health nursing.

In 2022, mpox, an orthopoxvirus first isolated in 1958 in cynomolgus monkeys, became a global public health threat. While the virus can be communicated through skin-to-skin contact from any infected person to non-infected person, most cases in the United States have been in gay and bisexual men. Consequently, early public health and community-based efforts concentrated on reducing infections in this population. This article explores current mpox case count epidemiologic data and trends. In addition, vaccination indications, contraindications, adverse events, and national administration data are provided along with directions for nurses and other clinicians moving forward in the outbreak.