Search

Background: Health service development aims to close the gap between evidence and practice by adopting and appropriately utilizing the latest findings. To address this gap, dissemination and implementation research has been promoted and developed. Despite promoting evidence-based programs over the years, public health nurses have had few training opportunities in evidence-based public health. This study evaluated the effectiveness of a web-based training in building the basic program implementation capacity of public health nurses with two to five years of experience. Methods: We developed a simulation-powered web-based training according to an Implementation Degree Assessment Sheet for health programs. This was a randomized, single-blind, parallel-group trial. The primary outcome, the result of implementation capacity for public health nurses, was assessed by the total score of the Implementation Degree Assessment Sheet, and scores for its five domains. The secondary outcome was evaluated by the level of understanding. The primary outcome was analyzed utilizing the t-test and analysis of covariance, whereas the secondary outcome was assessed utilizing the U-test and Quade's analysis of covariance. Data were collected directly before intervention (T1: baseline), immediately post-intervention (T2), and four weeks post-intervention (T3: endpoint). Results: The 197 participants were randomly allocated to either the intervention group (n = 98) or the control group (n = 99). A full analysis set of 152 samples and a per-protocol set of 104 samples were analyzed. The intervention group exhibited a significantly higher total score and five domain-wise scores at the endpoint compared with the control group. The disparity between the endpoint and baseline scores was significantly larger for the intervention group for all scores. The level of understanding was significantly higher in the intervention group than in the control group at T2 and T3. The effect size of the total score was higher in the full analysis set (Cohen's d = 0.5) than in the per-protocol set (d = 0.48). Conclusions: This web-based training was effective in building the program implementation capacity of participants four weeks post-intervention. Trial registration: University Hospital Medical Information Network Center Clinical Trials Registry UMIN000048421. [ABSTRACT FROM AUTHOR]

This study explored the experiences of public health nurses (PHN) in preventing obesity in preschool children and following national guidelines. We used a descriptive qualitative design with an online open-ended questionnaire based on vignettes describing fictitious practical situations during the follow-up of children presenting with overweight issues in child health clinics. Following qualitative content analysis, we identified one main theme: Strong but complex feelings of responsibility toward supporting parents in preventing obesity in preschool children and adhering to the guidelines. We also identified four subthemes: (a) Difficulties in deciding if the child's weight is a concern. (b) Challenges with meeting children's healthcare needs when weight is a concern. (c) Approaches for engagement and caring weight talks with parents. (d) The need for resources and interdisciplinary collaboration. PHNs suggested improvements for preventing childhood obesity and called for municipal prioritizing of organizational and personnel-related resources to ensure PHNs can efficiently follow national guidelines. [ABSTRACT FROM AUTHOR]

Objective Design Sample Measurements Results Conclusion This study was conducted to examine the relationship between public health nurses' holistic nursing and social justice advocacy competencies in terms of their attitudes toward sustainable development goals.Cross‐sectional survey.The study sample consisted of 384 public health nurses.Data were collected with the personal information form, the Attitudes toward Sustainable Development Scale, the Holistic Nursing Competence Scale, and the Social Justice Advocacy Scale.The sub‐dimensions of environment, public, education, and economy were found to significantly affect social justice advocacy, and the indirect effects of 0.191, 0.222, 0.205, and 0.201 were found to be statistically significant with the inclusion of holistic nursing competence in the model, respectively. It was found to explain 32%, 30%, 29%, and 22% of the total effect, respectively.It supports the claim that developing public health nurses' holistic nursing competence and social justice advocacy skills is an important criterion for achieving sustainable development goals. [ABSTRACT FROM AUTHOR]

Postpartum depression (PPD) is a mental health disorder that affects 10%–15% women globally. Longitudinal and meta-analyses have consistently demonstrated the negative impacts of PPD on both the affected mothers and subsequent infant development. Given the consideration that antidepressant side effects in breastfeeding infants and the cost-effectiveness considerations of psychotherapies, attention has been paid towards the promising role of social support interventions in order to prevent and reduce the PPD symptoms. Confirming the assertion, this narrative review examines the potential of five social support interventions to ameliorate PPD-related maternal and infant outcomes. The wide implications of psychoeducational strategy, nurses' supportive and non-directive counselling and home-visiting approach are outlined. Furthermore, the evidence underlying the role of peer support, culturally tailored intervention and community-based participatory approach in PPD is elucidated. In clinical practice, this review reinforce the roles of discharge educational intervention led by the experienced nurse during the postpartum stay, in order to maintain psychological mental health among the postpartum mothers. More importantly, the skilled and competence public health nurses act as valuable assets in treating PPD, and this effective treatment alternative should be considered by healthcare planners. In future, major investigations will be strategized to discover the synergistic effects of combined social support approaches to yield a better outcome in the prevention and treatment of PPD. [ABSTRACT FROM AUTHOR]

Background: The complex work of public health nurses (PHNs) specifically related to mental health assessment, intervention, and outcomes makes it difficult to quantify and evaluate the improvement in client outcomes attributable to their interventions. Objectives: We examined heterogeneity across parents of infants served by PHNs receiving different interventions, compared the ability of traditional propensity scoringmethods versus energy-balancing weight (EBW) techniques to adjust for the complex and stark differences in baseline characteristics among those receiving different interventions, and evaluated the causal effects of the quantity and variety of PHN interventions on client health and social outcomes. Methods: This retrospective study of 4,109 clients used existing Omaha System data generated during the routine documentation of PHNhome visit data. We estimated the effects of intervention by computing and comparing weighted averages of the outcomes within the different treatment groups using two weighting methods: (a) inverse probability of treatment (propensity score) weighting and (b) EBWs. Results: Clients served by PHNs differed in baseline characteristics with clients with more signs/symptoms. Both weighting methods reduced heterogeneity in the sample. EBWs were more effective than inverse probability of treatment weighting in adjusting for multifaceted confounding and resulted in close balance of 105 baseline characteristics. Weighting the sample changed outcome patterns, especially when using EBWs. Clients who received more PHN interventions and a wider variety of them had improved knowledge, behavior, and status outcomes with no plateau over time, whereas the unweighted sample showed plateaus in outcomes over the course of home-visiting services. Discussion: Causal analysis of PHN-generated data demonstrated PHN intervention effectiveness for clients with mental health signs/symptoms. EBWs are a promising tool for evaluating the true causal effect of PHN home-visiting interventions. [ABSTRACT FROM AUTHOR]

The connection between community healthcare providers and available community‐based programs is often weak. For community members to be connected with services, a strong referral link between providers and programs is paramount. The Referral Express and Central Hub (REACH) project was born out of this need for Nurse–Family Partnership (NFP) program sites in the Denver Metro area of Colorado to be better connected and coordinated with local referral sources. The objective of the REACH pilot was to create a centralized referral system and determine its feasibility in practice. After a 12‐month pilot, this innovative referral system supported the increase in a number of referral partners to Denver Metro area sites, an increase in clients served across the Denver Metro area, as well as an increase in the "refer to enroll" rate which increased by 37%. The success of the pilot of REACH led the developers to test the process on a second program, Child First, which was also successful. REACH has proved to be sustainable and continues to operate for both programs. Additionally, REACH acts as a consultant to NFP sites outside the Denver Metro area, in the state of Colorado, as each site works to increase its relationships with referral partners. [ABSTRACT FROM AUTHOR]

Objective: To illuminate child healthcare nurses' experiences of communication with 4‐year‐old children during their visit to the child healthcare center. Design: A qualitative method, using data collected from individual interviews. Sample: Fifteen semistructured interviews with nurses working in a child healthcare center. Measurements: The results were analyzed using reflexive thematic analysis. Results: The analysis resulted in three themes and eight subthemes: Adapting to the child in the conversation, based on the subthemes Preparing for the visit, Listening in and observing, and Creating a welcoming environment; Combining strategies for the conversation, based on the subthemes Engaging the child, Using visual tools, and Parental involvement; and Challenges due to language barriers, based on the subthemes Using an interpreter and Parent acts as interpreter. Conclusion: Child healthcare nurses focus on the child when communicating and strive to create joy and a welcoming environment. The communication strategies employed during the visit include engaging the child directly, involving parents in the conversation, and balancing the parental involvement. Communication challenges related to language barriers are addressed, particularly during interpreter‐assisted conversations. The study indicates a need for tailored strategies, collaboration, and sensitivity to ensure a child‐centered approach. [ABSTRACT FROM AUTHOR]

Introduction: The Norwegian Government introduced in 2002 a reimbursement scheme for hormonal contraceptives to adolescents at the same time as public health nurses and midwives received authorization to prescribe hormonal contraceptives. This study examines the impact of increased accessibility and public funding on hormonal contraceptive use among adolescents. Material and Methods: The Norwegian Prescription Database, Statistics Norway, and Norwegian Institute of Public Health served as data sources for this cohort study. The study population comprised 174 653 Norwegian women born 1989–1990, 1994–1995, and 1999–2000. We examined use of hormonal contraceptives through dispensed prescriptions from age 12 through age 19 with duration of first continuous use as primary outcome. The statistical analyses were done in SPSS using chi‐squared test, survival analysis, and Joinpoint regression analysis with p‐values < 0.05. Results: By age 19, ~75% of the cohorts had used at least one hormonal method. The main providers of the first prescription were general practitioners and public health nurses. Starters of progestogen‐only pills (POPs) have increased across the cohorts, while starters of combined oral contraceptives (COCs) have decreased. The use of long‐acting reversible contraceptives (LARCs) has increased since its inclusion in the reimbursement scheme (2015). Most switchers shifted from COCs or POPs as a start method to implants after LARCs became part of the reimbursement scheme. There has been a significant increase across the cohorts in the number of women who continuously used hormonal contraceptives from start to the end of the calendar year they became 19 years with the same method and after switching methods. We could not correlate changes in decreasing trends for teenage births or induced abortions (Joinpoint analysis) to time for implementation or changes in the reimbursement of hormonal contraceptives from 2002. Conclusions: Primarily public health nurses and to a lesser extent midwives became soon after they received authorization to prescribe COCs important providers. The expansion of the reimbursement scheme to cover POPs, patches, vaginal ring, and depot medroxyprogesterone acetate in 2006 had minor impact on increasing the proportion of long‐term first‐time users. However, the inclusion of LARCs in 2015 significantly increased the proportion of long‐term first‐time hormonal contraceptive users. [ABSTRACT FROM AUTHOR]

Background: The number of people who access social networking sites continues to increase at an exponential rate. The use of technology is an essential skill for nursing professionals and its development represents a challenge in improving health education, promotion and care. The objective of this systematic review is to analyse the use of social networking sites by healthcare professionals as an intervention tool for evidence-based public health education. Methods: The protocol of this umbrella review was registered in the International Prospective Register of Systematic Reviews (CRD42023407249). Searches were carried out in MEDLINE (PubMed), Web of Science, CINAHL, PsycINFO (EBSCOhost), and Cochrane Library of Systematic Reviews, in February 2023. A narrative synthesis of the results was conducted. Results: 1896 articles were found, of which 15 reviews fulfilled the inclusion criteria. Social networks broadened the profession; they were YouTube, X (formerly Twitter), Facebook, and Instagram. The target population was mainly young professionals, and they came across different topic areas that addressed health education. Conclusions: It is important to have information backed by scientific evidence to make health decisions. Health professionals active on social networking sites have a unique opportunity to educate the public about health by sharing scientific evidence in an accessible and clear way, which helps to combat misinformation. [ABSTRACT FROM AUTHOR]

Public health nurses (PHNs) constitute an important source of nutritional knowledge for parents during the child's first 1000 days of life, but parents also seek advice from various online sources. Access to timely digital interventions may facilitate healthful eating habits later in life. In the Nutrition Now project, we wanted to combine previously evaluated digital interventions on early nutrition and implement the integrated intervention at municipality level. We prospectively explored PHNs' thoughts, needs and expectations regarding the development and usability of such a digital resource. Semi-structured interviews were conducted with six PHNs, and data was subjected to thematic analysis. Four main themes were identified: (1) an online resource on nutrition may be a useful tool; (2) the content should attract interest and be broad in scope; (3) it must be easy to apply and adapted to different users; and (4) participating in a development process should seem meaningful. Our findings highlight the need for easily accessible, quality-assured online information to underpin the guidance provided by PHNs. The study further sheds light on prerequisites considered by PHNs to be crucial for parents to engage in a digital resource, as well as their perspectives on how it best may be communicated and used. [ABSTRACT FROM AUTHOR]

The aim of the study was to explore and describe how public health nurses at child health clinics experience and perceive the follow-up of children and families when there is concern about the child's care. The goal was to contribute to knowledge development to guide health-promoting nursing care for children and their families. Theoretical perspectives included health promotion, child-centered and family-centered care, in addition to nursing care. An exploratory qualitative design informed by a hermeneutic approach was used. Data were collected in 3 focus groups with 16 public health nurses and analyzed using latent content analysis. The findings detail public health nurses' internal negotiation processes in the follow-up of children and the family, and the ways these negotiation processes were influenced by various prerequisites, the approaches for follow-up, dilemmas that affected public health nurses' approaches, and prolonged dwellings on past responses to children and families of concern. The lack of routines and goals for follow-up, a dominant parental perspective, and ambiguity related to health promotion and disease prevention, all created challenges for the public health nurses. Based on these findings, a model of public health nurse's follow-up when there is concern about the child's care was developed for future research. [ABSTRACT FROM AUTHOR]

Public health nursing is grounded in public health ideologies and fundamental nursing values. Researchers have argued that ethical responsibility from the perspective of the nurse is an understudied phenomenon. This meta-ethnography provides in-depth knowledge of how public health nurses (PHNs) experience ethical responsibility when working to prevent injury and disease, and promote health and well-being in children, young people and their families. There are reciprocal findings across the 10 included studies. The findings reveal that these nurses often feel alone, have worries and uncertainties and are afraid of doing wrong. They describe unclear boundaries in their work, creating a heightened sense of responsibility. PHNs fight lonely battles. Yet they show courage and commitment and are ready to stand up and fight for children and families who do not receive adequate care. A line of argument is developed and the metaphorical phrase Chivalrous knights in moral armour is used to express the authors' overall interpretations of the findings. Reflection on the findings shows how the different dimensions of ethical responsibility are interconnected. The nurses' ethical sensitivity enables them to feel compassion for others and they show indignation when vulnerable others are not treated with dignity and respect. Indignation and compassion are interrelated, and when human life and dignity are threatened, the ethical demand to respond emerges. Indignation is a precursor to moral courage, and the nurses' moral sensitivity and respect for their clients emboldens them to stand up for vulnerable others. The findings also illustrate the paradoxical nature of freedom. Freedom of choice due to unclear boundaries heightens the nurses' sense of responsibility. This research is an important step in theory development and has implications for further research, education and practice. [ABSTRACT FROM AUTHOR]

Abstract Background Health service development aims to close the gap between evidence and practice by adopting and appropriately utilizing the latest findings. To address this gap, dissemination and implementation research has been promoted and developed. Despite promoting evidence-based programs over the years, public health nurses have had few training opportunities in evidence-based public health. This study evaluated the effectiveness of a web-based training in building the basic program implementation capacity of public health nurses with two to five years of experience. Methods We developed a simulation-powered web-based training according to an Implementation Degree Assessment Sheet for health programs. This was a randomized, single-blind, parallel-group trial. The primary outcome, the result of implementation capacity for public health nurses, was assessed by the total score of the Implementation Degree Assessment Sheet, and scores for its five domains. The secondary outcome was evaluated by the level of understanding. The primary outcome was analyzed utilizing the t-test and analysis of covariance, whereas the secondary outcome was assessed utilizing the U-test and Quade’s analysis of covariance. Data were collected directly before intervention (T1: baseline), immediately post-intervention (T2), and four weeks post-intervention (T3: endpoint). Results The 197 participants were randomly allocated to either the intervention group (n = 98) or the control group (n = 99). A full analysis set of 152 samples and a per-protocol set of 104 samples were analyzed. The intervention group exhibited a significantly higher total score and five domain-wise scores at the endpoint compared with the control group. The disparity between the endpoint and baseline scores was significantly larger for the intervention group for all scores. The level of understanding was significantly higher in the intervention group than in the control group at T2 and T3. The effect size of the total score was higher in the full analysis set (Cohen’s d = 0.5) than in the per-protocol set (d = 0.48). Conclusions This web-based training was effective in building the program implementation capacity of participants four weeks post-intervention. Trial registration University Hospital Medical Information Network Center Clinical Trials Registry UMIN000048421.

Abstract Background Universal health visiting has been a cornerstone of preventative healthcare for children in the United Kingdom (UK) for over 100 years. In 2016, Scotland introduced a new Universal Health Visiting Pathway (UHVP), involving a greater number of contacts with a particular emphasis on the first year, visits within the home setting, and rigorous developmental assessment conducted by a qualified Health Visitor. To evaluate the UHVP, an outcome indicator framework was developed using routine administrative data. This paper sets out the development of these indicators. Methods A logic model was produced with stakeholders to define the group of outcomes, before further refining and aligning of the measures through discussions with stakeholders and inspection of data. Power calculations were carried out and initial data described for the chosen indicators. Results Eighteen indicators were selected across eight outcome areas: parental smoking, breastfeeding, immunisations, dental health, developmental concerns, obesity, accidents and injuries, and child protection interventions. Data quality was mixed. Coverage of reviews was high; over 90% of children received key reviews. Individual item completion was more variable: 92.2% had breastfeeding data at 6–8 weeks, whilst 63.2% had BMI recorded at 27–30 months. Prevalence also varied greatly, from 1.3% of children’s names being on the Child Protection register for over six months by age three, to 93.6% having received all immunisations by age two. Conclusions Home visiting services play a key role in ensuring children and families have the right support to enable the best start in life. As these programmes evolve, it is crucial to understand whether changes lead to improvements in child outcomes. This paper describes a set of indicators using routinely-collected data, lessening additional burden on participants, and reducing response bias which may be apparent in other forms of evaluation. Further research is needed to explore the transferability of this indicator framework to other settings.

Abstract Background Child maltreatment is a global problem that puts children at risk of mental illness, substance abuse, and premature death. Interdisciplinary collaboration is important in preventing and detecting child maltreatment. In Norway, children undergo universal preventive health assessments and receive complimentary follow-up care from specialized public health nurses in child and family health clinics. These nurses conduct regular check-ups and home visits to monitor children for signs of maltreatment. Objective The objective of this study is to describe how public health nurses at child and family health clinics follow the National Clinical Guidelines to prevent and detect child maltreatment, with a particular focus on clinical procedures and interdisciplinary collaboration. Furthermore, we aim to determine factors that are associated with identification of child maltreatment. Design A cross-sectional online survey was conducted among public health nurses working in primary care between October 24th and December 31st, 2022. Public health nurses who worked with children aged 0–5 years and had consultations with families were eligible to participate, resulting in 554 responses. The study employed descriptive analysis, including frequency, percentage and mean, as well as a two-step logistic regression analysis. The study was approved by the relevant authority, and informed consent was obtained through questionnaire completion. Results The public health nurses in this study displayed strong adherence to the guidelines and utilized various comprehensive assessment procedures to monitor child well-being, growth, and development. However, there was limited and infrequent collaboration with other professionals, such as child protection services, general practitioners, and hospitals. Most public health nurses reported occasional suspicion of child maltreatment, with age and years of experience in child and family clinics influencing these suspicions. Older public health nurses were more likely to suspect physical violence, while those with less than two years of experience reported less experience in suspecting maltreatment. Additional education increased the probability of suspecting sexual violence. Conclusions This study provides insights into the practices of public health nurses in Norway regarding the detection and prevention of child maltreatment in child and family clinics. While adherence to guidelines is strong, suspicion of maltreatment is relatively rare. Collaboration across agencies is crucial in addressing child maltreatment. Age and experience may influence the detection of maltreatment. Improved collaboration, targeted guidelines, and ongoing professional development are needed to enhance child protection.

Abstract Background Mothers are recommended to breastfeed their children but can find it challenging and experience breastfeeding problems. Qualified breastfeeding counselling from healthcare professionals can help mothers master breastfeeding, but there is a need to explore mothers’ lived experiences with receiving breastfeeding counselling. We aimed to reveal breastfeeding mothers’ experiences with receiving breastfeeding counselling from midwives and public health nurses (PHNs) to provide a deeper insight into the phenomenon of breastfeeding counselling, which may improve breastfeeding counselling in practice. Methods A qualitative design with a hermeneutic phenomenological approach was used. Individual interviews of 11 breastfeeding mothers from Norway were conducted from September 2021 to 2022. Van Manen’s guided existential inquiry guided the reflective process to provide deeper insights into the phenomenon of breastfeeding counselling. Results The study captured the meaning of breastfeeding mothers’ lived experiences with breastfeeding counselling. Three themes and eight sub-themes were found. Breastfeeding was at stake for the mothers because breastfeeding could be reduced or stopped, and qualified breastfeeding counselling from midwives and PHNs was essential for them to establish and continue breastfeeding. They needed to be perceived as both breastfeeding mothers and as women with their own needs to master everyday life during the breastfeeding period. Conclusions This study offers insights to midwives, PHNs and others offering breastfeeding counselling by facilitating an understanding of being a breastfeeding mother receiving breastfeeding counselling. Qualified breastfeeding counselling and a trusting relationship with midwives and PHNs are essential for mothers to establish and continue breastfeeding, while deficient counselling may cause breastfeeding difficulties. Mothers need to be treated as whole and competent persons to avoid objectification and fathers/partners need to be included in breastfeeding counselling. The ‘Baby-Friendly Hospital Initiative’ should be continued, and guidelines should align with the mothers’ need to incorporate breastfeeding into their daily lives during the breastfeeding period.

Objectives: Women's attendance to cervical cancer screening (CCS) is a major concern for healthcare providers in community. This study aims to use the various algorithms that can accurately predict the most barriers of women for nonattendance to CS. Design: The real‐time data were collected from women presented at OPD of primary health centers (PHCs). About 1046 women's data regarding attendance and nonattendance to CCS were included. In this study, we have used three models, classification, ensemble, and deep learning models, to compare the specific accuracy and AU‐ROC for predicting non‐attenders for CC. Results: The current model employs 22 predictors, with soft voting in ensemble models showing slightly higher specificity (96%) and sensitivity (93%) than weighted averaging. Bagging excels with the highest accuracy (98.49%), specificity (97.3%), and ideal sensitivity (100%) with an AUC of 0.99. Classification models reveal Naive Bayes with higher specificity (97%) but lower sensitivity (91%) than Logistic Regression. Random Forest and Neural Network achieve the highest accuracy (98.49%), with an AUC of 0.98. In deep learning, LSTM has an accuracy of 95.68%, higher specificity (97.60%), and lower sensitivity (93.42%) compared to other models. MLP and NN showed the highest AUC values of 0.99. Conclusion: Employing ensemble and deep learning models proved most effective in predicting barriers to nonattendance in cervical screening. [ABSTRACT FROM AUTHOR]

Background: Child maltreatment is a global problem that puts children at risk of mental illness, substance abuse, and premature death. Interdisciplinary collaboration is important in preventing and detecting child maltreatment. In Norway, children undergo universal preventive health assessments and receive complimentary follow-up care from specialized public health nurses in child and family health clinics. These nurses conduct regular check-ups and home visits to monitor children for signs of maltreatment. Objective: The objective of this study is to describe how public health nurses at child and family health clinics follow the National Clinical Guidelines to prevent and detect child maltreatment, with a particular focus on clinical procedures and interdisciplinary collaboration. Furthermore, we aim to determine factors that are associated with identification of child maltreatment. Design: A cross-sectional online survey was conducted among public health nurses working in primary care between October 24th and December 31st, 2022. Public health nurses who worked with children aged 0–5 years and had consultations with families were eligible to participate, resulting in 554 responses. The study employed descriptive analysis, including frequency, percentage and mean, as well as a two-step logistic regression analysis. The study was approved by the relevant authority, and informed consent was obtained through questionnaire completion. Results: The public health nurses in this study displayed strong adherence to the guidelines and utilized various comprehensive assessment procedures to monitor child well-being, growth, and development. However, there was limited and infrequent collaboration with other professionals, such as child protection services, general practitioners, and hospitals. Most public health nurses reported occasional suspicion of child maltreatment, with age and years of experience in child and family clinics influencing these suspicions. Older public health nurses were more likely to suspect physical violence, while those with less than two years of experience reported less experience in suspecting maltreatment. Additional education increased the probability of suspecting sexual violence. Conclusions: This study provides insights into the practices of public health nurses in Norway regarding the detection and prevention of child maltreatment in child and family clinics. While adherence to guidelines is strong, suspicion of maltreatment is relatively rare. Collaboration across agencies is crucial in addressing child maltreatment. Age and experience may influence the detection of maltreatment. Improved collaboration, targeted guidelines, and ongoing professional development are needed to enhance child protection. [ABSTRACT FROM AUTHOR]

Background: Universal health visiting has been a cornerstone of preventative healthcare for children in the United Kingdom (UK) for over 100 years. In 2016, Scotland introduced a new Universal Health Visiting Pathway (UHVP), involving a greater number of contacts with a particular emphasis on the first year, visits within the home setting, and rigorous developmental assessment conducted by a qualified Health Visitor. To evaluate the UHVP, an outcome indicator framework was developed using routine administrative data. This paper sets out the development of these indicators. Methods: A logic model was produced with stakeholders to define the group of outcomes, before further refining and aligning of the measures through discussions with stakeholders and inspection of data. Power calculations were carried out and initial data described for the chosen indicators. Results: Eighteen indicators were selected across eight outcome areas: parental smoking, breastfeeding, immunisations, dental health, developmental concerns, obesity, accidents and injuries, and child protection interventions. Data quality was mixed. Coverage of reviews was high; over 90% of children received key reviews. Individual item completion was more variable: 92.2% had breastfeeding data at 6–8 weeks, whilst 63.2% had BMI recorded at 27–30 months. Prevalence also varied greatly, from 1.3% of children's names being on the Child Protection register for over six months by age three, to 93.6% having received all immunisations by age two. Conclusions: Home visiting services play a key role in ensuring children and families have the right support to enable the best start in life. As these programmes evolve, it is crucial to understand whether changes lead to improvements in child outcomes. This paper describes a set of indicators using routinely-collected data, lessening additional burden on participants, and reducing response bias which may be apparent in other forms of evaluation. Further research is needed to explore the transferability of this indicator framework to other settings. [ABSTRACT FROM AUTHOR]

Aim: The study goal was to inform the creation of a blueprint for an advanced practice nurse (APN) in public health. Background: No internationally accepted standard for an APN in public health exists. Activities of public health nurses (PHN) traditionally have centered on health promotion and disease prevention, but many have added other population‐based activities such as chronic and acute disease treatment. Introduction: An APN in public health is needed to address the global challenges threatening the physical, social, and mental health of populations worldwide. Methods: This qualitative study was comprised of six focus groups, each containing a different group of stakeholders (n = 40). Study results followed the requirements of the consolidated criteria for reporting qualitative research (COREQ). Findings: Two major themes emerged: the APN role in public health and core expectations. From the APN role theme, four subthemes emerged on APN domains of public health practice and functions. From the core expectations theme, nine subthemes emerged on the APN's qualifications and behaviors. Discussion: Agreement among stakeholders was found in the nine core expectations; however, among the four different visions of an APN in public health, two fit a population‐based model rather than the traditional PHN model. Conclusions: A single APN role in public health is insufficient to address the breadth and complexity of today's global challenges as detailed by the sustainable development goals. Due to the interaction between health and the biopsychosocial environments, we need APNs with different areas of expertise. Implication for nursing policy: Nurses working at universities, in public health services, and as healthcare policymakers are needed to create a multistage strategy that gradually introduces several different types of APNs in public health. [ABSTRACT FROM AUTHOR]

Aims and Objectives: This study aimed to explore public health nurses' experiences with mental health promotion for adolescent immigrants in lower secondary and high school, aiming to enhance knowledge and insights for effective mental health promotion. Methodological Design and Justification: A qualitative design employing a hermeneutic approach was chosen. Thirteen public health nurses were selected using purposive criterion sampling and snowballing. Thematic analysis was applied, adhering to COREQ guidelines for transparency. Ethical Issues and Approval: The research was approved by the Norwegian Centre for Research Data. The guidelines of the National Committee for Research Ethics in the Social Sciences and the Humanities were followed. Research Methods, Instruments, and/or Interventions: Data were collected through three focus‐group interviews (n = 13), using semi‐structured interview guides to explore the experiences of public health nurses in promoting mental health among adolescent immigrants. Outcome Measures: This study identified three key themes: (i) Striving to understand adolescent immigrants' mental health aspects, including both positive and negative aspects; (ii) Different strategies for promoting mental health, viewing adolescents as both recipients and contributors to their well‐being; and (iii) Barriers to public health nurses' promotion of mental health, including language, cultural, and knowledge‐related obstacles and trust issues. Results: Public health nurses noted that language barriers and trust issues often delayed adolescent immigrants from seeking help for mental health concerns. Cultural competence and empathy were deemed crucial. To meet these needs, public health nurses must build rapport with parents, collaborate with professionals, implement follow‐up programmes, and advocate for policy changes. Study Limitations: Limitations of this qualitative study include potential bias from the authors' background and non‐generalizability of results to other contexts. Conclusions: In conclusion, public health nurses' experiences reveal the need for enhanced cultural competence, language proficiency, and trust‐building to better serve adolescent immigrants. Collaborative efforts, follow‐up programmes, and policy advocacy are essential to improve mental health promotion in school settings. [ABSTRACT FROM AUTHOR]

Background: Despite news reports of morally distressing situations resulting from complex and demanding community-care delivery in Canada, there has been little research on the topic of ethical conflicts experienced by community-based health care professionals. Research aim: To identify ethical conflicts experienced by community nurses. Research design: Data were collected using semi-structured interviews and then relevant text was extracted and condensed using qualitative content analysis. This research was part of a larger grounded theory project examining how community nurses manage ethical conflict. Research context and participants: Community nurses, including 13 public health nurses and 11 home care nurses from two Canadian provinces, were interviewed. Ethical considerations: Study approval was granted by the Health Research Ethics Authority of Newfoundland and Labrador and by provincial health authorities. Findings: Seven ethical conflicts were identified and assigned to one of two groups. In the grouping categorized as challenges with obligations or risks, the ethical conflicts were: (1) screening for child developmental issues knowing there is a lack of timely early intervention services; (2) encountering inequities in the health care system; (3) not fulfilling principles, goals, and initiatives of primary and secondary prevention; and (4) feeling powerless to advocate for clients. The remaining ethical conflicts were categorized as challenges with process, risks, and consequences, and were: (5) jeopardizing therapeutic relationships while reporting signs of a child at risk; (6) managing confidentiality when neighbors are clients; and (7) supporting client autonomy and decision-making but uncertain of the consequences. Conclusions: Research investigation will continue to be important to raise awareness and mobilize ethics supports as health care services are steadily shifted from institutional to community settings. Moreover, with heightened potential for communicable disease outbreaks across international borders from global warming, community nurses around the world will continue to be required to address ethically-difficult care situations with competence and compassion. [ABSTRACT FROM AUTHOR]

Studies have shown that work burnout is an important factor positively associated with turnover of nurses, which implies that high burnout leads to high turnover. However, administrative data in Taiwan reveals that the turnover rates of nurses in public health centers have been low despite their high burnout levels. This study held three focus groups to investigate why public health nurses do not leave the system despite experiencing high burnout, as well as the reasons behind these high burnout levels. Thematic analysis was used to analyze the data. The results demonstrate that a sense of mission to serve the public; job security and pension provided by the career civil service system; and job flexibility were the three themes emerging when public health nurses explained why they keep working in the system when experiencing severe burnout. Moreover, the main reasons for the high burnout levels were work overload and staffing shortages. [ABSTRACT FROM AUTHOR]

Background: Mothers are recommended to breastfeed their children but can find it challenging and experience breastfeeding problems. Qualified breastfeeding counselling from healthcare professionals can help mothers master breastfeeding, but there is a need to explore mothers' lived experiences with receiving breastfeeding counselling. We aimed to reveal breastfeeding mothers' experiences with receiving breastfeeding counselling from midwives and public health nurses (PHNs) to provide a deeper insight into the phenomenon of breastfeeding counselling, which may improve breastfeeding counselling in practice. Methods: A qualitative design with a hermeneutic phenomenological approach was used. Individual interviews of 11 breastfeeding mothers from Norway were conducted from September 2021 to 2022. Van Manen's guided existential inquiry guided the reflective process to provide deeper insights into the phenomenon of breastfeeding counselling. Results: The study captured the meaning of breastfeeding mothers' lived experiences with breastfeeding counselling. Three themes and eight sub-themes were found. Breastfeeding was at stake for the mothers because breastfeeding could be reduced or stopped, and qualified breastfeeding counselling from midwives and PHNs was essential for them to establish and continue breastfeeding. They needed to be perceived as both breastfeeding mothers and as women with their own needs to master everyday life during the breastfeeding period. Conclusions: This study offers insights to midwives, PHNs and others offering breastfeeding counselling by facilitating an understanding of being a breastfeeding mother receiving breastfeeding counselling. Qualified breastfeeding counselling and a trusting relationship with midwives and PHNs are essential for mothers to establish and continue breastfeeding, while deficient counselling may cause breastfeeding difficulties. Mothers need to be treated as whole and competent persons to avoid objectification and fathers/partners need to be included in breastfeeding counselling. The 'Baby-Friendly Hospital Initiative' should be continued, and guidelines should align with the mothers' need to incorporate breastfeeding into their daily lives during the breastfeeding period. [ABSTRACT FROM AUTHOR]

Objectives: To clarify the conceptual structure of "cultural competence (CC)" among Japanese public health nurses (PHNs), to enhance culturally appropriate support. Methods: A modified grounded theory approach (M‐GTA) was used. A total of 11 municipal PHNs participated in this study. Data were collected through semistructured interviews. Interviews were audiotaped and transcribed. A comparative analysis was performed using M‐GTA. Result: Five categories were identified. Japanese PHNs supported foreign residents while (1) maintaining a sincere attitude with curiosity and humility toward others regarding CC; (2) deepening their realization of issues arising from awareness of one's own and other cultures; (3) developing their knowledge about clients' cultures and the surrounding environments; and (4) mastering the skills of building a relationship with clients while creating supportive systems surrounding them. As they gained more experience in supporting foreign residents, as indicated in the above categories, their cultural competence grew, allowing them to (5) gain experience while encountering individuals without holding stereotypes and prejudice. Conclusions: The concepts of CC that emerged are based on cultural humility and are cultivated through supportive activities. The concepts identified in this study can serve as educational guidelines for health nurses and other care providers in Japan. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Ege University Nursing Faculty (JEUNF) is the property of Journal of Ege University Nursing Faculty (JEUNF) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The workload of public health nurses (PHNs) working for local governments has been increasing as health issues become more diverse and complicated. Even amidst the ongoing administrative and fiscal reforms, there is an urgent need to ensure how effectively and efficiently public health nurses can practice in health service development. The objective of this research was to clarify the actual conditions of best practice transfer (BPT) and its related factors. Methods: An anonymous postal and self-administered questionnaire survey was conducted among PHNs working at 334 sites, including the local government offices and health centers across Japan, and analysed mainly through logistic regression analysis. Results: One hundred eighty-five of the 334 institutions (55.4%) agreed to participate, and of the 966 questionnaire forms distributed, 709 forms (73.4%) were collected, of which 702 responses (72.7%) were valid. Although less than half (43.2%) have experience in BPT in health service development, more than 80% are willing to perform going forward. Significant factors for both the group with experience in BPT and the group with willingness to perform include an organizational culture that promotes BPT, as well as multiple elements of the workplace environment and facilitating factors related to knowledge and learning. The experienced group recognised the needs for criteria to evaluate the adaptability of best practice, while the willing group, to evaluate the quality of practice. Conclusions: Through a nationwide survey, this research elucidated for the first time the actual conditions of BPT by PHNs in Japan and related factors. The results indicated the importance of developing a system to promote BPT at the workplace level, also highlighted the importance for practitioners and experts, including researchers, to work together to develop practical guidelines to ensure evidence-based practices. Urgent actions are needed for the national and local governments to develop a system to promote BPT from diverse perspectives, building on the findings of this research. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To explore midwives' and public‐health nurses' experiences of breastfeeding counselling in order to provide a deeper insight into breastfeeding counselling. Methodological Design and Justification: A qualitative design was used, and qualitative content analysis was conducted to analyse the data in accordance with the phenomenological hermeneutic tradition. Ethical Issues and Approval: The Norwegian Centre for Research Data approved this study. All participants provided written consent. Research Methods: Four focus‐group interviews were conducted on a sample of eight midwives and 13 public‐health nurses in Norway. Results: Three interrelated themes describing the meaning of midwives' and public‐health nurses' experiences with breastfeeding counselling emerged from the analysis: Breastfeeding Counselling Means Responsibility for Collaboration and Facilitation, Being Confident as a Breastfeeding Counsellor Means Striving for Professional Competence and Supporting the Individual Breastfeeding Family Means Being Sensitive and Adapting to Novel Situations. Study Limitations: The focus groups comprised a mix of midwives and public‐health nurses, which may have inhibited honest declaration of these professionals' opinions of each other. Conclusion: Midwives and public‐health nurses regard structural factors and prioritising breastfeeding support in society as important for providing good breastfeeding counselling. Midwives and public‐health nurses strive to find a balance between relying on their own competence, promoting breastfeeding in accordance with guidelines and respecting mothers' choices. Healthcare professionals require knowledge about breastfeeding, good clinical judgement, a listening attitude and openness to how breastfeeding affects mother's everyday life to provide good breastfeeding care. [ABSTRACT FROM AUTHOR]

The northern region of Portugal has the largest number of companies manufacturing granite and stone products, which has become the region's trademark. In the municipalities of Marco de Canaveses and Penafiel, the economic activity of this area is important. However, the lack of attractiveness of this activity, combined with the high prevalence of silicosis and tuberculosis in this population, has led to a growing shortage of labor. In order for this project to be the result of collaborative, integral work centered on the people who are the target of health promotion, we used the Participatory Health Research (PHR) approach, based on the PRECEDE-PROCEED model, to implement a mixed-methods study, including participant observation, interviews and document analysis. These data were used to co-create a study design. In 2021, a total of 102 interviews were carried out and self-completion surveys were distributed: the Fantastic Lifestyle Questionnaire (FLQ) and the EQ-5D-3L. Within the scope of occupational health nursing and in the field of action of public health nurses, with the interviews and self-completed surveys carried out, we identified potential focuses for occupational health nursing intervention to promote the health of stone industry workers: adherence to protective measures, energy balance deficit, tobacco and alcohol consumption and access to health services. Data analysis made it possible to assess the prevalence of risk behaviors by order and to involve managers and workers in the co-creation of a health promotion program. The accurate identification of the focuses for nursing intervention not only improves the effectiveness of occupational health services, allowing for targeted interventions adapted to workers' needs, but also contributes considerably to health promotion in the workplace, resulting in safer working environments, a reduction in occupational diseases and, consequently, a healthier and more productive workforce. This protocol of this study was not registered. [ABSTRACT FROM AUTHOR]

In this column, Barbara Glickstein, a public health nurse, health reporter, and media strategist, shares insights about nurses' involvement and engagement in the media. She founded "Barbara Glickstein Strategies," a company that trains healthcare leaders to become media competent to advance population health and public policy. [ABSTRACT FROM AUTHOR]

Public health nurses (PHNs) constitute an important source of nutritional knowledge for parents during the child’s first 1000 days of life, but parents also seek advice from various online sources. Access to timely digital interventions may facilitate healthful eating habits later in life. In the Nutrition Now project, we wanted to combine previously evaluated digital interventions on early nutrition and implement the integrated intervention at municipality level. We prospectively explored PHNs’ thoughts, needs and expectations regarding the development and usability of such a digital resource. Semi-structured interviews were conducted with six PHNs, and data was subjected to thematic analysis. Four main themes were identified: (1) an online resource on nutrition may be a useful tool; (2) the content should attract interest and be broad in scope; (3) it must be easy to apply and adapted to different users; and (4) participating in a development process should seem meaningful. Our findings highlight the need for easily accessible, quality-assured online information to underpin the guidance provided by PHNs. The study further sheds light on prerequisites considered by PHNs to be crucial for parents to engage in a digital resource, as well as their perspectives on how it best may be communicated and used.

In Norway, public health nurses (PHNs) are responsible for giving parents nutritional knowledge, but limited research describes how they perceive this task. This study explores PHNs' perceptions and experiences on nutritional guidance for parents of infants and toddlers. Semistructured interviews with six PHNs were conducted and transcribed verbatim. Data were subjected to thematic analysis. Five main themes were identified: (1) Dietary guidance for parents is central to the work; (2) PHNs perceive they have parents' trust, and parents are in general open to nutrition counselling; (3) food and meals must be seen in light of the family context; (4) The dialogue must be adapted to the individual family; and (5) PHNs have expertise on nutrition; however, updating knowledge is difficult. Nutritional guidance was perceived by PHNs as a core activity. They felt that they had parents' trust, and that parents were particularly open to nutritional guidance during the first 2 years. Counselling was generally well received, but conversations on overweight were perceived as difficult. PHNs strove to tailor their guidance to individual needs. However, providing guidance on a wide range of issues in different families and cultures could be challenging. They acknowledged a need for updating knowledge but the offer of courses was sparse. Our findings suggest a discrepancy between how nutrition is prioritized in the education of PHNs and what they encounter in clinical practice. In the future, this should be given more attention given the PHNs' unique position to promote healthy eating and long-term health. [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV) and child maltreatment (CM) – together referred to as family violence (FV) – often co‐occur. In Finland, public health nurses play an important role in identifying FV. They regularly meet families and assess children's health until the child turns seven. This nationwide retrospective cross‐sectional survey (FinChildren) aimed to describe and compare help and support needs in violent families from the perspectives of the parents of four‐year‐old children and public health nurses for advancing families' and professionals' collaboration in preventing FV. The data (N = 7476 families) included the responses of one parent from each family and public health nurses, caring for that certain family. The data analysis encompassed statistical methods. The results showed that 47.0% of the parents reported FV. The public health nurses assessed that 0.7% of the parents would have needed support for CM and 1.3% for IPV. They assessed that the parents involved in FV needed more support for their personal coping (p < 0.001) and intimate relationship (p < 0.017) compared with parents without FV. These parents were also found to have other support needs. We concluded that public health nurses recognise only a fraction of FV occurring in families. Risk assessment tools are needed to enable child and family professionals to better intervene in and prevent FV. [ABSTRACT FROM AUTHOR]

Copyright of Turkiye Klinikleri Journal of Nursing Sciences is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: The coronavirus disease 2019 (COVID‐19) pandemic has had a substantial effect on frontline health care workers and caused public health nurses (PHNs) to come under various forms of pressure. PHNs face high‐risk challenges in their work environment, and their professional commitment and adaptability are key concerns. The aim of this qualitative study was to describe the experiences of PHNs during the COVID‐19 outbreak. Methods/Design: Twenty PHNs who worked during the COVID‐19 outbreak were recruited from seven public health centres through posters. Data were collected through in‐depth interviews that comprised semi‐structured and open‐ended questions; subsequently, the data were analysed through content analysis. Results: Three themes emerged from the study findings, namely (1) the disorderliness of COVID‐19 pandemic prevention work, (2) managing stress and fear, and (3) the establishment of a new normal. Because of the severity of the pandemic, the workload and stress associated with epidemic prevention policies continue to increase. PHNs may infect their family members and experience a sense of alienation and distance. They must also deal with irrationality and reactions in the people within their community. Conclusion: Health department directors and policymakers should provide the necessary support and assistance to frontline pandemic prevention workers to increase the efficiency of pandemic prevention efforts. Patient or Public Contribution: The participants agreed to participate in the qualitative study during the study period. [ABSTRACT FROM AUTHOR]

Aim: To explore how public health nurses in child and family health centres experience detecting and preventing child maltreatment. Design: Qualitative study. Methods: 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. Results: 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. Conclusion: 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. Implications for Practice: 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. Reporting Method: EQUATOR guidelines were followed, using the COREQ checklist. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aims: 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. Methods: 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. Ethical Approval: The study was approved by the Norwegian Centre for Research Data. Results: 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. Study Limitations: 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. Conclusions: 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. [ABSTRACT FROM AUTHOR]

Early detection of developmental dysplasia of the hip (DDH) in children is crucial. Due to COVID-19, maternal and child health services have been suspended temporarily, increasing the risk of late detection of DDH. This study aimed to reveal Japan's current situation regarding community hip screening for newborns and infants and to provide health guidance for caregivers regarding DDH. A web-based, nationwide cross-sectional survey was conducted between February and March 2023 (n = 1737). One public health nurse overseeing maternal and child health per municipality responded to the 2022 municipality hip screening system. Among the 436 municipalities that responded (response rate: 25.1%), 97.5% implemented hip screening within 4 months, and approximately 60% performed it during newborn home visits, while only 2.3% conducted hip ultrasound screening. Perfect checking of the risk factors for DDH during newborn home visits and training opportunities for home visitors must be improved. Educational programs regarding DDH for home visitors and caregivers are needed to prevent the late diagnosis of DDH. Furthermore, collaboration between pediatric orthopedic surgeons and nurses is crucial for developing effective community-based hip-screening systems by bridging the evidence and practice gap in the early detection of DDH. [ABSTRACT FROM AUTHOR]

Objective: To examine the health‐housing relationship in low‐income older adults, and differences by income and receipt of housing assistance. Design: Secondary analysis of longitudinal survey data. Sample: About 10,858 adults aged 62+ who completed at least one wave of the 2014 Survey of Income and Program Participation (SIPP) (n = 37,333 observations). Measurements: SIPP variables representing demographics and housing quality, affordability, stability, and neighborhood were analyzed. Low‐income and higher‐income participants were differentiated by the household income‐to‐poverty ratio. Results: Low‐income participants were significantly more likely to be in poor health and report problems with housing quality, affordability, and neighborhood safety compared to higher‐income participants (p <.001). Increased household size and problems with housing quality and neighborhood safety were associated with poor health in both groups (p <.05). Low‐income participants who received housing assistance were significantly poorer, less healthy, and food insecure than participants not receiving assistance (p <.001); however, the health‐housing relationship was not different in the two groups. Conclusions: Results provide additional support for housing as a social determinant of older adult health. Though housing assistance programs reached a subset of low‐income older adults, the results suggest a housing assistance shortfall. Implications for public health nurses and researchers are explored. [ABSTRACT FROM AUTHOR]

Background: Public Health Nurses (PHN) caring for vulnerable populations amid systemic inequality must navigate complex situations, and consequently they may experience serious moral distress known to be detrimental to PHN wellbeing. Objective: Given PHN awareness of social inequities, the study aimed to determine if PHNs were motivated to enact social change and engage in social and political action to address inequality. Design and sample: A survey of 173 PHNs was conducted in fall 2022. The convenience sample was mainly female (96.5%), White (85%), had associate/bachelor's degrees (71.7%), and worked in governmental public health settings (70.7%). Measure: The study employed the Short Critical Consciousness Scales' subscales: Critical Reflection, Critical Motivation, and Critical Action. Results: PHNs were highly motivated to address inequities (Critical Motivation = 20.83; SD = 3.16), with similarly high awareness (Critical Reflection = 17.89; SD = 5.18). However, social and political action scores were much lower (Critical Action = 7.13; SD = 2.63). A subgroup of PHNs with strong agreement regarding the impact of poverty were more likely to be younger (p =.039) and work in a community setting (p =.003); with higher scores across subscales (p <.001). Conclusions: High critical reflection and motivation among PHNs aligned with literature. Lower Critical Action scores warrant investigation into validity for PHNs, and possible role constraints. [ABSTRACT FROM AUTHOR]

COVID‐19 pandemic brings to light similarities to the 1918 influenza pandemic, one of the deadliest outbreaks in United States history. The work of the Henry Street Visiting Nurse Service also referred to the public health nurses for that time, was a critical part of the New York City response. This case study examined Lillian Wald's leadership in directing the public health nursing response in New York City during the second wave of the influenza pandemic, from September through December of 1918. A historical social framework was used. Primary sources included the Lillian Wald Papers in the Rare Book and Manuscript Library, Columbia University in New York, Wald's (1934) Windows on Henry Street, medical, public health and nursing documents, journals, and newspaper articles published during the early 20th century. Secondary source material include works by historians Sarah Abrams, Arlene Keeling, Karen Buhler‐Wilkerson, Sandra Lewenson, John Barry, and Alfred Crosby. Key findings included developing a community wide strategic plan, using data driven decisions, implementing visiting nursing services, teaching in the home, and maintaining a diverse workforce. Lessons learned can guide leadership in emergency planning, system change, infection control and disease prevention, all familiar practices of public health nursing. [ABSTRACT FROM AUTHOR]

The 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. [ABSTRACT FROM AUTHOR]

Background: Early detection of autism spectrum disorder (ASD) is essential to provide children with timely treatment and support. Evidence‐based screening measures make it possible to identify children with suspected ASD at an early stage. Although Japan has a universal healthcare system that covers well‐child visits, detection rates of developmental disorders, including ASD, at 18 months vary widely between municipalities (0.2%–48.0%). The reasons for this high level of variation are poorly understood. The present study aims to describe the barriers and facilitators of incorporating ASD identification during well‐child visits in Japan. Methods: This is a qualitative study that conducts semi‐structured in‐depth interviews in two municipalities of Yamanashi Prefecture. We recruited all public health nurses (n = 17) and paediatricians (n = 11) involved in the well‐child visit in each municipality and caregivers of children who also participated in the visits during the study period (n = 21). Results: We identified four themes characterizing the process of ASD identification in the target municipalities: (1) Identification of children with ASD is driven by caregivers' sense of concern, acceptance and awareness. (2) Multidisciplinary cooperation and shared decision‐making is limited. (3) Skills and training for developmental disabilities screening are underdeveloped. (4) Caregivers' expectations shape the interaction in important ways. Conclusions: Non‐standardization of screening methods, limited knowledge and skills on screening and child development among healthcare providers and poor coordination among healthcare providers and caregivers are the main barriers to effective early detection of ASD through well‐child visits. The findings suggest the importance of promoting a child‐centred care approach through the application of evidence‐based screening measures and effective information sharing. [ABSTRACT FROM AUTHOR]

Background: 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. Research Aim: To identify the current practices and support needs of public health nurses who provide breastfeeding support in Ireland. Method: 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). Results: 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). Conclusions: 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. [ABSTRACT FROM AUTHOR]

Aim: To investigate reflections of public health nurses (PHNs) on implementing the New Families programme, a supplement to the usual Norwegian child health centre programme. It involves user‐led decisions on the content and number of home visits offered by the family's PHN from pregnancy week 28 until the child is 2 years. Design: An interpretive description approach. Methods: Altogether 206 anonymized, undated reflection notes by PHNs becoming familiar with the programme were collected in 2017–2020. NVivo 12 and inductive content analysis were used to convert the data into manageable segments. Results: Focusing on childhood experiences and parental role expectations among prospective parents during home visits was seen as a major shift in the nurses' counselling strategy. Providing relevant information to the parents‐to‐be ahead of a meeting was important. Given sufficient staff and guidance, the programme was considered a good basis for building a relationship with the family. [ABSTRACT FROM AUTHOR]

Abstract Aim The coronavirus disease 2019 (COVID‐19) pandemic has had a substantial effect on frontline health care workers and caused public health nurses (PHNs) to come under various forms of pressure. PHNs face high‐risk challenges in their work environment, and their professional commitment and adaptability are key concerns. The aim of this qualitative study was to describe the experiences of PHNs during the COVID‐19 outbreak. Methods/Design Twenty PHNs who worked during the COVID‐19 outbreak were recruited from seven public health centres through posters. Data were collected through in‐depth interviews that comprised semi‐structured and open‐ended questions; subsequently, the data were analysed through content analysis. Results Three themes emerged from the study findings, namely (1) the disorderliness of COVID‐19 pandemic prevention work, (2) managing stress and fear, and (3) the establishment of a new normal. Because of the severity of the pandemic, the workload and stress associated with epidemic prevention policies continue to increase. PHNs may infect their family members and experience a sense of alienation and distance. They must also deal with irrationality and reactions in the people within their community. Conclusion Health department directors and policymakers should provide the necessary support and assistance to frontline pandemic prevention workers to increase the efficiency of pandemic prevention efforts. Patient or Public Contribution The participants agreed to participate in the qualitative study during the study period.

Introduction: United Nations Sustainable Development Goals (SDGs) were adopted as a plan of action for people, planet, and prosperity by 2030. SDG 3 aims to ensure healthy lives and promote well-being for all ages, and other goals focus on reduction of inequality, abolition of poverty, decent work for all, and building effective, accountable, and inclusive institutions. A community pediatric clinic, Kidscope, was established in a vulnerable Irish community offering free developmental assessment and onward referral of children 0 to 6 years. The Kidscope model involves multiagency input with local public health nurses (PHNs) acting as fundamental partners in the provision of specialist early years support to vulnerable children and families. This study evaluates PHN involvement in Kidscope in the context of SDGs. Objective: To record and understand PHN roles within Kidscope and to capture their contribution to achieving SDGs in a disadvantaged Irish community. Methods: Qualitative stakeholder analysis and mapping design. Snowball sampling identified participants. Data collection involved scoping interviews, questionnaires, one-to-one interviews, and a focus group. A Stakeholder Matrix Table was developed in line with the guiding framework. Transcripts were thematically analyzed. Results: PHNs are key stakeholders in Kidscope contributing to clinic development, delivery, and sustainability. Six themes were identified: lead referrers, in-clinic support, learning and education, child and family follow-up, specialist early years role, and partnership working. PHNs contribute to six SDGs through the Kidscope model. Conclusion: PHNs are fundamental partners in achieving SDGs in a disadvantaged Irish community through ameliorating childhood developmental delay by intercepting the gap within Ireland's early intervention system and disrupting the impact exclusion to healthcare has on vulnerable children and their families. Findings underscore a shift from the current "cradle to grave" model of working toward a specialist early years PHN role. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to describe the alleged abuse of social care clients committed by nurses and other social services employees and actions as well as sanctions that followed the alleged abuse. Design: A retrospective study using a descriptive qualitative analysis. Methods: The data comprised mandatory reports made by social service employees under the Social Welfare Act. This study focused on the reported abuses of clients (n = 75) by social services employees from 11 October 2016 to 31 December 2020 in Finland. The data were analysed using inductive content analysis and quantification. Results: The majority of the reports were submitted practical nurses and other nursing personnel and by registered nurses. The severity of the abuse was most often mild or moderate. The most common abusers were nurses. The types of alleged abuse committed by professionals were as follows: (1) neglect of care, (2) physical violence/strong‐arm treatments, (3) neglect of hygiene, (4) inappropriate or threatening behaviour and (5) sexual abuse. The actions and sanctions that followed the alleged abuse were: (1) discussing the situation together, requesting an explanation, initiating hearing or defining developmental measures, (2) initiating disciplinary actions and providing verbal or written warnings, (3) dismissing or terminating the employee and (4) initiating a police investigation. Conclusion: Nurses are an important group working in social services and might also be involved in cases of abuse. Implications for the Profession and/or Patient Care: It is important that risks, wrongdoings and abuses are reported. Transparent reporting indicates strong professional ethics. Impact: Knowledge about abuse in social services from the viewpoint of nursing is important for ensuring the quality and safety of services. Reporting Method: The Standards for Reporting Qualitative Research guideline was followed. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]