BACKGROUND AND OBJECTIVE

Public health nurses (PHNs) are vital in the local implementation of the provisions of the Universal Healthcare (UHC) Act of 2019. However, they need adequate competencies in health systems approach to successfully implement the provisions of the law. In response to this, a leadership development course for public health nurses (LDC-PHN), anchored on the building blocks of health systems, was developed and implemented. This paper aims to describe the extent to which training participants have applied the competencies acquired from the LDC-PHN as manifested by the workplace application of their capstone projects.

Following Kirkpatrick’s Model of Evaluation, we used a multi-method study design to evaluate the extent of the participants’ workplace application of acquired competencies. Sources of data included the Workplace Application Plan (WAP) accomplished by each participant, a questionnaire to determine the perceived implementation status of the participants’ capstone project, interviews, and focus group discussions (FGDs) conducted with selected participants and their supervisors, and observation visits. Data were collected from May to December 2022. Data from the semi- structured interviews and FGDs were analyzed through content analysis, while the participants’ perceived status of their capstone project implementation was summarized as frequencies.

Majority of the participants (61.9%) reported partial implementation of their capstone project while 16.77% reported full implementation. Capstone project implementation was facilitated by the support received from their supervisors and local chief executives. Barriers identified included the demands of the COVID-19 pandemic and the challenges imposed by the events before and after the 2022 Philippine National elections. Major themes emerged from the interviews conducted among participants and their supervisors. The workplace application of the training program outcomes, based on participants’ perspectives, yielded increased capacity to lead and innovate, improved ability to advocate for capstone project implementation, transferability of acquired skill sets, and improved population outcomes. From supervisors’ perspectives, workplace application of training program outcomes include increased ability of PHNs to deliver health services, and visible enhancement of leadership and supervision skills among PHNs.

Given ample support and opportunities, and despite the barriers and challenges they faced, LDC-PHN participants, in general, utilized and applied the competencies they gained from the course in their actual work setting. Course graduates participated in health systems strengthening at various capacities by acting upon their capstone projects that addressed UHC challenges within their particular work settings.

PURPOSE: The purpose of this study was to develop a suicide prevention nursing competency program for visiting nurses, and to examine the effect of this program on suicide prevention-related knowledge, attitudes, and behaviors.METHODS: A total of 66 visiting nurses were recruited from 10 public health centers and divided equally into the experimental and control group. For the experimental group, the suicide prevention nursing competency program was provided twice a week for 120 minutes across 3 weeks. Participants were asked questions related to suicide prevention knowledge, attitudes, and behaviors at pre, post, and 1 month after the intervention. Data were analyzed using descriptive statistics, a t-test, repeated measure ANOVA, and Friedman test.RESULTS: There were significant differences in knowledge and behaviors at the measured time periods, and significant differences in attitudes and behaviors between the two groups. There were also significant interactions between groups and times in attitudes and behaviors. These results suggest that the effects of the program were persistent until the 1-month follow-up.CONCLUSION: The developed suicide prevention nursing competency program is effective in evidence-based education for visiting nurses to increase suicide prevention-related knowledge, attitudes, and behaviors.
Education ; Follow-Up Studies ; Home Health Nursing ; Nurses, Community Health ; Nursing ; Public Health ; Suicide

PURPOSE: The purpose of this study is to analyze the contents of disaster nursing education at universities in Korea and Japan, with focus on textbooks. METHODS: Disaster nursing contents from 11 Korean community health nursing textbooks and 3 Japanese disaster nursing textbooks were analysed. RESULTS: Three themes and 8 categories of disaster nursing content in the selected textbooks were analyzed. The themes classified include ‘understanding of disaster’, ‘disaster management’ and ‘disaster management system’. The theme of ‘understanding of disaster’ consists of such categories as ‘disaster concept/outline’, ‘classification of disaster’, ‘disaster management step’ and ‘disaster impact’. The theme of ‘disaster management activities’ consists of categories such as ‘disaster management activities’ and ‘disaster nursing’. The theme of ‘national disaster management system’ consists of categories like ‘national disaster management system’ and ‘international disaster relief’. From the comparison of disaster nursing education in the two countries, we found that themes were similar but there were differences between the two countries in content configuration. Korea and Japan have adopted the framework of International Council of Nurses for disaster nursing education. Korea stressed legal and ethical capabilities, while Japan included psychological support for disaster management service providers. CONCLUSION: Disaster education is an important factor in a nurse's ability for a disaster management. Development of a comprehensive disaster education program is necessary to enhance disaster care capacities.
Asian Continental Ancestry Group ; Community Health Nursing ; Disasters ; Education ; Education, Nursing ; Education, Nursing, Baccalaureate ; Humans ; International Council of Nurses ; Japan ; Korea ; Nursing ; Public Health Nursing

PURPOSE: This study aimed to develop a web-based cost management program for visiting nursing centers (CMP-VNC), using time-driven activity-based costing (TD-ABC), and to analyze effects of the program. METHODS: The CMP-VNC was developed using the combined prototyping approach and system developing life cycle method following four stages: need analysis with comprehensive literature reviews and focus group interviews, design and development of program algorithm, evaluation of the developed program validity using experts and users group, and application and effects analysis. The non-equivalent control group pretest-posttest design was used to analyze the effects of the program. The program demonstration was conducted for four weeks with 60 visiting nurses in 35 visiting centers. RESULTS: The web-based program was developed. It has five interfaces with basic and special functions using TD-ABC, namely, input, visiting nursing activity, visiting nursing activity cost, cost efficiency, and cost calculation report. The experimental group showed significantly higher cost perception and cost confidence than control group. CONCLUSION: We found that the CMP-VNC can be an effective tool to increase visiting nurses' competency of costing and enhance efficiencies of visiting nursing centers.
Costs and Cost Analysis ; Focus Groups ; Internet ; Life Cycle Stages ; Methods ; Nurses, Community Health ; Nursing

PURPOSE: It is extremely difficult to apply the model learned in basic education for public health nurses (PHNs) to conduct community health assessments. The purpose of this study was to clarify the process by which community health needs can be structured through PHNs' daily practice.METHODS: Semistructured interviews were conducted in 29 PHNs, and continuous comparative analysis using a qualitative study was performed with a modified grounded theory approach.RESULTS: The participants “used their five senses to understand the relationship between the health and life of people” and “considered those who do not attend” by “learning from stakeholders.” To verify such subjective feelings sourced from vague phenomena within the communities, subjective phenomena were converted into qualitative data.CONCLUSION: The application of the findings to organizational continuous education systems may not only help appropriately improve community health assessment methods but can also help improve the evaluation of daily practice and contribute to professional human-resource development.
Community Health Nursing ; Education ; Grounded Theory ; Nurses, Public Health ; Public Health Nursing ; Public Health

PURPOSE: This study was done to identify and prioritize educational needs for suicide prevention competencies among 212 visiting nurses from 33 public health centers. METHODS: Data were collected from August to October 2017 through self-administered questionnaires consisting of measures of suicide prevention competencies. Data were analyzed using descriptive statistics, paired t-test, and Borich's needs assessment model to determine the priority of educational needs. RESULTS: Visiting nurses reported that enhancing skills in suicide prevention were more significant than improving knowledge. The highest priority need was “utilizing counseling skills.” In addition, other educational needs were prioritized as followed by; “a strategic planning approach to suicide prevention”, “applying therapeutic communication”, “showing empathy”, and “using resources in the community.” CONCLUSION: The findings suggest that developing intervention programs to enhance counseling and strategic planning skills are needed to improve suicide prevention competencies among visiting nurses.
Counseling ; Educational Measurement ; Home Health Nursing ; Needs Assessment ; Nurses, Community Health ; Primary Prevention ; Public Health ; Suicide

Frailty is a distinct clinical syndrome wherein the individual has low reserves and is highly vulnerable to internal and external stressors. Although it is associated with disability and multiple comorbidities, it can also be present in individuals who seem healthy. Frailty is multidimensional and its pathophysiology is complex. Early identification and intervention can potentially decrease or reverse frailty, especially in the early stages. Primary care physicians, community nurses and community social networks have important roles in the identification of pre-frail and frail elderly through the use of simple frailty screening tools and rapid geriatric assessments. Appropriate interventions that can be initiated in a primary care setting include a targeted medical review for reversible medical causes of frailty, medication appropriateness, nutritional advice and exercise prescription. With ongoing training and education, the multidisciplinary engagement and coordination of care of the elderly in the community can help to build resilience and combat frailty in our rapidly ageing society.
Aged ; Aging ; Community Health Services ; Frail Elderly ; Frailty ; Geriatric Assessment ; methods ; Geriatrics ; methods ; Humans ; Nurses ; Nursing ; Primary Health Care ; methods ; Social Support

PURPOSE: Low muscle strength is central to geriatric physical disabilities and mortality. The purpose of the present study was to examine handgrip strength (HGS) and its associated factors among community-dwelling older people in Sri Lanka. METHODS: A cross-sectional study was conducted in the Kandy district using multistage sampling. A total of 999 older people were recruited, with a female preponderance. Data were collected using interviewer-administered questionnaires on demographic characteristics, depression, and physical activity. Anthropometric measurements including weight, height, mid-upper arm circumference, calf circumference, and HGS were recorded. Complex sample general linear model was used to examine the association between HGS and its associated factors. RESULTS: The mean highest HGS of the study group was 12.56 kg (95% confidence interval: 11.94–13.19). Male older people had a higher HGS (17.02, 95% confidence interval: 15.55–18.49 kg) than females (10.59, 95% confidence interval: 10.12–11.06 kg). For both men and women, older age was associated with lower HGS, while mid-upper arm circumference was associated with better HGS. Diabetes mellitus, vegetarian diet, and alcohol consumption were associated with HGS for women only. CONCLUSION: Men had a higher HGS compared with women. Age, mid-upper arm circumference, diabetes mellitus, vegetarian diet, and alcohol consumption were factors associated with HGS among community-dwelling older people in Kandy district, Sri Lanka. HGS can be used as a feasible strategy to improve health status of older people by community health nurses.
Aged* ; Alcohol Drinking ; Arm ; Cross-Sectional Studies* ; Depression ; Diabetes Mellitus ; Diet, Vegetarian ; Female ; Hand Strength ; Humans ; Independent Living ; Linear Models ; Male ; Mortality ; Motor Activity ; Muscle Strength ; Nurses, Community Health ; Sri Lanka*

PURPOSE: Competency is a key foundation of the nursing education curriculum and a baseline element of nursing practice. The purpose of this study was to explore the competencies of community health nurses in a maternal early childhood sustained home-visiting program based on nurses' field experiences. METHODS: The participants were 21 nurses who had more than 1 year of experience in this program. Reflective interviews were performed; lasting 1 hour per nurse, on August 18, 2016, and the collected data were analyzed using qualitative directed content analysis. RESULTS: Twenty-four themes were extracted for 9 competencies. The major themes included implementing a long-term relationship-based approach, providing client-led service rather than expert-led service, helping mothers with psychosocial difficulties, and applying skills in a practical manner in the home environment. CONCLUSION: In order to develop a home-visiting program as part of maternal-early childhood nursing practice, nurses should develop competencies that help them make significant and positive interventions. Results indicate that the curriculum for community health nurses should be changed to improve competencies in building relationships with clients and to focus on the application of skills in specific cases and in clinical practice.
Competency-Based Education ; Curriculum ; Education, Nursing ; Humans ; Mothers ; Nurses, Community Health ; Nursing ; Qualitative Research

PURPOSE: This study attempts to examine the extent to which competencies were identified in a Korean community nursing practice based on the 11 core competencies required by US health nurses. METHODS: This was a descriptive research study, and the subjects of this study were 11 students who were in a four-year nursing course. Data were collected by means of a questionnaire from October 19 to November 22, 2016. RESULTS: Core competencies in total were practiced in 60.0% to 98.5% of schools in Korea. Among these, competencies corresponding to the practice level of ‘high’ were identified as ‘communicating effectively with community nursing subjects and colleagues, and accepting various personal characteristics without criticism or prejudice’. On the other hand, competencies corresponding to the practice level of ‘low’ were identified as ‘to comply with social justice, public good, public health principles, and leadership in a community nursing practice’. CONCLUSION: This study can be used as a resource to categorize the competence of nursing students expected in the field of community nursing. Based on a careful review of core competencies with low practice, it is necessary to seek specific practical strategies to strengthen these competencies in the future.
Community Health Nursing* ; Hand ; Humans ; Korea ; Leadership ; Mental Competency ; Nurses, Public Health* ; Nursing ; Public Health Nursing ; Public Health* ; Social Justice ; Students, Nursing