Research article Topical Sections

Difficulties and distress experienced by Japanese public health nurses specializing in quarantine services when dealing with COVID-19: A qualitative study in peri-urban municipality

  • Received: 04 January 2023 Revised: 24 March 2023 Accepted: 30 March 2023 Published: 14 April 2023
  • Public health nurses (PHNs) are among the few municipal civil servants who lead community infection control and prevention initiatives in Japanese public health centers (PHCs). This study aims to investigate the distress faced by PHNs and clarify their difficulties and working environment relative to infection prevention control activities during the COVID-19 pandemic. We adopted a qualitative description methodology in this study of 12 PHNs who were involved in COVID-19 prevention and control in PHCs in Prefecture A. The distress during the early phase of the pandemic was due to the uncertainty of the SARS-CoV-2 related disease, which caused panic in medical institutions and among residents. PHNs were overwhelmed, distressed and exhausted by their inability to control the ‘pandemic’, lack of patient cooperation for prevention control and the unsustainable organizational environment. They were also distressed because they were one of the specialized personnel responsible for saving residents' lives with limited medical resources and while having identity crises due to an inability to carry out the PHN's role of controlling infection in the community. For future crises, rapid, drastic innovation defying conventional organizational systems is critical to reform sustainable organizations so that they play an effective role in the community. Innovation in crisis communication and strengthening the medical system will help achieve a resilient community in a health crisis.

    Citation: Akari Miyazaki, Naoko Kumada Deguchi, Tomoko Omiya. Difficulties and distress experienced by Japanese public health nurses specializing in quarantine services when dealing with COVID-19: A qualitative study in peri-urban municipality[J]. AIMS Public Health, 2023, 10(2): 235-251. doi: 10.3934/publichealth.2023018

    Related Papers:

  • Public health nurses (PHNs) are among the few municipal civil servants who lead community infection control and prevention initiatives in Japanese public health centers (PHCs). This study aims to investigate the distress faced by PHNs and clarify their difficulties and working environment relative to infection prevention control activities during the COVID-19 pandemic. We adopted a qualitative description methodology in this study of 12 PHNs who were involved in COVID-19 prevention and control in PHCs in Prefecture A. The distress during the early phase of the pandemic was due to the uncertainty of the SARS-CoV-2 related disease, which caused panic in medical institutions and among residents. PHNs were overwhelmed, distressed and exhausted by their inability to control the ‘pandemic’, lack of patient cooperation for prevention control and the unsustainable organizational environment. They were also distressed because they were one of the specialized personnel responsible for saving residents' lives with limited medical resources and while having identity crises due to an inability to carry out the PHN's role of controlling infection in the community. For future crises, rapid, drastic innovation defying conventional organizational systems is critical to reform sustainable organizations so that they play an effective role in the community. Innovation in crisis communication and strengthening the medical system will help achieve a resilient community in a health crisis.


    Abbreviations

    PHN

    Public Health Nurse

    PHC

    Public Health Center

    CDC

    Center for Disease Control and Prevention

    COVID-19

    Coronavirus Disease 2019

    SARS

    Severe Acute Respiratory Syndrome

    加载中

    Acknowledgments



    The authors would like to acknowledge all survey participants and public health experts in the PHCs for their support. This study was supported by the Gushinkai Grant and the Sasakawa Scientific Research Grant from The Japan Science Society (2022–1031). We would like to thank Editage (www.editage.com) for English language editing.

    Conflict of interest



    All authors declare no conflict of interest regarding the publication of this paper.

    [1] WHOWHO coronavirus (COVID-19) dashboard (2022). Available from: https://covid19.who.int/.
    [2] Ministry of Health, Labor and Welfare.Health crisis management in the community-guidelines for community health crisis management. Japan Ministry of Health, Labor and Welfare (2002) . Available from: https://www.mhlw.go.jp/general/seido/kousei/kenkou/guideline/index.html.
    [3] National Association of Public Health Center Directors.Changes in the number of public health centers. Japan National Association of Public Health Center Directors (2021) . Available from http://www.phcd.jp/03/HCsuii/index.html.
    [4] Ogata T (2021) COVID-19 up-to-date, role and challenges of public health center in response to COVID-19. Modern Media 67: 48-54.
    [5] Osumi M (2021) Rise in COVID-19 cases across Japan takes toll on public health centers. The Japan Times . Available from: https://www.japantimes.co.jp/news/2021/08/04/national/public-health-centers-strain/.
    [6] Kyodo.20% of Japan's public health center staff overworked with COVID-19 duties. The Japan times (2022) . Available from: https://www.japantimes.co.jp/news/2022/02/18/national/covid-overwork-health-services/.
    [7] Ide K, Asami T, Suda A, et al. (2021) The psychological effects of COVID-19 on hospital workers at the beginning of the outbreak with a large disease cluster on the Diamond Princess cruise ship. PLoS One 16: e0245294. https://doi.org/10.1371/journal.pone.0245294
    [8] Lai J, Ma S, Wang Y, et al. (2020) Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Netw Open 3: e203976. https://doi.org/10.1001/jamanetworkopen.2020.3976
    [9] Sasaki N, Kuroda R, Tsuno K, et al. (2020) The deterioration of mental health among healthcare workers during the COVID-19 outbreak: A population-based cohort study of workers in Japan. Scand J Work Environ Health 46: 639-644. https://doi.org/10.5271/sjweh.3922
    [10] Stone KW, Kintziger KW, Jagger MA, et al. (2021) Public health workforce burnout in the COVID-19 response in the U.S.. Int J Environ Res Public Health 18: 4369. https://doi.org/10.3390/ijerph18084369
    [11] Du Z, You H, Zhou H, et al. (2021) Difficulties encountered by public health workers in COVID-19 outbreak: a cross-sectional study based on five provinces. BMC Health Serv Res 21: 656. https://doi.org/10.1186/s12913-021-06699-4
    [12] Yamada H, Kusumi M, Yoshida H, et al. (2013) The research on the mental health and body health condition toward public health nurses working for the victims of east Japan great earthquake. Jpn Soc Health Sci Mind Body 9: 26-36.
    [13] Ushio Y, Osawa T, Shimizu M (2012) The psychological influence of a disaster experience on municipal staff; interviews with public health nurses sixteen months after a flood disaster. UH CNAS, RINCPC Bulletin 19: 41-53.
    [14] Usukura H, Seto M, Kunii Y, et al. (2021) The mental health problems of public health center staff during the COVID-19 pandemic in Japan. Asian J Psychiatr 61: 102676. https://doi.org/10.1016/j.ajp.2021.102676
    [15] Nishimura Y, Miyoshi T, Hagiya H, et al. (2022) Prevalence of psychological distress on public health officials amid COVID-19 pandemic. Asian J Psychiatr 73: 103160. https://doi.org/10.1016/j.ajp.2022.103160
    [16] Sandelowski M (2000) Whatever happened to qualitative description?. Res Nurs Health 23: 334-340. https://doi.org/10.1002/1098-240X(200008)23:4<334::AID-NUR9>3.0.CO;2-G
    [17] Neergaard MA, Olesen F, Andersen RS, et al. (2009) Qualitative description-the poor cousin of health research?. BMC Med Res Methodol 9: 52. https://doi.org/10.1186/1471-2288-9-52
    [18] Spencer RA, Joshi N, Branje K, et al. (2021) Early childhood educator perceptions of risky play in an outdoor loose parts intervention. AIMS Public Health 8: 213-228. https://doi.org/10.3934/publichealth.2021017
    [19] Knott A, Kee CC (2005) Nurses' beliefs about family presence during resuscitation. Appl Nurs Res 18: 192-198. https://doi.org/10.1016/j.apnr.2005.07.002
    [20] Krippendorff K (2004) Content Analysis: An Introduction to Its Methodology. CA: SAGE Publications 18.
    [21] Graneheim UH, Lindgren B, Lundman B (2017) Methodological challenges in qualitative content analysis: A discussion paper. Nurse Educ Today 56: 29-34. https://doi.org/10.1016/j.nedt.2017.06.002
    [22] Graneheim UH, Lundman B (2004) Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Educ Today 24: 105-112. https://doi.org/10.1016/j.nedt.2003.10.001
    [23] Lincoln YS, Guba EG (1985) Naturalistic inquiry. Newbury Park, CA: Sage Publications 294-301.
    [24] Guba EG, Lincoln YS (1989) Fourth Generation Evaluation. Newbury Park, CA: Sage Publications 245-251.
    [25] Goularte JF, Serafim SD, Colombo R, et al. (2021) COVID-19 and mental health in Brazil: psychiatric symptoms in the general population. J Psychiatr Res 132: 32-37. https://doi.org/10.1016/j.jpsychires.2020.09.021
    [26] Maggi G, Baldassarre I, Barbaro A, et al. (2021) Mental health status of Italian elderly subjects during and after quarantine for the COVID-19 pandemic: a cross-sectional and longitudinal study. Psychogeriatrics 21: 540-551. https://doi.org/10.1111/psyg.12703
    [27] Midorikawa H, Aiba M, Lebowitz A, et al. (2021) Confirming validity of the fear of COVID-19 Scale in Japanese with a nationwide large-scale sample. PloS One 16: e0246840. https://doi.org/10.1371/journal.pone.0246840
    [28] Intage.Media contact behavior change during COVID-19 pandemic, Capturing the changes after GW week and after lifting of the state of emergency declaration. Japan Intage (2020) . Available from: https://www.intage.co.jp/covid-19-itgreports/#anc_02.
    [29] Ratzan SC, Sommariva S, Rauh L (2020) Enhancing global health communication during a crisis: lessons from the COVID-19 pandemic. Public health Res Pract 30: 3022010. https://doi.org/10.17061/phrp3022010
    [30] Tatara K, Takatorige T, Kondo T Promoting health crisis management in the community: toward specific counter-terrorism measures, Shinkikaku Shuppan (2002).
    [31] Kasperson RE, Renn O, Slovic P, et al. (1988) The social amplification of risk: A conceptual framework. Risk Analysis 8: 177-187. https://doi.org/10.1111/j.1539-6924.1988.tb01168.x
    [32] Sell TK, Boddie C, McGinty EE, et al. (2017) Media messages and perception of risk for Ebola virus infection, United States. Emerg Infect Dis 23: 108-111. https://doi.org/10.3201/eid2301.160589
    [33] Ministry of International Affairs and Communications.WHITE PAPER Information and Communications in Japan. Japan Ministry of International Affairs and Communications (2021) . Available from: https://www.soumu.go.jp/johotsusintokei/whitepaper/eng/WP2021/2021-index.html.
    [34] Eurostat.Individuals using the internet for seeking health-related information. European Union Eurostat (2022) . Available from: https://ec.europa.eu/eurostat/databrowser/view/tin00101/default/line?lang=en.
    [35] Sell TK, Hosangadi D, Trotochaud M (2020) Misinformation and the US Ebola communication crisis: analyzing the veracity and content of social media messages related to a fear-inducing infectious disease outbreak. BMC Public Health 20: 550. https://doi.org/10.1186/s12889-020-08697-3
    [36] Suzuki Y, Fukasawa M, Obara A, et al. (2014) Mental health distress and related factors among prefectural public servants seven months after the great east Japan earthquake. J Epidemiol 24: 287-294. https://doi.org/10.2188/jea.je20130138
    [37] Suzuki Y, Fukasawa M, Obara A, et al. (2017) Burnout among public servants after the Great East Japan Earthquake: decomposing the construct aftermath of disaster. J Occup Health 59: 156-164. https://doi.org/10.1539/joh.16-0263-OA
    [38] Kayama M, Akiyama T, Ohashi A, et al. (2014) Experiences of municipal public health nurses following Japan's earthquake, tsunami, and nuclear disaster. Public Health Nurs 31: 517-525. https://doi.org/10.1111/phn.12140
    [39] Saeki K (2022) What is the power of continuing to work as a public health nurse? What it means to work as a public health nurse in a changing business and society. Jpn J Public Health Nurs 78: 12-17. https://doi.org/10.11477/mf.1664201793
    [40] Uozaki H (2010) Crisis Communications for Confidence and Safety. J Jpn Soc for Safety Eng 49: 78-86. https://doi.org/10.18943/safety.49.2_78
    [41] Su Z, Zhang H, McDonnell D, et al. (2022) Crisis communication strategies for health officials. Front Public Health 10: 796572. https://doi.org/10.3389/fpubh.2022.796572
    [42] Murai F, Yasuda T (2016) The current situation regarding support provided by public health center nurses in response to infectious disease: outbreaks at facilities for the elderly. Bulletin Nagano College of Nursing 18: 1-14.
    [43] Tsuboi R, Iida M, Osawa M, et al. (2013) Dilemmas of municipal public health nurses in the welfare sector who provide individual support to psychiatric patients: elements of dilemmas and their relationships. J Jpn Acad Community Health Nurs 15: 32-40. https://doi.org/10.20746/jachn.15.3_32
    [44] Tomioka K, Shima M, Saeki K (2022) Number of public health nurses and COVID-19 incidence rate by variant type: an ecological study of 47 prefectures in Japan. Environ Health Prev Med 27: 18. https://doi.org/10.1265/ehpm.22-00013
    [45] Almohammed OA, Aldwihi LA, Alragas AM, et al. (2021) Knowledge, attitude, and practices associated with COVID-19 among healthcare workers in hospitals: a cross-sectional study in Saudi Arabia. Front Public Health 9: 643053. https://doi.org/10.3389/fpubh.2021.643053
    [46] Tanaka K, Yamada Y, Fukuda K, et al. (2014) An experience report in the transport hub for the region in the acceptance of the great east Japan earthquake. Jpn J Disaster Med 19: 175-181.
    [47] Lamiani G, Biscardi D, Meyer EC, et al. (2021) Moral distress trajectories of physicians 1 year after the COVID-19 outbreak: a grounded theory study. Int J Environ Res Public Health 18: 13367. https://doi.org/10.3390/ijerph182413367
    [48] Holmström I, Höglund AT (2007) The faceless encounter: ethical dilemmas in telephone nursing. J Clin Nurs 16: 1865-1871. https://doi.org/10.1111/j.1365-2702.2007.01839.x
    [49] Holmström IK, Kaminsky E, Lindberg Y, et al. (2021) The perspectives of Swedish registered nurses about managing difficult calls to emergency medical dispatch centres: a qualitative descriptive study. BMC Nurs 20: 150. https://doi.org/10.1186/s12912-021-00657-5
    [50] Saeki K (2012) Considering the “sense of mission” of public health nurses: the soul of public health nurses today. Jpn J Community Health Care 43: 44-47.
    [51] Shoji H, Ueno M, Okawa S (2018) Factors influencing the formation of professional identity from municipal health nurse's experience process-narrative of experienced public health nurse's experience. Bull Fac Nurs Kobe Women's Univ 3: 55-64.
  • Reader Comments
  • © 2023 the Author(s), licensee AIMS Press. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0)
通讯作者: 陈斌, bchen63@163.com
  • 1. 

    沈阳化工大学材料科学与工程学院 沈阳 110142

  1. 本站搜索
  2. 百度学术搜索
  3. 万方数据库搜索
  4. CNKI搜索

Metrics

Article views(1588) PDF downloads(122) Cited by(0)

Article outline

Figures and Tables

Figures(1)  /  Tables(1)

Other Articles By Authors

/

DownLoad:  Full-Size Img  PowerPoint
Return
Return

Catalog