Indirect Effects of Municipal Public Health Nurse Workforce on Cancer Standardized Mortality Ratios Mediated by Cancer Screening Rates.

IF 1.7 4区医学 Q2 NURSING

Public Health Nursing Pub Date : 2025-01-01 Epub Date: 2024-10-16 DOI:10.1111/phn.13451

Shimpei Kodama, Rika Hinokuma

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引用次数: 0

Abstract

Objective: This study examined the indirect effects of the number of Japanese municipal public health nurses (PHNs) on cancer standardized mortality ratios (SMRs), using cancer screening and diagnostic follow-up rates as mediators.

Design: Ecological study using municipalities as the unit of analysis MEASUREMENTS: Aggregate, municipal-level government data were analyzed using a linear model with empirical Bayes estimates of SMRs (EBSMRs) for gastric, colorectal, and lung cancers as the dependent variables, and the number of PHNs, cancer screening rate, diagnostic follow-up rate, and adjustment variables as independent variables. Structural equation modeling (SEM) was used to examine the indirect effects of PHNs.

Results: Cancer screening rates were significantly negatively associated with EBSMR, except for gastric cancer in women. No significant association was observed between the EBSMR and diagnostic follow-up rates. SEM revealed a significant indirect effect of the number of PHNs, most of which was due to the cancer screening rate.

Conclusions: From a population-based public health perspective, increasing the number of PHNs and focusing on improving cancer screening rates may effectively reduce cancer SMRs.

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以癌症筛查率为中介的城市公共卫生护士队伍对癌症标准化死亡率的间接影响。

目的：本研究以癌症筛查和诊断随访率为中介，考察了日本市级公共卫生护士（PHNs）数量对癌症标准化死亡率（SMRs）的间接影响：设计：以市镇为分析单位的生态研究测量：市镇一级的汇总数据：以胃癌、结直肠癌和肺癌的 SMRs 经验贝叶斯估计值（EBSMRs）为因变量，以公共卫生网点数量、癌症筛查率、诊断随访率和调整变量为自变量，采用线性模型对市级政府的汇总数据进行分析。结构方程模型（SEM）用于检验PHNs的间接效应：结果：癌症筛查率与 EBSMR 呈明显负相关，女性胃癌除外。在 EBSMR 与诊断随访率之间没有观察到明显的关联。SEM 显示，PHN 的数量有明显的间接影响，其中大部分是由癌症筛查率引起的：从基于人口的公共卫生角度来看，增加公共卫生网点数量并重点提高癌症筛查率可有效降低癌症 SMR。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Public Health Nursing 医学-公共卫生、环境卫生与职业卫生

CiteScore

3.50

自引率

4.80%

发文量

117

审稿时长

6-12 weeks

期刊介绍： Public Health Nursing publishes empirical research reports, program evaluations, and case reports focused on populations at risk across the lifespan. The journal also prints articles related to developments in practice, education of public health nurses, theory development, methodological innovations, legal, ethical, and public policy issues in public health, and the history of public health nursing throughout the world. While the primary readership of the Journal is North American, the journal is expanding its mission to address global public health concerns of interest to nurses.