{"title":"Association Between Diabetes Knowledge and Self-Management Among Portuguese Americans With Type 2 Diabetes.","authors":"Peeranuch LeSeure, Elizabeth Chin","doi":"10.1111/phn.13571","DOIUrl":"https://doi.org/10.1111/phn.13571","url":null,"abstract":"<p><strong>Objectives: </strong>This study examined the relationship between diabetes knowledge and self-management among Portuguese Americans with type 2 diabetes.</p><p><strong>Method: </strong>This study included 500 Portuguese Americans with type 2 diabetes using a cross-sectional design with convenience and snowball sampling. Data were collected via an electronic survey comprising sociodemographic information, the Michigan Diabetes Knowledge Test (DMKT), and the Diabetes Self-Management Questionnaire (DSMQ).</p><p><strong>Results: </strong>The participants' mean age was 33.5. They were predominantly male (55.6%). The average disease duration was 3.98 years. Despite nearly half of the participants holding bachelor's degrees (48.2%), the mean diabetes knowledge score was moderate at 4.92 (SD ± 1.20) on a 0-10 scale, with self-management averaging 5.86 (SD ± 1.56). Age showed negative correlations with diabetes knowledge and self-management (r = -0.100, p < 0.05, r = -0.125, p < 0.01, respectively). Diabetes knowledge was positively correlated with employment and self-management (r = 0.096, r = 0.284, p < 0.01). Self-management demonstrated positive correlations with education (r = 0.154, p < 0.01), employment (r = 0.192, p < 0.01), years of residence in the United States (r = 0.111, p < 0.05, diabetes duration (r = 0.176, p < 0.01), and HbA1C levels (r = 0.201, p < 0.05).</p><p><strong>Conclusion: </strong>These findings suggest that factors, such as educational attainment, employment status, and lived experiences (including longer duration with diabetes and living in the United States), may influence diabetes knowledge, self-management, or both. Notably, the results emphasize that healthcare providers should recognize, when developing patient education plans, that a higher level of education does not necessarily correlate with knowledge of specific health conditions such as diabetes. Future research should explore culturally and contextually appropriate strategies, such as Portuguese-language educational materials and self-management programs, to enhance diabetes-related knowledge and self-care among Portuguese Americans.</p>","PeriodicalId":54533,"journal":{"name":"Public Health Nursing","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Climate Change Awareness: Does It Affect the Fertility Desire?","authors":"Özge Topsakal, Esra Çevik","doi":"10.1111/phn.13568","DOIUrl":"https://doi.org/10.1111/phn.13568","url":null,"abstract":"<p><strong>Aim: </strong>The primary aim of the study was to explore the impact of women's climate change awareness on fertility desire, while the secondary aim was to explore the factors influencing women's fertility desire.</p><p><strong>Material and methods: </strong>The study was performed descriptive and correlational type with 440 women without children between March and October 2023. The women's characteristics form and Fertility Desire Scale and Climate Change Awareness Scale were used for data collection.</p><p><strong>Results: </strong>The mean age of the women was 26.2 ± 4 years, with 55.2% aged 26 or younger; 54.3% held university degrees, and 93% had health insurance. Findings indicate a significant mean total score of 50.7 ± 7.6 on the Fertility Desire Scale, influenced by education, health insurance, income level, marital duration, and type of marriage. Women with higher education levels and those in couple-initiated marriages reported lower fertility desire. The Climate Change Awareness Scale showed a mean score of 210.8 ± 23.2, with higher awareness among those over 26, employed, and with higher education. Multiple linear regression analysis revealed significant predictors of fertility desire, including marital duration and income level. Notably, climate change awareness negatively correlated with fertility desire, explaining 3.1% of the variance.</p><p><strong>Conclusions: </strong>These findings highlight the complex interplay between environmental concerns and reproductive intentions among women, indicating a need for further research in this area.</p>","PeriodicalId":54533,"journal":{"name":"Public Health Nursing","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Effect of Health Literacy on Attitudes Toward Cancer Screening Among Individuals Aged 30-70.","authors":"Merve Tozlu, Fatih Okan","doi":"10.1111/phn.13567","DOIUrl":"https://doi.org/10.1111/phn.13567","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to examine the variables affecting the health literacy level and attitude towards cancer screening in individuals between the ages of 30 and 70 and to determine the effect of health literacy level on the attitude towards cancer screening.</p><p><strong>Methods: </strong>A cross-sectional study was conducted with a sample of 800 participants. Data were collected through self-reporting using the Personal Characteristics Information Form, the Turkish Health Literacy Scale, and the Attitude Scale for Cancer Screening.</p><p><strong>Results: </strong>The study revealed that scores on the Attitude Scale for Cancer Screening varied significantly based on age, educational level, income status, presence of health insurance, history of cancer screening (p < 0.001), confirmed cancer diagnosis, gender (p = 0.001), and presence of chronic illness (p = 0.005). Similarly, Turkish Health Literacy Scale scores differed significantly according to age, marital status, place of residence, educational level, income, chronic illness status (p < 0.001), and gender (p = 0.002). Furthermore, the Turkish Health Literacy Scale score was identified as a significant predictor of the Attitude Scale for Cancer Screening score. (β = 0.423, p < 0.05).</p><p><strong>Conclusion: </strong>Higher health literacy was associated with a positive attitude towards cancer screening. Nurses can contribute to the development of a positive attitude towards cancer screening in society through counseling and training initiatives to increase health literacy.</p>","PeriodicalId":54533,"journal":{"name":"Public Health Nursing","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
José Antonio Cernuda Martínez, Rick Kye Gan, Pedro Arcos González
{"title":"Disaster Preparedness Evaluation Tool: Adaptation and Psychometric Evaluation of the Spanish Version.","authors":"José Antonio Cernuda Martínez, Rick Kye Gan, Pedro Arcos González","doi":"10.1111/phn.13566","DOIUrl":"https://doi.org/10.1111/phn.13566","url":null,"abstract":"<p><strong>Background: </strong>A standardized tool, the Disaster Preparedness Evaluation Tool (DPET), originally published in English, is available for the purpose of assessing the level of disaster preparedness among nurses, however, a Spanish version is yet to be developed. The purpose of this study was twofold: first, to prepare a Spanish version of the DPET (DPET-SP), and secondly, to analyse the psychometric properties of the new Spanish version.</p><p><strong>Methods: </strong>The target population comprised nurses in the region of Asturias, Spain. Cronbach's alpha (internal consistency) and item-total correlations (item discrimination) were used to test the reliability of the tool. Construct validity was tested using confirmatory factor analysis. The content validity of the Spanish version was estimated using the scale-level content validity index. The appropriateness of the factor analysis was tested using the Kaiser-Meyer-Ollin test. Sphericity of the correlation matrix was examined using Barlett's test. Principal component analysis (PCA) was utilized to categorise the measurement instrument into salient factors. Convergent validity was assessed using Average Variance Extracted (AVE).</p><p><strong>Results: </strong>The PCA determined that the 45 items could be grouped into five factors Cronbach's alpha value was 0.964, the AVE values for the five constructs ranged from 0.51 to 0.71, the goodness-of-fit of the model structure was good, the convergence reliability values ranged from 0.80 to 0.95 and the square root of the AVE of each individual factor must be greater than all other correlations between pairs of constructs, so there is divergent validity.</p><p><strong>Conclusions: </strong>The DPET-SP has adequate validity and reliability. Therefore, it can be utilised by nurses for whom Spanish is their first language.</p>","PeriodicalId":54533,"journal":{"name":"Public Health Nursing","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Public Health NursingPub Date : 2025-05-01Epub Date: 2025-01-17DOI: 10.1111/phn.13536
Merve Çolak, Rıdvan Dogan, Selma Dogan
{"title":"Effect of Climate Change and Health Course on Global Warming Knowledge and Attitudes, Environmental Literacy, and Eco-Anxiety Level of Nursing Students: A Quasi-Experimental Study.","authors":"Merve Çolak, Rıdvan Dogan, Selma Dogan","doi":"10.1111/phn.13536","DOIUrl":"10.1111/phn.13536","url":null,"abstract":"<p><strong>Background: </strong>Climate change is the most important problem that threatens the health of individuals, public health, and health systems on a global scale. The International Council of Nurses emphasizes that nurses should strive to reduce the effects of climate change and help individuals and systems adapt. In addition, it is stated that climate change should be integrated into nursing education curricula and nursing students, who are future healthcare providers, should be prepared to reduce the effects of climate change and promote a healthier environment.</p><p><strong>Aim: </strong>The aim of this study is to examine the effect of the Climate Change and Health course on global warming knowledge and attitude, environmental literacy, and eco-anxiety levels in nursing students.</p><p><strong>Design and methods: </strong>In this study, a pretest-posttest comparative quasi-experimental design type was used. The research was conducted with 117 students taking the \"Climate Change and Health\" course added to the curriculum at the Nursing Department of a private university in Istanbul between February 2023 and June 2023. Data were collected before and after the intervention using the Descriptive Characteristics Form, Global Warming Knowledge Questionnaire, Global Warming Attitude Scale, Environmental Literacy Scale for Adults, and Eco-Anxiety Scale.</p><p><strong>Results: </strong>After taking the Climate Change and Health course, nursing students' global warming knowledge and attitude total scores increased, and a statistically significant increase was detected in the eco anxiety total and behavioral symptoms subscale mean scores. There was no statistically significant change in the Environmental Literacy Scale total and subscale mean scores.</p><p><strong>Conclusions: </strong>It can be stated that the Climate Change and Health course positively improved nursing students' knowledge and attitudes toward global warming and increased their sensitivity about climate change. Nurses, who constitute the most important part of the healthcare workforce worldwide, have an important role in creating a healthy and safe environment and in combating the effects of global warming and climate change. For this reason, in order to train knowledgeable and equipped health professionals on this subject, it is recommended that courses on the effects of climate change, adaptation, and coping with it be added to the nursing curriculum and integrated into all subjects every year to ensure continuity.</p>","PeriodicalId":54533,"journal":{"name":"Public Health Nursing","volume":" ","pages":"1315-1324"},"PeriodicalIF":1.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12001001/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Public Health NursingPub Date : 2025-05-01Epub Date: 2025-01-07DOI: 10.1111/phn.13521
Dipali Dumbre, Sheela Upendra, Betsy Sara Zacharias
{"title":"Unraveling the Relationship Between Vitamin D and Noncommunicable Diseases: A Systemic Review and Meta-Analysis.","authors":"Dipali Dumbre, Sheela Upendra, Betsy Sara Zacharias","doi":"10.1111/phn.13521","DOIUrl":"10.1111/phn.13521","url":null,"abstract":"<p><strong>Background: </strong>Subclinical vitamin D insufficiency is frequent in both developing and developed countries. Even after rickets was eliminated in the 1930s by fortifying milk, up to 1 billion people worldwide suffer from subclinical vitamin D deficiency (VDD). Numerous noncommunicable diseases (NCDs), including depression, autoimmune illnesses, diabetes, osteoporosis, and cardiovascular disease, are linked to this deficiency.</p><p><strong>Methodology: </strong>The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol was applied when conducting a systematic review. Relevant studies published between 2010 and 2023 were found by searching databases such as Web of Science, Scopus, and PubMed. To find correlations between deficiency of vitamin D and NCDs, data was extracted from the studies and analyzed using the Mixed Method Appraisal Tools (MMAT). In meta-analysis data combined from multiple observational Unraveling the Relationship Between Vitamin D and Noncommunicable Diseases-A Systemic Review and Meta-Analysis studies to evaluate the relationship between vitamin D insufficiency and health outcomes. Statistical techniques, such as calculating effect sizes and constructing confidence ranges, are employed to determine combined outcomes and investigate possible causal connections.</p><p><strong>Results: </strong>Fourteen studies-including cross-sectional studies, prospective cohorts, randomized controlled trials, and longitudinal studies-met the inclusion criteria. Significant correlations among deficiency of vitamin D and a number of NCDs, including anemia, diabetes, hypertension, rheumatoid arthritis (RA), mental health issues, and autoimmune hypothyroidism, were found in the review. The results highlight the prevalence of deficiency of vitamin D worldwide and its detrimental impact on health. In order to lower the risk of numerous NCDs, this review emphasizes the need for greater awareness and possible interventions to maintain appropriate vitamin D levels. A meta-analysis was conducted to investigate the potential causal connections between vitamin D insufficiency and different health disorders. It elucidates the connections between deficient levels of vitamin D and conditions such as mental health disorders, anemia, diabetes, hypertension, and autoimmune diseases. The study prioritizes the examination of temporal correlations, biological plausibility, and the removal of confounding factors to provide support for these associations. While the text acknowledges that experimental data, such as randomized controlled trials, would enhance the argument for causation, it mostly depends on observational studies.</p>","PeriodicalId":54533,"journal":{"name":"Public Health Nursing","volume":" ","pages":"1302-1314"},"PeriodicalIF":1.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Public Health NursingPub Date : 2025-05-01Epub Date: 2025-02-19DOI: 10.1111/phn.13541
Soyean Kang, Hae Sagong, Juyoung Lee
{"title":"Impact of Dietary Habits, Physical Activity, and Perceived Health Status on Health-Related Quality of Life by Household Characteristics of Patients With Chronic Diseases: The Korea Community Health Survey (KCHS).","authors":"Soyean Kang, Hae Sagong, Juyoung Lee","doi":"10.1111/phn.13541","DOIUrl":"10.1111/phn.13541","url":null,"abstract":"<p><strong>Background: </strong>Modern societies are seeing a steady rise in individuals living alone. This study examines the impact of dietary habits, physical activity, and perceived health status on the health-related quality of life (QoL) of adults aged 40 and older with chronic diseases, comparing living-alone households to multi-person households.</p><p><strong>Methods: </strong>Data from the 2022 Korean Community Health Survey, including 65,861 respondents, were analyzed. The analysis utilized the Rao-Scott χ<sup>2</sup> test, independent t-test, and multiple logistic regression with a complex sample design to assess differences in variables affecting QoL by household type.</p><p><strong>Results: </strong>Individuals living alone were more likely to be female, older, less educated, economically inactive, divorced or separated, and have lower household incomes compared to those in multi-person households. Physical activity, perceived health status, and QoL were higher in multi-person households. Although all variables influenced QoL in multi-person households, nutritional labeling awareness and frequency of physical activity showed no significant association with QoL in living-alone households.</p><p><strong>Conclusion: </strong>Living-alone households with chronic diseases face notable demographic disparities. Additional research is needed to understand why nutritional labeling awareness and physical activity frequency do not significantly affect QoL in this group. The influence of mental health warrants further investigation to guide targeted interventions.</p>","PeriodicalId":54533,"journal":{"name":"Public Health Nursing","volume":" ","pages":"1182-1191"},"PeriodicalIF":1.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Psychosocial Correlates of Loneliness and Suicidality in the Taiwanese General Population.","authors":"Wei-Chieh Hung, Chia-Yi Wu, Ming-Been Lee, Chia-Ta Chan, Vivian Isaac, Chun-Ying Chen","doi":"10.1111/phn.13531","DOIUrl":"https://doi.org/10.1111/phn.13531","url":null,"abstract":"<p><strong>Objectives: </strong>To estimate the prevalence of loneliness and to investigate the associations between loneliness and suicidality among the general population in Taiwan.</p><p><strong>Design: </strong>Cross-sectional analysis of random samples in surveys.</p><p><strong>Sample: </strong>During 2016 and 2017, 2148 and 2098 participants (N = 4246) from a representative sampling of the Taiwanese population were interviewed via the computer-assisted telephone system in Taiwan.</p><p><strong>Measurements: </strong>The study measured demographics, psychological distress, suicide risk factors, and loneliness status (single-item measurement). The association between loneliness and psychosocial factors was analyzed using Spearman's correlation. Logistic regression was applied in the association between loneliness and current suicide ideation.</p><p><strong>Results: </strong>Around 13.1% in the sample perceived feelings of loneliness. Loneliness status was significantly associated with increased psychological distress and suicide risks. The regression model indicated that the three most significant factors linked to loneliness were \"no one trustworthy to talk to\" (OR = 3.69), substance abuse (OR = 3.43), and depression (OR = 3.07), whereas self-rated mental health (poor to good) (OR = 4.11), loneliness (OR = 2.59), and depression (OR = 2.09) were associated with current suicide ideation.</p><p><strong>Conclusion: </strong>Loneliness was a significant suicide risk factor with multiple underlying psychosocial influences. Establishing support groups or service referrals through early psychosocial assessment could identify or alleviate loneliness and/or reduce suicide risk.</p>","PeriodicalId":54533,"journal":{"name":"Public Health Nursing","volume":"42 3","pages":"1171-1181"},"PeriodicalIF":1.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Diverse Care Needs Assessment for Older Adults in China: A Latent Profile Analysis Study.","authors":"Junyu Chen, Qing Wang, Zichun Ding, Meng Wang, Lixia Chen, Guihua Xu","doi":"10.1111/phn.13539","DOIUrl":"10.1111/phn.13539","url":null,"abstract":"<p><strong>Background: </strong>Grasping the nuanced needs of older adults is paramount for the efficacious provision of day-care services. Our study sought to identify the demand patterns for day-care services in China and to explore the underlying factors. This study aims to offer useful evidence that can refine nursing care strategies and guide policy development within day-care settings.</p><p><strong>Methods: </strong>We implemented a comprehensive electronic survey comprising 46 questions targeting older adults across nine day-care centers in Nanjing, China. Employing latent profile analysis (LPA), we systematically examined and categorized the demand characteristics for day-care services. This analysis was conducted using Mplus version 8.3 and SPSS version 26.0 software, ensuring a rigorous and precise methodological approach.</p><p><strong>Results: </strong>Our study involved a comprehensive survey of 1016 older adults. The participants were categorized into three groups based on their demand for day-care services: high demand (n = 127), medium demand (n = 197), and low demand (n = 692). The low-demand group exhibited higher levels of social support and better activities of daily living (ADL) scores compared to their counterparts. Multivariate regression analysis indicated that older adults characterized by male gender, advanced age, higher levels of education, receipt of support from a child, presence of chronic diseases, and lower social support and ADL scores exhibited a statistically significant inclination towards moderate to high demand for day-care services (p < 0.05).</p><p><strong>Conclusion: </strong>The demand for day-care services for older adults in China is intricately influenced by a complex array of interrelated factors. Tailoring service offerings to meet the varied physical and emotional needs of older adults is essential, with a particular focus on health and wellness management in day-care centers.</p>","PeriodicalId":54533,"journal":{"name":"Public Health Nursing","volume":" ","pages":"1160-1170"},"PeriodicalIF":1.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Development of the Essential Individual Care Needs Assessment Tool for Public Health Nurses.","authors":"Kyoko Yoshioka-Maeda, Hiroshige Matsumoto, Chikako Honda, Kazuya Taira, Noriko Hosoya, Miki Sato, Riho Iwasaki-Motegi, Yuka Sumikawa, Hitoshi Fujii, Takahiro Miura, Misa Shiomi","doi":"10.1111/phn.13545","DOIUrl":"10.1111/phn.13545","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to develop essential individual care needs assessment (EICNA) items and evaluate the validity of that judgment.</p><p><strong>Design: </strong>We used a sequential two-phase design for this study.</p><p><strong>Methods: </strong>Item selection was conducted using φ coefficients between these items' values and the care need levels and discussions with supervisory PHNs. Phase 1 was a cross-sectional, nationwide survey of 275 mid-level public health nurses (PHNs) from 196 municipalities in Japan (December 2022 to January 2023), including 46 potential EICNA items. In Phase 2, PHNs piloted the EICNA items in clinical settings, entering data into a web-based system that used an algorithm to determine care need levels based on the weighted sum of 21 items (August 2023 to January 2024). Thereafter, the PHNs evaluated the appropriateness of the algorithm's judgments.</p><p><strong>Results: </strong>Twenty-one essential items were identified. Among 1867 cases, care need levels were categorized as low (n = 1008, 54.0%), moderate (n = 652, 34.9%), and high (n = 207, 11.1%), with 94.9% of PHNs considered the algorithm's classifications appropriate.</p><p><strong>Conclusion: </strong>Twenty-one EICNA items were identified to assess the care needs, and the level of care needs determined by the weighted sum of these items was deemed appropriate by PHNs.</p><p><strong>Trial registration: </strong>UMIN000051509 (https://www.umin.ac.jp/ctr/; August 1, 2023).</p>","PeriodicalId":54533,"journal":{"name":"Public Health Nursing","volume":" ","pages":"1216-1225"},"PeriodicalIF":1.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12000994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}