[Nihon koshu eisei zasshi] Japanese journal of public health最新文献

{"title":"[Communication between pregnant women and maternal and child health professionals and trust in professionals and awareness of source of help in the postpartum period: Evaluation using JACSIS Pregnant-Postpartum Women's Data 2020-2021].","authors":"Midori Matsushima, Aya Takagi, Naoki Kondo, Takahiro Tabuchi","doi":"10.11236/jph.23-015","DOIUrl":"10.11236/jph.23-015","url":null,"abstract":"<p><p>Objective　This study aims to estimate the impact of maternal and child health professional consultation and development of support plans during pregnancy on trust in community health professionals (trust) and awareness of sources of public/private institutional support (awareness) in the postpartum period.Methods　A web-based panel survey was conducted in July-August 2021 and January-February 2022, targeting women who were pregnant during the 2021 survey and 0-5 months postpartum in 2022. We collected information about consultation opportunities and development of a support plan during pregnancy, trust and recognition, demographic characteristics, employment status, and pregnancy- and childbirth-related variables. First, logistic regression analysis was conducted by setting trust and recognition during postpartum as outcomes. Exposure variables were the consultation opportunities and development of a support plan during the pregnancy period. Second, we added the presence of a comprehensive support center for raising children, the financial index of the municipality of residence, the per capita child welfare expenditure, and the number of nurses at the comprehensive support center for maternal and child health to the analytical model as overall level of municipal support in order to check the robustness of our results.Results　Responses were obtained from pregnant women across Japan. Of the 616 respondents included in the analysis, 74.0% had opportunities for consultation, 23.7% made support plans, 69.8% trusted local maternal and child health professionals, and 63.6% recognized public/private institutional support as places for help-seeking. Logistic regression analysis showed that trust and recognition were higher among those who had opportunities to consult and had created a support plan compared to those who did not. With regard to trust, for those who had opportunities to consult, the odds ratio (OR) was 2.05 (95% confidence interval [95% CI] 1.37-3.07), and for those who developed a support plan, the OR was 2.25 (95% CI 1.41-3.60). As for recognition, the OR was 1.46 (95% CI 0.98-2.16) if given the opportunity for consultation. For development of a support plan, the OR was 3.05 (95% CI 1.94-4.80). These results did not change even after adjusting for municipal finances and the level of support for pregnant women in general.Conclusions　Consultation opportunities and developing support plans during pregnancy increased trust and recognition in the postpartum period while municipal finances or overall support for child rearing were not associated with these outcomes, thus suggesting the importance of engagement with professionals during pregnancy.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":"93-102"},"PeriodicalIF":0.0,"publicationDate":"2024-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138441738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Association among obesity, lifestyle, and home/neighborhood environment among preschool children in Hokkaido].","authors":"Ayaka Takahashi","doi":"10.11236/jph.22-119","DOIUrl":"10.11236/jph.22-119","url":null,"abstract":"","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":"108-116"},"PeriodicalIF":0.0,"publicationDate":"2024-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41221516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a partnership between academia, community, and government in response to the 2022 mpox outbreak in Japan.","authors":"Mio Kato, Fumi Yoshimatsu, Tomonori Yamamoto, Nozomi Kobayashi, Tadashi Kikuchi, Saori Matsuoka, Tetsuro Matano, Kota Iwahashi, Yuzuru Ikushima, Satoshi Shiono, Masahiro Ishikane, Shinichiro Morioka, Takato Nakamoto, Itsuro Yoshimi, Tomoya Saito","doi":"10.11236/jph.23-028","DOIUrl":"10.11236/jph.23-028","url":null,"abstract":"<p><p>Objectives　In response to the steady rise in the number of cases of mpox in nonendemic countries, starting with an outbreak in the United Kingdom in May 2022, the World Health Organization declared a public health emergency of international concern on July 23, 2022. As of November 13, 2022, seven cases of mpox have been reported in Japan.Methods　A community engagement approach was applied to prevent the spread of mpox in Japan.Results　A tripartite partnership between academia, community, and government (ACG) was established to promote multisectoral communication between vulnerable communities, medical personnel involved in diagnosis and treatment, public health specialists at public health centers, epidemiologists at the National Institute of Infectious Diseases (NIID), and government and public administration. Through information sharing, this ACG partnership can translate accurate information into effective infection control measures.Conclusion　By developing and maintaining the ACG partnership, an environment will be created that allows an immediate response to future public health crises affecting vulnerable communities. This Practice Report describes the process of establishing an ACG partnership.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":"103-107"},"PeriodicalIF":0.0,"publicationDate":"2024-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41221518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[A survey on the utilization of internet services to collect job information among medical students and initiation of video public relations activities for the recruitment of public health physicians based on the survey results].","authors":"Katsunori Yokoyama, Keiko Hiramoto, Ai Fujikawa, Hiroyuki Takechi, Toshihide Iwase, Honami Yoshida, Toshiyuki Ojima, Hideya Ueda, Kana Kodama, Tsukasa Muramatsu, Masaya Miyazono, Rie Fujita, Chika Shirai, Katsuhiko Uchida","doi":"10.11236/jph.23-046","DOIUrl":"10.11236/jph.23-046","url":null,"abstract":"<p><p>Objectives　It is difficult for medical students to obtain information about public health physicians because there are very few public health physicians near them. To improve this situation, we surveyed the utilization of internet services to collect job information among medical students and produced six videos and conducted public relations activities for the recruitment of public health physicians based on the survey results.Methods　The subjects of the survey were medical students in their third year or above from 18 universities. Public health teachers in these 18 universities sent their students anonymous self-administered questionnaires created with Google Forms mainly by e-mail. The questionnaires included the following items \"internet services used to collect job information,\" \"desired length of each video for knowing job information,\" and \"information you want to know about your future work.\" The responses were reflected in the length and the content of the videos and the settings for their distribution.Results　Responses were obtained from a total of 491 medical students, including 14 third-year students, 177 fifth-year students, and 300 sixth-year students. Homepages were the most frequently used online source for collecting job information (94.7%), followed by blogs (42.0%), Twitter (32.6%), and YouTube (18.9%). Medical students are less likely to use social networking services for collecting job information compared with non-medical job-hunting students. Regarding the length of the videos, 55.8% of the respondents preferred the length of one video to be less than 5 minutes, and 95.1% preferred it to be less than 10 minutes. Almost all of the respondents (93.1%) wanted to know the atmosphere of young public health physicians, and 74.1% also wanted to know the atmosphere of veteran physicians. Based on these results, we selected six public health physicians including young and veteran physicians and produced interview videos that conveyed the atmosphere of each doctor within 5 minutes per person. We refurbished the banner on the top page of the Japanese Association of Public Health Center Directors so that the videos uploaded to YouTube could be watched.Conclusion　We clarified the current situation of the utilization of internet services for job-hunting activities among medical students and were able to initiate video public relations activities for the recruitment of public health physicians in accordance with the needs. It is necessary to increase awareness of the video platform among medical students and clinicians by deepening cooperation with local governments, universities, and medical institutions and expanding the human network both online and in person.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":"24-32"},"PeriodicalIF":0.0,"publicationDate":"2024-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41173767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Developing a Japanese version of the Digital Health Literacy Instrument].","authors":"Rina Miyawaki, Mio Kato, Yoko Kawamura, Hirono Ishikawa, Koichiro Oka","doi":"10.11236/jph.23-021","DOIUrl":"10.11236/jph.23-021","url":null,"abstract":"<p><p>Objectives　The Internet has made it possible to search for, obtain, transmit, and share information. Accordingly, the ability to use health information and skills related to interactivity taken from the Internet have become important in the medical and health fields. However, there is no scale to evaluate these abilities. Therefore, this study was conducted to assess the validity and reliability of the Digital Health Literacy Instrument (DHLI) and examine the association of digital health literacy (DHL) with the characteristics of the study participants.Methods　The Japanese version of the DHLI was developed using the basic guidelines for scale translation. The participants included 2,000 Japanese adults (men: 50.0%, mean age: 40.7±12.0 years) who responded to an Internet-based cross-sectional survey. The Japanese version of the DHLI, attributes, sources of health information, contents of health information taken from the Internet, and eHealth Literacy Scale (eHEALS) scores were obtained using a questionnaire. Confirmatory factor analysis and correlation with eHEALS scores were used to assess construct and criterion validities. Cronbach's alpha and correlation coefficients were computed for internal consistency and test-retest reliability. Differences in DHLI scores for each attribute and variables related to health information were examined using the analysis of variance and t-test.Results　Confirmatory factor analysis revealed a goodness-of-fit index of .946, a comparative fit index of .969, and a root mean square error of approximation of .054, confirming that the Japanese version has the same seven-factor structure as the original version does. A significant positive correlation was found between DHLI and eHEALS scores (r=.40, P<.001). Cronbach's alpha was .92, and test-retest reliability was r=.88 (P<.001). DHLI scores were mainly associated with household income, health status, frequency of information searches on the Internet, and devices used. The subscale scores found difficulties in evaluating reliability, determining relevance, and adding self-generated content. Differences in DHL were observed among some sources and contents of health information on the Internet.Conclusion　The Japanese version of the DHLI was a sufficiently reliable and valid instrument for assessing DHL among Japanese adults. Our results suggest that low DHL may lead to health information disparities. Therefore, it is necessary to consider support strategies for individuals who need to improve their DHL and for skills that need to be strengthened.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":"3-14"},"PeriodicalIF":0.0,"publicationDate":"2024-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10170768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Associations between mothers' economic insecurity and mood and thoughts on life with children at infants' 3-month check-ups: A cross-sectional study using data from infant health check-ups].","authors":"Yasue Ogata, Ritei Uehara, Yoshie Yokoyama","doi":"10.11236/jph.23-027","DOIUrl":"10.11236/jph.23-027","url":null,"abstract":"<p><p>Objectives　We aimed to clarify the relationship between economic insecurity and the psychological profiles of mothers raising infants by analyzing data from three-month health check-ups in relation to the birth population in order to generate basic data that can be used to consider support for families facing economic insecurity.Methods　The study area was a neighborhood in a major Japanese city. The survey focused on 1013 mothers who had received health check-ups for children aged 18 months between November 2017 and October 2019. The data included in the analysis were data from the children's three-month health check-ups and survey data from 908 mothers who responded to the questionnaire and consented to the use of their health check-up data. After excluding data from potential participants who were not mothers or had multiple births, data from 847 participants were analyzed (valid response rate: 93.3%).　The objective variables were mothers' mood and thoughts about life with their children at the time of the three-month check-up as the mothers' psychological profiles. The explanatory variable was the presence or absence of maternal economic insecurity, and logistic regression analysis was conducted, adjusted for the children's sex and birth order, presence or absence of maternal counselors, and the mothers' educational attainment.Results　A total of 60 (7.1%) mothers were economically insecure. Of the mothers' moods, 122 (14.4%) reported feeling anxious, followed by 36 (4.3%) who reported feeling lonely. Of their thoughts on life with their children, 776 (91.6%) mothers reported that they enjoyed it, and 567 (66.9%) reported that they were happy to be parents. On the other hand, 157 (18.5%) reported feeling frustrated, and 75 (8.9%) reported that the lack of time for themselves was painful. Economically insecure mothers had an odds ratio of 5.59 (95% confidence interval, 2.49-12.55) for feeling lonely, 4.77 (2.67-8.54) for feeling anxious, and 2.70 (1.50-4.86) for feeling frustrated, all significantly higher than in mothers not facing economic insecurity.Conclusion　Economic insecurity among mothers at the time of the three-month check-up was associated with the psychological states of loneliness, anxiety, and frustration about living with their children. It was suggested that to solve economically insecure mothers' problems, they need support, including connecting them with social welfare services, so that they will be able to raise their children in a more stable environment.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":"33-40"},"PeriodicalIF":0.0,"publicationDate":"2024-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41153741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Effects of non-face-to-face gait and muscle strength training for urinary incontinence in community-dwelling middle-aged and older women: A randomized controlled trial].","authors":"Yoji Kameo, Motoki Sudo, Yukari Yamashiro, Takeshi Miyamura, Hunkyung Kim","doi":"10.11236/jph.23-030","DOIUrl":"10.11236/jph.23-030","url":null,"abstract":"<p><p>Objectives　Although the effectiveness of status-to-interview-guided exercise therapy to improve urinary incontinence has been reported, reports on non-face-to-face guided exercise therapy are lacking. This study aimed to analyze the effect of using non-face-to-face training guidance for walking and strength training on the frequency and degree of urinary incontinence and improvement in the urinary incontinence-induced decline in the quality of life (QoL) of community-dwelling middle-aged and older women.Methods　This study included 68 women, aged 46-64 years, having self-evaluated stress urinary incontinence. The participants in the intervention group watched a video that guided them on how to walk effectively and gradually increase their number of steps. Additionally, a non-face-to-face lecture was conducted on the comprehensive training content, including muscle strengthening exercises necessary for walking at home, as muscle weakness is one of the causes of urinary incontinence. The control group was instructed to continue living as usual without any interventions. The intervention period was 12 weeks. The primary endpoints included the urinary leakage frequency score, urinary leakage volume score, and degree of decline in the QoL, and these were compared before and after the intervention using the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF). To elucidate the effect of the increase in the step count on the primary outcome, we calculated the rate of increase in the step count before and after the intervention in the intervention group. Moreover, a sub-analysis was performed for the high-step count (n=16) and low step-count (n=16) groups before and after the intervention.Results　Significant differences were observed in the urinary leakage frequency, urinary leakage volume, and ICIQ-SF scores at 12 weeks post-intervention between the groups (P<0.05). In the high-step count group, both the urinary leakage frequency and ICIQ-SF scores showed a significant tendency to improve from 8 weeks compared to the pre-intervention scores.Conclusion　Since this study was conducted as an open-label trial, the possibility of an inherent bias in subjective outcome assessment should be considered during interpretation of the results. Our findings indicate that walking and muscle strength training, even with non-face-to-face guidance, for middle-aged and older community-dwelling women with urinary incontinence can effectively improve the urinary leakage symptoms and degree of decline in the QoL. Furthermore, greater effects could be expected by encouraging an increase in the number of daily steps with the intervention.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":"15-23"},"PeriodicalIF":0.0,"publicationDate":"2024-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41221517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Corrigendum: How accurate are self-reported anthropometrics among the Japanese? A scoping review].","authors":"Tomoko Aoyama, Xiaoyi Yuan, Mai Matsumoto, Emiko Okada, Chika Okada, Hidemi Takimoto","doi":"10.11236/jph.23-020e","DOIUrl":"https://doi.org/10.11236/jph.23-020e","url":null,"abstract":"<p><p>　Nihon Koshu Eisei Zasshi(JAPANESE JOURNAL OF PUBLIC HEALTH), Vol. 70 (2023) No. 12 pp.817-827.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":"71 2","pages":"124-126"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139934478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[How accurate are self-reported anthropometrics among the Japanese? A scoping review].","authors":"Tomoko Aoyama, Xiaoyi Yuan, Mai Matsumoto, Emiko Okada, Chika Okada, Hidemi Takimoto","doi":"10.11236/jph.23-020","DOIUrl":"10.11236/jph.23-020","url":null,"abstract":"<p><p>Objectives　Monitoring of obesity and underweight prevalence in general populations is crucial for the implementation of effective public health measures. Self-reported height and weight values are often used to assess the body mass index (BMI) in such epidemiological surveillance. However, it is known that using self-reported height and weight may underestimate the prevalence of obesity (BMI≥25 kg/m²), while its accuracy for underweight (BMI<18.5 kg/m²) prevalence is not well-understood. The aim of this study was to conduct a scoping review on the accuracy of self-reported anthropometrics in the Japanese population, where both obesity and underweight are prevalent.Methods　Using PubMed and CiNii Research, a literature search was conducted for studies published in English or Japanese by 2022 that were conducted in Japan and compared self-reported and measured height, weight, or/and BMI. The study design and mean reported errors (mean of reported values－mean of measured values) were extracted and tabulated, and differences by BMI categories were also considered.Results　A total of 17 studies, with 11 being published in English, were included in this review. These studies were conducted in nationwide cohort studies (n=4), local populations (n=4), workplaces (n=3), and educational institutions (n=6), with diverse age ranges (10-91 years) and sample sizes (<100 to >30,000). Although the degree of mean reporting error varied between studies, most of the studies reported that height was overreported, weight was underreported, and BMI was underestimated. In the three studies that reported mean reporting errors by BMI category, the direction of reporting error for height remained consistent across all body size categories, while weight and BMI were overreported and overestimated only among the underweight. Four studies in adults showed that 14.2-37.6% of actually obese individuals and 11.1-32.3% of underweight individuals were misclassified as 'normal range' (18.5≤BMI<25 kg/m²) based on self-reporting, while 0.8-5.4% and 1.2-4.1% of individuals actually within the normal range were misclassified as 'underweight' and 'obese' based on self-report, respectively.Conclusion　This study suggests that using BMI based on self-reported height and weight can underestimate the prevalence of both obesity and underweight in the Japanese population. These biases should be taken into consideration when using self-reported anthropometrics in epidemiological studies.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":"817-827"},"PeriodicalIF":0.0,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10170765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Characteristics of ethical dilemma and behavior in the support process of older adults and their families among nurses at a community general support center in Japan].","authors":"Emiko Saito, Yuki Kanzaki, Shizuko Omote, Kanako Murata","doi":"10.11236/jph.22-130","DOIUrl":"10.11236/jph.22-130","url":null,"abstract":"<p><p>Objectives　This study was aimed at clarifying characteristics of ethical dilemmas and behaviors in the support process of older adults and their families among nurses at community general support centers.Methods　A self-administered questionnaire survey was mailed to 449 nurses at community general support centers in Tokyo. Question items enquired their age, employment license, years of experience as a nurse, the presence of ethics-related organizations, number of cases in which nurses faced difficulties in supporting older adults and their families in decision making over the past year, the ethical dilemmas they experienced and their situations, and ethical behavior in the process of supporting older adults and their families.Results　From the 143 responses (response rate: 31.8%), 135 (valid response rate: 30.1%) nurses were analyzed. Overall, 43.0% and 27.4% of the participants were in their 50s and 40s, respectively. Of these, 77.0% and 23.0% were nurses and public health nurses, respectively. In total, 52 (38.5%) respondents had an ethics-related organization. The average number of cases in which the respondents faced difficulties in supporting older adults and their families in decision making over the past year was 8.3 (standard deviation, 12.5). Of these, the average number of cases in which they faced difficulties in making ethical decisions was 4.1 (standard deviation, 6.0). Regarding the perception of ethical dilemmas, 113 (83.7%) answered \"often\" or \"sometimes.\" Ethical dilemma situations included \"the intentions of the user and family were different, and I had trouble deciding what to respect\" 95 (84.1%); \"the user's intention was different from my judgment as a professional, and I had trouble deciding what to respect\" 64 (56.6%); and \"the intention of the user and neighbors were different, and I had trouble deciding what to respect\" 56 (49.6%). Ethical behaviors included \"I observe the management rules in my organization regarding personal information data\" 116 (85.9%); \"I provide easy-to-understand explanations appropriate to the user's situation\" 115 (85.2%); and \"I decide on a support policy with several staff members when self-decision making is difficult due to the user's situation\" 113 (83.7%).Conclusion　More than 80% of the nurses perceived ethical dilemmas. Characteristics of the situations were that users and their families, users and professionals, and users and their neighbors had different intentions. Further research should be conducted on ethical issues related to community-based integrated care.</p>","PeriodicalId":72032,"journal":{"name":"[Nihon koshu eisei zasshi] Japanese journal of public health","volume":" ","pages":"836-842"},"PeriodicalIF":0.0,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10172921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}