Factors Associated with Prenatal Smoking Cessation Interventions among Public Health Nurses in Japan

Abstract

This study aimed to identify the factors associated with prenatal smoking cessation interventions based on the 5As model among public health nurses (PHNs) in Japan. A nationwide cross-sectional study was conducted from December 2019 to February 2020 via a self-administered questionnaire. The study subjects were 1988 PHNs working in 431 health centers of municipalities and special wards across the country. Of the 1988 questionnaires mailed, 521 responses (26.2%) were included in the analysis. Of the 521 responses, most of the respondents were female (98.1%) and the mean age was 37.5 years. There were statistically significant differences on age, work regions, experience years working as a PHN and smoking cessation training after becoming a PHN in implementing the 5As. Self-efficacy, professional development competency, research utilization competency, age and experience years working as a PHN were positively associated with the 5As. Social nicotine dependence was negatively associated with the 5As. Furthermore, self-efficacy mediated the relationship between the 5As and professional development competency, research utilization competency, social nicotine dependence, age and experience years working as a PHN. In the future, smoking cessation intervention training should be widely implemented to improve self-efficacy and prenatal smoking cessation interventions among Japanese PHNs.

How Self-Efficacy toward, Perceived Importance of, and Beliefs about Smoking Cessation Support Impact-Related Behaviors in Japanese Nursing Professionals

“…The present study largely supports these findings. At the same time, Li et al’s model found that public health nurses’ years of experience positively influenced self-efficacy, but years of nursing experience were not found to be a significant factor in the present study [ 19 ]; Chatdokmaiprai et al similarly found no relationship between self-efficacy and a nursing professional’s age or years of nursing experience [ 23 ].…”

“…Exploratory factor analysis (maximum likelihood method, promax oblique rotation) was performed to identify latent variables for structural equation modeling. The observed variables consisted of a total of 20 items: six items on SCS behaviors, three items on SCS self-efficacy, ten items on attitudes and perceived importance of SCS, and, with reference to the results of Li et al, years as a nursing professional [ 19 ]. The analysis identified the four factors shown in Table 3 : Factor 1 [smoking cessation support behaviors], Factor 2 [smoking cessation support self-efficacy], Factor 3 [importance of smoking cessation support], and Factor 4 [beliefs about smoking cessation support] (hereafter, square brackets represent latent variables).…”

“…The results of this study are considered novel findings. Li et al reported that self-efficacy (β = 0.52) influences Japanese public health nurses’ SCS behaviors toward pregnant women (R 2 = 0.41) [ 19 ]. Further, Chatdokmaiprai et al reported that self-efficacy (β = 0.51) impacts occupational health nurses’ SCS behaviors (coefficient of determination 38%) and that nursing professionals’ attitude toward SCS (β = 0.37) in turn influences self-efficacy [ 23 ].…”

“…A previous cohort study in Japan reported the importance of counseling by nurses in maintaining patients’ self-efficacy to quit smoking and helping them achieve smoking cessation [ 18 ]. A study by Li et al has revealed the interrelationship of these factors, in the context of SCS interventions, by public health nurses for pregnant women about to give birth [ 19 ]. This study was conducted in a cohort of only public health nurses.…”

Factors Associated with Nursing Interventions for Smoking Cessation: A Narrative Review

“…Finally, our results also indicate that nurses with higher self-efficacy to engage in smoking counseling were more likely to implement smoking cessation interventions [ 19 , 22 , 25 ]. A previous study, in Japan, reported that research utilization competency was positively associated with self-efficacy and prenatal smoking cessation interventions among public health nurses [ 49 ]. Additionally, another study including 1054 primary healthcare nurses, in Sweden, reported that the ability and use of research were significant determinants of attitudes towards research and use of research findings [ 50 ].…”