Leveraging public health nurses for disaster risk communication in Fukushima City: a qualitative analysis of nurses' written records of parenting counseling and peer discussions

Abstract

BackgroundLocal public health nurses (PHNs) have been recognized as the main health service providers in communities in Japan. The Fukushima nuclear disaster in 2011 has, however, created a major challenge for them in responding to mothers’ concerns. This was in part due to difficulties in assessing, understanding and communicating health risks on low-dose radiation exposure. In order to guide the development of risk communication plans, this study sought to investigate mothers’ primary concerns and possible solutions perceived by a core healthcare profession like the PHNs.MethodsA total of 150 records from parenting counseling sessions conducted between PHNs and mothers who have attended mandatory 18-month health checkups for their children at the Fukushima City Health and Welfare Center in 2010, 2011 (year of disaster) and 2012 were examined. Discussion notes of three peer discussions among PHNs organized in response to the nuclear disaster in 2012 and 2013 were also analyzed. All transcribed data were first subjected to text mining to list the words according to their frequencies and inter-relationships. The Steps Coding and Theorization method was then undertaken as a framework for qualitative analysis.ResultsPHNs noted mothers to have considerable needs for information on radiation risks as they impact on decisions related to relocations, concerns for child safety, and experiences with interpersonal conflicts within the family owing to differing risk perceptions. PHNs identified themselves as the information channels in the community, recommended the building of their risk communication capacities to support residents in making well-informed decisions, and advocated for self-measurement of radiation levels to increase residents’ sense of control. PHNs also suggested a more standardized form of information dissemination and an expansion of community-based counseling services.ConclusionsInadequate risk communication on radiation in the Fukushima nuclear incident has resulted in multiple repercussions for mothers in the community. Empowerment of local residents to assume more active roles in the understanding of their environment, increasing PHNs’ capacity in communication, and an expansion of health services such as counseling will together better address risk communication challenges in post-disaster recovery efforts.

Explanatory Meetings on Thyroid Examination for the “Fukushima Health Management Survey” after the Great East Japan Earthquake: Reduction of Anxiety and Improvement of Comprehension

“…This result is in accordance with previous findings that women have higher anxiety and risk perception regarding radiation (Sugimoto et al 2013;Fukushima City 2014;Goto et al 2014;Suzuki et al 2015) and that civil servants and institutional staff have the least anxiety about the health effects of exposure (Fuku- Relationship between anxiety about the effects of radiation on the thyroid before and after the explanatory meeting. Areas of circles are proportional to the number of participants.…”

“…Regarding attitudes about radiation, bearing in mind the existence of discussions of the relationship between radioactive risk perceptions and attitudes on gathering information about radiation, advisors on radiation, or knowledge (Perko et al 2012; Science Council of Japan Committee on Supporting Reconstruction after the Great East Japan Earthquake 2012; Sugimoto et al 2013;Goto et al 2014), the subjects were asked to select the statement that applied to them from among seven items: "I collect information on radiation" (information), "I have previously collected information because of anxiety, but not now" (information, previously), "I can talk about radiation with my family without experiencing stress" (family with whom to talk), "I can talk about radiation with my friends or acquaintances without experiencing stress" (friends with whom to talk), "I have no people around me to whom I can talk about radiation" (no one with whom to talk), "I understand radiation to some degree" (understanding), "I do not know about radiation" (no understanding). Level of understanding can be measured subjectively through respondents' self-reported knowledge (Imai et al 2015), objectively based on whether questions are answered correctly or incorrectly (Perko et al 2012), or both (Vandermoere 2008).…”

Development of the salt‐reduction and efficacy‐maintenance program in Indonesia

“…Qualitative data were analyzed by text mining using KH Coder, a free and open source software program created by Koichi Higuchi at Ritsumeikan University, Kyoto Japan (Higuchi, 2012). Text mining is a computerized process of extracting information from collected discussions, and has been widely used in health science research to improve the consistency of qualitative data analysis (Goto et al, 2014). We conducted three analysis steps: (i) a word frequency list was applied to determine the frequency of words mentioned in the conversation; (ii) to identify groups of words, a cooccurrence network of words was performed; large bubbles represented words frequently used in the meeting; and (iii) to explore co-occurrence networks in detail, key words in context concordance was used.…”

Difficulties of fathers whose families evacuated voluntarily after the Fukushima nuclear disaster

“…In Japan, public health nurses (PHN) support maternal and child health in each municipality and prefectures as public servants (Japanese Nursing Association, ). Through risk communication with mothers, PHN have enabled them to understand their environment and to protect their health (Goto et al, ). On the contrary, occupational health nurses (OHN) provide direct care to employees in private companies in Japan, and protect their health (Inoue, ).…”