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Public Health Nurses' Time Allocation in Local Government Nursing Settings: A Self‐Reported Prospective Time Study

ABSTRACT

Aim

To clarify how public health nurses allocate their time across various tasks and compare time-use patterns between prefectural and municipal public health nurses in Japan, where distinct administrative mandates define their roles.

Design

A self-reported, prospective time study.

Methods

Public health nurses from two municipalities and one prefecture recorded their daily practices and time allocations using Kintone. Time allocation differences by administrative level and job position were analysed using linear mixed-effects models.

Results

Overall, 121 participants contributed 9502 person-days of data. Participants spent an average of 463.6 min/workday on work-related activities. Municipal public health nurses dedicated more time to application paperwork (64.0 min), health examinations (57.6 min), and individual coordination (48.3 min). Prefectural public health nurses allocated more time to business management and organisational operations (69.0 min) and traveliing, particularly in rural contexts. Managers spent less time on direct care and more on administrative tasks.

Conclusion

This study provides the first quantitative, self-reported evidence of task distribution among public health nurses across administrative levels and positions. The findings reflect structural differences in role expectations and underscore the need to reallocate workloads to better align with each level's mandate.

Implications for the Profession

Task prioritisation, information and communication technology tool integration, and administrative support are essential in optimising public health nurses' contributions to community health. These strategies can reduce non-clinical workload and enable public health nurses to focus on high-impact, value-added public health services that promote health equity.

Impact

This study closes a longstanding gap by quantifying PHNs' time allocation, revealing the hidden burden of administrative work, and providing critical insights for workforce planning and sustainable public health service delivery.

Reporting Method

This study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology guideline.

Patient or Public Contribution

No Patient or Public Involvement.

Trial Registration

UMIN Clinical Trials Registry; UMIN000051509 (https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_his_list.cgi?recptno=R000058761; August 1, 2023)

Development and Validation of a Negative Emotions Scale for Public Health Nurses Engaged in Child Abuse Prevention Activities

ABSTRACT

Aims

To assess the reliability and validity of a negative emotion scale for public health nurses conducting child abuse prevention activities.

Design

A four-phase mixed method design.

Methods

Participants were public health nurses with experience in child abuse prevention across Japan. The initial scale was developed and refined based on previous studies, expert panel reviews, interviews with public health nurses, and a questionnaire-based pilot study. In 2024, 549 public health nurses completed a questionnaire on scale items. Item analysis, exploratory factor analysis, confirmatory factor analysis, comparisons with a preexisting scale, the number of times negative attitudes and the types of behaviours exhibited by parents were used to narrow the scale and assess its psychometric properties.

Results

Item analysis and exploratory factor analysis reduced the scale to 15 items on two factors: ‘negative emotions toward aggressive and emotional attitudes’ and ‘negative emotions toward rejecting and uncooperative attitudes.’ Confirmatory factor analysis indicated a good model fit. The Cronbach's alpha was high, and the negative emotions scale score positively correlated with the pre-existing scale, negative attitudes and parental behaviours.

Conclusions

The Cronbach's alpha coefficient and other factors confirmed the scale's reliability, and correlations with other scales confirmed its validity.

Implications for the Profession

Evaluating negative emotions provides critical insights into the quality of support and its influence on psychological well-being.

Impact

By assessing negative emotions that public health nurses find difficult using this scale, the support system for them can be examined.

Reporting Methods

STROBE checklist for cross-sectional studies was followed.

Patient or Public Contribution

Public health nurses were involved in the generation of items for the scale. Their perspective was sought in determining the items for the scale.

Trial and Protocol Registration

Registered in the UMIIN Clinical Trial Registry (UMIN-CTR ID UMIN000054650).

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