Journal of Health Care and Prevention
Open Access

Structure; Public health nurses; Professional identity

Introduction

In Japan, public health nurses (=PHNs) are professionals with national licences who serve as members of local governments and offer services to citizens of their communities. It has been discovered that possessing a "professional identity" is essential for professionals to carry out their obligations. According to research, professional identity evolves as a result of participation in everyday tasks at work, and the structure of this identity differs depending on the occupational sector. According to Gregg and Magilvy, nurses develop their nursing practise as they define their professional identities. Particularly [1-8] for PHNs, they are required to base their professional actions on two identities: that of a medical professional and that of a local government employee. Furthermore, the health-related issues that PHNs deal with form their professional identities. When compared to other occupations, their professional identity likely has a more sophisticated structure in this regard. If this is the case, it may help to explain why PHNs struggle to define their professional identity.

To provide top-notch public health services, PHNs must forge their professional identities early on. Regrettably, their professional identity's organisational structure is not well understood. The purpose of this study was to investigate the composition of the professional identity of PHNs. The education and training of PHNs would be improved by disclosing this framework.

Methods

In this study, a person's "professional identity" as a PHN was characterised as a mindset that defines his or her beliefs and values and promotes constant development. This definition was developed based on earlier publications.

Creating Proposed Items Outlining the Professional Identity of PHNs

On the basis of Kanefuji's definition of the elements of a beginner PHN's professional identity, a collection of draught question items was created. Eight experts—PHNs with master's degrees, PHNs with more than 30 years of experience, and university professors who trained PHNs—created this list of 21 items. We also made reference to scales that are currently in use to rate nurses' professional identities.

Individuals and method

670 PHNs in prefecture A participated in a questionnaire survey. The study's goal and methodology were communicated to supervisor- PHNs who were solely appointed by their local governments over the phone, and their participation was asked. If a supervisor-PHN agreed to take part, the required number of questionnaire sets were sent to him or her via mail. Each set included a questionnaire, an explanation of the study's goals and methods, a return envelope, and a questionnaire itself. The supervisor-PHNs disseminated the questionnaire sets to all of the PHNs in their local government after receiving them.

Research content

Basic characteristics such as age, professional nursing experience, the number of years spent as a PHN, the superior's vocation, and the number of PHNs employed were all covered by the questionnaire. It also featured Rosenberg's self-esteem measure and the 21 questions on PHN professional identity. This self-esteem scale, which consists of 10 items graded on a 5-point scale, measures how much people value themselves. It has been discovered that self-esteem serves as a foundation for forming identity. This makes it a useful tool for evaluating the reliability of a professional identity system.

Analytical statistics

By condensing the data on fundamental qualities, the sample's fundamental demographic characteristics were first determined. Following that, the generalised least squares (GLS) and promax rotation procedures were used in an exploratory factor analysis to examine the responses to the 21 professional identity items. Items in this study having factor loadings less than 0.4 were removed. A confirmatory factor analysis was carried out to verify the structural model produced by this analysis' goodness-of-fit. Based on the components they included, factors were given names. For the entire model, Cronbach's alpha was determined to assess the model's dependability.

Ethics-related issues

Returning the form signified agreement to participate in the study, and the survey was anonymous. The briefing went over the purpose and methods of the study, how [9,1] personal information would be protected, that participation was entirely voluntary, and that the findings will be made public. The Graduate School of Biomedical & Health Sciences at Hiroshima University's ethics committee gave the project their seal of approval for the Health Sciences Major. So, it stands to reason that PHNs gain a comprehensive understanding of the PHN model through observation of their surroundings and interaction with other PHNs, which then inspires them to grow into PHNs. To mature as a professional, one must have a strong desire to grow. As a result, "intention to develop professionally" is a crucial component of the framework of the professional identity of PHNs. According to the literature, scores for "confidence in one's own talents" were favourably connected with years of PHN experience. Years of nursing experience and pride in one's nursing abilities are (Figure 1) positively correlated, according to Fuji, This phenomena is seen in PHNs' professional identities as well. According to Matsuo et al., unique experiences foster growth more than familiar ones do, and Cox found that the experience of having one's behavior provoke immediate reactions from other people considerably increased one's self-confidence. PHNs assist the community's citizens by tackling the region's health problems, for which they must use creative solutions and collaborate with other experts. As a result, PHNs encounter many unique situations and frequently hear encouraging remarks from people. Hence, when PHNs have more experiences of having direct interactions with residents, their professional identities grow.

Figure 1: Confirmatory factor analysis (N = 309).

PHNs' improve their "professional affinity" by connecting with various individuals they encounter in their employment. According to Dahl et al., PHNs developed their professional identities through reflection with other PHNs. Inter-professional interactions encourage PHNs to recognise their roles, which aids in the development of their professional identities. Professionals have new learning opportunities that increase their level of professional awareness when they reflect on earlier events. As a result, "professional affinity" grows as a result of interactions with other professionals and PHNs.

Conclusion

The findings of this study reveal that the three factors of "intention to improve professionally," "confidence in personal talents," and "professional affinity" make up the professional identity of PHNs.

Acknowledgements

To all the PHNs in the Prefecture who took part in the study, I would like to express my gratitude.

Competing Interests

The authors say they have no competing interests.

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