[Systematizing public health nursing intervention skills in Japan: An intervention-wheel-based approach]

Objectives　To acquire public health nursing skills, it is important to comprehensively address and name all the skills. This study focused on intervention skills, aiming to systematize intervention skill items and structures in public health nursing. Furthermore, based on the Intervention Wheel-an intervention model for public health nursing systematized in Minnesota, USA-the characteristics of intervention skills in Japan were considered.Methods　Public health nursing interventions were systematized into three stages: draft creation, validity verification, and public health nursing intervention skills system development. Thirty-two meetings of approximately two hours each were conducted, attended by four investigators with experience in public health nursing practice and research. The draft creation had four stages: (1) extracting public health nursing intervention skills from public health nursing textbooks and the Intervention Wheel and organizing them inductively; (2) using the Intervention Wheel to deductively examine skill items; (3) considering the structural framework of intervention skills based on the functional aspects of public health nursing and incorporating the Intervention Wheel; and (4) illustrating a model of public health nursing intervention skills. Ten experts in public health nursing practice, education, and research were interviewed to verify the validity of the original framework and intervention skills. The results from the interviews were revised through discussions with the investigators to formulate a system of intervention skills for public health nursing. The Intervention Wheel functioned as a reference for the characteristics of these skills in Japan.Results　Twenty-one major skills required for public health nursing interventions in Japan were identified: social resource management and development; care system construction; outsourcing projects and quality monitoring; and systems, community, and case management. These skills differ from those of the Intervention Wheel. It was also demonstrated that these skills function at the system, community, and individual and family levels to solve health problems. Intervention skills functioned at all three levels; however, some were ineffective at the system or individual and family levels.Conclusion　Twenty-one major public health nursing intervention skills were identified to address health issues, ensuring that each of the three levels (system, community, and individual/family) function differently. In addition, the scenarios where these skills perform different yet complementary functions across the three levels were organized and systematized.