[Nation-wide research on current status and related factors for collaboration with occupational health services by public health nurses working for municipalities: comparison between major cities and other communities].
OBJECTIVE
The purpose of the this study was to clarify the nation-wide current status for collaboration between occupational and municipal health services, taking into account related factors and comparing Major Cities (with health centers) and Other communities (other cities and towns).


METHODS
A nation-wide questionnaire research was conducted by mail among 350 randomly selected public health nurses (PHNs) taking part in adult health services at municipal health centers (Tokyo was excluded). The valid-response rate was 61.7%. Characteristics of the samples, promoting factors, hindrance factors, and status of implementation of collaboration were analyzed separately for Major Cities and Others using the X2 test and the Mann-Whitney U test. Promoting and hindrance factors related to collaboration were assessed with Spearman's rank correlation coefficients and multiple logistic analysis.


RESULTS
While the percentage of PHNs who felt the necessity of the collaboration was 96.8%0, those who actually collaborated with occupational health services was currently only 34.9% in Major Cities and 22.9% in Others. There were two types of collaboration. The first involved conferences of stakeholders, including PHNs, on common health problems in the community and participation rates were 24.5% for Major Cities and 25.8% for Others. The respective figures for the second type, in which health services were delivered to workplaces, were 56.3%0 and 52.2%0. The corresponding rates for promoting factors such as "Attend educational seminars concerning collaboration" (Major Cities 22.2%, Others 17.1% and "Work with existing PHNs who are motivated for collaboration" (Major Cities 9.7%, Others 13.9%) were low. On the other hand, "Discuss with superiors and colleagues about collaboration" was much more common (Major Cities 83.9%, Others 74.0%). The promoting factors significantly related to practice of collaboration were "Read the Collaboration Guidelines" and "Inclusion of collaboration with occupational health services into the municipal health plan" in Others. The significant hindrance factors were "Insufficient manpower" and "Non-residential workers are not recognized as being entitled to support."


CONCLUSIONS
This study demonstrated the nation-wide current status concerning factors for collaboration for the first time. Based on these results separate for Major Cities and Others, countermeasures should now be considered.
Department of Nursing, School of Health Sciences, Tokai University.
Yuko
Y
Mitsuhashi
Noriko
N
Nishikido
D007400:Interprofessional Relations; D007564:Japan; D009111:Local Government; D009786:Occupational Health Services; D011637:Public Health Nursing; D011897:Random Allocation; D011795:Surveys and Questionnaires