Development and evaluation of asbestos related health consultation for public health nurses.

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Because the number of mesothelioma grew rapidly, people are anxious about asbestos. However there was no guideline of asbestos related health consultation for public health nurses. Analysis of 344 asbestos related consultation records by NPO showed many kinds of worriers,such as anxiety on exposure, including children's exposure in school, worriers of onset of asbestos related diseases, problems of patients, grief of bereaved. Consultation requires knowledge such as medical, construction, law, psychology and so on. Especially, parents worried children's exposure; a website for parents and children about asbestos was established. The survey on all health centers showed a health center put 3 health staffs for asbestos related consultation and had 5.3 cases in previous year. More than 70 % health centers put nurses as consultants. Among consultants, only 14% attended training and 35.4% did not used manual at all. About 70% of staffs of asbestos related health consultant were not confident on their duty because they cannot keep their knowledge for rare consultation that requires many kinds of special knowledge. Those result indicated the needs of guideline of asbestos related health consultation. However other research group developed an excellent guideline, we focused a patients' distress that was most difficult issue for health center's staffs. According to our research on 14 malignant pleural mesothelioma patients, they were in multiple difficulties caused by malignancy, rareness and happened by asbestos. Since mesothelioma progress fast, new problems keep happening before one problem was solved. Also, patients felt they were not well treated because medical staffs were lack of knowledge and experience in mesothelioma.