Factors Associated with Public Health Nurses' Anxiety About Accepting Evacuees During Nuclear Disasters: A Cross-Sectional Study in Oita Prefecture, Japan

Background/Objectives: The Fukushima Daiichi Nuclear Power Station accident underscored the critical role of public health nurses (PHNs) in managing evacuees during nuclear emergencies. Despite their importance, PHNs often lack sufficient knowledge and experience, which may make them anxious about this role. This study aimed to investigate the factors associated with PHNs' anxiety about accepting evacuees and identify strategies to alleviate this anxiety. Methods: A cross-sectional survey was conducted among 100 PHNs working in Oita Prefecture, Japan, a region designated to receive evacuees in the event of a nuclear disaster. Data were collected via an online questionnaire assessing radiation knowledge, workplace characteristics, and anxiety about accepting evacuees. Univariate and multivariate logistic regression analyses were performed to identify the predictors of anxiety. Results: PHNs working in prefectural offices were 3.4 times more likely to feel anxious about accepting evacuees than those in municipal offices (OR = 3.488, 95% CI = 1.236-10.963, p = 0.023). Awareness of evacuation site responsibilities significantly reduced anxiety (OR = 0.412, 95% CI = 0.134-1.211, p = 0.110). Overall, knowledge of radiation was low, with only 8% correctly identifying the differences between stochastic and deterministic effects. Online training was the preferred format for education. Conclusions: Workplace characteristics and knowledge of evacuation responsibilities significantly influence PHNs' anxiety levels. Addressing knowledge gaps through tailored, accessible training programs, particularly in online formats, is essential. Strengthening preparedness among PHNs could enhance their confidence and ability to manage evacuees effectively during nuclear disasters.