Negative Capability-Related Dimensions Among Local Government Public Health Nurses in Japan and Their Associated Factors

Objective Local government public health nurses (PHNs) in Japan deliver community-based public health services and often make practice decisions under uncertainty, incomplete information, and competing priorities. This study examined negative capability (NC)-related dimensions among PHNs in Japan - operationalized as ambiguity intolerance (MAT) and attitudes toward ambiguity - and explored factors associated with these dimensions. Methods We conducted an anonymous web-based survey of local government PHNs in Japan from July 16 to August 25, 2024. Ambiguity intolerance (indexed by higher MAT scores) was assessed using the Japanese 24-item Measure of Ambiguity Tolerance (MAT), and attitudes toward ambiguity were measured using a 26-item scale with five subscales (enjoyment, anxiety, reception, control, exclusion). Self-rated understanding of NC was assessed using a visual analogue scale (VAS, 0-100), resilience was measured using the 14-item Resilience Scale (RS14), and career development was measured using a 26-item career development scale for local government PHNs. Multiple linear regression (forced entry) was conducted for MAT and each attitude subscale, including sex, municipality type, years of PHN, RN, and other work experience, resilience, NC understanding, and career development subscales as explanatory variables. The primary outcome was ambiguity intolerance (MAT total score). The five attitude subscales (enjoyment, anxiety, reception, control, and exclusion) were treated as secondary exploratory outcomes. Results Data from 380 PHNs were analyzed (94.7% female; mean age 41.2 years, SD 11.9). The model for ambiguity enjoyment was significant (F(12,367)=9.03, p