[Conflicts and responses of municipal public health nurses during the COVID-19 pandemic: A focus group interview].

Objectives　This study clarified the practical activities undertaken by municipal public health nurses (PHNs) during the coronavirus disease 2019 (COVID-19) pandemic and ethical and emotional conflicts they experienced to derive implications for strengthening community health responses and capacity building during future health crises.Methods　This qualitative descriptive study was conducted using focus group interviews with eight municipal PHNs, with an average of 23.88 years of experience. Interview transcripts were transcribed verbatim and analyzed using inductive content analysis to extract themes regarding participants' activities and emotional experiences during the pandemic.Results　Under crisis conditions, six categories describing PHNs' activities included (1) coping with rapidly increasing responsibilities under uncertain conditions, (2) supporting vulnerable populations and their caregivers, (3) restoring maternal and child health services, (4) initiating organizational and interagency collaborations to mitigate social deterioration, (5) collecting and sharing information to minimize the negative impacts of restrictions, and (6) working with community leaders and professionals to sustain residents' well-being.　Seven categories emerged regarding ethical and psychological conflicts; (1) confusion from expanded roles, (2) frustration at being unable to support those in need, (3) self-doubt about service effectiveness, (4) barriers to collaboration with health centers and other institutions, (5) discrepancies between organizational policies and community realities, (6) re-examination of the meaning of public health nursing during pandemics, and (7) challenges due to insufficient infection control knowledge and systems. A key competency theme was the need to reacknowledge the PHNs' role during health crises.Conclusion　During the COVID-19 pandemic, municipal PHNs have experienced limitations in providing individual support and changes in their professional roles. However, they continued to support residents via trust-based relationships with the community and the foundation of public health services, which has been built during normal times. Furthermore, they frequently face ethical dilemmas if prioritizing tasks and responding to residents, which often entails emotional burdens.