This study examined comprehensive care to promote independence in excretion in the city with such regional characteristics as a basis for discussing the roles of the nursing college with the mission of contributing to “education”, “research”, and “society” in this area. A questionnaire survey was conducted involving 72 professionals, who participated in a training course provided by the community-based comprehensive support center of a provincial city (study city), and their responses in a free-description style were examined by Berelson’s content analysis. The current status of IPW to promote independence in excretion among older people requiring care was outlined by the following 7 categories: collaborating with professionals needed in consideration of user individuality, collecting/sharing information, performing the PDCA Cycle, providing guidance for family caregivers, respecting users’ and their families’ intentions, respecting various other professionals, and raising awareness to promote independence in excretion. Challenges of such IPW were classified into factors associated with current challenges and approaches required to resolve them, which were represented by 8 categories each: the former included: users’ and family caregivers’ personal backgrounds, barriers between medical and other institutions, deficiency of resources for collaboration, complexity of various excretion care interventions, and facilities’ problems; and the latter included: education, Ingenuity for consensus-building, partnership, and ethical considerations. The results highlighted the necessity of examining the types of information to be shared, as well as the methods to share such information and make use of it for plan implementation through a series of processes, when proving care to promote independence in excretion among older people requiring care through IPW. Interprofessional education to improve management skills as a basis for promoting independence in excretion was also suggested to be required.

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The purpose of this study was to clarify the association between the level of midwifery skills evaluation and midwifery experience in maternity care among young midwives with two to four years of experience, excluding new midwives with one year of experience among those with less than five years of experience working at perinatal medical centers in Japan. The survey was conducted among consenting midwives in 38 cooperating facilities. The subjects of the survey were randomly selected from 407 perinatal mother and child healthcare centers in Japan, and 38 midwives who cooperated were surveyed. Maternity care skills (20 items on pregnancy, 41 items on labor, 34 items on the puerperium and neonatal period) in the training guide for newly-graduated midwives were used as survey items. Responses were received from 102 (42.1%) midwives, of which 99 (97.1%) were valid responses. Twenty-seven (27.3%) were in their second year of midwifery experience, 33 (33.3%) in their third year, and 29 (39.4%) in their fourth year. The percentage of "able to do" response was high for 17 items in <diagnosis and care during pregnancy>, 37 items in <Diagnosis and care during labor>, and 31 items in <Diagnosis and care in puerperal and neonatal periods>. The percentage of responses other than "possible" was high for items in the high-risk diagnosis and care in all periods. In terms of "maternal transport care" and "mental health follow-up of maternal women and families with children such as fetal abnormalities and deaths," and similar issues, midwives with 2 years of experience had a low score for "do it yourself." Clearly, young midwives still have items that are difficult to evaluate with confidence. Therefore, midwives have yet to acquire the skills necessary for high-risk cases compared to low-risk cases. We believe that these skills would improve as the midwife gains more experience.

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Kataoka points out changes in the circumstances surrounding young children, particularly the time spent the media, such as television and smartphones, may negatively affect infants' speaking functions. In this study, it was investigated the effects of "Involvement of the parents" and "Time spent watched the media" on infants "Have or haven't delay in eating function" and "Have or haven't delay in talking function". In addition, this study aimed to clarify whether there is a relationship between "Delay in eating function" and "Delay in speaking function" in infants.Twenty-three children (13 boys and 10 girls, mean age 30 ± 9.1 months) attending a nursery school (Yamaguchi prefecture) were studied. The results showed that "The time spent watched the media" was significantly longer in the group have delay speak than in the group haven't delay. The score of "Talking" in parent's involvement was significantly lower in the group have delay language comprehension than in the group haven't delay language comprehension. the results of logistic regression analysis suggested that the time spent watched the media had an impact on delay in speaking function. In conclusion, he responsive relation with the person who is close rather than the one-way information through the electronic device is important for "Speaking function".

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The purpose of this study was to clarify the factors related to preparatory behaviors for death of older women who lost their husbands before old age and are now in old age. Five older women who lost their husbands before old age were interviewed. Data were analyzed using Steps for Coding and Theorization (SCAT), which is a qualitative data analysis method using four-step coding. Factors related to preparatory behaviors for death were generated in three categories, such as behaviors that help in adapting to life without a spouse, behaviors that aim at seeking to live better, and behaviors that prepare for the final stages of life. Behaviors that help in adapting to life without a spouse included time factors, living factors, financial factors, health factors, and family factors related to the opportunity and room to think about their death. In behaviors that aim at seeking to live better, it was the action factors with a view to enjoyment and death, such as goal factors, internal factors, acceptance factors for aging, and acceptance factors towards death. Behaviors that prepare for the final stages of life included recognition of preparatory behaviors, expectations for preparatory behaviors, actual preparatory behaviors, and the matter that revealed in preparatory behaviors. These were not behaviors of a particular order, but occur naturally as part of a spouseless life.

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Background: Psychiatric treatment in Japan is shifting from hospital to community-based care. However, many patients require re-hospitalization in the short term, indicating that recovery support is insufficient and does not correspond to the needs of patients. Aim: In this study, nine community-dwelling patients with schizophrenia were interviewed regarding their experiences from hospital admission to discharge and their return to community life. Method: Data from interviews were transcribed and analyzed using qualitative descriptive methods. Results: The participants described encountering the unknown and tried self-coping, but were still being hospitalized in crisis. In the hospital, they experienced distress in the closed environment; however, they also received support that ensured security and motivation, and were able to confront their distress, transform themselves, and leave the hospital. They described their experiences of having symptoms and regarding community life concerns, but were still able to accept things as they were and obtain support, which gave them hope. Finally, they described realizing recovery from illness and seeking a way of life with goals. Conclusions: This study demonstrated the recovery process (patients learning to help themselves and increase their resilience), as well as the protection of patients’ human rights (listening to their subjective and informed experiences).

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It is still unclear whether the effects of lower-limb aerobic exercise (Kohzuki Exercise Program; KEP) are effective in improving physical function as an exercise program for frail older adults. The aim of this study was to determine the effect of the 6-month structured KEP on physical function in frail older adults. The KEP group participants engaged in a total of 72 sessions, 3 times a week for 6 months. The KEP consisted of 5 minutes of warm-up and stretching, 30 minutes of lower-limb aerobic exercise, and 5 minutes of cool-down and relaxation. The control group (CON group) participants were asked to maintain their normal behavior over the same 6-month period. Physical function as an outcome was measured using the Short Physical Performance Battery (SPPB). A total of 23 participants (KEP group: n=12; CON group: n=11) who participated in this study. The analysis of outcomes was performed by Friedman test and Wilcoxon signed rank post-hoc test with Bonferroni correction for the comparison between the time; baseline, 3 months and 6 months. There was a significant changed in physical function over the baseline, 3 and 6-month in the KEP group for SPPB total score (p‹0.01), balance time (p‹0.05), gait speed time (p‹0.01), and chair stand time (p‹0.01) at 6-month. In summary, the 6-month KEP intervention targeting physical function is an effective, long-term, and sustainable program for frail older adults.

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