Purpose
This paper evaluates the background to the introduction of long-term care with utilization of local festival activities upon the discontinuation of publicly supported long-term care services, as well as associated challenges on a minor outlying island, thereby discussing the creation of community care through the restoration of mutual aid as local culture in Okinawa.
Method
After grasping the background to the discontinuation of publicly supported long-term care services on an Okinawan island where the influence of local culture remains strong, a semi-structured interview survey regarding the discontinuation was conducted with 10 care provider (hereinafter, “care workers”) and 27 members of families of long-term care receivers (hereinafter, “families”). The survey data were then subjected to qualitative inductive analysis, and both sets of data were summarized and discussed to identify the nature of the strengths of community care arising from the utilization of the local culture of minor outlying islands.
Results
Assessment of the background revealed that replacement of the traditional care style, which mainly relied on family members and local people (in the form of mutual aid), with publicly supported long-term care services created a sense of crisis that elderly residents in need of long-term care would be deprived of their sense of unity with their families and the community. Both care workers and families identified [pleasurable reactions of the elderly] and [positive value to have local festivals at home]. Care walkers identified [confirmation of family care], [expectation of motivation to live through local festivals], [revival of island local festivals by the care of island residents and mission], [new tasks after discontinuation of long-term cares] and [reflection of the care so far]. Families identified [accepting of family care], [enhancement of family tie by local festivals], [empathy and appreciation to the view of care of island residents], [limitation of family care] and [dissatisfaction of long-term care services discontinuation].
Discussion
From the evaluation of discontinuation of long-term cares in a minor outlying islands, we found utilization of local culture creates local care. Since local culture exists in each everyday life area or self-governing association in urban areas, the necessity of incorporating community culture to build comprehensive community care system.

The purpose of this study was to examine the relationship between mothers’ positive child-rearing feelings and social capital (SC) of mothers, and to consider adequate child-rearing support measures within the community culture of various regions.
We selected 3 regions with different degrees of social capital in Japan based on a Cabinet Office survey (2003), and conducted an anonymous self-administered questionnaire survey for mothers having 2 to 3-year-old children at nursery schools or other facilities. Chi-square test was used to compare SC, and the Kruskal-Wallis test was used to compare mothers’ positive child-rearing feelings among the 3 regions. For multiple logistic regression analysis, positive feelings on child-rearing were set as dependent variables, after adjusting personal attributes for each region.
Significant regional differences of SC were noted regarding mothers’ awareness of mutual aid and regional community activities. However, no significant regional differences were found in mothers’ positive feelings on child-rearing. Multiple logistic regression analysis showed that, in a high SC region, positive child-rearing feelings were higher in mothers aware of mutual trust than those who were not with an odds ratio of 3.11; while the odds ratio was 3.34 in an intermediate SC region. In the high SC region, mothers who participate in regional activities had positive feelings about child-rearing, with an odds ratio of 2.06.
The SC related to positive feelings of mothers during child-rearing varies depending on regional community culture; thus, adequate child-rearing support measures are considered necessary based on regional cultural aspect.

Purpose
The purpose of this study was to clarify regional potential based on traditional cultures of B, a fishing and agricultural village in Okinawa, and to gain hints for constructing a care system for mutual support in the neighborhood in the future.
Methods
The authors conducted a qualitative and descriptive analysis of interviews with five participants who had experiences in giving care in B and contents of participant- observation of traditional events. As a result, 87 key sentences, 15 sub-categories and following five categories as indicated in square brackets were extracted.
Results
Familiar relationships over many generations based on [strong relationships by territorial bonds] were continued in B. The community center had functions, roles for sending and collecting information, and became a place for further exchanges in the elderly: alleviation of burdens for caring families, emergency counseling. Besides, social- workers based in the center supported the elderly and took care of them. Thus, [elderly-care by highly trusted social workers and community center] was practiced.
Residents cared for each other and looked after the elderly in need. They especially helped the families of the elderly with dementia directly and indirectly. Therefore, the basis of informal support by [mutual aid as personal affairs between residents] was seen.
In addition, “Honen-sai”, a harvest festival treasured the traditional cultures that has a history over 120 years, nutured young generation’s feelings toward their community and had rich social resourses such as [traditional events inherited by all residents] via [multi generational connections strengthen by the events].
Conclusion
Consequently, the result suggested that even the small village based on cultural basis like B may have the enough regional potential to help each other and survive.

Purpose
The purpose of this study was to clarify pride and important things in cultures of Okinawa via stories of the elderly people who are first-generation Japanese-Bolivian from Okinawa, and to gain hints for construction of community-based integrated care- system considered cultures of the colony, Bolivia.
Methods
We conducted interviews with 102 research participants by use of semi-structured servey questionnaires and extracted a series of context talked about their pride and important things in the cultures as the original via verbatim reports, then categorized them.
Results
The participants had “pride in opening up a new field” with “nostalgia for home”. They valued the culture of mutual aid via “YUIMARU blended in daily life” (YUIMARU, a word from Okinawa dialect, refers to mutual assistance) and received energy, friendship from “empathic Okinawa dialect” based on “ties of family, relative strengthening a sense of belonging” in the enviornment which they could feel “pleasure and ease among friends from the same home-town”.
They treasured such as “Honen-sai”(a harvest festival) as “traditional performance art everyone can enjoy and dance together” and inherited ancestor worship, events related to the lunar calender as “traditional events passed down continuously”. They were impressed at “deference to elders” of the next(second and third) generations and proud of living with “a mind to pass down traditions” to them.
Discussion
As the future direction of the community-based integrated care system, it is necessary to promote the system after considering the cultures, the state of healthcare, welfare in Bolivia and understanding YUIMARU, the cultures of Okinawa taken root in the older first-generation immigrants as advantages.

Purpose
To clarify the actual conduct of home-visit nurses for end-of-life care in a rural mountainous region with having a shortage of medical resources, and to investigate the relationship between nurses’ the roles of nurses and regional culture.
Methods
Semi-structured interviews were conducted with 2 home-visit nurses who had experienced in dealing handling “cases in which a patient died in the course of home-visit nursing practice care” in a region lacking adequate numbers of doctors or with, decreasing birthrate and aging population. The modified grounded theory approach (M-GTA) was used to qualitatively analyze the obtained data.
Results
Home-visit nurses were found to “provide “opportunities for emotional happiness” of each patient by conducting “assessment of the health conditions and normal life-style” and “understanding needs to maintain the patient’s life-style till time of death”. For “preparation of environment surrounding a dying patient”, nurses provided consultation, coordination, education, and close connection with the patient’s family, local community people, and administrative organizations including medical/public health specialists for care of the patient. Home-visit nurses were “built ding up human relationships surrounding the patient” for to support the patient with from the regional people through by “educating families about physical indicators of the end-of-life” and “acted served as a liaison and coordinated as a medical specialist aware of the patient’s ordinary life-style between the patient and hospital staffs with relatively high threshold”.
Discussion
In practicing nursing care, home-visit nurses provide heart-felt care are providing heartful consideration while respecting individual patients, through understanding patients’ and their family’s the sense of values of the patients and their families. This indicates home-visit nurses are trying to care help dying patients, while considering regional culture of the region and wishes of each patient.

The purpose of this paper is to identify a viewpoint for assessment of local culture care by describing assessments by nursing professionals who practice local cultural care for the elderly requiring long-term care. Two nurses, each with at least 30 years of experience in providing elderly care, participated in this study as research collaborators. Data were collected through an interview survey about cases of local cultural care, and about the reasons and background for assessing the necessity of local cultural care. Qualitative inductive analysis was applied to data on practices of local cultural care and assessments of the necessity of such care. The local cultural care practiced by the research collaborators consisted of the acceptance, utilization, and succession of local culture. Such local care also received favorable responses from the elderly and their families, increased the effects of care, and deepened care relations. The nurses assessed the necessity of local cultural care from viewpoints of reuniting elders who were isolated from local culture with their families, realizing a perspective on nursing based on local culture, and demonstrating the effectiveness of local cultural care. It was suggested that local cultural care by nursing professionals can deepen care relations and can enable the elderly to continue participating in their community even if they require long-term care. To promote local cultural care, the results of this study suggest that, as an assessment item, it is necessary to hear about the origins of the elderly requiring long-term care and their experience of local cultural behavior.

Background
As Japan is a rapidly aging society, nursing approaches that help enable the elderly to lead longer and more independent lives are needed.
Objective
The objective of the present study was to clarify characteristics of community-dwelling senior couples on the independent life.
Methods
The study participants were three community-dwelling senior couples living independently. Data were collected through semi-structured interviews and analyzed using a qualitative synthesis method (KJ method). This study was approved by the Ethics Committee of Saitama Prefectural University.
Results
The three senior couples had a mean age of 73.3 years and marital histories ranging from 46 to 48 years. The couples’ characteristics for continuing to live independently at home consisted of the following five characteristics: [do the favorite things and enjoy a satisfying life in good health], [engage in free discussion and acquire the life space each other to alleviate stress], [wife’s thanks for husband who after compulsory retirement to do domestic affairs with warm-heartedness], [devise ways to adapt to the various challenges of aging, such as physical, emotional, economic, and environmental changes], and [focus on health promotion and the ability to perform delicate attention].
Conclusions
The results of the present study suggest that to promote health among the community-dwelling elderly, such as senior couples, in an aging society, nursing care should consist of interventions with cultural perspective and focus on involve systems of comprehensive support.