The objectives of this study were to clarify the self-rated health of local residents, to investigate the practices and preferences for promoting good health, and to outline the necessary support of health professionals for it. There were 1905 subjects (902 males and 1003 females), 20 years or older, living in the area of a public health center in Wakayama Prefecture. The self-rated health of the individuals was evaluated by visual analogue scales. Among the 6 aspects of the self-rated health model that were adopted, physical and environmental aspects were the highest in both sexes, followed by social and spiritual aspects, and last by mental and emotional aspects. All aspects generally increased with increasing age in both sexes. Multiple logistic analysis revealed that advantageous factors related to those aspects of high self-rated health were good dietary habits, activities in the community, laughter, pleasurable or impressive events in daily life, as well as rest. Disadvantageous factors were stress and depressive moods. Practices and preferences that promoted good health were "a routine lifestyle, sound sleep and sufficient rest (routine lifestyle)", "the intake of good food for health (good food)" and "attitudes for alleviating stress." Routine lifestyle and good food were found to be significantly less in the group with the poor self-rated health than the other groups. Necessary support for health promotion was preserving good living environments for health and having more comprehensive and more explicative health checkups. These factors were significantly lower in the group with the poor self-rated health. These results suggest that health professionals need to provide local residents with support for alleviation of stress, encouragement for getting regular health checkups, participation in activities in the community and preservation of good lifestyle environments for health in order to raise individuals' self-rated health.

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While more attention is paid to home care evaluation, not only objective but also subjective evaluation is important. We can review nursing care by evaluating client satisfaction. The purpose of this study was : (1) to identify home care services contributing to client satisfaction, (2) to analyze relations between client satisfaction and characteristics ; and (3) to examine home care services for improvement of client satisfaction. The subjects were 116 of 191 clients in four home care agencies in "Y" city. After excluding 22 incomplete responders and 13 representing responders, we analyzed Slclients. The results were as follows ; 1. Client satisfaction and home care services 1) "Home care can avoid hospitalization or institutionalization" The satisfaction ratio was raised from 1.84 times to 2.84 times when indirect services like acting as go-between physician and family were performed. The satisfaction ratio was raised from 1.42 times to 1.96 times when direct services including personal hygiene were carried out. 2) "Frequency and time of home care services" Indirect services such as information sharing and coordination with care manager raised the satisfaction rate to 1.3 times each. 3) "Reasonable care services" Listening to anxiety and distress raised the satisfaction rate to 1.8 times. 2. Client satisfaction and characteristics Avoidance of hospitalization or institutionalization" Clients who needed help for transfer and ambulation were satisfied 1.5 and 1.4 times more, respectively than those who did not need such help. Since home care providers do not work alone, multidisciplinary collaboration is important. It is necessary to effectively provide preventative direct care services for clients to live at home. Furthermore, sharing information and coordination with care managers are needed, and home care providers are also required to have good communication skills and identify clients' needs accurately and quickly.

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With increasing numbers of women joining the evening/nighttime and extended-hour workforce, there is a need for quality childcare during these hours. This project, conducted in Japan, sought to compare the effects of expanded child-care on the development and adaptation of 30 infants after five years in care. Parents completed a survey on the childrearing environment at home, their feelings of self-efficacy, and the presence of support for childcare. Childcare professionals evaluated the development of children. The results indicate that factors in the home environment, not length of center-based care, explained developmental risks five years later.

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The purpose of this study was to classify the home-bound disabled according to their ability to perform activities of daily living and according to their lifestyle, and to examine effective care for each class when a physical therapist does visiting rehabilitation. The study involved 11 disabled persons in A Prefecture. The method was as follows : their ability to perform activities of daily living and their lifestyle were rated, and cluster analysis was used. As a result, cluster analysis formed 3 clusters : "Preventing the person from withdrawing into a shell," "Improving the performance of activities of daily living," and "Preventing disuse syndrome." Effective care for each type was believed to be as follows : Care to prevent withdrawal and physical depression caused by withdrawal appears to be effective in preventing withdrawal into a shell. Care to improve performance in the activities of daily living appears to be important in establishing an early independence in performing activities of daily living. Care to prevent the home-bound disabled from becoming bedridden and to maintain QOL appears effective in preventing disuse syndrome. This study suggests that, compared with the care level classifications of long-term care insurance, classification of the home-bound disabled by their performance of activities of daily living and by their lifestyle would be useful as an index to determine the appropriate care menu when a physical therapist does visiting rehabilitation.

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The purpose of this study is to identify the needs for novice public health nurses to formulate professional capability. In this study, we discussed the overall professional capability of nurses and defined as follows," from the viewpoint of health authority and nursing, public health nurses need the ability to work with residents, specialists and organizations, and to encourage people to promote their own good health. They also need to interact with performance in processes to identify, plan, implement and evaluate the assessment needs to provide supports to individuals, families, groups and communities. Under such perspective, we collected data by the group interview technique to analyze. We divided 17 nurses with less than 5-years experience into two focus groups, and examined whether they gained or failed to gain high approval by residents and organization, and their background factors respectively. We asked experiences and environment to improve their abilities, their thoughts and expectations for the current training programs. As a result, we found they need three domains of needs to formulate the professional capability ; 1) individual domain, which was classified into commitment, basic skills, attitude of work-based learning, forward-looking and flexible personal nature and stable life in the region, 2) reciprocal domain, which was into communication with mentors, other stakeholders and residents, and collegial support, and 3) environmental domain, which was into mentor's attribute, job descriptions in the organization, OJT and Off-JT programs, well-balanced human resources allocation, office culture, and vertical/horizontal networking. The outcomes suggested that novice nurses have to acquire skills to learn from daily practices through job identity base during the basic training, and that they review the structure by the concept of mentoring concerning development support at the workplace in order to nurture the mentors.

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