We performed a survey on the conditions of weekend home return of physically handicapped children reared in the Tokyo Metropolitan Kita Medical and Rehabilitation Center for therapy and/or rehabilitation (n=83). Their frequency of weekend home return during one year (1/4/1994〜31/3/1995), their character and information related to family circumstances were collected from the case records and annual reports of each resident child. We divided the children into two groups : the "good" group (G-group ; n=48) who can return home every weekend, and the "obstructive" group (O-group ; n=35). There was no differences between the groups in the children's characteristics, e.g., degree of disability, ability of ambulation and communication, etc., except for abnormal behavior. Activities of daily living (ADL) are considerably better in the O-group. On the contrary, the degree of influence of their mothers was critical. Once they had become motherless because of death of mother, divorce, physical ill-health or mental disorder of mother, etc., children were not in a position to return to their own homes. There was also a significant difference between the groups in respect to the conditions of entry to the institution, such as the reason, route and experience of former admission. The children in O-group have been living in this institution for more than four years on average, and with the maximum 13 years. He/she has been brought up by nurses and child-care workers in charge of him/her for individual treatment. But these workers work in shift relays and often transfer to other institutions. Thus, they cannot take coherent care of their children patients once in charge of them. In addition, because the children's rooms are equipped as a hospital, children cannot make themselves at home. The treatment plan should be reconsiderd to enhance children's Quality of Life (QOL).

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The aim of this study was to clarify the characteristics of media usage to information concerning home based welfare services in the aged. The subjects were randomly selected by staff of the Department of Welfare in K town from among people aged over 65 years old who were residing in k town at the time of the survey in December 1994. The items surveyed were sex, age, educational background, family composition, income, family care, self-rated health, medical care received, extended ADL, TMIG Index, and sources of information on home based welfare services. Answers to the survey were obtained from 295 people and the results of analysis showed that the extent of information media concerning home based welfare services in the aged differed according to the type of media. Quantitative analysis also showed that differences in the usage of information media could be group according to local, mass and personal media. This study also showed that the following factors affected the degree of each type of media usage : self-rated health and famity care in the case of local media, educational background and level of intellectual activity in the case of mass media, and medical care received, total income, educational background and instumental ADL in the case of personal media. The results of this syudy indicated the importance of considering the characteristics of the aged subjects for the selection of an appropriate medium to convey information concerning home based welfare services in the aged.

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The study examined the relationship between the level of subjective QOL and impairment and disability of 327 stroke patients living at home. Among the 327 samples, 89 subjects who responded to the subjective QOL questionnaire by themselves were used for data analysis. With the nine subjective QOL factors being the dependent variables and the 12 extended ADL factors being the independent variables, the canonical correlation analy siswas conducted.Finding was a significant correlation between the energy of livingand instrumental activities of dailiy living (IADL). In term of improving the level of QOL for the stroke patients living at home,the study suggested that, besides being the ADL scale,the IADL can be aneffective index for one's level of adaptability to the social environment.

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Evaluation of Environmental Stimulation (EES) was done to clarify the feature of the Evaluation of Environmental Stimulation for children of 6 month, and the related factors. EES is the scale which has been developed in Japan since 1987 for identifying the risk of raring" environment and support. The subjects were all the 381 children of 6 month who came for the compulsory health check up. Caregivers were asked to answer the questionnaire version of EES, and interviewed at the center. The results are as follows ; 1) The feature of the rearing environment for children of 6 month were evaluated by using the items which directory assessed the kinds and times of stimulation, which include 7 regions, (1) human stimulation, (2) response, (3) avoidance of restriction, (4) physical stimulation, (5) social stimulation, (6) safety, (7) social support. 2) The feature of the EES were strongly related to the child development, for example, 6 month age is the point of having curiosity to the environment around themselves, so the human stimulation and the timely, suitable response are very important at this stage. 3)The relation between EES and the risk against development, risk against health, number of siblings, and stress of rearing were examined. The subscales and some of the items were related significantly. EES is useful to assess the framework of the rearing environment, and helped the health-social staff to make effective care plan. Further research must be done to develop more effective and useful scale of environmental stimulation.

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