Recently, it has been recognized as important that public health nurses (PHNs) of the public health insurance societies should contribute not only to individual worker's health but also to healthy workplaces. However, these support processes by PHNs have not been fully elucidated. Therefore, the objective of this study was to clarify the support processes for promoting healthy workplaces by PHNs of general health insurance societies (GHISs) and the related factors. Semi-structured interviews to 6 expert PHNs of GHISs were conducted for clarifying their support processes and the related factors. As the results, three main support processes were identified as follows, "designing strategies and making consensus for workplace health promotion (WHP) activities in GHIS," "establishing reliable relationships with key persons in enterprises, giving them needed support and encouraging employees to conduct WHP activities" and "informing PHNs of GHISs the meaning and the support skills for WHP activities, evaluating and prevailing WHP activities." Also, three main factors were identified, "the factor related to the characteristics of PHNs," "the factor related to the policies of GHISs" and "the factor related to the workplace environments of the insured companies." In the future, it is expected that these findings will contribute to further dissemination of the support activities for WHP by PHNs of GHISs.

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Purpose: To identify, through a review of the literature, the current status and challenges facing childcare support provided by public health nurses. Method: We searched the relevant literature featured in Japanese Central Review of Medicine and Public Health Nursing Journal. Results: According to Public Health Nursing Journal, public health nurses are providing diverse types of childcare support to numerous targets. However, few of their activities are reported in the form of research papers, which also tend to lack detail on the actual content of childcare support and on how mothers and public health nurses themselves assess such activities. The authors cite the main task of childcare support provided by healthcare professionals as supporting the programs to promote continued assistance in regional areas. Although childcare support by husbands is reported to help mothers' quality of life, and increase their self-confidence and awareness as childrearers, no papers describe efforts by public health nurses to contact the husbands or attempts to coordinate husbands' childcare support with that provided by public health nurses. Discussion: The literature confirms the need for public health nurses to provide childcare support. However, since they carry out frequent childcare assistance on a daily basis in a variety of forms, they appear to perceive it only as a vague concept. We conclude the following to be our future tasks: (1) to use the findings of case studies on childcare support as a starting point for research on establishing assessment indicators that can be used by the mothers, and thence to construct an assistance setup; (2) to study and evaluate a screening system; (3) to establish a method of providing mothers with ex post facto assistance; and (4) to study factors for assessing the degree of childcare support by husbands and to develop a method of following up the resultant findings.

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Maintaining the peak bone mass at a higher level acts to prevent fracture due to osteoporosis in the future. To elucidate whether health training for the prevention of osteoporosis that included bone density measurement would help trainees understand preventive measures and change their behavior, we evaluated the effects of training by comparing the subjects' level of understanding concerning exercise and diet and their behavior before training with those 3 months after training. The subjects were 45 healthy female college students. They had their bone density measured and were informed of the results, and then received health training to prevent osteoporosis. A comparison of their understanding/behavior scores before training with those 3 months after training demonstrated the development of their understanding regarding 2 items (habit of exercise, and consumption of green and yellow vegetables) and an improvement in their behavior for 2 items (consumption of fish and salt). These results suggest that health training for osteoporosis prevention has the effect of promoting trainees' understanding of a healthy lifestyle and improving their diets toward the prevention of osteoporosis.

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The purpose of this study was to explain the practice and the meaning of visiting bereaved families by nurses engaged in home terminal care. A qualitative-inductive design was utilized. Eight visiting nurses participated in semi-structured interviews that were recorded and transcribed. Grounded theory approach was employed for data analysis to compare similarities and differences among the interviews. Visiting nurses described the following actions: <sharing their inner world>; <understanding actual condition of the bereaved>; <ensuring evaluation of home terminal care>; <advising from a different perspective>; <referring life-supporting resources>; and <realizing bereaved spiritually depended on them>. Through these actions, visiting nurses <became aware through introspection>; <established direction for better nursing care>; <improved motivation>; and <accumulated the ability to give nursing care with better anticipation and understanding>. Furthermore, the nurses <determined their continued involvement of care> by <understanding the actual condition of the bereaved>, and <terminating the professional relationship> if it was not necessary. Theses actions included either [sorting out feelings for both parties], [acting as an advocate for the bereaved], or [leaning from the bereaved to make terminal care more constructive]. In conclusion, visiting nurses practice visiting bereaved families with two direction: 1) to help the bereaved accept the reality of family member's death and to implicate their caring for the loved one as a positive meaning; 2) to maintain their own mental health and to hone their skills to respect the life of persons whom they care for.

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Purpose: The present study aims to explore practicable and effective e-mail-based intervention methods for improving lifestyles. In the aim of this, we analyze the processes and outcomes of intervention we conducted. Methods: Subjects were 14 male workers (age range: 40-59 years) who completed a medical checkup at a hospital selected by their company. As a 12-week e-mail-based intervention, 10 non-smoking workers were sent guidance regarding nutrition, exercise, sleep, and drinking behaviors, and 4 workers who smoke were sent guidance regarding smoking cessation. In addition, face-to-face guidance was provided after the medical checkup. During the 12-week e-mail-based intervention, we recorded how long it took to prepare the e-mail guidance, what facilities are required for providing guidance, and what problems we encountered while preparing the email guidance. Based on follow-up e-mails and records made during the 12-week intervention, the frequency of providing guidance to each subject, the time required to prepare the guidance, the purposes and contents of guidance, and necessary conditions for improving e-mail-based intervention methods were clarified. Results/Discussion: The 13 subjects except 1 smoker have finished the program. Their lifestyles and results of medical checkups improved. The frequency of providing guidance and the time required to prepare the guidance were different among them. Some of the contents of guidance included intervention with counseling. The present findings indicate that in order to improve the effectiveness of an intervention, it is necessary to modifying guidance to correspond with the situation and behavior of the subject. Furthermore, because the face-to-face guidance facilitated our understanding of the lifestyle and personality of the workers, including face-to-face guidance in e-mail-based interventions is effective. Regarding the practicability of facilities needed to interventions, it is important to design interventions that do not require subjects to acquire special skills or software to participate in the program. In addition, to improve the efficiency of an intervention, prepared guidance materials should incorporate content that is common to many subjects and is frequently used.

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The purpose of this survey was to analyze the mental health and stressors of the engineers who work in the semi-conductor maker. The survey involved 273 engineers. 245 engineers responded, making the recovery rate 89.7%. 1) 132 (59.7%) of male engineers and 17 (70.8%) of female engineers presented abnormal findings, representing 149 (60.8%) of all engineers tested. Classifying the average of the GHQ28 results by age, it was shown that the group aged 35 to 39 scored highest at 109 (70.6%) engineers. 2) Severe displays of "physical symptoms" scored highest at 13.5% on the hypostasis scale. Regarding the ratio of abnormal findings, the following 3 items got high scores; "social behavior disorder" (80.8%), "physical symptoms" (71.0%), and "insomnia and anxiety" (71.0%). 3) What engineers regarded as stressors were; a job (72.2%), personal relationships (31.8%) and a family (16.7%). The significant difference were found between the group who feel stressors and the group who don't feel stressors in both the total GHQ28 score and the all hypostasis scales (p<0.001). 4) Regarding "the stressors on the job," "the stressors on the personal relationships" and GHQ28 score, the significant difference was found between the group who feel stressors and the group who don't feel stressors in both the total GHQ28 score and the all hypostasis scales (p<0.05). The causes may be stressors resulting from the short development time for the product and "techno-stress." It is expected that the mental health problems of the engineers who work in the semi-conductor maker will be cleared by analyzing the factors of the stressors in detail.

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Purpose: Women raised in the present generation grow to adulthood without seeing mothers raising children firsthand or actual contact with young children, and so it is easy for a discrepancy to occur between child-rearing as they had imagined it and as it really is. We aimed to clarify the effects that mothers' emotions can have on the discrepancy between the imagined and real. Methods: Semi-structured interviews were conducted of 15 mothers of 10-month-old first children. Results and Discussion: The mothers perceived a discrepancy in that the extent of changes in their life from having a baby, and the level of the accompanying physical and mental burden, was greater than they had imagined. It has been indicated that the emotions women feel when they become mothers, as well as the emotions that accompany the burden they experience in actual child rearing, are difficult to imagine from short-term contact with other people's children. When a woman loses her mental latitude, negative feelings toward her husband and child-rearing may arise even while she maintains a generally positive assessment of her husband and child-rearing. The findings suggest that the emergence of dissatisfaction with one's husband and negative feelings toward child-rearing affect the mental state of the mother. They also suggest that, by comparing the pluses and minuses of child-rearing, a mother will feel she has gained more, and positive feelings toward child-rearing will dominate in the mother's heart.

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Purpose: The objective of this study is to clarify the nursing interventions of public health nurses (PHNs) who visit housebound elderly people in order to expand their daily activities. Methods: A qualitative inductive (factor-exploratory) study using semi-structured interviews was conducted with eleven PHNs who had been in charge of the community for over 5 years, who were recommended by PHN administrators, and each of whom gave consent. The interviews were recorded and transcribed, and a detailed analysis was carried out for clarifying concrete nursing interventions. Results: We found that nursing interventions consist of three levels for housebound elderly people themselves, their families, and communities, which were classified into 14 categories (e.g., connecting with uses of resource), 8 categories (e.g., understanding relation in family), and 6 categories (e.g., analyzing community problems), respectively. Conclusion: We found how to support house bound elderly people concretely in order to expand their daily activities and by working with multi-level nursing interventions for housebound elderly themselves, their families and communities.

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[in Japanese]

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[in Japanese]

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Objective: To clarify the characteristics and the significance of the activities of public health nurses (PHNs) belonging to public sector and private sector, especially nonprofit organization. Methods: Semi-structured interviews were conducted with three PHNs working at nonprofit organizations after retiring from public sector. Data were collected from September to December, 2004. Results: The following cases were reported: "PHN of public sector saved nursery school in a remote area from removal," "PHN of nonprofit organization expanded the use of Mother-Child Exercise she originally devised when working at public sector," and "PHN of nonprofit organization swiftly took care of health problem in the community." Conclusion: The characteristics of the activities of PHNs of public sector are as follows: they can contact with community residents with legal basis, by judging from the original information of public sector; they can provide the administrative specialist services without considering profit; they can directly lobby the decisionmakers. Moreover, those of PHNs of private sector are as follows: they can build the equal relationship with community residents; they can approach the various administrative departments from their position as PHNs of private sector; they can provide the specialist services on their own ground; they can swiftly take care of the problem. Among the fast-flowing of switching from public to private sector, it might be important to develop the PHN activities fully utilizing the characteristics of both public and private PHNs.

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Purpose: Since 2000, mini-day-services for preventive health care and healthful life have been implemented in every community of K town, S Prefecture, Japan. Our goal was to look at community empowerment through these mini-day-service activities using the Community as Partner Model. Methods: Focused Group Interviews (FGI) were done on 3 groups consisted of supporting members. And, Individual interviews and participant observation were held. And, existing material were used. Results: The Community Core and the 8 segments of Subsystems were discussed according to the Community as Partner Model example. After making a full and accurate transcription from the tapes, we generated a list of key ideas. We did this to formulate categories of concerns and placed the items and quotes in the most appropriate categories. We picked out 4 stressors and showed the community member's reaction against each stressor. After that, several plans they implemented to cope with each stressor were examined, and their activities were carefully evaluated. Conclusion: Through our research and analysis, we found that the community (composed of the core group and subsystems) was changed and empowered through coping with several stressors. We found the Community as Partner Model to be a useful tool to demonstrate the community empowerment process.

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Purpose: The starting times of community health nursing courses differ from college to college. This study was aimed to analyze how this difference affects students' levels of understanding community health nursing and interest in it, as well as the formation of their nursing philosophy. Methods: The starting times of community health nursing courses were categorized into 5 patterns. For each pattern, 28 colleges were selected, and a questionnaire was sent to the senior students by mail. Relating to community health nursing, the questionnaire contained 7 survey items: (1) image, (2) interest, (3) level of understanding, (4) level of difficulty, (5) positioning, (6) period of the course, and (7) nursing philosophy. The answers were statistically analyzed for each of 3 student groups formed for each pattern based on the college year-specific starting time. Results: The results showed no significant difference by the course starting time in students' attitudes toward community health nursing. Their images of community health nursing included "extensive," "warm," and "ambiguous," and many students found the level "a little difficult." Their interest was greater in the area of home nursing. Comparison between the 3 groups revealed that the group of students starting the course from the third year significantly differed from the other groups in the items of image, level of understanding, level of difficulty, and nursing philosophy. Conclusion: The difference in course starting times was relatively strongly reflected in the answers from students starting the course from the third year. Overall, however, each student presented a similar tendency.

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[in Japanese]

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