Purpose : The present study aimed to clarify the content of the support extended by public health nurses to encourage resident's organizations efforts toward encouragement of community activity. Method : The author conducted a semi-structured interview with 5 skilled public health nurses respectively who worked at different health promotion advanced regions. The author asked them to describe the contents of the support, or the process that the resident organizations activities developed into community ones. Results : The process had 5 periods: support preparation, decision-making for the activities, activities commencements, independent activities, and activities spread to region period. With respect to the content of each period of the support extended, 37 main categories and 81 sub-categories were developed. For instances, some of the main categories were consideration of residents' needs, establishment of new organization, management of the organization, maintenance of the activity, consultation with difficulty. Moreover, regarding their support that prevailed in the all periods, 12 main categories and 31 sub-categories were identified. For example, they were rapport with the residents or encouragement of their independence. Conclusion : The public health nurses' extended their support to encourage the independent health activity undertaken by residents' organizations and to spread such activities in the region as well as to appeal to the municipal government to establish a system whereby residents could participate in the administration.

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Purpose : This study examined job satisfaction in novice public health nurses (PHNs) employed by a local government, in relation to mentoring, individual factors and organizational factors. Method : The subjects were 756 PHNs with work experience of 2 to 5 years. A total of 312 (41.3%) questionnaires were collected, of which 226 (29.9%) provided valid responses. Self-administered questionnaires (unsigned) were used to collect the data by mail. The questionnaire consisted of 93 items, including 14 items on job satisfaction, 42 items on mentoring, 13 items on individual factors (individual attributes, job attributes, job background, self development, etc.), 24 items on organizational factors (working environment, availability of continuing education at the workplace, working conditions, availability of mentoring, etc.). The mean scores of job satisfaction were obtained as two separate items. The data were analyzed by using chi-square test, t-test and multivariate logistic regression analysis. Results : The significant relation were found between job satisfaction and "mentoring scale" (OR ; 4.57, 95% CI ; 2.38-8.76), "small amount of overtime" (OR ; 1.75, 95% CI ; 1.17-2.61), and "large number of PHNs in one's division" (OR ; 1.28, 95% CI ; 1.05-1.55). Discussion : This study showed that novice PHNs employed by a local government recognition of support from a mentor seems to be prerequisite of job satisfaction, and the importance of mentoring was reinforced.

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Objective : To elucidate factors affecting the sense of fulfillment experienced by volunteers working with the handicapped during activities in order to enhance support for volunteers by public health nurses. Methods : Self-report questionnaires were administered to 396 volunteers registered at healthcare and welfare institutions in Hokkaido who were participating in "activities for the handicapped." From a total of 260 responses (65.7%), analysis was performed for 244 responses. The sense of fulfillment associated with volunteer activities was measured using a fulfillment scale. In addition, factors affecting the sense of fulfillment were structured into the following eight frameworks : "personal attributes," "volunteer experience," "motivation for volunteering," "knowledge of diseases," "experience of contact with the handicapped," "expansion of perspectives," "emotional support," and "burden." Multiple regression analysis was performed using sense of fulfillment as the dependent variable and 29 factors derived from the eight frameworks as independent variables. Results : A total of 10 factors affected the sense of fulfillment felt by volunteers working with the handicapped during activities, with "changes in perspective on the handicapped," followed by "age," "financial burden," and "confidence in knowledge of diseases" showing the most significant effects. Conclusion : The sense of fulfillment among volunteers was most affected by "changes in perspective on the handicapped." Support for promoting mutual interaction between volunteers and the handicapped that contributes to changes in perspectives on the handicapped is of utmost importance in enhancing the sense of fulfillment among volunteers.

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Objectives : The objective of the present study was to describe the gender differences among bereaved elderly adults with regard to social contact and going outdoors. Methods : A districtwide mail survey was conducted among 4,523 elderly residents, of which 72 (2.1%) had experienced bereavement. From the remaining 3,420 (75.6%) participants, 72 age- and gender-matched controls with corresponding levels of functional independence, who had not experienced bereavement, were enrolled. We compared the difference in social contact and going outdoors between the 2 groups using chi-square analysis. Results : The study participants (n = 144) comprised 46 males (31.9%) and 98 females (68.1%) with a mean age of 73.2 years (SD = 6.2). Of these, 128 (88.9%) elderly adults were capable of performing their physical functions independently. Compared to the nonbereaved elderly, the bereaved elderly reported that they were more likely to live alone or go shopping by themselves and were less likely to have a social network providing help with daily chores. The bereaved male elderly were reportedly less communicative with their family members or friends (in lending advice, asking for help or care when unwell) and did not have a support in crisis situations and have intention to use public service. Conclusions : The above results suggest that the male elderly has a greater tendency to remain socially isolated, especially the bereaved male elderly, who lack the support of a social network and intention to use public service. Hence, we need to develop particular community-based care programs for the bereaved male elderly population.

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Purpose : To explore the methods used by public health nurses (PHNs) to provide culturally appropriate health counseling for community residents in order to prevent life-style related diseases in rural areas. Methods : In 3 rural areas, a total of 14 subjects who have shown changes in habits that are necessary for preventing life-style related diseases after health counseling by 3 PHNs were enrolled as participants. Participant observation was conducted at health counseling sessions and during interviews with PHNs. Qualitative and inductive analysis was conducted on the following research questions: a) "What cultural themes did PHNs consider in health counseling?" b) "How did PHNs use those cultural matters in health counseling?" and c) "How did subjects respond?" Results : Four important cultural themes, including home style and work style that incorporate the sense of values common to the elderly, were extracted. Four methods for using these cultural themes, including 'addressing cultural issues when suggesting factors in life-style related diseases and making residents conscious of them', 'explaining the cultural reasons why life-style could be a factor in life-style related diseases, and motivating them to change their habits', 'understanding the value of their life-style and helping them to identify methods for changing their behavior,' and 'proposing methods that correlate classic and new habits in order to reinforce their decision,' were observed. Conclusion : PHNs are required to understand the generation and background of community residents in order to make them feel comfortable. When comfortable, the residents can act independently to change their behavior.

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The purpose of this study was to explore factors promoting health checkups in small-scale enterprises (SSEs), from the viewpoint of social capital. Concerning health care, surveys conducted using questionnaires in 198 SSEs in F-city, as well as semi-structured interviews of health care managers in five SSEs and executive managers and public health nurses in five health service agencies (HSAs), were analyzed by qualitative induction. The results show that the following factors promoted health "active involvement of the person in-charge of health management," "providing enough information on health management," "quality guarantee of provided health care," "efficient system support using resources from HSAs" and "relationship with mutual trust." To implement health management by considering these factors, it is necessary for the people in-charge to develop health care skills, in addition to effective and organic cooperation between related organizations. To achieve this, it is important to create opportunities for better communication and interaction among related regional organizations.

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Purpose : This study aims to evaluate the outcome of organizational level on-the-job training (OJT) conducted by public health nurse's leaders (PHN-L). Methods : PHN-Ls participated in off-the job training (Off-JT) concerning in-service education, which was conducted in four fields. Subsequently, they prepared an educational plan for the staff, implemented it, and evaluated it through one year. These educational practices were evaluated using a self-administrated questionnaire before the first Off-JT and after 10-12 months. Ninety of 145 PHN-Ls responded completely. Data were analyzed using Wilcoxon signed-ranks test and χ² test. Results : On conducting OJT, the self-evaluation showed high ratings for the second study in "distributing job tasks according to staff ability," "leading team work," "conducting case conferences for staff development," and "organizing meetings for in-service education." On creating organizational circumstances, the self-evaluation showed significant ratings in "formulating an educational plan for the organization," "identifying the educational stipulations at a work place," and "setting an educational position." We concluded that the working circumstances for in-service education improved because an education plan for the staff involving their superiors had been formulated and implemented. Improved OJT items related significantly to "disposing the person in charge of education," "years of experience in PHN," and "position." From these results, disposing the person in charge of education at the work place and empowerment are considered important for establishing an organizational level of OJT.

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Purpose : The purpose of this study was to clarify the required level of competency of public health nurses (PHNs) with 10 years of experience, working at a prefectural level, compared to local government administrators (LGAs). Methods : Subjects comprised PHNs and LGAs with ten or more years of experience, working for a prefecture or municipality. Self-administered questionnaires were sent by mail. The subjects were free to cooperate with or decline the survey. The required level of competency of PHNs was determined based on ten years of experience and measured based on a four-point scale. Data were analyzed by the Mann-Whitney U test. The number of valid respondent was 864 (response rate of 29.8%), they were analyzed. Results : For 37 competencies, more than 80% of subjects required the PHNs with 10 years of experience to have a level better than the level of "this activity can be done." They required the PHNs to have the level of "this activity teach to other" in the following competencies: Basic Competency, 50-70%; Individual/Family/Group Support Competency and Community Health Care Competency (CHCC), 25-60%; Policy-making Competency (PC) and Administrative Competency (AC), 15-55%. The each two-group comparison in three-group of answers revealed that PHNs working for a municipality and LGAs required a higher level of competency in CHCC, PC, and AC. In addition, there was a significant difference between the two groups. Conclusion : It is important to nurture competency for leadership in mid-career PHNs through continuing education.

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Purpose : This report examines mothers and the nursing of their babies. It focuses on breastfeeding practices and other related factors. Method : The subjects were 216 mothers with four-month old babies who were undergoing a scheduled health check in a northern Japanese city. Anonymous, self-administered questionnaires were used to collect data. The questionnaire focused on breastfeeding practice and the relationship to: socio-demographic data, interest in breastfeeding and support network. Results : A total of 138 questionnaires were returned, 137 of which met the inclusion criteria. Most mothers (94.2%) reported being interested in breastfeeding. There was a significant difference between the breastfeeding of babies and ; infant birth order, interest in breastfeeding, ease of breastfeeding, attendance of prenatal classes, support by midwives when needed and appraisal support from family. Discussion : This study found that in order to encourage breastfeeding it is important that mothers are initially interested in breastfeeding, and they realize the convenience of breastfeeding. They, moreover, have to be encouraged and supported by family. It is also important for breastfeeding promotion to support primiparous women, educate families and support mothers when necessary.

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Objectives : The purpose of this study was to clarify the obesity status and lifestyle characteristics of Filipinos residing in urban area of Japan. Methods : Self-reported anonymous English questionnaires were distributed to 60 Filipinos aged 20 years and older residing in Japan. Results : Among the 53 responses received, 40 valid responses were selected for analysis. Of the total number of subjects, 30.0% were men and 70.0% were women. The rate of obesity (BMI ≧ 25) was 25.0%. Compared to women, men had a significantly higher frequency of "living with someone other than a family member," "post-graduate education," "working more than 8 hours per day", "eating Philippine cuisine everyday", "eating a large number of merienda per day", a significantly lower "average of the score of various food intakes." Compared to non-obese individuals, obese individuals had a significantly higher "waist circumference ≧ 90 cm," significantly more "physical fatigue due to work," significantly lower "frequency of eating Japanese cuisine." Conclusions : The rate of obesity (BMI ≧ 25) was 25.0%. These findings suggest the necessity of preventive care in order to protect against obesity and maintain the health of Filipinos residing in Japan.

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[in Japanese]

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[in Japanese]

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