Purpose : The purpose of this study is to delineate substantive concepts that describe characteristics on the policy implementation measure performed by the public health nurses (PHNs) in regional fields who had gained the rich experiences in their activities. Methods : The study was exploratory using methodology for conceptualization of nursing in which semi-structured interview was applied. Purpose sampling was used to recruit 7 PHNs who had gained the rich experiences as an administration job in respect of experience of enforcement of policy in detail. Results : Five core categories were delineated from the data to describe characteristics on the policy implementation measure: 1) the challenge of enforcement of policy based on the recognition with sure in actual conditions; 2) the challenge as the professionals from the administrative point of view; 3) improvement of the execution basis in the policy implementation; 4) competence learnt for the policy implementation, and 5) acquisition and succession of the position which enhances participation into the policy implementation. Conclusions : The categories were described as a process of challenge in policy implementation measure strongly reflecting administrative specialty in regional field under actual condition sustained by complement of professional consciousness, and also workmanlike self effort to accomplish the policy implementation measure in personally experiencing in response to the request in the age. Core categories of 4) and 5) in this study were originals, and not found in the previous studies.

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Purpose : The purpose of this study was to clarify the characteristics of emotion management of visiting nurses using the concept of the Hochschild' s concept of emotional labor. Methods : Yin's multiple case study method was used. Ten visiting nurses were individually interviewed to explore their emotional experiences of working. Unstructured interviews were conducted for the first five nurses to make an interview guide, and afterward semi-structured interviews were conducted for the remaining five nurses. All the interviews were audio-recorded under consent of the nurses and transcribed by the author. The analysis used to construct two types of case report. The case reports were repeatedly compared with each other. After this circular process was completed, the elements common to Hochschild's concept and the variation elements unique to each nurse were summarized. Results : Nineteen kinds of emotions were expressed by the nurses. The nurses recognized the emotional management of clients and families. They had a feeling rule to maintain good relationships with clients and families. They expressed positive emotions like "joy" while they withheld negative emotions like "anger." Sadness was uniquely expressed as "sympathy." Nurses were able to vary their emotional management according to with situations during home visits. They empirically learned it.

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This study examined the relationships among five types of significance of work and basic attributes in public health nurses working for administrative agencies. A questionnaire was mailed to all 750 such public health nurses in two prefectures. With 422 valid responses (56.3%), multiple regression analysis was performed according to the stepwise procedure for each type of significance of work in these public health nurses. The basic attributes selected for each type of significance of work and the corresponding coefficients of determination (R²) with the degree of freedom adjusted were as follows: orientation toward social acceptance was explained by a longer experience as a public health nurse (R² = 0.034); orientation toward cooperation with the community was explained by being assigned to a section unrelated to healthcare (R² = 0.007); orientation toward leadership was explained by a longer experience as a public health nurse and having a post (R² = 0.221); orientation toward stability as well as challenge was explained by an experience of transfer and a limited experience as a public health nurse (R² = 0.029); and orientation toward service and contribution was not explained by any basic attribute. Some had significance of work associated with the duration of practice in which deepening expertise and the importance of extensive responsibility were recognized inside and outside the organization, while others had significance of work possibly affected by assigned departments and transfer experiences. However, their specific effects could not be explained. Among the five types of significance of work for public health nurses, orientation toward leadership showed the strongest relationship with certain basic attributes, with a relatively large R² value of about 20% compared to less than 10% for the others. Further investigations should be conducted using a study design which considers both internal and external factors that may affect the significance of work.

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The object of the research being the structural clarification of support skills offered by public health nurses (PHNs) to parents and pre-school children with developmental disorders by focusing on the period from the start of support through to the acceptance of the disorder, we conducted a semi-structured interviews. Research participants were eight PHNs working at support centers for people with developmental disorders located within cities, towns and villages across Japan and who possess a wealth of experience in providing support for children with developmental disorders. The method of investigation was based on asking PHNs to recall one case where they provided assistance to a child with developmental disorder in the past five years by providing a description of the background of the case and the type of support offered until the child reached school age. Based on results of our analyses, the support skills offered to families and children with developmental disorders by the PHNs were divided into six categories: "Support for assessing the necessity of support," "Continuous support," "Support promoting the developmental stages of the child," "Support in giving consideration during times of infant health examinations," "Support in the form of problem-sharing with parents until the diagnosis is obtained," and "Support for parents in accepting the disorder." Four characteristics of support provided by PHNs were suggested by the same exercise: 1. Assessing the traits of developmental disorders, 2. Ensuring that the support offered by PHNs does not damage the trust of parents, 3. Deepen the understanding of problems facing the child by parents until a diagnosis has been obtained, and 4. Standing by parents affected by their own inner struggles to support the process of their acceptance of the disorder.

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The objective of this study was to elucidate the roles of fathers that were expected by mothers of infants with Down's syndrome. A questionnaire survey and interviews were conducted on 12 mothers of infants with Down's syndrome who lived at home with their children. Interviews focused on the expectations of mothers toward the roles of fathers in child rearing, and the mothers' statements were summarized and categorized according to semantic content. The survey results showed that the infants with Down's syndrome in this study were aged three to 18 months, while their mothers were aged 30 to 42 years. The roles of fathers expected by mothers of infants with Down's syndrome were categorized as follows: "child-rearing in general," "direct interaction with the child" such as willingness to provide child rearing and playing with the child, "joint provision of child rearing and care" such as joint involvement in upbringing and care, "consideration for the physical and mental status of the mother" such as understanding and concern for the mother, in addition to "continuation of current roles." These findings indicate that the roles of fathers expected by mothers of infants with Down's syndrome reflect expectations that are specific to parents of children with Down's syndrome, expectations for further enhancing the future development of the child, as well as the mothers' desire for attention from fathers as partners in child rearing. Future issues include investigation of both the actual roles played by fathers in child rearing for infants with Down's syndrome in addition to the roles of fathers expected by mothers.

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[in Japanese]

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The purpose of the study is to identify effects and challenges in home visits during practicum by sorting out lessons students learned through their experience. The subjects are 79 seniors who visited patients with public health nurses during the practicum. The author qualitatively analyzed the content of community health nursing practicum reports submitted by students. There are 360 comments on what they learned through the experience, which are further classified into 37 categories in line with the practicum objectives. The practicum has given students the first hand observation of the patient/family lives and their environment. It has also been a good opportunity to see the process of assistance by public health nurses. The students understood characteristic of information they get at patient home as well as specific methods of support such as how to make assessment and to promote health and welfare service utilization as well as how to improve families' problem solving capacities. They, however, have not learned enough how to plan visits and to produce visit reports. It was found necessary for university faculty to create better teaching methodology including simulation at school and to collaborate with outside agencies to discuss and plan the practicum contents.

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[in Japanese]

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[in Japanese]

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