Purpose : The purpose of this paper is to develop self-efficacy scales for the health practices of middle-aged male workers, including well-balanced diet, physical activity, sleep, drinking behavior, and smoking cessation. Methods : We administered a self-completed questionnaire to 1,000 male workers, using self-efficacy scale items, including ten items on well-balanced diet, seven items on physical activity, six items on sleep, eight items on drinking behavior, and eight items on smoking cessation derived from health guidance provided to 14 workers. Cronbach's Alpha coefficients (henceforth alpha) were calculated to confirm the reliability of the scales. The relationships between our scales and the workers' lifestyles, as well as between our scales and the Perceived Health Competence Scale, were examined to confirm the validity of our scales. Results : After factor analysis of 953 subjects, we identified two factors from the ten items on well-balanced diet: controlling eating habit and dealing with eating environment. We identified one factor each from the seven items on physical activity, the six items on sleep, the eight items on drinking behavior, and the eight items on smoking cessation. The alpha of well-balanced diet, physical activity, sleep, drinking behavior, and smoking cessation were 0.87, 0.90, 0.89, 0.92, and 0.94, respectively. The examination of the relationships between our scales and the workers' lifestyles showed that subjects who practiced recommended lifestyle habits recorded significantly higher scores than subjects who did not practice such habits. Correlation analysis of the relationships between our scales and the Perceived Health Competence Scale indicated that the well-balanced diet, physical activity, and sleep scales were all satisfactorily associated with the Perceived Health Competence Scale. Conclusions : Ten items on well-balanced diet, seven items on physical activity, six items on sleep, eight items on drinking behavior, and eight items on smoking cessation which we developed from our study could be used for intervention as self-efficacy scales for the health practices

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Purpose : The purpose of this analysis was to clarify the features of the concept of "partnership in community health activities" in Japan, and to examine the usefulness of the concept. Method : The concept analysis was based on Rodger's approach, and focused on attributes, antecedents, consequences, and surrogate terms. Results : There were two attributes of "partnership in community health activities." The first attribute was the principle of "equal relationships between people or organizations with different points of view." The second attribute was the strategy of "establishing relationships and developing activities by trial and error." Antecedents came from "community health concerns needing to be addressed," "changing norms and requirements," and "professionals realize limitations of traditional activities and hope to overcome challenges." Consequences were identified as "improvement in participants' mutual relationships and the community beyond professional's hope," and "improved health indicators for the community." Conclusion : A partnership in community health activities in Japan is defined as "the principle of equal relationships between people or organizations with different points of view." In addition, the strategy for community health activities is through "establishing relationships and developing activities by trial and error to address community health concerns by creating systems to support activities, trying to have equal relationships, sharing aims, information, and experiences, and making full use of mutual power." The feature of partnership in Japan is an emphasis on mutual relationships. This concept may be useful as a guide for community health activities and their evaluation in Japan.

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Background : Although discharge planning is gaining in importance for promoting post-discharge home care, the impact of the support provided during hospitalization on outcome after discharge is less clear. Purpose : A follow-up study was performed to identify the requirements for discharge planning of patients being sent home. Methods : A descriptive qualitative study explored ten patients requiring post-discharge care. They were at least 60 years old, and had been hospitalized in general wards in two hospitals selected by convenience sampling. Participant observation was done to collect data on support during hospitalization. In addition, the patients and families were interviewed and observed at home two weeks after leaving hospital in order to identify problems occurring at home after discharge. If the problem was detected, support during hospitalization was reviewed in comparison with support for the patients with no problem. The discrepancy of them was identified as the requirement of discharge planning. Results : Three requirements for discharge planning were identified : "hospital care," "coordination for home care" and "link." "Hospital care" consisted of two subcomponents : [day to day care] and [teaching for patients and their families]. "Coordination for home care" consisted of four subcomponents : [introduction of available resources], [continuity of medical care], [contact of and arrangement for home care providers], and [readjustment of hospital care]. Discussion : Relationships between requirements for discharge planning and subsequent problems post-discharge at home were clearly documented. Therefore, the requirements should be taken into account by health care providers to avoid unnecessary post-discharge problems.

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Objectives : This study investigates current conditions and problems regarding health care provision for residents of group homes (GH) for elders with dementia, staff responses to changes in residents' medical conditions or accidents, and nursing systems. Methods : Survey questionnaires were mailed to 442 GH facilities in Kanagawa prefecture, Japan. Results : We collected survey questionnaires from 175 facilities (response rate, 39.6%). More than 70% of the facilities had residents who needed regular visits to physicians or physician home visits. Regarding daily medical treatments in GHs, 49.7% of the facilities provided dermatological treatments, and 19.4% of the facilities offered enema or stool extraction. In the previous three months, there were about 460 cases of changes in medical conditions or accidents, and 76 facilities (43.4%) requested ambulance transport. There were 65 facilities (37.2%) that had nursing staff, and 80 facilities (45.7%) used reimbursement for medical coordination systems. Facilities that used reimbursement for medical coordination systems to contract with visiting nurse stations comprised 14 facilities. The following were found as effects of visiting nurse services: improvement in responses to medical care needs, and availability for consultation when assessing symptoms. A problem to be addressed concerned the occasional differences between nurse and physicians judgments, which resulted in confusion. Discussion : While GH resident needs for medical and nursing care were assumed to be high, less than half of the facilities used reimbursement for medical coordination systems. This suggests that GHs should seek adequate nursing services through medical coordination systems.

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Objective : Well-rounded training (WRT), consisting of resistance training, aerobic training and flexibility exercise, has been shown to be effective for increasing the physical strength of the elderly. The purpose of this study was to investigate effect of 7-month voluntary WRT after community WRT class on physical activity of elderly women. Methods : The subjects were 18 elderly women aged 65 to 74 years in a town, central Japan, who participated in a municipal WRT class and the subsequent voluntary WRT. The former class was done by the town public health center once a week for three months, while the latter was voluntarily held by the former participants once every two weeks for seven months. Self-administered questionnaire surveys of health status and examinations on physical characteristics and physical fitness were conducted three times before the municipal class, at the end of the class, and 7-month after the end of the class. Results : The replies to the questionnaire of "Are you confident in your present physical strength?" and "How many times do you go out usually?" were significantly improved at the end of the municipal training class and also after 7-month voluntary WRT. Regarding physical fitness, the subjects showed significant improvements in a 10 meter-walking test, a 30-sec chair-stand test, a body reaction time test, and forward bending ability after 7-month voluntary WRT as well as at the end of municipal training class. Conclusion : The present study has suggested that WRT can have some beneficial effects to increase or maintain the physical strength of elderly women. Community-based WRT programs would be an effective exercise program for elderly inhabitants.

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Purpose : To illustrate factors that support the continuation of team members' activities during the course of community organization activities, and to suggest what is needed to provide further support. Methods : With the cooperation of seven members of the community organization, Child-Raising People's Working Team, a semi-structured group interview was conducted, and the outcome was qualitatively and inductively analyzed. Results : Five categories have been selected as factors which help members continue their activities: "Their own experience of feeling the need for assistance when raising a child," "opportunities that made them continue their activities," "changes in their own attitudes," "growth of the team" and "a goal set by the team." Discussion : As the members experienced bringing up children of their own and learnt how people around them brought up theirs, they felt the need for support and continued their activities. During that time, they changed their attitudes and developed a deeper understanding for collaboration. Furthermore, as members of the team gained empowerment, the team grew and future tasks became clearer, and this in turn affected the continuation of their activities. Conclusion : Public health nurses can serve as facilitators within community organization activities by gathering members' opinions, assigning members' roles, connecting teams with relevant organizations, and in this way they can provide continuous support for the proactive activities of a team.

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[in Japanese]

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[in Japanese]

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