Public Health Nurses (PHNs) have supported community health in regenerating the relationship with residents of the community. But it is not sufficient that we assess the community as the subject of PHNs' activities referring to only health indications as has been done in the past. The purpose of this study is to develop a scale for evaluating the characteristics and degree of personal trust (PT) and theoretical verification. First, in reference to earlier literature on the subject of trust, a questionnaire was made using a hypothetical framework. Construct validity was examined using factor analysis. Next, we investigated the relation between commitment to the community and Sense of Coherence (SOC) with each factors of trust for evaluating the performance of the scale. The study sample consisted of 338 parents of children who have taken the Health Examination for Children 3 years of age in City A of Okinawa, Japan. A factor analysis of personal trust yielded 3 factors in both males and females: (1) Strategic trust for making bonds ; (2) Universal trust for general public ; (3) Trust for specific persons. We investigated commitment to the community and SOC affected by these 3 factors of PT using correlative analysis. Results indicated that there is significant positive correlation between all factors of PT and pride and attachment to the community and SOC. Only between factor 1 and the frequency of participation in community activities, no significant correlation was found. Cronbach's alphas (male 0.737, female 0.774) were adequate. We confirmed the validity and reliability of the scale through these results.

View full abstract

Objective : To develop social health performance scales for mothers to seek how to support a mother caring for children as she plays a major role in making them socially independent. Procedure : We mailed anonymous personal response questionnaires to 743 mothers who have 18-month old infants scheduled to be given check-ups in B City in A Prefecture, and included 214 of the returned questionnaires in an analysis. Results : We drafted a social health performance questionnaire consisting of 23 items for investigation. We attempted factor analysis on 22 items excluding one item which showed ceiling effect, repeated factor analysis by promax rotation, and finally employed 4 factors and 19 items. Cronbach's alphas of the four factors were all more than .70. We detected a positive correlation between "No feeling of constraint in raising a child" and positive maternal consciousness (MP), and a negative correlation between the former and negative material consciousness (MN). Discussion : As a result of the examination of this social health performance scale consisting of 19 items, it was suggested that it could be an indicator for evaluating the awareness on the part of a mother regarding her acceptance of the maternal role, and interaction with society.

View full abstract

Purpose : To clarify the relationship between the stages of behavior change in exercise and its related factors focusing on health behaviors, health check-up results and QOL among adults who participated in a health checkup. Methods : Self-administerd questionnaires were mailed to 396 adults recruited from a health-check up in a suburb of Sapporo, Hokkaido from April 2006 to March 2007. Data on the stages of change for exercise, socio-demographic data, utilization of health care, health behaviors, health check-up results and the MOS 36-item short-form health survey (SF-36) were collected. Data were analyzed using the chi-square test, ANOVA, Kruskal Wallis test and ANCOVA. This study obtained consent of the Ethics Committee of the Health Sciences University of Hokkaido and considered privacy protection. Results : There were 363 respondents who completed the questionnaire (response rate: 91.7%). The mean age was 50.2 and the majority was female (n = 263; 72.5%). The participants were classified into one of the five stages of change for exercise: precontemplation (n = 196; 54.0%), contemplation (n = 57; 15.7%), preparation (n = 26; 7.2%), action (n = 25; 6.9%), and maintenance (n = 59; 16.3%). Most of the respondents in the precontemplation stage were male. The respondents in the action and maintenance stages were older than those in other stages. According to gender with age as a co-variate, ANCOVA was conducted. There was no significant difference in health behaviors and check-up results for any stage of behavior change. In female respondents only, six of eight subscale SF-36 scores were significantly lower in the contemplation and preparation stages than in the action and maintenance stages. Conclusions : The results suggest that understanding the stages of behavior change and their relevant factors can effectively be utilized for individual health counseling as well as for planning and evaluation of health check-ups and health counseling in the community at large.

View full abstract

The purpose of this study is to explore how nursing practices reflect the intentions and actions of public health nurses, in order to clarify the characteristics of home health nursing appropriate for patients with disabilities or spinocerebellar degeneration. This study examines three cases of home health nursing as practiced by three public health nurses. The three nurses were contacted and interviewed about their "intentions" and "actions" in their home health nursing. The public health nurses involved in this study were selected for their ability to aptly describe their home health nursing practices in their own words. In total, 233 of their "intentions" as well as 942 of their "actions" as regarding their home health nursing for patients with disabilities or spinocerebellar degeneration were recorded. These intentions and actions were critically reviewed, and relevant data was extracted. Public health nurses aim to : (1) establish and maintain relationships with care receivers, (2) consider the views of the particular family and community, (3) sustain the desired lifestyle of the care receivers, (4) respect and promote the ability of family members to help themselves, (5) consider the means of establishing support systems, (6) help patients to view themselves and their life experience positively. Public health nurses caring for patients with disabilities or spinocerebellar degeneration exert themselves to : (1) always consider risks in daily life, any indication of the relapse of a disease, complications of illnesses, (2) maintain contact with care receivers at any and all necessary times, (3) consider the policies of multidisciplinary professional health care providers in order to ascertain the appropriateness and effectiveness of the aims and methods of their own nursing.

View full abstract

Purpose : The purpose of this study was to explore strategies of public health nurses (PHNs) who support mentally ill people with potential treatment interruption in order for them to obtain psychiatric medical care and to inspire the ideal way of supporting them in the future. Methods : The qualitative research method was used. Data were collected by semi-structural interviews with five prefectural PHNs who had experience in supporting mentally ill people with potential treatment interruption in order for them to obtain psychiatric medical care. Results : Common strategies of four PHNs emerged for supporting mentally ill people with potential treatment interruption to obtain psychiatric medical care. Out of 542 codes, forty-three sub-categories were identified and integrated into 10 categories. When the categories were analyzed in the individual care process of PHNs, the following common phases were found : identification of the individual's condition, and exploration of the need to provide support for the individual and his/her family (Phase 1) ; tentative assessment of the individual's status and the direction of support for them (Phase 2) ; based on the psychiatrist's diagnosis, making arrangements for the individual to obtain psychiatric medical care (Phase 3) ; and encouraging the individual and his/her family to see the doctor together (Phase 4). Conclusion : The findings suggest that based on assessment of the mentally ill people's condition and their ability to maintain a healthy life by oneself, the aim of PHNs is to support mentally disordered people that they will be able to keep a stable life in their community in the future.

View full abstract

The study analysed the support given by public health nurses by focusing the mutual relationship between them and local residents through the process of independent group formation and continuation. The subject was an independent group comprised of people aged over 65 who had participated in the public health center's strength training class. Data was collected through 1) project records, 2) participant observation and 3) interviews, and acquired data were classfied into "residents' opinions" and "public health nurses' opinions." The Trajectory Equifinality Model (TEM) was used for analysis. The process was organized into four phases, and the obligatory passage points (OPP) crucial to the relationship between the residents and public health nurses occurred twice, in Phases 1 and 3. In Phase 1, the public health nurse understood the needs of participants who wanted to continue exercising after completing the class, and through group work, established a venue to discuss needs (OPP1). In Phase 2, the public health nurses offered support, and participants experienced in group activity showed interest, resulting in the decision to create an independent group. In Phase 3, a group coordinator consulted with the public health nurses, and a meeting to discuss changing coordinators was held (OPP2). In Phase 4, the participants began to proactively discuss subjects relevant to the group amongst themselves, and no longer needed the support of the public health nurses. The public health nurses maintained a mutual relationship with the residents, and functioned as a facilitator who enabled the group to gain a foothold.

View full abstract

Purpose : The purpose of the present study was to clarify factors related to mothers' perceptions of fathers' support for 18-month-old infants. Methods : The subjects were 323 mothers with 18-month-old infants who were undergoing a scheduled health check in A City, Hokkaido. Data were collected using an anonymous, self-administered questionnaire. The questionnaire focused on the mother's perceptions of the father's support according to the mother's background, the father's working hours, the time the father returns home from work, the number of hours the father works per week, the father's participation in child rearing, and the mother's happiness with child care. Data from 161 (49.8%) valid responses were subjected to analysis using the Mann-Whitney U test. Results : Most mothers confirmed receiving emotional support from the father. Significant relationships with the mothers' perceptions of fathers' support for 18-month-old infants were found for "mother's occupation," "birth order," "best person in child-rearing support," "the time the father returns home from work," "the father's participation in child rearing," and "mothers' happiness with child care." Discussion : This study showed that mothers' recognition of their expectations of the fathers' participation in child rearing affected their perceptions of the fathers' support. Furthermore, these findings emphasize the important influence of mothers' happiness with child care on their parenting and family.

View full abstract

Purpose : To develop a practically feasible checklist for network building between a community comprehensive support center (CCSC) and an informal community organization (ICO). Methods : The item pool of the checklist was developed based on a preliminary interview survey conducted on the staff members of the CCSC, and based on group tasks conducted as part of a program to promote network building between a disciplinary agency and the ICO. Following this, we developed a checklist for network building between the CCSC and the ICO by selecting some items from the pool. We tried to ensure the validity of the checklist by getting it confirmed by the staff members of the CCSC. Results : From the preliminary survey, it was found that there are three steps to network building between the CCSC and the ICO. As such, three-step (Stages I to III) checklists for four different kinds of ICOs were developed. Conclusion : The checklist for network building between the CCSC and the ICO is significant and practically feasible even though its applicability and validity need to be further confirmed.

View full abstract

Purpose : To establish a hypothetical-inductive framework of the characteristics of the population approach based on an analysis of cases in which public health nurses are involved in planning, conducting and evaluating activities for community residents. Methods : We extracted the thought processes and methods used by public health nurses in providing health support to community residents, based on eight cases, and analyzed the characteristics of the methods used. Specifically, we analyzed characteristic patterns for the population approach with focus on the purposes of activities, ways of combining two or more methods, and reactions of community residents to activities. Results : The characteristic patterns of the population approach included: (1) a pattern for spreading activities among all community residents by promoting the participation of residents with determinants through group activities conducted by residents who are interested in health, (2) a pattern for spreading activities among all community residents by working with both residents with determinants and residents without determinants at approximately the same time by specific residents to make residents with determinants in cooperation with residents without determinants. Two other patterns were also identified. Conclusion : The characteristics of the population approach were clarified in consideration of the purposes of activities. The characteristic patterns of the population approach suggest possible applications to the practice of public health nurses.

View full abstract