Objective : This study examined the factors influencing the health-related quality of life (QOL) of late middle-aged public assistance recipients. Methods : The subjects were public assistance recipients aged between 40 and 64. Among the 21 social welfare offices in the prefecture, 17 agreed to participate and received anonymous self-administered questionnaires. The questionnaire included questions on health-related QOL (SF-8), health behavior, and social support. We employed a gender-specific multiple linear regression analysis to analyze the survey data, with the physical component summary (PCS) and mental component summary (MCS) scores of the SF-8 the dependent variables. Results : The response rate was 32.2% (246 persons). In males, the PCS was 41.7 ± 7.8 and MCS was 43.1 ± 8.5. In females, the PCS was 43.1 ± 8.5 and MCS was 42.4 ± 8.4. In males, PCS was related to the "self-rated health", "musculoskeletal disease", and MCS was related to "self-rated health", "being depressed", "rest acquired through sleeping", and "understanding of the health information supplied by the municipalities". In females, PCS was related to "age", "subjective health feeling", "physically disabled certificate", "rest acquired through sleeping" and "participating in health classes", and MCS was related to "being depressed", "daily vegetable intake", and "stress in the past month". Conclusion : This survey revealed that the health-related QOL of late middle-aged public assistance recipients is low, especially for depression, and males and females related to MCS. This study indicated the importance of the health information supplied by minicipalities, nutrition, and rest for improvement in health-related QOL.

View full abstract

Purpose : The purpose of this study is to develop "The Needs Assessment Scale of Discharge Planning for Dementia (NASDPD)" and then to investigate the reliability and validity of the scale, which is used as an assessment tool for discharge planning in people with dementia. Methods : Firstly an interview was conducted with four family members of people with dementia, four experts of A city community comprehensive care center and three researchers as a preliminary research for the tentative version of scale. Second, a survey including the Camberwell Assessment of Need for the Elderly (CANE) was given to 200 professionals in hospitals, 492 professionals in community comprehensive care centers, and 90 public health nurses in A city. Results : "NASDPD" was developed to four factors and 22 items by factor analysis: six items of activities and functions of daily living; six items of medical and social service; five items of community network; and five items of family functioning and perspectives. The Cronbach a coefficient of the scale was 0.897. A significant positive correlation was found between the total score of the scale and the CANE (r=0.701, p<0.001). Conclusion : "NASDPD" demonstrates considerably high reliability and validity as an assessment tool for home care needs in people with dementia. In the future, it is necessary to promote an interdisciplinary discharge care system with "NASDPD" based on their community, for people with dementia.

View full abstract

Purpose : The purpose of this study was to track the performance of five health professionals, responsible for specified health guidance services at the healthcare centre, who participated in a Practical Learning Skill Upgrading Program (hereinafter referred to as "the Program"), a variant of the Learning Outcome Creation Program to Enhance the Competence of PHNs. Methodology : The outcomes before and after participating in the Program were assessed by the Wilcoxon's signed rank test using three scales to measure professional competencies. The learning process was assessed by content analysis of quantitative data obtained from group sessions, transcripts of personal phone interviews, observation notes, e-mail messages and worksheets. Results : The scores on the three scales rose significantly after the Program. The following categories of learnings were obtained from qualitative data on participants: recognition of own immaturity as a "public healthcare professional;" identification of own learning tasks as a "public healthcare professional;" determination of own learning objectives as a "public healthcare professional;" redefinition of the substance of health guidance by tackling the learning tasks to achieve one's objectives; correction/acquisition of health guidance skills by applying the theory of healthcare; recognition of own responsibility for ongoing self-development as a professional; and creation of supportive relationships and structure to share learning among colleagues. Discussion : The categories thus identified may be classified into reflection on oneself to define learning tasks and reflection challenging oneself to create learning outcomes. The research findings suggest the possibility of applying the Program to the training of specified health guidance providers and the inherent challenges therein.

View full abstract

Purpose : This was a qualitative descriptive study aimed to describe the expert home visiting nurse's support for the patient with tracheotomy intermittent positive pressure ventilation to live at home. Method : This study was qualitative descriptive study. The participants of this study were seven home visiting nurses who had more than four years experience of home care. A semi-structured interview was conducted with the participants about the daily support and the meaning of the support for the patient. Result : Ten core categories of the expert home visiting nurse's support for the home patient with tracheotomy intermittent positive pressure ventilation to live at home were extracted : (1)【assessment of the signal of the body】, (2)【respiratory care team building and adjustment】, (3)【understanding the care giver as a person】, (4)【relief from body and pain of immobility】, (5)【respect identity of home patient and families】, (6)【decision-making support in anticipation of losing function】, (7)【maintenance of relationships of home patient and families】, (8) 【easing conflict accompanying with ventilator】, (9)【getting along with patient】, (10)【realization of patient identity】. Conclusion : In this study of the role of the home visiting nurse for the patient with tracheotomy intermittent positive pressure ventilation, what was considered to be important was the educational role for care systems, decision-making support and Adjustment between families for patients and families.

View full abstract

Purpose: To clarify the support skills provided by public health nurses (PHNs) to assist residents living in poverty in welfare centers. Methods: Study participants were four highly experienced PHNs working at four welfare centers. Data was collected by semi-structured interviews and observations during study periods. PHNs were asked about the nursing which they provided for case works. In addition, they were also asked about their work except for case work at the welfare centers. The interview transcripts and observations were analyzed qualitatively and inductively. Results: The six categories of support skills which PHNs provided for case work were described, including, Building trust through nursing, Nurturing self-esteems, Nurturing life-skills and self-care abilities, Dealing with emergency, and Supporting normal lives in the community. Four categories that comprise the nursing support skills except for case work which were utilized by PHNs in the welfare center were created. These included Enhancing mutual understanding between Case workers and PHNs in moderation, Enhancing the abilities of Case Workers and PHNs in moderation, Extension on the subjects of welfare and health care, and Building systems for continuation of normal lives in the community. Discussion: The attributes of PHNs' support skills are described as sensitivity about the subculture of poverty, nurturing future-oriented practice and its value in both health centers and welfare centers, and centering social justice on the support skills in the welfare center. These support skills would be utilized for not only for households on welfare but also various residents living in poverty and with health problems.

View full abstract

Objective: To clarify the collaboration methods used by municipal public health nurses in regional and cross-occupational collaboration as well as the outcomes perceived by public health nurses and the associated underlying factors. Method: A self-administered survey questionnaire was distributed to 350 public health nurses working in municipal governments around Japan, except for Tokyo, and who were in charge of adult health. Two hundred and seventeen valid responses were collected (62.0%). Results: Cluster analysis of the outcome items suggested five classification categories. In terms of collaboration perceived by public health nurses, outcomes most frequently reported included "understanding more deeply the health issues facing the working generation" at 76.5% and "formation of a relationship of mutual trust with related professionals" at 54.6%. Collaboration methods that involved a collaboration promotion council and workshops organized by each municipal government also showed a significant positive association with all categories. Discussion: As a result of cross-occupational collaboration, public health nurses acquire new perception into outcomes, including "decreased burden of work", "identification of methods to evaluate health services", and "capacity to cut expenditure on items such as venue rental costs". Furthermore, while some outcomes such as deepening the understanding of public health nurses about the working generation are relatively easy to achieve, outcomes such as improvements in tangible indicators and results are more difficult to acquire, possibly due to insufficient time for collaborative projects. Offering collaboration promotion councils and workshops organized by municipal governments may be an effective method to enlist collaboration.

View full abstract

Objective : To clarify the intention of obtaining health checkup among middle-aged non-attendees with national health insurance and the characteristics of intenders / non-intenders, to improve the rates of having the intention to obtain a health checkup specifically for metabolic syndrome. Methods : Subjects were aged 42 to 49 with non-attendance for three consecutive years to health checkups by national health insurers in a rural community in Japan. Data were collected through structured interviews at the subjects' homes. Results : Eighteen attendees who had health checkups specifically for metabolic syndrome at other locations (hospital, workplace, etc.) were excluded. Among seventy-two subjects interviewed, fifty-five non-attendees had the intention of obtaining health checkups. Intenders were significantly affected by injunctive norm from partners, and believed in the need for health maintenance. Non-intenders were significantly more male, non-married, living alone. Conclusion : 55.6% of continuous non-attendees of health checkup had the intention of obtaining them. The intenders were affected by injunctive norm from partners and understood the need for health maintenance. Non-intenders were mostly male, non-married, and living alone. A positive approach to such characteristic non-attendees and approaches to partners of non-attendees by public health nurses are needed to improve their intention.

View full abstract

Objective : The objective of the present study was to elucidate factors influencing the spirituality of visiting nurses in A Prefecture using the Spirituality Rating Scale (SRS). Methods : An anonymous self-report questionnaire was administered to a total of 244 visiting nurses working at one of the 40 visiting nursing stations located in A Prefecture. Responses were obtained from a total of 183 nurses, and analysis was performed for 173 complete responses (valid response rate, 70.9%). Items related to the spirituality of visiting nurses were investigated using the SRS-A. The relationships of SRS-A scores to the 11 items identified in a previous study as factors influencing spirituality were analyzed using the t-test as well as multivariate analysis using quantification theory type I. Results and Discussion : Subjects had a mean age of 44.0 years (± 7.8) and a visiting nursing experience of 7.7 years (± 5.6). The mean spirituality score of visiting nurses was 46.8 points (± 8.7), and the score distribution was close to normal. As for relationships to the 11 items thought to influence spirituality, multivariate analysis showed that the items most strongly influencing spirituality were "Having an interest in spirituality" and "Having participated in a workshop (on spirituality)". The present findings suggest that spirituality is not influenced by age or experience, and that interest in spirituality and opportunities for learning about spirituality are important for enhancing the sense of spirituality among visiting nurses.

View full abstract

Objective : To elucidate characteristics of people able to use a pedometer continuously of their own free will by selecting general clerical workers as subjects. Research methods : Conducting a baseline survey by written questionnaire in 105 people, a pedometer was provided to 92 who had not been using one. Whether to carry the pedometer was left to each subject. The pedometer was collected three weeks later and a follow-up survey by written questionnaire was conducted. Subjects were divided into "continuing" and "non-continuing" groups based on days they carried the pedometer and the follow-up survey, and relative factors by sex were examined using the "continuing" and "non-continuing" groups as dependent variables. Results : Mean age was 39.9 ± 10.2 years for men and 32.8 ± 8.3 years for women. Of the 92 people given the pedometer, 9 were excluded because pedometers were not collected for reasons such as breakage. Among the remaining 83 people (57 men and 26 women), 29 (17 men and 12 women) were classified as continuing and 54 (40 men and 14 women) as non-continuing. Applying multiple logistic regression analysis, extracted relative factors in men for continuous pedometer use are "Not good at cooperating with others" and "Exercising for maintenance and promotion of good health" and for women "Intention to lose weight." Conclusions : Men were suggested to be inclined to prefer individualized rather than collective activities and to have sporting habits, while women intended to lose weight.

View full abstract

[in Japanese]

View full abstract

Purpose : This paper aims to clarify how Peruvian women with infants rear their children under the circumstances of foreign laborers in a certain prefecture of Japan, whose culture and institutions are significantly different from those of Peru. Methods : We conducted eight months of fieldwork among seven Peruvian women with infants. The fieldwork was conducted mainly in their own homes. We also went with them to medical institutions, public health centers and supermarkets for participant observation. Only Spanish was used in informal interviews. Results : Interview data were grouped into 7 large categories, 25 medium categories, and 73 small categories. Peruvian women living in Japan lived "a turbulent life as guest workers in bachelorhood", overcame numerous hardships such as "environments bound up with work" and "living in Japan shut themselves behind closed doors" by "the strength of family ties beyond national borders," and conducted "Peruvian culture-based child-rearing which also drew from Japanese elements," while facing "role performance as a Peruvian mother and its conflicted feeling" and "confusion over the use of maternal and health system in Japan." Conclusion : Peruvian women staying in Japan overcame difficult conditions of life such as foreign laborers and confusion arising from difference in culture and institutions through strong family ties. Our analysis suggests that we need to develop a research study on foreign residents in Japan through the analysis of how nursing staffs are involved in their welfare by attaching a high value to transcultural connection.

View full abstract

[in Japanese]

View full abstract