Purpose: To review the literature focused on program and project planning by Japanese public health nurses (PHNs), and to clarify what kind of research has been done in this field. Method: A search of the literature published between 2001 and 2013 was conducted by using the web of Japan Medical Abstracts Society and CiNii Articles. The researcher utilized five key words; 'PHNs,' 'program planning,' 'project planning,' 'policy-making,' 'public health, medical care and welfare plan.' Results: Forty one articles were identified. There were 21 qualitative studies, 18 quantitative research, articles and 2 literature reviews. The literature was divided into three categories; 'To clarify the necessity skills and abilities for developing projects and programs,' 'to cultivate the abilities to create new projects and programs in the educational field,' 'practical case report.' In spite of the rapid progress of the research, the way of assessing community health issues which were based on the PHNs' daily practice was not fully developed. Discussion: To improve their abilities to create new projects and programs, we need to develop a new assessment tool which prioritizes community health issues for the necessity of tackling public administration, and also to create a continuing educational program. The results showed that researchers verify the effectiveness of the new assessment methodology and the new educational program by using intervention study. The results also indicated that we need to develop a new teaching methodology for undergraduate students to help them understand PHN programs and projects planning more deeply.

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Purpose : To elucidate the structure of the difficulties and issues experienced by visiting nurses in their cooperation with care managers in homecare in order to obtain ideas for strategies for resolving issues in cooperation. Method : Focus group interviews were conducted with visiting nurse managers, and contents related to difficulties and issues in cooperation with care managers were analyzed using the qualitative synthesis method (KJ method). Results : A total of six areas were identified and structured based on the difficulties and issues recognized by visiting nurses in their cooperation with care managers. The current condition of cooperation with care managers as recognized by visiting nurses included "the difficulty of sharing information with care managers" due to "individual differences in the ability to cooperate" with the spread of "increased awareness regarding the necessity for cooperation". At the same time, however, the visiting nurses themselves made "efforts to share information based on establishment of open relationships" and "adjustments to and searches for methods of transmitting information", and these factors affected the "active stance of care managers toward information-sharing". Conclusion : These findings suggest that in order to enable the smooth progress of cooperation between visiting nurses and care managers, it is necessary to carefully select efforts and adjustments for information-sharing, with which visiting nurses experience issues, as purposeful strategies for inter-professional work (IPW).

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Objective: This study describes the support process of public health nurses (PHNs) for immigrant Children with Special Health Care Needs (CSHCN) and their caregivers. It also explores the factors promoting or preventing the effective progress of this process. Method: Participants were 13 PHNs working in cities with high foreign resident registration rates. Data were collected by semi-structured interviews. The participants were asked to describe one of the most difficult immigrant CSHCN cases from their experiences. The data were first analyzed via case by case, and then the results were integrated to create an overview of the support process. Results: The CSHCN included Brazilians, Filipinos, and Peruvians. Their chronic conditions were developmental delay, congenital diseases, malignant tumor, cerebral palsy, and complications of low birth weight. The support process was categorized into five stages: <taking a chance for case identification>, <clarifying client's needs and situation>, <exploring client's intention on health service use>, <supporting client in appropriate service choice and preparing for service introduction>, <encouraging client for continuous service use>. The factors that influenced the process were 【child physical conditions】【caregiver and family factors】【support from ethnic community】【support from Japanese community】【quantity and quality of interpreter】【network with key service providers】【health and welfare service system】【preparedness of PHNs for foreign clients】. Conclusion: The support process for immigrant CSHCN was doubly interfered by immigrant and CSHCN-specific factors.

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Introduction: We translated into Japanese the Advanced Directive (AD) Knowledge Test and the AD Attitude Survey, which were created by Murphy P (2000), and checked the reliability and validity of these scales for use in local older residents. Method: Subjects were members of the Elderly Meeting of A city (N = 104). We administered questionnaires using the AD Knowledge Test and AD Attitude Survey for Japanese. The statistical analyses were conducted by I-T correlation analysis and checked for internal consistency with Cronbach's alpha. The correlations with intent to create an AD from a preceding study related to these scales were checked with t-tests. Results: The numbers and percentages of both men and women were 51 and 50%, and the average age was 74.9 years old (SD = 6.6). I-T correlation checks identified 2 items of 0.3 or less in each measure and these were deleted, leaving 8 items in the AD Knowledge Test and 11 items in the AD Attitude Survey for Japanese. Cronbach's alpha for the AD Knowledge Test was0.67 and for the AD Attitude Survey,0.86. In criterion-related validation, the AD Knowledge test was related to "suffering serious disease and operations", and the AD Attitude Survey was related to "have heard about AD" and "suffering serious disease and operations". Conclusion: These results suggest that the reliability of AD Attitude Survey has been verified. However, further checking with additional data including verification of concurrent validity is required.

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Purpose : Identify the factors capable of predicting the degree of fathers' participation in care of preschool children, specifically of fathers of single-birth child and those of multiple-birth children. Method : Self-administered questionnaires were distributed to 1,016 fathers of multiple-birth children and 300 fathers of single-birth child. We received responses from 211 fathers of multiple-birth children and 101 fathers of single-birth child. The response rates were 20.8% and 33.7%, respectively. Results : In the multiple regression model for fathers of multiple-birth children who were younger than one year, the regression coefficients for "the father accompanied the mother to her pregnancy checkup," "the father consulted his friends and colleagues about problems related to child-raising," "the father received compliments from the mother for his efforts in childcare," "the father received compliments from the mother for his efforts at his job" (negative correlation), and "the father believes that both parents should participate in childcare" were significant, yielding an adjusted-R2 of 0.326. On the other hand, in the regression model for fathers of single-birth children who were younger than one year, the coefficients for "the father received compliments from the mother for his efforts in childcare," "the father has little interest in raising a child" (negative correlation), "the father wants to be involved in the child's life through local and job-related activities," and "the father feels the need for understanding from his manager and colleagues" were significant, resulting in an adjusted-R2 of 0.366. Similarly, we have also analyzed models that child was 1-2 and 3-5 years old. A few factors that were identified as significant predictors at 0 years old were not significant, but a similar trend was observed as a whole. Conclusion : For the cases of single-child fathers and multiple-children fathers, different factors were identified as significant predictors of fathers' participation in childcare. A different measure is necessary to promote childcare participation for each group of fathers.

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Objective : We developed scales for demonstrating how public health nurses in charge of preventing suicides foster social capital (hereinafter called SC) : scales fostering SC for suicide prevention; and examined their reliability and validity. Procedure : We made a questionnaire consisting of 22 items extracted from literature examination and interviews. We mailed the questionnaires to 271 public health nurses in charge of preventing suicides in every municipality in 9 prefectures which had a suicide death rate of 27.0 and over in 2007. 129 valid responses were analyzed by factor analysis (principal factor analysis, promax rotation), and reliability and validity were examined. Result : We obtained 16 valid items, and from these made scales consisting of three factors: "Workable cooperation with the parties concerned," "Shared individual needs and their connection with residents' independent approach," and "Networking where everyone takes care of everyone else." Cronbach's α in the whole of the scales was 0.91, and that of each item was from 0.79 to 0.88. A significant difference was shown using the known-groups technique, and a significant correlation with external indexes was indicated, but coefficient of correlation was not 0.7 and over. Discussion : Our scales remained a matter of verification in criterion-related validity, but their internal consistency and construct were validated. It was suggested that they were available as scales fostering SC for suicide prevention.

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Objective : The purpose of this research was to clarify factors associated with functional capacity decline risk over a 6-year period among Independent elderly persons living in the community. Method : In 2004, we surveyed 201 persons with good walking function participating in "Senior College". In 2010, 185 survivors were followed by the Kihon checklist which measures one's functional capacity in the community. Subjects were 146 follow-up survey respondents. Zero for no life-function risks and 1 for risks were set as dependent variables. Multiple logistic regression analysis with independent and moderator variables was performed for significant variables. Results : The 146 follow-up survey respondents were 53 men and 93 women. Twenty-seven (18.5%) were elderly with no functional capacity risks. Factors influencing functional capacity decline were "lower-limb muscle strength (extension)" (OR: 95% CI, 2.01: 1.12-3.62), "experiences of falling during the past year" (18.83: 2.13-166.21), and "persons outside family members living together who nurse or take care of elderly persons coming down with diseases for a few days" (13.53: 3.21-57.02). Discussion : Even independent seniors are likely to have more functional capacity decline risks with aging. In those walking independently, poor leg strength indicates life-function decline. Falling influences life function, reflecting leg-strength decline. Even briefly bedridden elderly persons do not receive non-familial support, likely accelerating functional capacity decline. Conclusion : New factors influencing functional capacity decline were elucidated. For primary prevention of functional capacity decline in independent elderly persons, respecting their intentions and also leg-muscle strength maintenance and enhancement, plus informal community support are important.

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[in Japanese]

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[in Japanese]

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Objective : The aim of this study was to identify immigrant women's experiences of birth and child rearing in Japan, their mental health, and their support needs during birth and child rearing, and to explore ways to support these needs. Method : A search and analysis of both domestic and foreign literature, using the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, and Japanese Central Review databases, was conducted. Results : Immigrant women in Japan experience difficulties related to cross-cultural conflict and dilemma, lack of support, isolation, and loneliness. The effects of these difficulties on their mental health include postpartum depression. These women experience stress related to acculturation and a sense of loneliness due to the lack of a social network. They need access to information and social support services, and help in coping with difficulties as immigrants. Immigrant women worldwide have a lot in common, and hence, we can refer to international literature to reform support for immigrant women in Japan. Conclusion : The results of this literature review confirm the need for studies on ways to support immigrant women during birth and child rearing in Japan. Specifically, information is needed regarding ways to satisfy their support needs, to prevent depression and other mental health conditions. We also found that Public Health Nurses and other professionals need to empathize with the difficulties faced by the immigrants and interact with them regularly, aid family members by developing a system that connects them to information, social support, and a new social network.

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