Objective: The objective of this study was to clarify the relationship between home nursing agencies for nurses which recognize that they provide quality terminal care and the profitability, cooperation with medical institutions, and user characteristics. Method: A questionnaire survey was conducted with visiting nurses at 2,750 home nursing service providers nationwide. The relationship between the characteristics of users of home nursing services was examined specifically in terms of patient care, and the facility background of home nursing agencies for nurses that recognize they provide quality terminal care was analyzed using a logistic regression formula. Results: Ninety home nursing services listed terminal illness as a characteristic of users, by which they demonstrated their recognition that they provide quality terminal care. The home nursing agencies for nurses which recognized that they provide such quality terminal care had the following qualities compared with other services: an additional charge for a 24-hour support system on insurance claims had been filed (OR = 3.89 ; 95%, CI: 1.71-8.83), more users ranked C on the scale of independent living (health insurance) (OR = 2.0 ; 95%, CI: 1.16-3.43), more medical institutions (home care support clinics) issued written orders (OR = 2.11 ; 95%, CI: 1.33-3.35), more reports were submitted to discharging hospitals and institutions (OR = 1.65 ; 95%, CI: 1.04-2.62), and more summaries were written at the time of admission to hospitals and institutions (OR = 1.1 ; 95%, CI: 1.01-1.21). Conclusion: This study revealed that home nursing agencies that offer 24-hour support, as well as services that actively cooperate with home care support clinics and hospitals by providing support upon discharge and admission, demonstrated the recognition that they provide quality terminal care.

View full abstract

Purpose: To clarify the details and characteristics of occupational health nurses' (OHN) coordination for workers with cancer in each support stage. Methods: Semi-structured interviews were conducted with 10 OHNs working for companies to encode narratives and classify them into information collection, assessment, and intervention based on the support stage. Subsequently, content analysis was performed to create categories, focusing on similarities between these codes. Results and Discussion: In all support stages, the OHNs collected information regarding the pathological, working, and psychological conditions, in addition to the availability of support from surrounding people, to assess systems to support target workers to "cope with cancer while safely working" and "undergo treatment while continuing to work". Based on the results of such assessment, it was clarified that the nurses supported "target workers to continue to work" and "their bosses and personnel management officers to establish and strengthen support systems". When workers were on administrative leave after diagnosis, the nurses developed an overall perspective, and supported them to concentrate on treatment, while reducing their and their bosses and personnel management officers' anxiety. When they were returning to work, the nurses considered possible changes in their pathological conditions and necessary support in the workplace, and provided approaches to promote their independence, with cooperation from their bosses and personnel management officers. After returning to work, the nurses observed changes in their working and pathological conditions to analyze their support needs, focusing on their and their bosses and personnel management officers' independence. These results provide a basis for the improvement of OHN coordination skills.

View full abstract

Purpose: To clarify the state of care services of community-based services in order to obtain suggestions regarding the functions and future issues of community-based services under a community comprehensive care system. Method: Conduct a comparative study of the care service items of 3 community-based services to identify the current state of care service and to conduct a study from 5 perspectives for building the community comprehensive care system presented by the national government. Result: The current state of care service of community-based services is: 1. It is possible to provide thorough individual care using small-scale, small number of people, unit based care; 2. Care service is being provided through cooperation among specialized organizations and professions related to community-based services, the community and residents, and the government; 3. Care is being provided together with the family by placing importance on the bonds with the family; and 4. In environments where it is difficult to provide medical treatment, some efforts can be taken to meet medical needs and provide end-of-life care and caregiving. Conclusion: It was clarified that community-based services for aging-in-place under a community comprehensive care system has an important function in meeting care needs in a timely manner by strengthening and enhancing nursing care services, having home functions, and utilizing networks. An issue suggested by the study is identifying how medical treatment can be provided to the elderly through community-based services by strengthening the cooperation with medical care.

View full abstract

Objective: To elucidate factors associated with visiting nurses' intent to continue working by focusing on their communication with both coworkers and related professionals in the community. Methods: A self-report questionnaire survey was conducted on both full and part-time nurses (excluding administrators) working as visiting nurses at a visiting nursing station in Hokkaido Prefecture. Results: The following items concerning informal communication with nursing peers were significantly related to intent to continue working: "consult nursing peers about the provision of nursing care" ; "know the areas and fields of nursing care in which nursing peers have expertise" ; "consult nursing peers having expertise in relevant fields when facing problems at work" ; and "receive requests for advice from nursing peers in their areas and fields of expertise". No significant relationships were observed for items on either informal communication with coworkers or communication with related professionals. Discussion: These findings suggest that both opportunities and atmosphere are important for enabling active engagement in spontaneous communication with coworkers.

View full abstract

[in Japanese]

View full abstract