Purpose: This study aimed to explain the difficulties experienced by home-visit nursing administrators during workplace management. Method: The study was conducted at home-visit nursing stations established by different agencies in Prefecture A, where 14 administrators participated in semi-structured interviews to identify the difficulties they experienced in management. Interview data were analyzed qualitatively and inductively. Results: Analysis revealed that there were three main difficulties. First, there were "troubles in the system," which comprised conflicts and systematic difficulties arising in the relationship with the parent organization, resulting from the inherent restrictions of the home-visit nursing system. Second, there were several administrative issues associated with "irritation at carrying out their role in their workplace." Finally, the administrators expressed "isolation, a sense that there was no one who understood them" when they faced the above situation. Conclusion: Improvements can be made in the duty environment of administrators by providing sufficient transfer of power from the parent organization and assistance with administrative roles, and giving importance to recognition as an aspect of psychological support.

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Objective: The purpose of this study was to develop a scale to measure the social activities of older women who require daily support, and to assess its reliability and validity. Method: Using a pilot study, we developed a tentative Social Activities Scale for Older Women requiring Support (SASOWS). A questionnaire survey was conducted of older women requiring support and older women (>65 years old ). Responses were obtained from 269 older women requiring support and 306 older women. Valid responses were obtained from 253 older women requiring support and 250 older women. Results: An exploratory factor analysis was performed. A three-factor structure was postulated in the pilot study. The three factors included "interaction with familiar people," "performing proactive and creative meal-related activities," and "consulting with care service providers." Confirmatory factor analysis based on the three-factor structure was performed. The goodness-of-fit index of SASOWS was within an acceptable range. Scores of the scale for older women requiring support and for older women showed significant differences in all subscales. Additionally, SASOWS showed little correlation with activities of daily living (ADLs) and subjective sense of health. Discussion: A three-factor SASOWS was developed with reliability and validity confirmed. Using this scale for care can help older women requiring support to maintain and improve their social activities, contribute to enhancing their feelings of well-being and their willingness to obtain preventive care.

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Objective: This study aimed to analyze the relationship between drinking and functional and psychosocial characteristics among male elders certified as Support Level in the Long-Term Care Insurance system. Method: Subjects were 600 community-dwelling male elders aged > 65 years who were classified into the two lowest care need levels in the public Long-Term Care Insurance system in Japan. The questionnaire included items on drinking, instrumental activities of daily living, chronic disease, sleep, depression, self-rated health, and social support. Respondents were categorized as non-drinkers, lightmoderate drinkers, and hazardous drinkers. Results: A total of 271 individuals (45.2%) responded to the survey. From these respondents the data of 218 individuals (80.4%) were analyzed. There were 111 non-drinkers, 73 light-moderate drinkers, and 34 hazardous drinkers. Hazardous drinkers were much more likely to have liver disease (OR: 6.5, 95% CI =1.18-35.7, p=0.03l) and engage in fewer intellectual activities (OR: 2.48, 95% CI= 1.07-5.75, p=0.034) than light-moderate drinkers. Non-drinkers were more likely to have lower levels of ADLs (OR: 1.84, 95% CI=1.00-3.38, p=0.049), instrumental ADLs (OR: 2.10, 95% CI=1.14-3.87, p=0.017), and lower perceived health status (OR: 2.48, 95% CI= 1.33-4.61, p=0.004) than light-moderate drinkers. Conclusion: The results suggest that hazardous drinking is related to low levels of physical activity among frail male elders. Further, appropriate promotion of healthy living habits, screening tests, assessments of life history, and counseling are necessary to improve individuals' quality of life with regard to drinking.

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Purpose: To consider effective dissemination strategies for the family peer-education program on mental disorders, we aimed to clarify the factors related to intention to continue for family groups that had already implemented the program. Method: A cross-sectional mail survey was sent to 59 family groups that had implemented the program from its development in 2007 through to 2012. The conceptual framework of the diffusion and dissemination of innovation in a health-care organization was used as the analysis framework. We analyzed the relationships between the dependent variable, which was groups with or without intention of regular implementation, and independent variables regarding system antecedents, system readiness, and consequences. Results: Fifty-six family groups responded. A multivariate logistic regression showed that intention to continue was related to whether the family group was motivated with the program as a new goal (OR=7.11, p=0.005) and had adequate finances (OR=1.98, p=0.035). Discussion: Following the loss of the goal of running community workshops, family groups need family mutual help and mutual learning as new goals. These new goals are consistent with the family peereducation program. The investigation showed that finances were related to the intention to continue with program. Therefore, strategies to secure financial resources, including useful tools to apply for local governmental grants and others, are needed.

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Purpose: To perform a literature review on public health nurses' (PHNs') activities and challenges in preventing child abuse. Method: We searched the database of the Japan Medical Abstracts Society (ver.5) using keywords of "child abuse and "public health nurse or community health nursing or public health nursing," published between January 2006 and March 2012. We retrieved 60 papers and selected 33 papers that described PHNs' activities. Results: PHNs' activities were classified by the target of PHNs' support into three categories: (1) "individual/family," (2) "group," and (3) "local/system." In category 1, common techniques used in various targets or fields aimed at preventing further child abuse, and their characteristic techniques of finding and supporting high-risk mothers in specific fields such as child welfare centers were abstracted. In category 2, organizing support groups for high-risk mothers or abusive mothers, and the operational methods of the groups were discussed. The activities in category 3 were home visits to support child-rearing, and postpartum depression screening to prevent child abuse. The collaborative roles of PHNs with local medical services and in child welfare centers were clarified. Seven papers disclosed difficulties in supporting high-risk mothers or abusive mothers, the PHNs' activities in the local/system, and the need for education of PHNs for their activities against child abuse. Conclusion: Changing numbers of papers addressed the following : Activities of individual, family and group support of high-risk mothers; development and modification of child abuse prevention programs at the system level; collaborative activities with other organizations.

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