Purpose: To examine the effect on public health nurses of a reflection-based health guidance skills improvement program for the prevention of lifestyle-related diseases. Method: A 4-day program was conducted over a 3-month period. We evaluated the effects of the program by measuring participants' responses to items on health guidance skills (before, immediately after, and 3 months after the program). Regarding health guidance skills, participants carried out 30 minutes of health guidance for simulated patients. After this was complete, the simulated patients evaluated others, and participants performed self-evaluations at the three different time periods. We also performed a content analysis to explore changes in the intervention group as a function of the reflection process during the program. Results: There were 11 participants in both the intervention and the control group. After 3 months of the program, a multivariate analysis of variance found that, in the self-evaluations, the control group scored significantly higher on two items. For evaluations of others, there were no significant differences between the items. Content analysis showed that the intervention group was aware of their personal challenges, and all resolved to continue with professional learning. However, the intervention group found adapting their new skills to actual practice to be difficult. Conclusion: The content analysis showed that the intervention promoted reflection, but the intervention group did not score significantly higher on any items. This suggests that there was no effect of the program.

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Purpose: The purpose of this study was to develop a Community Intergenerational Observation Scale for Elders (CIOS-E) and Children (CIOS-C) to observe interactions between elders and children in intergenerational programs in the community and examine its reliability and validity. Method: Step 2 with 113 elders over 60 years of age and 130 children from six programs were recruited and their interactions were observed by the researcher using the initial forms CIOS-E (27 items) and CIOS-C (26 items) made from Step 1. Step 3 with an additional 174 elders and 175 children from 17 programs were recruited and their interactions were observed by the researcher using revised forms CIOS-E (18 items) and CIOS-C (16 items). Subjects completed a voluntary self-report questionnaire to evaluate their interactions and describe their satisfaction. Elders completed a Generative Concern Scale and SF-8 and the researcher used a Social Skill Scale to record observations of the children. Results: CIOS-E had three factors named Tolerance; Telling own history; Nurture. Measurement equivalence across Step 2 and Step 3 was accepted (p=0.078). CIOS-C had two factors named Succession and Respect. Measurement equivalence across Step 2 and Step 3 was accepted (p=0.392) CIOS-E and CIOS-C showed a Cronbach's α=0.79-0.81 and inter-observer reliability κ=0.73-0.88. Conclusion: CIOS-E and CIOS-C had reliability and validity to evaluate interactions between elders and children in intergenerational programs in the community.

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Aim: The purpose of this study is to clarify the subjective well-being and related factors for healthy longevity among community dwelling elderly people. Method: Subjects were 623 persons over 65 years old, who were randomly extracted from the Citizen Resident Register System in A City. The unsigned questionnaires, including basic demographic characteristics, physical, psychological and social status, were mailed to the all subjects. Results: The rate of valid answers was 350 (56.2%). The mean age (SD) of subjects was 73.5 (6.1) years old and 180 (51.4%) of the subjects were male. The subjective well-being distributed from perfectly well=32 (9.1%), to well=244 (69.7%), poor=54 (15.4%), and very poor=15 (4.3%), and was significantly associated with sex (β=-0.136, p<0.05), subjective symptom (β=0.308, p<0.05), primary nursing care requirement authorization (β=-0.147, p<0.05), K6 (β=0.167, p<0.05), LSNS-6 (β=-0.238, p<0.05), oral health (β=-0.173, p<0.05), exercise (β=-0.253, p<0.05), rest and sleep (β=-0.127, p<0.05), and total scores of healthy activities (β=-0.191, p<0.05). Conclusion: To promote the subjective well-being for healthy longevity in community-dwelling elderly, supporting the health system and eldery people's every activity for health are required.

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Purpose: This study evaluated the learning achievement of baccalaureate nursing students in the seminar program for Home Health Care Nursing Education using a student questionnaire. The questionnaire contents included level of learning achievement, level of understanding of the lecture, level of usefulness of seminar program, and level of visualization of the actual care system. Method: The participants of the survey were 45 third year nursing students of A University before and after the seminar program for examination. Results: Students said that level of usefulness of the seminar program was better after the completion of seminar program compared to before the start of the seminar program. The results showed there were positive correlations among the level of understanding of the lecture, level of usefulness of seminar program, and level of visualization of the actual care system. Also, there was a positive correlation of communication with the level of visualization of the actual care system. Conclusion: The seminar program is useful for students before the practicum of home health care nursing. In addition, there was a considerable correlation between the level of visualization of the actual care system and communication practicum. Therefore it is important to ensure a high level of communication practicum to increase visualization.

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Purpose: The purpose of this study is to clarify the strengths of adult men who received the health guidance in the process of lifestyle transformation. Method: The word "strengths" is defined as "the powers and abilities of people" in the lifestyle transformation process. Participants were a total of 15 adult men who received the Specific Health Guidance (age 40s-50s), obtained consent for this study. The design of this study is a qualitative inductive research. Semi-structured interviews were conducted. Interview time needed about an hour per person. The guidance for the interview corsisted of the following points: the nature of life after having the health guidance and the changes that occurred due to the guidance, the meaning of changing the life style, the things that helped make improvements in life style, and the future goals or aims in sustaining this new life style. Results: The results of the qualitative inductive analysis showed six categories of Strengths: the strength to think about one's own life-span; the strength to understand one's own state among one's personal relationships; the strength to analyze one's own personality and lifestyle; the strength to be aware of possible conduct to change one's own lifestyle; the strength to respond to and control stress; and the strength to realize the objectives in the improvement of one's lifestyle habits in accordance with one's own life. Discussion: The contents of the strengths of adult men in their lifestyle transformation process included not only the recognition side but also the action side. And the strengths had the power to create changes. Furthermore the strengths interacted with each other and were brought out from the interaction with others in the time axis of past, present and future. These findings suggest the possibility of introducing the concept of strengths into health guidance for preventing lifestyle-related diseases.

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Purpose: The purpose of this study was to explore support methods by public health nurses for encouraging behavioral change and sustainability for healthy lifestyle of persons at high risk of lifestyle-related diseases. Method: The subjects were four local government public health nurses. The data was collected by semi-structured interview on the support methods by the nurses, which was to clarify intention, contents, target of encouraging behavioral change and sustainability for healthy lifestyle support for high-risk persons. Interview transcripts were analyzed by using an inductive coding approach. Results: The support methods which consisted of 42 <sub categories>, nine <<categories>>, and two 【core categories】: 【Cultivating the power to appropriately adjust their own lifestyle】 consisting of <<Encouraging objective view of their own-lifestyle>>, <<Finding a way of behavioral change that matches the pattern of lifestyle>>, <<Developing an ability to experience effect of behavioral change>> and 【Advancing the ability to adjust relationship with surroundings】 consisting of <<Considering the views of the family on health and the view on life>>, <<Entertaining how to declare intention of behavioral change with people around one>> and <<To confer the role of healthy behavior>>. Conclusion: Support aiming at highly sustainable behavioral change, which is carried out by public health nurses, is set out 【Cultivating the power to appropriately adjust their own lifestyle】 and 【Advancing the ability to adjust relationship with surroundings】. Moreover, the supported high risk persons improved their own self-care skills and they were motived to willingly ameliorate their environment as factors in health promotion throughout their regions.

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Purpose: The purpose of this article is to clarify how elementary school teachers dealt with school non-attenders who were neglected by their parents. Method: We conducted semi-structured interviews with 13 elementary school teachers who had handled school non-attenders neglected by their parents. We conducted data analysis using Methodology for Conceptualization of Nursing developed by Naomi Funashima. Results: We extracted 414 codes and 7 core categories which showed the experience of elementary school teachers who had tried to help school non-attenders to go to school. Seven concepts that were extracted in our analysis were as follows: "efforts to make a school enjoyable for children," "the support by all school staff (especially class teachers) and the community members," "involvement for strengthening parents' nurturing skills," "the difficulty in dealing with child problems coming to the surface," "the difficulty in supporting children in a timely fashion," "the limit of involvement with parents of neglected children in the current school system," and "the authority and mechanism for making forceful intervention in the families of neglected children possible." Discussion: Our analysis revealed that although they made strong efforts to help school non-attenders in neglected families to go to school beyond the scope of their work responsibility from the perspective of goal achievement, elementary school teachers faced problems when dealing with the issue of children, which arose secondarily from the characteristics seen in parents of neglected children and the nature of their neglect, so that such teachers requested the assistance of the community in and out of schools.

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Objective: This study aimed at identifying a relationship between workers' perceived purpose in life and lifestyle in workers and effective health guidance in occupational health. Method: Using an anonymous self-administered questionnaire, we collected information on demographics, lifestyle, and perceived purpose in life from 638 workers employed at a manufacturing plant. Lifestyle was categorized into good or bad based on the national standards of screening and follow-up. We used the Japanese version of the Purpose in Life (PIL) test, and classified the workers into three groups (low, middle and high purpose in life) with scoring criteria. Multiple logistic regression analysis was used to determine factors associated with purpose in life. Results: The data from 265 of 419 respondents were analyzed. The mean age of respondents was 33.9±8.3 years old, and the age of sex was not significantly. The PIL rates were 50.2% in the low, 36.2% in the middle, and 13.6% in the high groups, respectively. Age and sleep were related to purpose in life, and poor sleep was found to affect purpose in life in the low purpose group (odds ratio 3.213, P<.01). Conclusion: It was identified that the workers who did not get enough rest or sleep had a low purpose in life. These findings suggest that health guidance and education on sleep and rest are needed.

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[in Japanese]

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