Purpose: In community health nursing practicums, learning is assessed based on students’ performance. This study aims to clarify how teachers assess students’ learning outcomes of community health needs assessment in practicums and to elucidate the criteria of performance evaluation of learning community health needs assessment.

Method: The research participants were 12 community health nursing faculties directly instructing in practicums at a nursing university, comprising three lecturers, eight associate professors and one professor. The author carried out interviews by asking the teachers to recall teaching situations in community health nursing training exercises and to relay the educational intervention situation and the reactions to the learning as grasped by the teachers. The author used the narratives obtained in the interviews to interpret/describe learning outcomes that the teachers had expected of students, and compared these to the community nursing process and four aspects of assessing learning.

Results: The teachers’ assessments of students’ performances: thinking, e. g. “extracting significant information and interpreting”; and “empathetic understanding of the community and their life”, skills, e. g. “communicating with informants”; understanding, e. g. “increased understanding of theory and concepts of community/public health nursing”; and attitude, e. g. “commitment to public health nursing practices”.

Conclusion: The evaluation criteria of community health needs assessment learning outcomes are the ability to extract significant information and create connection, empathic understanding of the community and their lives, communication, and internalization of theory and concepts of community / public health nursing.

Purpose: The purpose of this study is to identify the frailty status and associated factors among community-dwelling elderly people.

Method: Seventy-four community-dwelling people 65 years and older were recruited at a community health care center in A city in this cross-sectional survey. Data were collected on demographics, personal factors including body mass index, frontal assessment battery, depression, self-esteem, subjective well-being, environmental factors including generativity-related interest as independent variables, and the Frailty Index as dependent variable.

Results: A total of 68 elderly persons participated in this study（response rate:100.0 %）. The mean±SD age of all participants was 76.3 ± 6.1 years old, and 45（66.2%）were female. Of the participants, 4.4% were frail, 57.4% were pre-frail, and 38.2% were non-frail. The multiple regression analysis indicated that the score of the Frailty Index significantly correlated with subjective well-being（β=－0.306, p=0.006）, and generativity-related interest（β=－0.410, p<0.001）in community-dwelling elderly people.

Conclusion: It is recommended that health practitioners should develop an intervention program and a system to enhance the subjective well-being and the generativity-related interest for primary prevention of frailty in the elderly people in a community.

Objective: To demonstrate the process of developing community activities, including the thinking of expert public health nurses（PHNs）through practice.

Method: This was a qualitative, inductive, descriptive study. Subjects were 10 expert PHNs. Data were obtained from semi-structured interviews and analyzed using M-GTA.

Results: Subjects were PHNs with at least 10 years of experience as well as considerable experience in community activities. The results showed 38 concepts comprising 13 subcategories that fell into 2 categories, namely “increased earnestness” and “earnestness leading to fostering a sense of taking initiative”, and a single core concept of “wanting to do something”.

Discussion: The process of developing community activities by expert PHNs moves from “increased earnestness” to “earnestness leading to fostering a sense of taking initiative”, at the center of which, the core concept of “wanting to do something” is the driving force in motivating the community. PHNs expressed their desire to genuinely improve the community by contemplating community phenomena. This desire had been recorded in the personal records of PHNs with past achievements but was actively demonstrated by our study findings. Although theories and models do not express “increased earnestness”, the process of “earnestness leading to fostering a sense of taking initiative” is a PDCA cycle.

Conclusion: These findings empirically demonstrated the process for developing practical community activities based on the core concept of “wanting to do something”. The core concept was expressed among PHNs who contemplate community phenomena. It was also connected to the PDCA cycle for promoting initiatives among local residents.

Objective: The purpose of this study is to describe the collaboration between midwives affiliated with medical institutions and public health nurses（PHNs）working with health organizations by comparing facility types.

Method: We conducted a self-rating anonymous questionnaire survey that asks about collaboration with PHNs, and the necessity, methods, and particulars of the collaboration.

Results: The questionnaire was distributed to 1000 midwives, and 376 responses（38.0％）were received. Of these 183 were from midwives working in hospitals（48.7％）and 193 in clinics（51.3％）. For collaboration 88.6％ of the midwives reported “collaborating” with PHNs, and “if possible collaborating”. For the necessity of collaboration, 98.2% of the midwives answered that collaboration is “necessary” and “somewhat necessary” because there are limitations in assistance by medical institutions and increasing numbers of families at high risk. For collaboration methods, the frequency of phone communication scored the highest overall, and having case conferences and using written documents were significantly more frequent in hospitals. For collaborative activities, providing information was the most frequent, and being informed and confirming collaboration aims were significantly more frequent in hospitals. For the time to conduct activities, within working hours was the most frequent, and on days-off was significantly more frequent in clinics.

Conclusion: The midwives were collaborating with PHNs with awareness of the necessity of collaboration. They were also aware of the need to exchange information about families with problems. The findings suggest the necessity to build direct, close relationships through case conferences and meetings.

Objectives: We aimed to understand the psychological characteristics of elderly mothers attempting to decide on future living arrangements for their adult children with intellectual disabilities. This would help inform community care practice, thereby improving disabled children’s independence and parents’ quality of life.

Method: Subjects in this qualitative, inductive study were 6 mothers（aged 65–74 years）from a parents’ self-help group.

Results: All subjects experienced “the necessity of mother–child independence,” “mother–child emotional ties,” “anxiety about utilizing residential institutions,” “guilt related to children without disabilities,” “anxiety about children’s life skills,” and “feelings of security in belonging to a group.” Mothers who wanted to continue their children’s institutionalization（Type 1）experienced “feelings of security in moving towards mother–child independence” and “dissatisfaction with the relationships between institutions.” Mothers who intended to change from temporary to permanent institutionalization（Type 2）experienced “readiness of temporary institutionalization” and “anxiety related to life after permanent institutionalization.” Mothers who hesitated in deciding（Type 3）experienced “reluctance related to children’s institutionalization.” Mothers who relegated responsibility for the disabled children to the children’s siblings（Type 4）experienced “feelings of security” and “feasibility of resorting to children’s siblings.”

Conclusion: Our results imply that professionals respected mother–child emotional ties and managed facilities with consideration for disabled children’s ageing. Type 1 mothers required greater communication between institutions, institutionalized children, and themselves; type 2 mothers required advice to ease their anxieties; type 3 mothers required group discussions; and type 4 mothers had to better observe their non-disabled children.

   The purpose of this study was to elucidate the conditions needed to improve the skills of health guidance for lifestyle related disease prevention in municipalities. The conditions has been decided what health guidance practitioners should do and the organizations where they belong to.

   The research participants were fifteen people who worked in seven cities based on recommendations from prefectures undertaking organizational initiatives to improve skills in health guidance. Semi-structured interviews were conducted in each municipality. Interviews included the implementation of a system for health guidance, and measures taken during OJT to improve health guidance skills, Comprehensive summaries were made from the verbatim records, and were organized based on the practices of the health guidance practitioners and the organizational systems which were required to promote the efforts of the health guidance practitioners. Categories were made homogeneously.

   For health guidance practitioners to perform their duties, four conditions were identified which include ‘Being conscious of the program’s precise objective for health guidance’. Regarding the organizational system, three conditions were clarified: ‘Mutual support in the practice of health guidance aiming toward the result’; ‘Guarantee of learning time and the opportunity for skills improvement on the basis of practices’; and ‘Building the foundation of the organization for the improvement of health guidance skills’.

   The following organizational conditions are necessary for promoting learning by experience of the health guidance practitioners. They include securing a budget, making conditions to functionalize OJT, making and updating manuals and records, and creating learning systems for new practitioners.

Purpose: To clarify the interprofessional collaboration process and role of the nurses in relation to social welfare workers and chief care managers at Community Comprehensive Care Centers.

Method: Semi-structured interviews were conducted with a total of 9 public health nurses and experienced nurses with at least 4 years of work experience at Community Comprehensive Care Centers directly operating in the Kanto Region regarding their thinking and actions concerning interprofessional collaboration. A qualitative and inductive analysis was then conducted using the Modified Grounded Theory Approach.

Results: Interprofessional collaboration of nurses follows the process, first, of “Unification between specialists” and then moving through “Fusion of the specialty between specialists” of ‘Mutual support using specialization’ and ‘Mutual instruction’ before arriving at “Transformation to comprehensive roles” that ‘expand rule functions,’ which at the same time causes “first an increase and then decrease of specialization recognition” resulting from the ‘Exercise of specialization recognition’ and then the ‘Burying of specialization recognition.’

Consideration: A characteristic of and issue with comprehensive interprofessional collaboration of nurses is the inability to increase specialization recognition and pride, even though the nurses are exercising specialization.

Objective: To elucidate the reasons on which public health nurses base their determination of the need for support for mothers during pregnancy, such as at the time of submission of the pregnancy notification form, as well as subsequent support contents.

Method: Semi-structured interviews were conducted with 10 public health nurses with 5 years of practical experience in maternal and child health activities, and the data were qualitatively analyzed.

Results: The reasons on which public health nurses based their determination that mothers required support comprised six categories and 15 subcategories. “Inference of having difficulties in life” was identified as a core category. Support contents for mothers comprised seven categories and 32 subcategories. “Always being nearby and accompanying the individual on her path” was identified as a core category. Feelings experienced during support comprised two categories and seven subcategories.

Discussion: Public health nurses determined the need for support in mothers by engaging in “Inference of having difficulties in life” based on the observations they made in their interactions with mothers during pregnancy. They provided support for these women by always being sympathetic and focusing on feelings in their interactions. This support method of “Always being nearby and accompanying the individual on her path” was based on a gradual development of relationships. Public health nurses have thoughts such as “Impatience towards the due date as delivery approaches” and “Anxiety regarding the safety of the child not being ensured” while providing support. However, they think that valuing the mother’s thoughts, such as “Waiting for the mother to decide by herself to the limit” raises confidence in her child care and helps to prevent abuse.