Objective: To explore the gender differences in factors related to locomotive syndrome among community-dwelling elderly in an urban area forward community health promotion.

Method: This cross-sectional study involved general citizens aged over 65 years in Yokohama City, with physical performance tests after a self-administered questionnaire by mail. Data were collected on presence of locomotive syndrome stage 1（LS）by index of stand-up test as dependent variables, demographics, self-rated health, life style behavior, Philadelphia Geriatric Center moral（PGC）, Frontal Assessment Battery（FAB）, life style and so on as independent variables. The association between LS and the predictive factors was evaluated using logistic regression analysis.

Results: Valid respondents both of questionnaire and physical performance tests were 302 participants. Participants age was 71.7±5.2（range: 65-88）, and 168（55.6%）were male. The prevalence of LS was 51.3%. Logistic regression analysis revealed that for aged men, severe of living arrangement（OR=13.15, 95%CI:1.00-172.57）, PGC（OR=0.81, 95%CI:0.71-0.91）and FAB（OR=0.79, 95%CI:0.65-0.96）, were significantly associated with presence of LS.

Discussion: The present study demonstrated that half of elderly are facing the risk of locomotive syndrome. Health promotion activities should be aimed not only at exercise but also improvement of moral and cognitive function in community.

Objective: The purpose of this study was to develop a Research Utilization Competency Scale（RUC）for public health nurses.

Method: The item pool of the RUC was selected from previous studies and refined by researchers, and was corrected through a pilot survey. The subjects were half of the approximately 2,000 full-time public health nurses（PHNs）working at all 184 local governments of the Chugoku District of Japan. Questionnaires were distributed by mail. We explained the ethical considerations in writing and those who returned the completed questionnaire forms were deemed to have given their consent.

Results: Of the 1094 recipients, a total of 614（56.1%）responded, and 604（55.2%）responses were valid. Ten items were selected among 15 items based on the results of item analysis, and exploratory and confirmatory factor analyses to confirm the construct validity showed that the RUC consisted of two subscales: to search the research results to solve on-site problems, to appraise, apply, and evaluate the research results. The correlation coefficient between two groups divided by odd/even-number method of the split-half method was 0.91, and Cronbach’s alpha, a reliability coefficient of RUC, was 0.92 and the score of each subscale was over 0.8, thus supporting the internal consistency of RUC. The correlation coefficient between RUC scores and the external variables that measured the practical competence of public health nurses was 0.4–0.5, supporting the coexistence validity of the criterion-related validity of RUC. The significant differences were observed between known-groups, supporting the known-group validity of RUC.

Conclusion: This study developed RUC consisting of ten items and two subscales to measure a research-results utilization competency of public health nurses, and confirmed constant reliability and validity. Hereafter it is expected to use RUC for the competency development and evaluation of public health nurses.

Purpose: The purpose of this study was to identify qualitatively the reflection on reflective practice for public health nursing students to increase the competency of public health nurses through health promotion activities.

Method: 20 public health nursing students participated in this study. The subjects of this study were reflective journals for six students submitted five times at reflective practice during about 8 weeks, and which were judged according to selection criteria to check the richness of data.

Result: As a result of SCAT, the concepts that constitute reflection such as “reflective ruler”, which is a tool to know oneself objectively, were extracted. The public health nursing students learn about “sympathy” and “commitment” which are abilities to increase the competency of public health nurses through reflection.

Conclusion: The concepts constituting the reflection of public health nursing students included the reflective skill by Atkins & Murphy, namely, self-awareness, description, critical analysis, synthesis, evaluation. These results suggest that these concepts can enable an evaluation of the reflection.

Purpose: The aim of the present study was to examine floor nurses’ discharge guidance provided for facilitating daily living of patients undergoing Home Oxygen Therapy (HOT) and to extract factors related to discharge guidance.

Method: Questionnaires were mailed to floor nurses who were responsible for providing discharge guidance at regional medical support hospitals in the capital region.

Results: Eighty-six floor nurses at 21 hospitals responded to the questionnaires (the recovery rate was 62.3%), and the number of valid responses was 68 (71.9%). Five factors related to discharge guidance were extracted. These were dietary habits and nutrition, means of transportation, living environment, ways to improve daily living, and maintaining personal hygiene. Floor nurses, who participated in a workshop on discharge guidance and were primarily responsible for patients undergoing HOT, provided appropriate discharge guidance for dietary habits and nutrition and means of transportation. Floor nurses, who worked at hospitals that held a workshop on HOT, provided appropriate discharge guidance for maintaining personal hygiene.

Discussion: For floor nurses to provide appropriate discharge guidance for facilitating daily living of patients undergoing HOT, they need to frequently practice discharge guidance as a part of their daily duties, cooperate with outpatient departments, and have access to educational opportunities, such as study sessions to improve the nurses’ expertise.

Objective: To reveal needs related to child rearing mothers with cerebral palsy children discharged from the neonatal intensive care unit（NICU）and at home from infancy.

Method: A qualitative descriptive approach was employed with descriptive analysis. Participants were six mothers of first-born children（3 years）with cerebral palsy, of whom four and two had extremely low birth weight and neonatal asphyxia, respectively. Data were collected through semi-structured interviews.

Results: Needs related to child rearing in mothers with cerebral palsy children were classified into nine main categories. 《Supplying enough milk and food》《keep relaxed by stopping crying》《relief muscle tonus, taking a bath and going out safely》were related to the following needs, and indicated mothers’ willingness to meet children’s basic requirements such as diet, sleeping patterns and cleanliness, and ability to go out safely in daily life. There were characteristic causal starting classic symptoms gradually found in the central nervous system after leaving the hospital. The mother’s mind changed when she recognized the child’s mortal impairment,《performing strenuous effort for children’s growth》through effective rehabilitation at facilities for care and education. 《Feeling about the children’s development and future perspectives》have continued from birth up to the present. 《Understanding and cooperation among family members》《receiving peace of mind regarding medical condition and child rearing from medical staff》, and《meeting other mothers who can share their troubles and concerns》《receiving suitable services for the family and children rearing situation》were concerned in child rearing environment.

Discussion: Newborns with extremely low birth weight and/or neonatal asphyxia are at risk for cerebral palsy, and early intervention and appropriate support are therefore necessary throughout the course of their development. Also suggested is the need for collaborative approaches involving clinical and community nurses.

Purpose: The purpose of this study was to specify parenting troubled mothers’ shifting states of consciousness towards their children in group sessions organized by public health nurses.

Method: Survey data was collected from participants of the group sessions (6 in 2008 and 4 in 2009) held in A City by recording the sessions and asking participants to write a comment on every session, fill out a questionnaire and be interviewed at the first session, the last session and 6 months after the last session. The data on the mothers’ self judgement on their parenting were distilled for qualitative and descriptive analysis.

Results: The category distilled from the mothers’ introspection shows characteristic results in each phase. The participants realize that their mindset has shifted in group sessions and their parental attitudes towards their children improved as they looked back on their parenting and their own childhood. By the time the last session ended, they learned to ask for help and improved parenting skills, and 6 months after the last session they found new values in life and didn’t get irritated unnecessarily. On the other hand, worries and anxiety for parenting existed at every phase.

Conclusions: The group sessions provided encouragement for the mothers to reflect on their behaviors, which eventually helped them acquire new values. This study indicates that mothers improve themselves within a comfortable setting, provided by public health nurses, in which to talk and look back on their past.

Objective: The purpose of this study was to compare the characteristics of the complaints of neighbors toward mentally ill persons (MIPs) and the difficulties faced by public health nurses (PHNs) in responding to them, depending on their years of experience in mental health and welfare (MHW).

Method: The subjects were 659 PHNs supporting MIPs in 53 municipalities. A mail-in self-reported questionnaire survey was conducted in 2015, covering the characteristics of the PHNs, the consulters and their main complaints toward MIPs, and the practices and difficulties of PHNs in responding to the most difficult cases. After comparing each item by the t-test, chi-square test and Kruskal-Wallis test, we divided the PHNs into 2 groups; those who had less than 10 years of experience in MHW were classified as the ‘<10 years group’, and PHNs who had more than 10 years of experience were classified as the ‘≥ 10 years group’.

Results: Among the 261 PHNs (valid response rate: 40.1%), the ‘< 10 years group’ included 159 persons (60.2%), and the ‘≥ 10 years group’ included 105 persons (39.8%). Neighbors, civil servants, and other municipal staff complained or consulted about the MIPs. The most common request was to ‘hospitalize the MIP’. The ‘≥ 10 years group’ used significantly the approach of ‘enhancing the understanding of mental illnesses than the ‘< 10 years group’.

Conclusions: Through this approach, the ‘≥ 10 years group’ would enrich the complainers’ understanding of MIPs for developing a comfortable community to live for both of them.