Objectives: To ascertain a self-assessment of the state of discharge support provided to older adults by nurses in integrated community care wards and to determine the personal factors and factors related to working conditions associated with the provision of that support.

Methods: Nine hundred and sixty-eight nurses at 47 facilities with integrated community care wards under the jurisdiction of the Tokai-Hokuriku Regional Bureau of Health and Welfare were anonymously surveyed using the Discharge Planning scale for Ward Nurses (DPWN).

Results: Responses were received from 587 nurses (response rate: 60.6%). Five hundred and eighty-four valid responses were received (valid response rate: 60.3%). The mean total score on the DPWN was 100.31 points. Multiple regression analysis with the total score on the DPWN as the response variable indicated that factors associated with the total DPWN score were: Motivation (β＝0.268, p＜0.001), “Being in” a leadership position (β＝0.099, p＜0.01), “Having experience” dealing with the families of older adults (β＝0.101, p＜0.05), “Having received” in-house training in discharge support (β＝0.091, p＜0.05), and “Having opportunities” to share information with other professionals besides discharge planning conferences (β＝0.093, p＜0.05).

Discussion: Increased motivation, training from and inculcation of attitudes by personnel in leadership positions, the systematic creation of conditions for nurses to share information with other professionals inside and outside of the hospital, and the creation of a system to facilitate participation in training will presumably help to improve the provision of discharge support to older adults by nurses in integrated community care wards.

Objective: To clarify factors influencing the maintenance and promotion of oral medication adherence in initial, continuation, and completion phases among older patients with tuberculosis at home who follow a regional directly observed treatment short-course (DOTS) for all treatment phases.

Methods: Semi-structured interviews were conducted with 10 patients aged 65 years or older who had followed a regional DOTS for all treatment phases. The data were qualitatively and descriptively analyzed with reference to Berelson’s content analysis for each phase.

Results: In the initial phase, the factors included “determination to take oral medication for early recovery,” ”a way to help take and manage oral medication suited to oneself,” and “the building of relationships through interactions with doctors, nurses and other healthcare professionals.” In the continuation phase, the factors included “realization of the significance of continuing to take oral medication through the experience of taking medication” and “positive feedback and coordination by doctors and nurses to promote continuation of oral medication.” In the completion phase, the factors were “firming determination to take oral medication enhanced by the imminent completion of oral medication” and “support from doctors, nurses, and other healthcare professionals with a mutually forward-looking attitude toward the completion of oral medication.”

Discussion: Support for older patients with tuberculosis at home needs to enable maintenance and promotion of oral medication adherence using approaches tailored to the characteristics of phase-specific factors, including building trusting relationships, explaining the effects of oral medication, providing feedback, and adopting a cooperative attitude toward completion of treatment.

Objectives: We aimed to elucidate the role of nurses in end-of-life care for older adults in long-term care facilities using the plan-do-check-act cycle of end-of-life care.

Methods: Semi-structured interviews were conducted with 12 nurses affiliated with long-term care facilities that have introduced end-of-life nursing care and the data were analyzed using qualitative descriptive research.

Results: We extracted 9 categories and 30 subcategories of nursing roles in end-of-life care for older adults in long-term care facilities, including [creating a system for older adults and their families to face the end-of-life with ease in a facility], [educational support for staff to provide end-of-life care with ease], [planning of medical care needed in end-of-life care], [clinical judgments to provide appropriate medical treatment in end-of-life care], [multidisciplinary coordination and information-sharing to provide pain-free end-of-life care for older adults], [support for the caregiver providing end-of-life care in the absence of a nurse], [support in accordance with the families’ thoughts and intentions], [reflection of end-of-life care for older adults], and [considerations for family members and caregivers who have experienced end-of-life care].

Discussion: On examining nursing roles required for the end-of-life care of older adults in long-term care facilities using the plan-do-check-act cycle, we found that nurses perform various roles from a medical perspective in preparing a system (Plan), performing end-of-life care (Do), and reflecting (Check). However, there was no category generated with regard to system improvement (action), and therefore, we believe the nursing roles undertaken, such as evaluating the state of implemented medical care and clarifying problems, are needed to improve the end-of-life care system.

Objective: The number of foreign tuberculosis patients in Japan has been increasing. The incidence is higher in people from Asia. To provide support suitable for patients born abroad in regional DOTS, identifying contributing factors for treatment default specific to their countries is required. Our objective is to extract contributing factors for default in tuberculosis patients born in Vietnam（hereinafter referred to as Vietnamese tuberculosis patients）showing the highest incidence in foreign tuberculosis patients in Japan in recent years, to identify factors contributing to treatment default in these patients and to obtain suggestions for such factors.

Method: We conducted semi-structured interviews with five interpreters who have experience of interpretation for Vietnamese patients in regional DOTS and are familiar with medical terms on contributing factors for default to perform qualitative inductive analysis.

Results: Five categories were extracted: “Economic burden of tuberculosis treatment”, “Burden of hospital visits”, “Knowledge of tuberculosis that is incorrectly understood”, “Prejudices against the patients receiving tuberculosis treatment”, and “Absence of people close to the patients who support them to receive the treatment”.

Discussion: The interpreters considered that contributing factors for default are things that influence the patients’ daily life in Japan including costs for the treatment and time spent for hospital visits. They considered that a lack of correct knowledge of tuberculosis is also a contributing factor. Prejudice against tuberculosis was also recognized as a contributing factor. Vietnamese tuberculosis patients need to have trustworthy people who support their medication adherence to continue treatment in Japan.

Purpose: To clarify the triggers and ingenuity to promote reciprocal exchange of support among participants in resident-led preventive care activities recognized by leaders.

Methods: The subjects included 16 leaders─6 males and 10 females, with an average age of 77.3─of a voluntary group that performed 11 preventive care activities recommended by City A. The design of the study was through research by qualitative induction. The data were collected by semi-structured interviews and analyzed.

Results: Two categories of triggers were extracted to encourage participants to promote reciprocal exchange of support：【Awareness regarding the need for connections among local residents】 and 【Realization that casual opportunities to see each other frequently in the neighborhood are important】．The following five categories were identified as promoting the exchange of support：【Creating an atmosphere where participants can easily connect with each other】；【Valuing each individual participant】；【Eliciting what participants believe they can do】；【Encouragement to take on roles without feeling burdened】 and 【Creating a flow where they could participate spontaneously without a specific role】．

Discussion: The need for community connections was the trigger for reciprocal exchange of support. The leader cared for each participant, emphasizing involvement that drew out the potential of each participant and created a supportive atmosphere. Role taking needs to be adapted to the nature of the activity. It is important to create a community where residents support each other through preventive care activities.