The purpose of this qualitative study was to describe strategies and activities of public health nurses' management during the process of developing service programs. Seven public health nurses at a municipal health center participated in semi-structured interviews about their work to develop new service programs. Ten cases of developed service programs were examined. Their analysis resulted in the following description of the program development process (core-categories of activities and general strategies describing significant steps in the processes are presented in quotation marks). The process began when the public health nurses (PHNs) extracted "needs which she/he wanted to solve" and, "lack of existing services" and "limits of current organization". At that stage of assessment, the PHNs began collecting more information about the "way residents live" and "social resources which residents were able to use". They developed a "vision of a new service"; then planned "strategies for preparing the services", "for building resident support", "for acquiring administrative approval of administrator" and "for utilizing existing Community resources". During the next stage of implementation, the PHNs first sought an "acquisition of agreement" with key persons, confirmed agreements about "construction (arrangements) related to collaboration. "Second, the PHNs executed the strategies that were devised previously. The PHNs were constantly working to maintain the "motivation" of everyone involved. The PHNs described the evaluation as continuous; throughout, from the beginning and as necessary. The PHNs evaluated and adjusted all aspects of the development process. As a result of analyzing the frequencies at which the core- and sub-categories occurred in the description of PHNs' management of the process of developing new services to meet community needs, four patterns were extracted to characterize their, management. Collaboration of labor, maintain motivation, use of the power of organizations, and empowerment of residents were the four patterns. The management of PHNs who work up the strategies for developing service programs toward their purpose promotes the efficient use of community resources, the empowerment of residents, and the community development.

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The first purpose of this study was to develop a Sitting Independence Measure (SIM) for the disabled elderly in a community and to examine the reliability, validity, and usefulness of the SIM. The second purpose was to explore the community health nursing care for prevention to a bed-ridden based on the SIM. The subjects were 94 disabled elderly, 65 years and older, in a rural community in Japan. Community health nurses and home visiting nurses in the study field conducted the interview research. The SIM consists of four items based on the sitting tolerance (if they attempt they can achieve it) and five items based on the routine sitting (sitting activities of daily living). The total score of the nine items determines the sitting independence of the elderly. The reliability assessment demonstrated that the sitting tolerance, the routine sitting, and the SIM total score had a Cronbach alpha coefficient of 0.96, 0.69, and 0.72 respectively. The constant validity assessment demonstrated that a significant correlation between the SIM and ADL (the sitting tolerance, the routine sitting, and the SIM total score had a correlation of 0.78, 0.73, and 0.78 respectively), and between the SIM and sitting tolerance time per a day (the sitting tolerance, the routine sitting, and the SIM total score had a correlation of 0.48, 0.78, and 0.58 respectively). Looking at the SIM, the subjects can be classified into four main groups that focus on health promotion, risk management, vitality promotion, and disuse-syndrome prevention in the community health nursing approach. It was concluded that the SIM had a certain reliability, validity and usefulness in a clinical setting.

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The purpose of this study was to examine the utility of an assessment tool for parenting and family function I (PAFFAT. ver.I). PAFFAT. ver.I was developed as an assessment tool to be used in a health interview of an infant's group health checkup and to evaluate parenting functions. The investigation was executed from July to October, 2001. The object districts were a town of 20,000 people and a village of 15,000 people in Shizuoka. An infant's checkup for one and half year olds and three-year old infants, 134 health interviews were recorded before and after using the PAFFAT.ver. I, and the changes of the content were examined. In addition, 119 PAFFAT.ver.I filled in by their parents were examined, and the following results were obtained. 1) It was suggested that the numbers of items and content of the PAFFAT.ver. I were adequate to answer for parents, both for the collection rate and the pass rate of the questionnaire. 2) The Cronbach's alpha of the PAFFAT.ver. I was 0.84. It was confirmed that the PAFFAT.ver. I had been used in health interviews as changes in the content of the health interviews and analysis of the conference of public health nurses after infant's health checkups. 3) In addition, the factor analysis was executed to decrease the number of items and to improve the utility, and eight factors had been extracted. 4) There was a significant relationship between the three factors and the necessity of passage observations by public health nurses. Therefore, it was thought that the PAFFAT.ver. I was reliable and valid as a questionnaire to assess parenting functions. It was selected carefully based up on these results and the PAFFAT.ver. II consisting of 35 items was developed.

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Aim : The aim of this study was to elucidate the needs of senior citizens convalescing at home, and their families, with regards to visiting nurses as well as defining the roles of those nurses by analyzing how they collaborated with other health care professionals according to those needs. Subjects : The subjects of the study were ten visiting nurses, selected from four visiting nursing stations, who had been employed in their profession for three or more years and were involved in active collaboration with other health care professionals. Method : The study was performed through semi-structured interviews with visiting nurses, clients and their families, and when allowed, subjective observation through visiting the clients with the visiting nurses. The data collected, was qualitatively analyzed and summarized to give the following results: The needs of clients convalescing at home and their families were classified as : "need of the clients", "need of their families" "need of the clients and their families". The characteristics of the collaborative needs were overt needs, "adjusting the relationship between other health care professionals and the families" and potential needs, "preventing incidental difficulties in the clients' life" and "managing the course of the clients' convalescence." There were 14 kinds of collaborative patterns of activity associated with the needs of the clients and their families. The role of visiting nurses in collaborative activities was suggested to be as follows : "assessing the clients' condition and symptoms during the collaboration and indicating the appropriate health care professionals" ; "observing the management, indication and efficacy of medication" ; "coordinating suitable health care professionals based on an assessment of the clients mental state" ; "the importance of collaborating with the families" ; "guiding home helpers with regards to the health care management of the clients"; "preventive guidance and prevention" and "constructing a collaborative relationship with other health care professionals".

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Purpose : The purpose of this research was to prove the relationship between lifestyle and the physical and mental health among Chinese immigrants residing in H city. Method : A health survey was conducted with 42 Chinese immigrants. Thirty out of 42 subjects were surveyed through home-visits. The remaining subjects were surveyed at Japanese language schools. There were 21 males and 20 females in this subject group. The average age of the subjects was 38.6 years(±11.9), ranging 21-78 years. Questionnaire items were, 1) individual backgrounds, (age, school education, occupation, length of living in Japan etc), 2) health condition, (medical history, illness, medical examination, etc), 3) lifestyle (consciousness of health, smoking, drinking, sleep,etc),4) mental health condition (General Health Questionnaire 12 items), 5) nutrition (average intake tendency per day, out of 12 different nutrition groups) Result: Among the subjects,15.9% of them smoked, 34.1% of them drank, which was relatively fewer than Japanese residents. As they got older, they had more cases of illness (p<0.01). Peoples who stayed shorter (p<0.01) and males tended to have a higher health consciousness (p<0.05). However health consciousness did not relate to the number leading a healthy lifestyle. The number leading a healthy lifestyle were very few, which of the age of 40 years old was lowest, more than another age. The GHQ score was very high as compared to Japanese residents and the pregnant in China, especially those who had been sick (p<0.01), people who had a health examination by the government (p<0.01), and people who have healthy lifestyle behavior (p<0.05) had lower GHQ score. The number of healthy lifestyles were related to their level of education, breakfast, drinking (p<0.05), and sleeping (p<0.01). Conclusion : It was proved the importance between health conditions and mental conditions. It was subjected that health consciousness and education prevented chronic illness, which was needed for those aged 40 years old. In order for Chinese immigrants to get more knowledge and information about health, they need to communicate with local Japanese, and get involved with the local community.

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The importance of normalization is ever-increasing. In Japan, the first movie starring a person:with a hearing disability, was produced and released in 1999, aiming at a barrier-free society. The second movie was produced in 2000, and was released in 2001. Since these were only released in urban cities, an independent organization of persons with and without hearing disabilities showed the films in rural cities. An evaluation was conducted. Purpose: 1. To evaluate the movies by both of the viewer and the organizer. 2. To identify contributing factors to the continuation of viewing and presenting the movie. This was basic data to promote activities of independent organizations collaborating with persons with disabilities seeking a barrier-free society. Methods: Subjects were 1,620 viewers, and 49 organizers who agreed to participate in the survey at the movies in 2000 and 2002. We conducted a questionnaire survey. We asked whether the subjects would watch the movie or participate in the activity again. Outcome measures were also included in the questionnaire. The items included were: satisfaction on the movie, and the understanding of persons with hearing disabilities and sign language, and the experience of activities for persons with hearing disabilities and other disabilities. Results: The higher satisfaction of viewers at the movies was observed, a deeper understanding of persons with hearing disabilities and sign language, a deeper understanding of a society inclusive of persons with and without disabilities, and a higher willingness to participate in activities involving persons with hearing disabilities was observed. Viewers tended to want to participate in activities for persons with hearing disabilities after seeing a movie starring an auditory impaired person. Re-viewing factors were interest in sign language, overall enjoyment of the movie, the story itself, satisfaction in date and time of the presentation, understanding of persons with hearing disabilities, and understanding of normalization. The organizer's factors to continue the movie-project, was willingness of participation in activities for persons with hearing disabilities. Therefore it is important to associate with persons with hearing disabilities.

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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The purpose of this study was to better define program development for Japanese Public Health Nurses (PHNs) who work for municipalities, and to imply a better direction for PHNs' practices. Some articles regarding program development and making policy appeared in Japanese public health nursing journals published from January 1995 to July 2001. Here are the compiled results of reviewing these articles; 1. Recently, PHNs' interests in program development and health policy have increased. That movement has been effected by not only by the Ministry of Health, Labor and Welfare but also by the localization and administrative reform taking place in by the municipalities. 2. In promoting program development, three models were used; Management Cycle Model (Plan-Do-See), Policy Making Process Model and System Oriented Joyful Operation Model. 3. By analyzing each case of program development, we found two types in the ways by which PHNs' had developed programs. One is the adjustment of Policies in accordance with the community. The other is program development as it relates to the needs of the community. In the case of the adjustment of Policies in accordance with the community, PHNs modified policies from parliament, municipality, or the Ministry of Health, Labor and Welfare to meet the needs of community. On the other hand, in the case of program development to meet the needs of the community, PHNs discovered the needs through daily exercise. PHNs are attempting to create new projects and to return their experience gained back into the programs.

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