The purpose of this study was to identify the basic elements and implications of interpersonal communications (positive communication : PCom) among co-workers to develop positive feelings toward occupational mental health promotion. Semi-structured interview survey was conducted, in which 35 workers were interviewed. A qualitative approach was employed in the content analysis of the collected data. Six elements were determined in the co-workers' behavior that induced positiveness : attitude of recognition as a member of the workplace, openness and fairness in the acceptance as a co-worker, cooperativeness in the work performance, considerations for hardship and emotional support, understanding of the situation and giving words of comfort, and frank responses to requests, suggestions or questionings. Subjects' cognitions resulted from PCom experiences involved four factors : feelings of being of a part of network, ability to perform appropriately in the current work environment, presence of mind as causes for anxiety were solved, and improved morale in work engagement. The relationship between co-workers' behavior of PCom and their cognition as a result of PCom experience was studied. It seems that PCom is a kind of social support actions and work experience to contribute to mental health promotion. To cultivate organizational climate that workers are able to experience PCom naturally is thought to be important for mental health promotion. Furthermore, PCom was found to contribute to productivity in both morale and work motivation. It is suggested that PCom could provide practical resource for healthy work organization.

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The purpose of the present study was to clarify the level of adaptation and factors related to adaptation among relocated elderly community residents. Questionnaires were delivered by mail to 731 elderly who relocated to a northern urban area during summer of 2003 to summer of 2004. Analysis was performed on valid responses obtained from 299 individuals who indicated feeling either "adapted" or "not adapted". From the analysis of correlations between residents' level of adaptation and changing of living arrangement, health status, and social support, the following results were obtained. 1) Seventy seven % of respondents indicated they felt "adapted" to the new environment while 23.1% felt "not adapted". 2) Mean age and the percentage of residents requiring nursing care were higher among the "not adapted" group. Relocation was more often involuntary in the "not adapted" group. They had less knowledge of the new area, had more negative feelings about the new environment, and were in poorer health than the "adapted" group. 3) The "adapted" group had more positive feelings about the new environment, had more social support from relatives, and a larger social network of friends than the "not adapted" group. 4) Results of multivariate logistic analysis showed that the factors correlated with feeling "adapted" or "not adapted" were knowledge of the new area, social support, voluntarily relocating, financial difficulties. It is important for elderly to know new environment and preparation before relocation.

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This study proposea a self-rating scale that can be used among participants in diabetes education to assess and support the learning processes for self-care ability for diabetes prevention. In this study, self-care abiligy refers not only to ways of taking care of oneself but also to ways of improving one's environments. Both the reliability and validity of the proposed self-rating scale were examined in this study for further revision and refinement. The subjects were 206 individuals who had undergone a health checkup and who were subsequently diagnosed as either having diabetes or possibly having diabetes. Based on the results of factor analysis, the self-rating scale was revised to include the following six sub-scales consisting of a total of 33 items : 1) to explore and determine how to improve current food intake and exercise patterns ; 2) to implement, monitor, and improve one's self-care ; 3) to approach families/community ; 4) to direct interest toward self-care ; 5) to assess the adequacy of rest ; and 6) to understand the symptoms of diabetes. The Cronbach's coefficient (α) calculated for the overall scale was 0.94, which is indicative of an adequate internal consistency. There was significant correlation between this self-rating scale score and the HbA_<1c> values (r=.18, p<.05). The validity of its related standards wasn't supported. But the path diagram of this self-rating subscales had explanatory power and a food fit to the data (GFI=-.94, RMSEA=-.079). A longitudinal study will be carried out in the future to further evaluate both the reliability and validity of the scale. The scale is intended for use among participants in diabetes education, who may examine the methodology to utilize the results obtained from the scale for facilitating the advancement in the learning process.

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Purpose: To improve health guidance in Japanese-Brazilians living in Japan, we evaluated their diet and culture/ideas associated with their dietary habits. Methods : Ethnographic study. An interview survey, participant observation, and data collection in 14 Japanese-Brazilians were performed. Themes on the diet was extracted by data analysis. Results: Theme 1. In Brazil, the Japanese-Brazilians had a "Japanese-Brazilian diet," which was the mixture of Brazilian and Japanese diets. Theme 2: In Japan, the Japanese-Brazilians maintained the "Japanese-Brazilian diet" style with incorporation of foods and seasonings that agree with their working style and taste. The diet of the Japanese-Brazilians in Brazil markedly differed among individuals according to habits inherited from their parents/grandparents and surrounding environment. The Japanese diet in the Japanese-Brazilians was characterized by "rice and miso soup as a basis," "Brazilian and Japanese foods simultaneously served on the table," and "use of Japanese seasonings." The factors affecting the diet of the Japanese-Brazilians in Japan were "the frequencies of Japanese foods they had in Brazil," "the present life and working environment," and "Brazilian foods that can be purchased in their area", and "the purpose of visiting Japan." Discussion: "Japanese-Brazilian diet" originated in the Japanese food culture of Japanese immigrants in Brazil. Although Japanese-Brazilians working in Japan had held their own Japanese food culture, previous diversification of food culture in Japan forced them to adjust to modern Japanese food culture.

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The purpose of this study was to clarify the constructive concept of an empowered community. The focus interview was conducted with three health promotion academicians and a skilled public health nurse. A qualitative analysis was employed. The result revealed 127 sub-categories and 36 middle categories which could be arranged into 11 upper categories. The constructive concept was mainly classified into the following areas : personal, organizational and community. The personal area comprised realization of health and health behavior changes. The organizational area pertained to organizational growth, the notification of common issues and influences on the community, participation in decision-making, and the shaping of partnerships. The community area included the following factors : community cultures which respects a variety of aspects, growth through interaction and mutual aid, people's participation in their community activities, improvement with regard to support networks, increase in the social resources of the community and policy improvement, as well as change with respect to municipal government and health professionals. Therefore, the desirable state of an empowered community was one in which interpersonal relationships grow dynamically, and people interact with each other as social resources in order to influence their community. This situation can be considered from the community empowerment orientation and an evaluation viewpoint.

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The purpose of this study was to produce risk assessment tool that enables care providers to evaluate symptoms of abuse when visiting a client's home for the first time. Also this study will help identify cases that need support to correct the causes of abuse and prevent future cases. A comprehensive list of risk factors affecting abuse was compiled using 106 recorded abuse cases in literatures. Risk factors that were seen repeatedly in these recorded cases were selected and combined to produce a risk assessment questionnaire for abuse of the elderly. Then a survey was performed on 100 care providers (effective replies 77) to confirm each items degree of contribution towards abuse. After that, a temporary tool was constructed to compare differences between abused case groups and non abused case groups. The results were used to assess a practical criterion for screening the cases. As a result, the risk assessment tool was constructed containing 55 items and 4 categories, such as 1) cared elderly, 2) care giver, 3) other family members and 4) care condition. Further studies are necessary to improve the precision of the screening criteria of the tool and to make the best use of it by care providers for promoting their assessment skills for more suitable activities on collaborative community health care.

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Purpose : The purpose of this study was to examine the study of health seminar for preventive health care and self-help in ADL of "care house" residents. Subjects and Methods : Subjects consisted of 17 residents at a care house. Based on a survey of physical, psychological, and social functions, a seminar program was established, and 2-hour sessions were conducted every two weeks, continuously for 4 months. Results : Regarding changes in ADL scales, significant improvement were observed in the total ADL-20 and in the IADL subscale for females. Comparisons of score differences before and after the program revealed significant positive correlation between age and the BADL subscale. Individuals who weren't using Long-team Care Insurance (LTCI) showed significantly higher values for the total ADL-20 and the BADL subscale than those who were using LTCI. Regarding social support scales, a significant increase in the subscale of passive-instrumental support was observed among females. In terms of subjective happiness based on the PGC morale scale, significant increases were observed in the subscales of attitudes towards aging, loneliness, and dissatisfaction among all subjects. Conclusion : Effects of this seminar program on "care house" residents were observed. It was suggested that the program increased the communication among residents, and triggered enhanced motivation, and individual interaction. The results indicated the importance of nursing interventions for preventive health care with "care house" residents, as well as frail elderly residents of the community.

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Objective: To identify cues to facilitate independent eating behaviors in elderly with dementia (EWD). Methods: Subjects comprised 20 elderly with dementia who required eating assistance and were admitted to health care facility in Y city. Common problems and care methods with eating behaviors for EWD were extracted from the literature. The problems and the care provided during the lunch time was observed, by the two researchers for one subject on the different days. The study was approved by the Research Ethics Board of the University and conducted after obtaining informed consent from the subject or their legal representative. Results : Mean age was 86.4±5.8 (S.D.) years and 17 were women. Thirty-five % of the subjects had Alzheimer's disease and 75% were scored under 5 points with HDS-R, 70% were level III on ADL. The eating behaviors were categorized into following 5 steps, "start," "food and utensils manipulation," "mastication and swallowing," "continuation of eating behaviors" and "finish." A total of 11 subcategories were defined. Eating assistance was categorized into following 4 categories, "verbal cues", "visual cues", "tactile cues" and "environmental arrangement". The caregiver verbally facilitated to continue eating, showed foods and demonstrated mastication and swallowing. Furthermore, behavioral induction such as initial support, and physical guidance to facilitate reflection were performed. As to environmental arrangement, caregivers simplified foods, arranged utensils. Discussion : To improve the latent abilities of EWD, and to facilitate independent eating, 4 categories of inductions were performed in steps and in combinations. Judging appropriate times to progress the assistance level is also important.

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The present study aims to identify factors essential to the activity of senior citizens clubs in order to develop an assessment index for senior citizens clubs. Subjects were 24 leaders of senior citizens clubs who lived in three areas in Aichi Prefecture : An urban area in a large city, a rural coastal area, and a rural area in the mountains. Data collected during semi-structured interviews were analyzed by inductive and descriptive methods. Two primary categories of factors essential to the activity of senior citizens clubs were extracted from the analysis : <The consciousness and actions of the members> and <The function of the organization>. Five secondary categories, 15 tertiary categories and 66 quaternary categories were classified under the primary categories. Of the five secondary categories, [Members' positive attitudes], [Cooperation among assistant leaders], and [Leadership] were classified under <The consciousness and actions of members>, with each of these three categories affecting the others. The two remaining secondary categories, [Types of activities and administration] and [Associations with other organizations], were classified under<The function of the organization>. <The consciousness and actions of members> is a factor fundamental to the activity of senior citizens clubs and influences<The function of the organization>. Essentially, senior citizens clubs function effectively when the members, assistant leaders, and leader actively participate in the activities of the club. In the present study, many factors essential to the activity of senior citizens clubs were found to be common to a variety of clubs located in different areas and with different types of activities and administration. These results are useful to the development of an assessment index for senior citizens clubs.

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Purpose : The purpose of this study was 1) to examine the actual situation of public health nurses (PHN) in Japan coping with child abuse prevention and 2) to discuss the issues that they are expected to work on in the future. Methods : The subjects of this study are PHNs working in 120 municipalities of "A" prefecture. I conducted this survey by sending a questionnaire to a chief PHN of each municipality (total of 120 PHNs) and collecting them by mail. Results : The chief PHN of the 71 municipalities responded. When they found families anxious about child abuse, they took particular notice of "emotions and appearances of mothers and their children," "position in a family and a community of mothers and their children," "living conditions in a family," "history of health and life of mothers and their children," and "information from relevant organizations." The cases of child abuses and suspicions were increasing between 2000 and 2004, of which 35.0%〜51.5% turned into a better situation. Discussion : The chief PHSs identified from various information some suspicious families for child abuse. The child abuse cases and suspicions that the PHNs engaged in changed for the better, which can be regarded as the important point to evaluate the PHNs' activities for child abuse prevention. The result indicated that PHNs needed to establish a rapport with local residents, to improve their skill for find about the child abuse cases and suspicions, and the municipalities needed to strengthen the support system of maternal and child health.

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[in Japanese]

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Purpose: The purpose of this study was to compare family caregivers' burden and satisfaction with visiting nurses' perceptions about caregivers.' Methods: The subjects included 79 caregiver-nurse dyads of frail elderly who received visiting nursing services. The study used demographic data questionnaires, the Japanese versions of the Zarit Caregiver Burden Interview (22 items), and the satisfaction subscale (9 items) of Caregiver Appraisal Scale. Family caregivers' data were collected by interviews and nurses' data were collected by self-administration. Results: The results revealed the low degree of agreement between caregivers and nurses. As differences, nurses' perceptions were significantly higher than caregivers' perceptions on 10 items of burden including "Do you feel that your relative asks for more help than he/she needs?" and 2 items of satisfaction including "Do you really enjoy being with impaired person?" Caregivers' perceptions were significantly higher than nurses' perceptions on 2 items of burden including "Do you feel your relative is dependent on you?" and 1 item of satisfaction including "I do pretty much what I have to do, not what I want to do, in relation to impaired person." Conclusion: These results indicated that nurses had a tendency to estimate caregiver's burden and satisfaction more than caregiver's them. In order to accurately assess caregiver's burden and satisfaction, visiting nurses may need to encourage caregivers to express their feelings, and to accept their feelings while providing care.

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The purpose of this study is to clarify the situation of Japanese Public Health Nurses (PHNs) in the conduct of community health assessment. Related articles published in Japanese journals from January 1998 to January 2005 were analyzed according to : 1) how they acquired essential skills in community health assessment, 2) what kind of practical methods were used by PHNs, 3) what were the difficulties of PHNs in assessing community health issues. Review of articles showed the following results: 1. There were differences in terms of community health assessment as a required course. A specialized curriculum for public health nursing would be influential. 2. To assess the community, PHNs collect information through analysis of existing documents, interview, and questionnaires. The most-used method for community health assessment is descriptive epidemiology to show the community health problem as a quantitative data. 3. For collecting information and assessing the health issues, PHNs organized interdisciplinary project team including residents. This method is advantageous because PHNs can collect information, share the community health problems with many people, and promote the project smoothly. 4. PHNs felt difficulties in community health assessment because they did not know how to identify the health issues. It is necessary to clarify the assessment skills which the PHNs can integrate in daily practices.

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