Purpose: This study aims to clarify the experiences of commissioned welfare volunteers，hereinafter referred to as “welfare volunteers”，related to Advance Care Planning (ACP) for older people living alone in the community and to gain insights into collaboration with these volunteers.

Methods: Semi-structured interviews were conducted with nine current and former welfare volunteers in City A，Prefecture A，Japan. The interviews examined the process used by welfare volunteers to understand the wishes and intentions of older people living alone regarding end-of-life care，as well as the thoughts and considerations the volunteers formed throughout this process. The contents were analyzed qualitatively and descriptively.

Results: Five major categories were identified: [Building relationships with older people living alone], [Respecting the autonomy of older people living alone], [Understanding the true intentions of older people living alone], [Appreciating difficulties], and [Delegating to the appropriate person(s) considering one’s position].

Discussion: It was suggested that welfare volunteers can provide valuable information，from different perspectives and positions than those of professionals，regarding ACP for older people living alone，and contribute to understanding their intentions. However，when welfare volunteers engage in ACP，there are evident issues with psychological burdens，a lack of specialized knowledge，and challenges related to collecting and sharing personal information. Therefore，a collaborative framework is necessary in which professionals take the lead while leveraging the community-based perspectives and trusting relationships formed by welfare volunteers，and utilizing their expertise to complement ACP-related activities.

Purpose: The purpose was to identify the work experience items that facilitate the acquisition of program development and policy-making competencies by public health nurses working at prefectural government offices (“government office public health nurses”) to obtain suggestions for a human resource development for prefectural public health nurses.

Method: Using the Delphi Method with government office public health nurses around Japan, surveys were conducted three times to assess the agreement and importance of experience items.

Results: Of the 749 public health nurses in 44 prefectures who consented to the survey, responses were obtained from 195 in the first survey, 94 in the second survey, and 86 in the third survey from 40 prefectures. In an examination of agreement and importance of the 67 items in the third survey, 90% or higher agreement was obtained for 65 items, enabling the identification of concrete experience items. Regarding importance, with a mean score of 4.0 or higher set as ‘important or higher,’ 37 items were identified. Nine items considered ‘very important’ by at least 51% of respondents included checking legal basis and national trends, preparing a response proposal and discussing it with a superior, setting priority among work tasks, checking the direction to aim for in prefectural plans, and identifying health needs.

Discussion: Sixty-five experience items that facilitate the acquisition of program development and policy-making competencies by government office public health nurses were identified, and their characteristics were clarified. They provide hints for use in human resource development of public health nurses.

Aim: This study aimed to identify the supportive methods used by public health nurses（PHNs）to promote behavior change, particularly among middle-aged men who participate in specific health guidance at least twice (repeaters).

Methods: A qualitative descriptive design was used to analyze the content of semi-structured interviews with six PHNs about the content and intent of the support provided during the initial interview, and describe their supportive methods.

Results: The supportive methods that promoted behavior change for repeaters were engaging with repeaters by prioritizing what was important in their current lives; engaging with repeaters to increase health guidance acceptance; reviewing past progress with repeaters and encouraging awareness of the increased risk of lifestyle-related diseases; encouraging the repeaters to visualize the future image and state they should aim for; reviewing past failures with the repeaters and considering information provision and action plans from a new perspective; supporting the repeaters to make an action plan based on past records that allowed them to feel the effects promptly and to continue without difficulty; encouraging the repeaters to make renewed efforts to reach their goals; and recognizing the efforts that had been made so far so that the repeaters could move towards their goals again.

Discussion: To promote behavior, change for repeaters, particular importance was attached to considering information provision from a new perspective, engaging with repeaters to increase health guidance acceptance and supporting them at making an action plan that allows them to feel the effects promptly and to persist without difficulty.

Purpose: This study aims to evaluate the effectiveness of on-demand e-learning video teaching materials developed for public health nurses (PHNs) to learn family assessment.

Methods: Twenty-one PHNs voluntarily participated in this study. The method involved categorizing the content of the assessments and nursing plans posted by PHNs, who agreed to participate in an e-learning study to learn family assessment, identify the family member's relationship written in the assessments and content, and understand whether complex issues were described. The learning objectives were to ascertain whether the three contributions of family assistance skills could be performed. After the e-learning, a voluntary web-based questionnaire survey was administered to ask for an evaluation of the video materials and learning objectives. The effectiveness of the video teaching materials was evaluated from the qualitative classification of assistive for family assessment and learning objectives, the number of PHNs who posted them, and descriptive statistics of positive responses to the questionnaire survey.

Results: In total, 13 PHNs contributed a family assessment and 11 responded to the questionnaire. PHNs wrote assessments for 12 children, 10 mothers, 13 fathers, and 10 grandparents among the family members and these assessments included complex issues. Learning objectives were written by 9 to 11 PHNs for each item. 7 of the 11 PHNs indicated that they were able to learn to assess families with complex issues.

Discussion: In the on-demand e-learning using the produced video teaching materials, it was found that PHNs can learn family assessment.

Objective: To examine the attitudes of older people living in public housing toward continuing their daily lives in the event of a major earthquake.

Method: Semi-structured interviews were conducted with nine older residents of Apartment A, a public housing complex where an earthquake of seismic intensity 6 or higher is expected to occur in the Tokyo metropolitan area. The data were analyzed qualitatively and descriptively.

Result: Six categories were extracted from the analysis: ［Past disaster experiences shape current preparedness］, ［Want to continue living at the same place despite toilet concerns and the risk of collapse］, ［The fact that many residents have high daily support needs is a problem in itself］, ［Overwhelmed with their own problems during an emergency］, ［Support each other during an emergency by making connections］, and ［Maintaining physical mobility is the key to disaster preparedness］.

Discussion: Although the older residents of Apartment A are aware of the risk of the building collapsing in a disaster, they expect to continue living in public housing with some support, suggesting the possibility that they may become isolated if their means of mobility is restricted. Therefore, in the event of a major earthquake disaster, the possibility that many older people may choose to shelter in place should be taken into account when considering disaster response, and public support is necessary for mutual aid including daily encouragement of self-help by support organizations, daily relationship building among residents, disaster prevention plans, and the establishment of post-disaster information gathering systems.

Objectives: To clarify aspects of assessments regarding safety confirmation and difficulty for single older adult residents by nursing professionals in community general support centers.

Method: Semi-structured interviews were conducted with nursing professionals in community general support centers, which were analyzed qualitatively and descriptively.

Results: Eight safety confirmation categories were generated: “Emergency needs owing to a life-or-death situation”, “Needs for safety to determine if there is any abnormality in a person”, “Needs to check on the person with any abnormality to continue living alone”, “Needs to visit every day to confirm their safety because there is no daily living support”, “Needs to cooperate with family members according to the person’s situation,” “Needs to emphasize interactive relationships with the person”, “Needs for the cooperation of nearby residents to check on the person”, and “Needs for cooperation with related organizations in responding to the person”.

Discussion: Aspects of assessments of single older adult residents related to safety confirmation obtained in this study are related to life and death; moreover, the aspect of maintaining home life also considers how to proceed with life after safety confirmation. Strategies for confirming the safety of older adult residents can help build relationships with them and prepare for situations in which neighbors or relevant organizations are unable to confirm their safety in emergencies or in cased of the breakdown of home life.

Objective: To understand the experience of care managers and health care professionals who participate continuously in community care conferences in a small municipality.

Methods: Semi-structured interviews were conducted with four care managers and four healthcare professionals who attended a series of community care conferences in municipality X. The results were analyzed qualitatively and inductively.

Results: The care managers [prepared thoroughly for care conferences], while some [found it challenging to have case studies centered on service implementation]. They [improved their assessment skills], and [developed closer relationships with healthcare professionals]. They [learned about the strengths and challenges within the community] and developed [a more positive attitude towards conferences]. The healthcare professionals [attended the conferences expecting to share their medical knowledge with care managers] and to [help them become more familiar with medical care]. Their [perspective shifted from a disease-centered mindset to a focus on community living]. They [became respectful of care managers’ profound role involved in the community], [became more cognizant of the role of medical care in the community as a whole], and recognized [the purpose of conferences in connecting everybody in the community]. They experienced [the joy of attending conferences].

Conclusion: Based on these case studies, care managers increased assessment skills through learning of the medical perspective, while healthcare professionals came to a better understanding of the homecare perspective. Both experienced deeper connections with each other. This suggests that both parties gained holistic perspectives, prompting an increased understanding of their own roles in the community.

Purpose: This study aims to clarify the social participation status and motivations of older people with a stoma and to examine the factors associated with their social participation.

Methods: Patients with ostomies aged 65 years and older completed a self-administered questionnaire and were divided into two groups: those who “participated in society” and those who did not.

Results: Questionnaires were sent to 1,330 individuals through 16 ostomy appliance retailers, with 338 valid responses（25.4%）. The social participation rate was 39.6%. Factors related to social participation were divided into four categories: “mental, time and physical aspects of spare time”, “stoma management concerns”, “individual motivation” and “the presence and support of a companion”, such as being invited to participate in activities by a close person.

Discussion: Factors related to social participation among older people with a stoma are a sense of having “mental, time and physical freedom”, a reduction in “anxiety about stoma management”, and the emergence of “individual motivation”. These factors suggest an improvement in perceived health status. In addition, the positive encouragement of others through the presence and support of companions is an important factor related to social participation among elderly stoma patients, and these are complex issues that affect each other. Therefore, it is necessary for the relevant professions and organizations to work together to develop a community support system.