A survey was made to determine a clarification of post-retirement life plans of female nurses in China and the motives behind their decisions.<br>The subjects were nurses over forty years old, working at twenty hospitals in three provinces and two cities. The survey was conducted from November 1997 until August 1998.

The questionnaire distributed consisted of demographic data, working conditions, retirement age desired, type of work desired after retirement, present health conditions, views on work and adaptability to work.

One thousand six hundred and thirty-four questionnaires were collected, out of which 1,521 (92.6%) were effective and considered. The questionnaire results showed that 74.2% of those surveyed planned to retire at the age of fifty-five, 60.2% intended to live free from employment and remain self-sustaining after retirement and 35.1% wished to go on working. Of the respondents wishing to keep working after retirement, 70.4% hoped to maintain the same nursing work. Forty-three point eight % wished to be engaged in the work in hospitals, and those interested in the work of visiting nursing and community health nursing were 20.5%.

This survey showed that the factors that decide the desires of the nurses after retirement are closely related to their health conditions, adaptability to work, and their views on work. The survey also indicated that the nurses with better health conditions, higher work-adaptability and more positive views on work were likely to prefer to work in hospitals after retirement.

The purpose of this study was to develop and refine a self-assessment tool for a nursing group's evaluation of the process of nursing care. We expect this study influence the improvement of measurement of nursing care quality and thus the dissemination of quality assessment data from hospitals.

To develop a self-assessment tool, two methods were used. One was a method of testing validity based on the consistency between the results of self-assessment and assessment by a third party by using QI program. The other was a method of obtaining opinions on the self-assessment tool at a focus group interview with nurses. The self-assessment tool was initially developed based on the QI program.

Five nurses, one from each of five hospitals, completed the Nursing Care Quality Process Self-Assessment Tool (NCQPSAT). The researchers assessed nursing care by the same five nurses using the QI program. NCQPSAT scores were higher than QI program score in four out of five nurses. The results were more similar in self-assessment questions where nurses made a choice from a list of evaluations and described the details and the researcher made a judgment for scoring.

Fourteen nurses, who were not assessed in the comparison, participated in the focus group interviews. They were asked to respond about the design, usefulness, and comprehensibility of the NCQPSAT. As a result, the following five points were identified as items to be refined in NCQPSAT: (1) Specify the relevant time period for self assessment. (2) Consider inclusion of an explanation of the intent of the questions. (3) Ensure that each question includes only one content area. (4) Rewrite choices to avoid overlapping answers. (5) Reduce the time needed for complication of the NCQPSAT.

This paper proposes a new role for nurses in health care policy development using the example of a community-based health education program. Due to rapid changes in health care policy in Japan and the United States, there is a growing need for community-based health education programs. In Japan, Healthy Japan 21 emphasizes the importance of health education programs. Health promotion in the United States as well as Japan is viewed as beneficial to both the individual and society. Efforts at health promotion among the elderly population have been initiated at the national level by the U.S. Department of Health and Human Services, as a part of their objectives for Healthy People 2000. Participation by members of the community in program planning necessary to ensure that programs meet the unique needs of the target population. Communities are unique in their characteristics, and their needs should be assessed holistically at the local level. Intervention also occurs at the local level, even if government regulations and health plans are regionally controlled, as they are in Japan. The significant steps in developing community-based health education will be illustrated using the example of the BABS(Be Able Be Satisfied)program, which was designed based on U.S. federal health care policy and implemented for an elderly Japanese population in San Francisco, California. The BABS program is discussed in terms of its process, impact, and outcomes with a particular focus on the changes necessitated by the demands of the actual situation. This adjustment during the implementation of the program, led to effective outcomes. Such information from the local level is needed to address existing problems in the community and needs to be heard at the national level. Therefore, the future role of nurses as facilitators of community-based health education programs will include knowledge of the political process, the ability to communicate the needs of a local community's population to health care policy decision makers, and the presence of a strong voice in professional organizations, as well as the skill to provide comprehensive health care. Nursing leadership in the process of policy development will assure the public of the provision of effective health education programs for the entire nation.

The creative public system construction is the reform or integration of the personal health service system that exist. It is said as the reform strategy that intends, the preparation/plan/application of the activity that stood to long-term/general view. The public health nurse systematizes the project team. The team is made with the person in charge of the relation organization/party. The activity puts emphasis to the adjustment between the organization.

The purpose of this research clarifies what kind of reform strategy was used the practice example of public system establishment, and also the process. And, I present 1 model for the reform.

The research object is 3 public health nurses of public health center. As for their experience years, there are 14-21 years. They established the public system construction.

The collection of data used the phenomenon observation by recollection law. I used the method of phenomenology to analysis.

The strategic reform plan that was established with this research puts a large goal to the activity idea. One stage is the system construction that tries to tackle now. The firm collaboration relation based on confidence/trust is made with the process of this system construction. The trust/collaboration relation with the relation organization/party becomes the core of new system construction. I see the wisdom which it was started to guide with this research and be a progressive gearing strategy plan.

As for the process, there is a start stage/implementation stage/progressive stage. I see the new wisdom with the middle, and be a progressive stage.

It is widely known that the proficient nurse staffs have a great influence in the actual clinical scenes. Therefore it is the theme in the system of staff education to train them to be proficient in their career. We have done a survey subject to 574 nurses out of 3 hospitals with a career of 3 years and more, aiming to clarify the practical ability of the proficient nurses, based on an estimation that having experiences and spending years are just not good enough to train them to be a proficient one.

The survey was proceeded through the analysis of anonymous, self-complete questionnaire, our original one based on our clinical and educational experiences. The questionnaire consists of 48 questions related to the 5 categories of practical ability, and 21 questions related to the general attribute and other factors which may have an influence on one's ability.

We have scored the clinical practical ability questions at 4 levels, and scored the average with each questions and categories. And the unitary arranged and scattered analysis was done, about the relation between the total score and the general attribute, the influence factor. Besides the chi-square test between items with a significant difference and total years of experience was done.

We have come up to the following results through the data analysis.

1. The "management" ability marked the highest of all the 5 categories of practical abilities, followed by the "influential power","nursing","education", and the "self learning" ability.

2. The average score was high in the item of prevention of the accidents out of the management category.

3. The average score was low in the item of self learning category, especially on those regarding to the researches.

4. There was a significant difference between the score of practical ability, and some of the general attributes such as ; age, social status, career length, number of years after graduation, reason for not quitting the job, consciousness as being the "proficient staff", and some influence factors such as ; an encounter with a patient who has affected one's nursing, an intention to be a manager, marital status, number of different departments one has experienced.

5. The practical ability can not be judged just by one's career for the fact that the reason for not quitting the job, the encounter with a patient who has affected one's nursing and the intention to be a manager do affect the practical ability regardless of one's career.

What kind of difference do we see in the nurse's clinical ability in each age? We have compared the factors composing the clinical ability in 6 classes with the ages of range in 5 years. The factors we have found through the analysis of late survey are as follows ; "training ability","ability to build up human relation and activate the office", "ability to cultivate oneself","ability to assess,judge, and to respond to the changes", "ability to adapt new systems", "cooperative ability with the patient, the family, and the team staffs","one's commitment in nursing", "the countermeasure and attitude toward malpractice prevention". We use the same subject, time, questionnaire, and the method as in the first report, and we used the Kruskal-Wallis test for analysis. We divided and showed the result with each factors in the radar chart, and compared with each age classes.

The following results came up to be the theme in education/support system.

1. There is a remarkable gap among each classes on the "ability to train" and the "cooperative ability". However there is no remarkable gap among the classes on the"ability to build up the human relation and activate the office", and "one's commitment in nursing".

2. The "ability to adapt new systems" shows high score below the age of 25, however the score decreases at once afterwards. There is almost no difference in the "commitment in nursing" among each groups after the groups of age of 26 to 30.

3. The "ability to adapt new systems" is the only remarkable high factor under the age of 25. It shows an average of low score in 5 factors in the group of ages 36 to 40, especially in the "ability to build up human relation and activate the office" and the"ability to assess,judge, and to respond to the changes".

4. The clinical ability of the group of ages 36 to 40 may be estimated as a reflection of one's own life stages. This period of time where the life itself has much more values, should be considered as the charging period for a nursing with a better quality throughout various experiences, for the fact that the following group shows high and well balanced score in the ability of clinical practice.