Communication skills are essential to nursing and are applied in every nursing practice setting, either proactively or spontaneously. This is undertaken not only to provide nursing care but also to be able to make a professional presentation to an audience. These skills are particularly effective with regard to "early detection" and "prevention" of problems faced by patients concerning various aspects of the nursing environment. This paper focuses on communication skills used in the "early detection of problems," as well as discusses how an outpatient nurse may identify those problems faced by a mother who provides home care for her severely disabled child. This can be accomplished by referring to practice protocols developed previously by nurses. Thus, we will study those communication skills specific to nurses and the methods used in teaching such practical skills.

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Occupation comprises three broad areas of doing: activities of daily living, play, and work. Most occupation is conducted with other people, necessitating interpersonal communication. According to the Model of Human Occupation, occupational performance is made up of three types of skills: process skills, motor skills, and communication and interaction skills. Most problems concerning the mind and body are related to communication and interaction skills. Occupational therapy evaluates problems in environments and individuals and supports environmental adjustment, reconstruction of individuals' methods of stress management, and improvement of communication and interaction skills, and helps individuals to become competent at doing the things they value. Performing valuable or diverse types of occupation, it is possible to improve communication and interaction skills and construct social relationships among users of mental health services, thereby developing users' occupation and quality of life. Thus, occupational therapy should be used to support users' occupational performance.

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The aim of this study was to examine the fit of the hypothesized conceptual model to the input data of participating in a caregivers' group. The model was based on Carl Rogers' theory of personality that "Sympathy" would raise "Adjusting" and "Adjusting" would improve mental health. Self-administered instruments were mailed to 626 members of caregivers' group, and 181 usable responses were analyzed (response rate=28.9%)."Sympathy" and "Adjusting" were measured using the original scale of caregiver's feelings after participating in the caregivers' group. Mental health was measured by the Japanese version of the 12-item General Health Questionnaire. The hypothesized conceptual model was examined using Structural Equation Modeling. This model performed well in term of CFI=0.93 and RMSEA=0.05. Coefficient from the variable of "Sympathy" to that of "Adjusting" was significantly (p<0.01)073. Coefficient from the variable of "Adjusting" to that of "GHQ" was significantly (p<0.05)0.19. The hypothesized conceptual model showing good fit to the input data would be useful theory for family caregivers in bad mental condition to support them. We found that sympathetic relation promoted adjusting to care and that raising adjusting to care would improve mental health with low degree.

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The purpose of this research is to clarify the relationship between the daily hassles and subjective quality of life (QOL) in the family caregivers of elderly people. Also, this research is aiming to obtain important information in terms of improving support for those caregivers. A questionnaire survey was administered in A, B, C city. Participants were 283 family caregivers of elderly who used visiting nurse stations in this survey. The questionnaire included the caregiver's characteristics, recipient's characteristics, daily hassles and subjective QOL. In this research, first, we conducted confirmatory factor analysis in order to consider construct validity about daily hassles scales of family caregivers which author made, the goodness of fit was statistically acceptable. Next, we constructed causal relationship model(multiple indicator model) which frequency of caregiving-related daily hassles influences subjective QOL through strength of caregiving-related daily hassles, the path coefficient of frequency about daily hassles to strength was significant (0.82), that of strength to subjective QOL was significant (-0.71). These results showed that caregiving-related daily hassles were significantly associated with subjective QOL. Among the subordinate factors of daily hassles, related to the care and the decrease of the time for rest, was stressor of family caregivers. Variables of daily hassles and subjective QOL were no significant relationship between family caregivers' gender and duration of caregiving. In order to prevent decrease of the family caregivers' QOL, it was suggested that not only direct elderly care services but also retention of manpower which alternate these services were important.

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The purpose of this study was to examine inter- and intra-rater reliability of isometric muscle strength measurements using a hand-held dynamometer (HHD) fixed to the pillar or treatment plinth leg by a belt. Ten healthy subjects (5 male and 5 female which totals to 20 lower extremities) participated in this study. Two raters used a HHD to measure the maximum isometric muscle strength twice for the following muscle groups : extensors of the knee; dorsiflexors, plantar flexors, evertors, invertors of the ankle. Inter and intra-rater reliability were evaluated using the intra-class correlation coefficients(ICC). The results of ICC (ICC1.1, 1.2/ICC2.1, 2.2) were 0.86, 0.94/0.84, 0.96(knee flexors), 0.94, 0.97/0.94, 0.97 (ankle dorsiflexors), 0.98, 0.99/0.97, 0.98 (ankle plantar flexors), 0.90, 0.94/0.92, 0.98 (ankle evertors), 0.80, 0.91/0.91, 0.97 (ankle invertors). These results show that this method can be performed clinically with high reliability

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