The purpose of this study is to clarify the present reality of accidents in home help service, and to examine home helpers themselves for factors that lead to the occurrence of accidents.

The situation in which the accidents occurred was examined through the contents of accident reports for the 274 cases that occurred between April and September 2003. In the analysis, I transformed the situation into variables and clarified the details of the accidents by combining the variables. A multiple logistic regression analysis was conducted using the occurrence of accidents as a dependent variable and information about all the home helpers (5,237) as independent variables.

As a result, given the condition of the other variables being constant, the group of home-helpers who had been in service for less than two years showed a statistically significant odds ratio (P<0.05) However, significant statistical differences were not observed between those who did and did not possess qualifications, and among those employed in different conditions.

From the above, it is suggested that the accumulation of practical experience is more effective in preventing accidents than the possession of higher qualifications.

The current study examined factors related to satisfaction of the intention to participate in social activities among the elderly in a rural area. Data of 502 persons aged 65 years and over were obtained from a mail survey in a rural area. Two types of social activities such as social group activities and hobbies were measured. The authors compared the elderly in two groups: participants in social activities who had intended to participate, and non-participants who had intended to participate. Logistic regression analyses revealed the following results:

(1) The characteristics of non-participants who intended to participate in social group activities had poor IADL and more depressed score than participants who intended to participate.

(2) The characteristics of non-participants who intended to participate in hobbies were younger, female, poor IADL, more depressed score, and lower satisfaction score of the transportation.

The elderly who had a low score on IADL and high score on depression tended to have unmet needs for social activities, and those who reach a certain score on these indexes were likely to increase rapidly the rate of unmet needs for social activities.

The findings suggest that a profession should carefully assess the IADL and depressed score of the elderly in order to meet the needs of the elderly for social activities.

The present study was conducted in order to clarify the relationship between self-evaluations of elderly individuals requiring assistance or care who moved in order to be with or closer to their children and their pre-move preparation. Interviews were conducted on 81 elderly individuals, and the following results were obtained: ①Self-evaluations of the move were favorable for 47 individuals (58.1%) and poor for 34 individuals (41.9%). ②The following factors positively affected self-evaluations of the move: gender (female), family structure (single or married), and type of residence (except apartments). ③Self-evaluations of the move were favorable for individuals who prepared to move as follows: prepared for more than one month, decided to move on their own or by consulting with family members, contacted friends and neighbors before moving, gathered information about hospitals and nursing-care insurance services, had ideas about how and where to spend time, and communicated with children before moving. ④Multiple logistic regression analysis showed that the following individuals had poor self-evaluations of the move: men, individuals living in apartments, and individuals who infrequently communicated with their children. These findings suggest that elderly individuals requiring assistance or care may be able to positively accept a move if they, their families, and healthcare professionals communicate while valuing the elderly individual's opinions and if elderly individuals have concrete ideas about their lifestyle and available services before moving.

The percentage of the elderly who live with children has been decreasing in Japan recently, and so how the elderly can maintain adequate communication with their children has become a serious issue. Thus, information devices are playing more and more important roles as alternative tools to communicate with children. This study examines quantitative data collected in the suburb of Tokyo. Findings include: (1) a majority of the elderly use land-line connected phones at home, while a small percentage of the elderly use new media such as cellular phones and email; (2) elderly women are more likely to use phones than elderly men; (3) there is a positive relationship between the usage of phones and the elderly's satisfaction with their relationship with their children; (4) however, face-to-face communication provides the elderly with more satisfaction than communication by information devices; (5) the elderly feel more satisfied with communication both by face-to-face contact and by information devices than financial support from children. These findings would imply some suggestions for the future practices of home health care.

Aims: The purpose of this study was to propose a policy to support mothers having childcare anxiety.

Methods: A survey was conducted of mothers in an urban area with a child under one year old in a nuclear family. The sample was taken from the customer's list of a nursing products company and the data was collected by mail. Firts, we selected the mothers of the high anxiety group by using the questionnaire of MAKINO which was based on the factors and symptoms of accumulated exhaustion related to child care, and then analyzed the mothers' needs to reduce the anxiety by K-J methods.

Results and Conclusions: The mothers in the high anxiety group mostly needed to set themselves free from a childcare environment in which they felt physically and emotionally restricted. To support the mothers, the first thing to be done was that health care professionals should change their attitude on home visit to check on newborns and regular checking on infants from focusing only on the health problems of babies to focusing on both the babies' health problems and the mothers having childcare anxiety.

It was very important that professionals, then figured out that the mothers wanted to liberate themselves from such anxiety and that they understood their needs.

Finally, we had to design a policy which would create the environment to provide for the interaction of the mothers with each other, or mothers and other people as main means to support the mothers.

We also had to prepare facilities for the mothers, especially those who have difficulty in making relationships with others, where the mothers could easily leave their children and take time to go out.

To illuminate the reality of "coping with aphasic persons' speech defect" faced by caregivers of aphasic persons and then to examine related matters, we sent a questionnaire by mail for investigation. We collected 40 usefu l responses for analysis.

1. Male aphasic persons accounted for 70% of the respondents. Their average age was 63.4 (SD 10.2), and the average duration of aphasia up to the time of the study was 441 months (SD 33.1). Slightly less than 80% of caregivers are female.

2. There appeared to be a correlation among the communicative abilities of "Listening" 'Talking" and "Daily Communication". However, there is a significant correlation with "Talking" and "Daily Communication". (R=.802, p<.01).

3. A significant correlation was shown between CADL-FQ scores though "Coping with aphasic speech defect " score that the caregivers was spending time, but the correlation was not confirmed for the score and the aphasia period of "Correspondence of the word to the trouble". (R=.312~.580, p<.05~.01)

For caregivers' "coping with aphasic persons' speech defect" while living at home, there are other factors of experience and knowledge in their daily life.

I investigated the experiences, especially psychological aspects, of family care givers engaged in medical care at their homes. The subjects were 4 family care givers who had received service from home care nursing. All subjects were engaged in the care of their parents. I analyzed the texts of dialogues of individuals by a qualitative inductive study method. I demonstrated the content of their experiences and compared them to demonstrate the tendency of their experiences. I found 4 to 6 categories of experiences for each person. I also found that the family care givers tended to discuss 4 subjects, namely, the feeling that "the parents had changed," the feeling that "medical treatment isn't difficult," "the benefits" brought about be medical treatment, and the fear that "the parents would feel pain from medical treatment." The care givers felt deeper mental anguish from the feeling that the parents had changed than from learning medical treatment. Furthermore the fear that "the parents would feel pain from medical treatment" was related to support by nurses.

A prospective study on death factors among elderly people with care needs at a visiting nurse service station.

A prospective study was performed to investigate death factors among care receivers at a visiting nurse service station.

The subjects were 212 care receivers who had written consent at the visiting nurse service station. The prospective study was performed between 2002 and 2004. Death of the subjects was set as the end point of the observation period.

In this prospective study period, there were 48 subjects in the death grou p and there were 164 subjects in the living group. Cox proportional hazard regression model was used to test death factors after adjustment for gender, age, dementia disease, visiting rehabilitation service, and management of home oxygen therapy (HOT) in the contents of nurse care. The rate of death among elderly people with dementia disease was significantly higher than for those without (hazard ratio2.11; 95% Cl1. 03-4.35). The rate of death among elderly people with management of HOT was significantly higher than among those who had not used it (hazard ratio3.54; 95% Cl1. 47-8.55).

These results suggested that significant death factors were the presence of dementia disease and that of management of HOT.

This study was performed by conducting focus group interviews with managers at the N city visiting nursing stations with the following purposes. To identify the conditions of occurrence of accidents and incidents in visiting nursing stations after the establishment of long-term care insurance. To identify countermeasures for preventing accidents / incidents corresponding to the accidents / incidents.

As a result of the study we found the background of the occurrence of accidents / incidents as well as the necessary conditions which may prevent future accidents / incidents.

Background of the occurrences of accidents and incidents indicate;

① Mental conditions of nurses when offering service of visiting nursing

② Circumstances in which accidents and incidents more easily occur

③ Situations in which the information is hard to analyze

Necessary conditions which prevent accidents of nurses of visiting nursing stations in dicate;

① To review survey and records

② Try to include the review of the survey and records consciously in practice

③ Practice countermeasures of accidents

④ Education for the prevention of accidents and incidents

⑤ Evaluation of the practice

⑥ Sense of responsibility as a manager

Based on this study of the background of the occurrences of accidents and incidents, it was indicated that, for the solution to future problems, each station and organization discuss the part which is currently outside their system, and acts to create the necessary conditions and measures which prevent accidents of nurses of visiting nursing stations.