As Japan is rapidly becoming a super-aging society, in which a new type of medical recruitment is demanded,"Tokutei Kangoshi (TK) (Japanese nurse practitioner)," i.e., Japanese nurse practitioners, are attracting attention as a strategy to address problems of primary care delivery in the community. This study sought to describe the new practice of a TK working at a primary care community hospital. Subjects were three female patients aged 66-90 years who had multiple chronic diseases and who received care from the TK. A semi-structured interview was conducted with each subject in 2013. The interview was audiotaped and transcribed verbatim, and the collected data were analyzed and categorized qualitatively. The results suggested that the TK, who had been performing this role for > 3 years, provided "assessment of treatment principles from a long-term point of view" and "symptom management for the quality of life of elderly patients and clinical assessment based on evidence of elderly patients" for elderly patients with multiple chronic diseases. The patients reported "satisfaction with the holistic care provided by the TK." It is expected that TKs will increase in number, their use will spread throughout the country, and they will contribute to the improvement and advancement of national healthcare delivery.

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The objective of this study was to clarify the difficulties nursery teachers face in responding to guardians of children who develop fevers at nursery school. From among 99 certified nursery schools in two cities in Prefecture A, we randomly selected 20 facilities, 15 of whose directors provided consent. The 314 participants were nursery teachers employed at these schools. We administered a questionnaire asking nursery teachers about their support of children who develop fevers and their interactions with guardians. Then, we qualitatively analyzed the free-response content from 119 nursery teachers regarding the difficulties they experienced in responding to guardians. Based on this analysis, we extracted the following three categories: "difficulty with guardians' attitudes," "difficulty with situations in which guardians prioritize their work,", and "difficulty in instructing and responding to guardians in regards to the body temperature management of children with fevers." Our results indicated that nursery teachers experienced the most problematic interactions with guardians who prioritized their own convenience over the needs of the children and the nursery teachers, and they also experienced great difficulty in instructing guardians about the importance of body temperature management in order to prevent the spread of infection in group child care.

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