Objectives: This study aimed to determine the issues mothers face in regards to child rearing by analyzing data obtained from mothers at health check-up 3 months after delivery. The factors that constitute effective support provided by local maternal and child health institutions were then examined.
Methods: Health examination data, excluding personal data, and self-reported questionnaire responses about child rearing concerns were analyzed for mothers who attended the health check-up 3 months after delivery in Ward B in Osaka City.
Results: Study subjects comprised 2,552 mothers, 1,213 (47.6%) of whom asked for advice about child rearing-related issues. The most common concern was “skin treatment”, followed by “breast-feeding” and “stools.” The common factors among the mothers who asked for advice were as follows: “first-time mothers”; “living in an apartment”; “having problems in life”; “feeling mentally and/or physically ill”; and “the feeling of a lack of time for themselves”. The influence of these factors was statistically significant. On the other hand, 36.1% of the mothers did not ask for advice, even though they had reported being anxious.
Conclusion: Many of the mothers’ concerns pertained to the current situation, and it was found that their backgrounds influenced whether they asked for advice. Some mothers had concerns but neither voiced them or sought advice. These findings suggest that mothers’ concerns and feelings of burden related to child rearing cannot be evaluated based on whether they ask for advice or by the number of concerns they report.

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For the purpose of clarifying the components comprising the concepts of “job demands” and “job resources” among public health nurses, semi- structured interviews were conducted with eight public health nurses, and their statements explaining the motivation to leave or to stay at their position in any given situation were recorded.
The results showed that the job demands of public health nurses comprise the following eleven categories: “quantitative work overload”; “qualitative work overload”; “transformation of various duties”; “professional role conflict”; “interpersonal conflict”; “lack of effective leadership”; “undeveloped project evaluation system”; “burden from workplace culture”; “devaluation of the nursing sector within the health organization”; “difficulty dealing with the organizational administration”; and “negative mutual impact of individuals and work”.
The results also showed that the job resources of public health nurses comprise the following eight categories: “job satisfaction”; “perception that their work is meaningful”; “perception of control in work”; “evaluation and expectations from others”; “support of senior staff, colleagues, and superiors”; “support of family and friends”; “good working conditions”; and “positive mutual impact of individuals and work”.
The job demands and resources of public health nurses were considered to have a hierarchical structure, from the individual to the departmental to the organization level, wherein personal work and the function of each segment of the hierarchy mutually affect each another.

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Objective: In this report, we describe the difficulties presented by caring for patients with amyotrophic lateral sclerosis (ALS), and the people facing them. This report is intended to support dispatched ALS caregivers in Miyagi prefecture’s public welfare program in their continued duties. We also discuss the role the prefectural government and public health centers should take in improving the caregiver dispatch system.
Methods: Data were collected by conducting semi-structured interviews on 5 caregivers registered with in-home ALS caregiver dispatching agencies in Miyagi prefecture.
Results: The common difficulties found among caregivers included “responding to ALS patients with a unique set of ALS symptoms and their families,” “creating smooth relationships with ALS patients and their families,” and “building teamwork based care in order to provide consistent care.” Coping strategies included “obtaining support from others around them” and “being able to take care of oneself.” Interviewees stated that by continuing their work they have obtained “an affirmation of themselves as ALS caregivers.”
Conclusion: Our findings suggest that the prefectural government and public health centers should have the following important roles: to provide ALS caregivers opportunities to share their work difficulties with one another and to help reduce their mental burden; to reinforce teamwork-based care by sharing information and care goals; to make the content of their work widely known; and, lastly, to stress the importance of the activities carried out by public health nurses engaged in legal preparations and raise awareness of measures concerning compensation issues.

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Objectives: To clarify the effects of a peer-education program for non-member families on the organizational development of familial groups with mental disorders.
Methods: A cross-sectional mail survey was conducted on 59 family groups that had implemented the Omotenashi – Family Experiences Learning Program before March 2012. The independent variables were the overall number of program implementations and the number of program implementations among non-member family groups. The dependent variables were objective and subjective measures of organizational development. We used regression analysis for statistical testing.
Results: Of the 56 family groups that responded, 42 had implemented the program for non-member families. Of all 793 program participants, 300 (37.8%) were non-member families, of which 155 (51.7%) joined the groups after participating in the program. If family groups employ a larger number of program implementations for non-member families, the number of new members will increase with participation, as will the overall number of members and number of younger ones.
Conclusion: The family-peer education program could contribute to the organizational development of family groups.

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Purpose: This paper presents the concept analyses of ‘attachment to the local community’ including: individuals’ inner awareness; relationships between individuals and relationships with their local community. The rationale for adopting the concept for public health nursing practice is identified and useful public nursing activities are suggested.
Methodology: We interviewed nine participants selected for their social activities in their local community. Concept analysis yielded: concept characteristics, factors affecting the formation of the concept and the outcome expected from the formation of the concept, which were classified into categories. Focusing on relationships between the categories, we examined the overall structure of the concept at three levels: personal, inter-personal and community (ranging from the neighborhood to municipality).
Results and discussion: The findings indicated that the categories interact at each level to bring about inner and external changes among individuals. The concept reflected a process structure. Progress in the formation of ‘attachment to the local community’ stimulates community-oriented behavior, thereby generating better and greater outcomes than expected at the formation stage. Thus, ‘attachment to the local community’ may be defined as a supportive mind-set and forward-looking intention towards their local community that is formed by sharing experiences with others in their day-to-day living situation and which changes as they interact with social circumstances.
Conclusion: Our study implies that the concept is useful for the practice of public health nursing aimed at both improving individuals’ QOL and building local capacity.

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