A QWL measurement scale was developed based on Alderfer's need satisfaction theory called E.R.G. theory. The QWL measurement scale (QWLSCL) was designed to measure the extent to which four types of needs (or facets of QWL) : treatment (including pay, fringe-benefits and welfare programs), relationship with boss, relationship with colleagues, and growth needs are met by nursing personnel working in nursing facilities for the elderly. Using Structural Equation Modeling (SEM), confirmatory factor analyses were employed on the data of 575 nursing personnel to examine the validity and reliability of the QWLSCL. Deletion of redundant observed variables changed the original 18-item scale to the respecified 15-item scale. Goodness of fit indices (GFI = .984, AGFI = .978, CFI = .978, RMSEA = .058) revealed the 15-item 2nd order factor model fit the data well, which confirmed the construct validity of QWLSCL. In addition, the factor score of QWL succeeded in predicting "overall job satisfaction," "intent to stay" and "life satisfaction in nonworking life domains," which supported the criterion-related validity of the QWLSCL to some extent. The necessity of a QWL approach to human resource management in nursing facilities for the elderly, as well as the necessity of undertaking more QWL research in this field is discussed.
Care managers are expected to play a role as the linkage between the needs of frail elderly people and provision of the necessary care service. Making a care service plan is not only package making for care service but it needs decision making from both the elderly and his/her family. The aim of this study was to collect and analyze up-to-date information from the fresh knowledge of care supporters who take part in the care management of the elderly and to investigate the ethical dilemmas that arise during the decision making required in care service planning. As a result of the study, the following dilemmas have become clear. 1. The need for the autonomy of the individual vs. the necessity of help, 2. Disagreement between the elderly and their family to the care service plan, 3. Continuing home care vs. entering an institution, 4. Conflict among different professionals: medicalization of care services, 5. Conflict among the organizations, 6. Information offered and the confidentiality in care management, and 7. Conflict with the organization care managers belong to.
The purpose of this study was conducted to examine factors related to social activities of the elderly living at home. Data was obtained by a questionnaire distributed to 494 (220 males, 274 females) elderly people living at home. Covariance Structure Analysis was conducted to analyze the causal relations between the related factors. The main findings were as follows: 1) 64.5% of elderly males and 61.8% of elderly females actively participated in social activities. In addition, the overlap participation rate in more than two activities was 40% in males and 37.7 % in females. 2) For both elderly males and elderly females, the results of covariance structure analysis showed that Physical and Mental Health and Self-Efficacy were significantly correlated reciprocally, and Self-Efficacy and Social Support significantly influenced Social Activity. Judging from each standardized causal coefficient of the paths, high Self-Efficacy and positive Social Support respectively enhanced the participation rates in social activities of elderly people living at home. In "Self-Efficacy in Changing Societies", Bandura (1997) pointed out that high self-efficacy influenced a person or a group to become motivated and to act towards self-change or desirable adaptation, and to put effort forth towards the realization of social policy decisions. Also, in "Clinical Psychology of Self-Efficacy", Sakano & Maeda (2002) exemplified that self-efficacy was very useful for improving mental problems and maladaptive actions in school or everyday life, that is, for urging the desirable behavior changes. Finally, from the researches and the surveys on self-efficacy, it is safe to say that self-efficacy is very useful for deciding upon policies and executing programs regarding welfare because self-efficacy influences motivation, behavior changes and adherence to welfare-related behavior. In this survey, Self-Efficacy was significantly related to Positiveness of Action and Insecurity to Failure, but not significantly related to Social Positioning of Ability. That is to say, self-efficacy is increased not by confidence of capability by comparison with others, but by the expectation of failure based on past failure experiences, or cognition of self-confidence of one's ability to perform a task successfully. Bandura(1997) identifies four sources of efficacy formation and modification; that is, 1) Enactive attainment, 2) Modeling or learning by observing others, 3) Verbal persuasion, and 4) Physiological and emotional activation. Enactive attainment provides the most potent influence on self-efficacy; therefore, in order to increase social activities of elderly people, it is most important for the elderly to have mastery experiences in various activities. Also, it is necessary that activity programs include the process in which elderly people manage with volition automatically and independently. In particular, it may be essential to create social activity programs in which elderly people can find worth for living through the contents and the personal relations in the activities, or can utilize their experience in positively.
One of the current subjects concerning elder care is how we can provide better care to disoriented elderly people with dementia. In addition to evaluation criteria applied to elderly people generally, practitioners need a tool to evaluate disoriented elderly people's psychosocial difficulties/challenges caused as well as physical functioning and mental status. In order to operate such a tool appropriately, practitioners should have enough communication skills. Validation method sets four stages of disorientation according to the verbal communication functioning of disoriented elderly people. By focusing on their emotions and using techniques corresponding to each stage, practitioners can maintain communication with those disoriented elderly people until they go into the last stage of their life. Validation theories and techniques give practitioners better understanding of disoriented elderly people with dementia, and make it possible that such elderly people participate in assessment process.
The purpose of this study is threefold: 1) to find out whether there are differences in the extent of participation among the types of physical disabilities; 2) to identify differences in the level of participation across age categories; 3) to analyze the factors that influence the extent of participation. In 2001, the author conducted a nationwide survey of 3,200 people with physical disabilities who were 30 years of age and older and obtained 1,653 valid responses. Both R-CHART (Revised Craig Handicap and Reporting Technique) and CIQ (Community Integration Questionnaire) were used to measure the extent of participation. The results were as follows: First, the level of participation among people with cerebral palsy was much lower than those with other types of disabilities. Second, occupational scores of CHART decreased greatly after the respondents reached 70 years of age. Finally, it was found that social integration in CHART was influenced by marital status and that economic self-sufficiency was affected by the level of education. As for educational support, we must develop a strategy by taking into account the life stage of people when they received disabilities.
It aimed at examining the structure of the care burden of the family who provide care to individuals with higher cortical dysfunctions by using The Burden Interview (BI Scale, Zarit:1980). All samples were convenient samples, from five caregiver's associations. The research design was a cross-sectional survey with self-administered questionnaire. The questionnaire included a set of items that assessed basic demographics of caretakers and caregivers, BI Scale (Japanese version) of caregivers. Four factors were extracted as a result of the factor exploratory analysis. Then, as for the care burden of the family it suggested that it was constructed from four sides of (1) A negative emotion, (2) The limitation of the daily life, (3) Emotional pressure, (4) Care will. It was shown by these results that the structure of the demented elderly and similarity had it in the structure of the caregivers burden of the persons with traumatic brain injury.
In Japan, the core agencies of child abuse prevention are the child guidance centers of local governments. The child guidance centers provide examinations, diagnosis of child abuse and child protection, including legal procedures, treatment and integration of children and parents. When parents strongly abuse their child, social workers need to shelter the child from his/her parents. If parents do not agree with the protection of their child, social workers must remove the children from their homes and put them into a temporary institution under legal procedures. Conflict often occurs between social workers and parents, so then social workers cannot establish relationships with parents. When social workers intervene in the family in the name of governmental authority, they need to acquire special skills in social work. The present study proposes "a system reform" for child abuse prevention. In other words, first, child guidance centers should be changed into institutions for guarding children's rights. Second, the quantity and quality of social workers should be improved. Furthermore, social network systems, commitment systems by legal authorities, and advocators' involvement in child abuse prevention are also discussed.
The purpose of the present study is to examine the effectiveness and tasks of group work practice that focus on support groups for mothers of children who refuse to go to school. These mothers are now experiencing a variety of difficult situations in the relationships among children, their husband, grandparents, and the schools. Therefore, support groups which work to help members cope with stressful life events and revitalize their coping abilities may be effective for these mothers. However, few studies of such practices have been carried out until now. This time, group work practice was planned for a total of 6 times (once a month, for 90minutes), and was announced to the mothers of children who were attending a special class for school refusal. As a result, 13 mothers participated in the practice. To evaluate the success of the group, the workers focused on each member's satisfaction with the group experience and whether the group had met their needs. As self-report measures, after each practice, mothers were requested to write their feelings about it. As a result of the practice, all the mothers wrote that they were satisfied with the group experience because they could get information from other mothers. However, there remain some tasks related to their needs.
The purpose of this study is to understand mothers' bereavement process and coping following the death of a child from cancer. Data were collected from 11 bereaved mothers using the life story interview method. Data were analyzed using a categorical-content analysis method that was well suited for life story interviews. Four categories were discovered in mothers' bereavement process. They were psychological, social, physical, and spiritual responses, and had changed as time had passed. Psychological responses involved emptiness, loneliness, and guilt. Under the psychological categories, mothers reported that fear hindered them in expressing their true feelings. Social responses included social stigma and difficulty in expressing of true feelings. Physical responses involved sleeplessness, loss of appetite, and spiritless. Spiritual responses involved loss of the value living, longing for the child, searching for the meaning of the death of the child, keeping bonds with the child. Mothers coped with grief by talking with people (family, clergy, spiritual counselor), seeking from medical workers, going to hospitals, writing about their experiences, drawing the child, and participating in self-help group / support groups. They shared grief with people, who had experienced the death of the child, in self-help group / support groups.
The purpose of this study is to examine the trends and features of the policy for homeless people in recent years as a result of the sharp increase in their numbers. The policy which can be analyzed is composed of three approaches- 1) promoting independence through work; 2) promoting independence through welfare services; and 3) eviction. This study reveals that among these approaches the 'approach to independence through work' has occupied the most prominent position through a series of governmental legislations and other related matters. However, the approach that tries simply to make homeless people return to the labor market has considerable limitations. 'Promoting independence through welfare service' this hitherto has been rather depreciated in the policy for homeless people. More importance should be attached to it, as well as promoting independence through work.