Nihon Koshu Eisei Zasshi(JAPANESE JOURNAL OF PUBLIC HEALTH)
Online ISSN : 2187-8986
Print ISSN : 0546-1766
ISSN-L : 0546-1766
Volume 56, Issue 2
Displaying 1-4 of 4 articles from this issue
Original article
  • Junko HOSHINO, Yoko HORI, Takaaki KONDO, Atsuko MAEKAWA, Koji TAMAKOSH ...
    2009 Volume 56 Issue 2 Pages 75-86
    Published: 2009
    Released on J-STAGE: June 13, 2014
    JOURNAL FREE ACCESS
    Objective In Japan, research into physical conditions or illnesses of female caregivers focusing on biological markers in biological materials such as blood and urine has been limited. Therefore, the present study was conducted to clarify the physical and mental characteristics of female caregivers in comparison with the general population, using biological markers and self-answered questionnaires.
    Methods The subjects were 161 female in-home primary caregivers for persons requiring care at level 3 or more or less than 3 if suffering from dementia (caregiver group). The control group consisted of females matched 1:1 in the same decade of life who received medical checkups in K city. The survey period was from December 2005 to April 2007. The methods were self-answered questionnaires, including lifestyle, caregiving conditions, the Pittsburgh Sleep Quality Index (PSQI) and frequency of taking food, and common parameters for lifestyle diseases using blood and urine and blood pressure, taken by trained investigators at the subjects homes.
    Results Average age was 62.8±11.9 years in the caregiver group and 63.2±12.4 years in the control group. 46.0% had 5 or more years experience in caregiving and 8.7% had less than 1 year. The required care level most common was 5 at 33.8%, with levels 3 and 4 the next most common. 46.0% of the caregiver group had hypertension, significantly higher than the 34.2% in the control group. The prevalence of glucose intolerance and hypo-HDL-cholesterolemia was also high in the caregiver group, but without significant difference. The caregiver group had lower HDL-cholesterol values than the control group. In lifestyle, the two groups differed in exercise, PSQI, proportion of energy from carbohydrates and estimated 24-hour excretion of sodium (Na) in urine. In particular, it was clear that Na was undesirable for caregiver,s even using urine samples for examination. Although more in the caregiver group described themselves as unhealthy, fewer of them received annual health checkups than in the control group. More in the caregiver group felt stress about their health or aging or depression, with few opportunities for diversion.
    Conclusions Hypertension, the most important risk factor for brain and cardiovascular disease, is significantly high in caregivers, suggesting the need for preventive measures. Similar findigns were also obtained with other biological markers and more in the caregiver group felt stress about their health or aging or depression, pointing to a nee for health support.
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  • Yasuhisa NAKATANI, Keiko SUGIURA, Hiroshi MIKAMI
    2009 Volume 56 Issue 2 Pages 87-100
    Published: 2009
    Released on J-STAGE: June 13, 2014
    JOURNAL FREE ACCESS
    Purpose To develop a scale for home care workers focusing on work motivation and to determine influential underlying factors.
    Methods This study was an anonymous mailed survey of home care workers who provided home help services in July 2007. We collected information in the following areas: demographics of home care workers and care-recipients, burnout, stress, job satisfaction, life satisfaction, and self-esteem (SE). Hierarchical regression analysis was performed in order to identify factors related to work motivation.
    Results Construct validity was analyzed by factor analysis. Two subscales were obtained by the analysis and designated as “positive appraisal of the current state” (9 items) and “uplift of morale” (3 items). Content validity was analyzed by good-poor and item-total, and all correlations were strongly positive. Reliability was analyzed by internal consistency. Cronbach's ? values were 0.94 and 0.77, respectively. Concurrent validity was analyzed by correlation coefficient and a significant negative correlation was seen between the two subscales and burnout (r=−0.23-−0.50), while positive correlations were noted for job or life satisfaction (r=0.24-0.49). The positive influential factors on “positive appraisal of the current state” were satisfaction in 1) relation to care-recipients, 2) work environment for skill improvement and 3) the wages. The positive influential factors on “uplift of morale” were satisfaction with relation to care-recipients and their own life.
    Conclusions This scale has sufficient reliability and validity. “Positive appraisal of the current state” and “uplift of morale” were confirmed as appropriate work motivation subscales for home care workers. Thus, support to augment job satisfaction with the work environment and wages appears to enhance “positive appraisal of the current state” and support to augment life satisfaction appears to enhance “uplift of morale”.
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  • Koichi OTSUBO, Kazue YAMAOKA, Tetsuji YOKOYAMA, Kunihiko TAKAHASHI, Ma ...
    2009 Volume 56 Issue 2 Pages 101-110
    Published: 2009
    Released on J-STAGE: June 13, 2014
    JOURNAL FREE ACCESS
    Background and objective The standardized mortality ratio (SMR) is frequently used to compare health status among different populations. However, SMR could be biased when based upon communities with small population size such as towns and wards and comparison of SMRs in such cases is not appropriate. The “empirical Bayes estimate of standardized mortality ratio” (EBSMR) is a useful alternative index for comparing mortalities among small populations. The objective of the present study was to use the EBSMR to clarify the relationships between health care resources and mortalities in 3,360 municipalities in Japan.
    Materials and methods Health care resource data (number of physicians, number of general clinics, number of general sickbeds, and number of emergency hospitals) and socioeconomic factors (population, birth rate, aged households, marital rate, divorce rate, taxable income per individual under taxes duty, unemployment, secondary, tertiary industrial employment and prefecture) were obtained from officially published reports. EBSMRs for all causes, cerebrovascular disease, heart disease, acute myocardial infarction, and malignant neoplasms were calculated from the 1997-2001 vital statistic records. Multiple regression analysis was used to examine the relationships between EBSMRs and the variables representing health care resources and socioeconomic factors as covariates. Some of the variables were log-transformed to normalize the distribution of variables.
    Results The correlation between number of physicians and general sickbeds was very high (Pearson's r=0.776). So, we excluded the number of general sickbeds. Some of the EBSMRs were inversely associated with the number of physicians per person (all causes in males (β=−0.042, P=0.024) and females (β=−0.150, P<0.001), cerebrovascular disease in females (β=−0.074, P<0.001), heart disease in males (β=−0.066, P<0.001) and females (β=−0.087, P<0.001), acute myocardial infarction in females (β=−0.061, P=0.003), and malignant neoplasms in females (β=−0.064, P=0.001)). In contrast, when there was a higher number of clinics per persons, the EBSMR was higher for all causes in males (β=0.053, P=0.001) and females (β=0.115, P<0.001), cerebrovascular disease in males (β=0.047, P=0.002) and females (β=0.070, P<0.001), heart disease in females (β=0.061, P<0.001), acute myocardial infarction in females (β=0.048, P=0.006), and malignant neoplasms in males (β=0.036, P=0.018) and females (β=0.046, P=0.005). Next, we selected the number of emergency hospitals as the variable representing health care resources. Some of the EBSMRs were inversely associated with the existence of emergency hospitals (all causes in females (β=−0.085, P<0.001), cerebrovascular disease in males (β=−0.032, P=0.031) and females (β=−0.059, P=0.001), and heart disease in females (β=−0.052, P=0.008)).
    Conclusion The results suggested that an appropriate distribution of health care resources such as physicians and emergency hospitals is an important factor associated with mortality in a community.
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Research note
  • Chikage TSUZUKI, Sachiyo MURASHIMA
    2009 Volume 56 Issue 2 Pages 111-120
    Published: 2009
    Released on J-STAGE: June 13, 2014
    JOURNAL FREE ACCESS
    Objective This study was conducted to investigate the actual activities of public health nurses (PHNs) during routine health check-ups at health centers of municipalities, for the 18-month-old children in Japan.
    Methods The targets were municipalities with 200 births and more per year. A questionnaire about the contents of implementation of health check-ups, and follow-up activities, were mailed to 105 municipalities between April 2000 and March 2001. The response rate was 62.9%.
    Results 1) All municipalities adopted some form of group checku-ups. They mainly conducted medical interviews by physicians and dentists (100%), somatometry (100%), health interviews by PHNs (95.5%), group lectures (47.0%), individual health consultations, 93.9% (for all participants, 83.3%), and conferences after check-ups by main staff, (92.4%).
     2) The allocation of various professionals included physicians and dentists (100%), PHNs (100%), dental hygienists (98%), dieticians (88%), and psychological staff. (75%).
     3) Municipal populations had a negative correlation with check-up rates. Municipal populations and birth numbers per year had positive correlations with the frequency of group check-ups per year.
     4) PHNs were involved in many scenarios, and were concerned with decisions regarding the effects of health check-ups. However, among these municipalities, only 36.4% had definite criteria, or a manual, for assessment of check-ups by PHNs. The follow-up rates ranged from 1.9 to 56.3%, with considerable differences.
     5) Follow-up and absentees of check-ups were mainly dealt with by PHNs.
    Conclusions We clarified the implementation of health check-ups and associated activities of PHNs among municipalities. The check-ups and follow-up activities were mostly conducted PHNs. However, the existence of standards for check-ups by PHNs, and the methods for follow-up differed considerably. Therefore, it is necessary to further consider the quality of check-ups.
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