Objectives To identify difficulties that caregivers at group homes for elderly with dementia (hereafter “GH”) have in dealing with residents and related factors, and to study how to best provide support to GH caregivers.
Methods An anonymous, self-administered questionnaire was distributed to 600 caregivers working at 47 GHs in “A” City, Fukuoka Prefecture. Analysis was conducted on 333 responses.
The questionnaire consisted of 14 items for basic attributes and facility environments, and 27 items for difficulties caregivers perceive in dealing with the demented elderly. These 27 were derived from semi-structured interviews with 10 GH caregivers conducted in advance and their factor structure was determined by factor analysis. In addition, relationships of total subscale scores for each factor with basic attributes and facility environments were analyzed.
Results The difficulties perceived by GH caregivers were subsumed into 4 categories, namely “conflict with the demented elderly,” “support system at workplace,” “conflict among staff members,” and “sense of burden.” The Cronbach's alphas of individual factors were found to be in the range from 0.75 to 0.82, confirming their internal consistency. The items significantly related to “conflict with the demented elderly” were anxiety for the future, care-giving experience, understanding the wishes of residents' families, and understanding the GH facility principles. The items significantly related to “support system at workplace” were thoughts of quitting their job and a cooperative system, while those for “conflict among staff members” were anxiety for the future, thoughts of quitting their job, a cooperative system, and information sharing. The items significantly related to “sense of burden” were anxiety for the future, thoughts of quitting their job, information sharing, and wishes regarding working schedule arrangements.
Conclusion The GH caregivers had various difficulties in dealing with the demented elderly. It became clear that, for alleviation of the difficulties caregivers perceive, the educational system needs to be improved to help the caregivers have better understanding of GH facility principles and the wishes of the residents' families. It was also clarified that organizational efforts to promote information sharing and a cooperative system among staff members, as well as to provide support to individual caregivers by addressing the difficulties encountered, are of great importance.

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Objectives The purpose of this study was to clarify the causal relationship between students' well-being and their parents' knowledge and support in raising them in a prefecture by using covariance structural analysis.
Methods In November 2007, a questionnaire survey was conducted with 11,363 elementary school students (4th grade), junior high school students (1st grade) and high school students (1st grade) as well as their parents. The total number of responses analyzed were 9,651 pairs of matched data for parents and their children.
Results A concept model was proposed to use four latent variables determined by factor analysis. “Students’ well-being” (“ ” means latent variable) classified as a latent variable, was not prescribed directly by “parents’ knowledge and support”, but rather developed indirectly through “physical activities” and “communication between the students and parents”. The decision coefficients for the students' well-being determined with this model ranged from 27% to 40%. Depending on the participant's age and gender, they were divided into six groups.
Conclusion This study indicated that positive support for children's health and well-being by the parents was important for students to have a happy and healthy lifestyle. It became structurally clear that it was necessary for both students and their parents to engage in physical activities and have good communication with each other in order to stimulate and develop children's health practice and well-being.

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Objectives Due to the increased population of elderly people requiring care and assisted living care, as well as changes in the social structure, the number of males playing a role in home care has therefore been increasing each year. The purpose of this study was to clarify characteristics related to subjective mental and physical health of male family caregivers based on a comparison with male non-caregivers.
Methods The subjects comprised 52 male family caregivers (caregiver group) who provide care for those requiring at-home care at level 3 or above, or who provided care for people with dementia in cases at a level below 3, with an average age and standard deviation of 69.3±10.9 years old. The comparison group comprised 52 people who underwent regular health checkups in K city, whose gender and ages, by 10-year age group, were matched to the subjects on a 1:1 basis, and whose average age and standard deviation were 69.2±11.1 years old. The research was conducted over ther period from December 2005 to April 2007. The survey was conducted with a self-answering format, and subjects were asked questions about such matters as lifestyle, QOL, psychosocial stress and coping with stress.
Results The average age of people requiring care was 75.7±9.5 years old, and it became apparent that elderly caregivers generally provide care for other elderly people. In a health-related QOL (SF–8), care-giver group were significantly low in “General Health” and “Bodily Pain” in the physical health domain. In the mental health domain, “Mental Health” and mental health summary score of the care-giver group were significantly low.
 Regarding lifestyle, it was apparent that the care-giver group had significantly fewer sleeping hours than the control group and the PSQI score was also lower. Coping scores were significantly low for the caregiver group regarding 2 items, “Evasive Thinking” and “Recreation”, and this indicated a tendency toward not adopting an evasive type of coping.
Conclusion It became clear that male caregivers have low subjective health and experience problems about sleep and stress. In addition, they tended not to take coping of evasion type and a need of comprehensive support was suggested.

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Objectives This qualitative and quantitative research was conducted to develop an empowerment scale for health promotion volunteers (hereinafter referred to as the ESFHPV), key persons responsible for creating healthy communities.
Methods A focus group interview was conducted with four groups of health promotion volunteers from two cities in S Public Health Center of N Prefecture. A qualitative analysis was employed and a 32-item draft scale was created. The reliability and validity of this scale were then evaluated using quantitative methods. A questionnaire survey was conducted in 2009 for all 660 health promotion volunteers across the 2 cities. Of 401 respondents (response rate, 60.8%), 356 (53.9%) provided valid responses and were thus included in the analysis.
Results 1) Internal consistency was confirmed by item-total correlation analysis (I–T analysis), assessment of Cronbach's coefficient alpha for all except one item and good-poor analysis (G–P analysis). Four items were excluded from the 32-item draft scale because of correlation coefficients more than 0.7, leaving 28 items for analysis.
 2) Based on the results obtained from the factor analysis performed on the 28 provisional empowerment questions, 28 items were chosen for inclusion in the ESFHPV. These items consisted of four sub-scales, namely ‘activity for healthy community’ (10 items), ‘intention for solving health problems of the community’ (10 items), ‘democratic organization activity’ (four items) and ‘growth as individual health promotion volunteers’ (four items).
 3) The Cronbach's coefficient alpha for the ESFHPV and its four sub-scales were 0.93, 0.88, 0.89, 0.84 and 0.79 respectively. The coefficients of I–T analysis were between 0.33 and 0.69.
 4) The health promotion volunteers who attended other community activities demonstrated significantly high scores for the ESFHPV and the four sub-scales. Persons who were above 60 years, had a longer duration of activity as a health promotion volunteer and were housewives showed significantly high scores on the first sub-scale, ‘growth as individual health promotion volunteers’
Conclusion To measure the empowerment levels of health promotion volunteers, a 28-item scale was developed and its reliability and validity were confirmed. Health promotion volunteers as well as the public health nurses who assist them can use this scale to assess the empowerment levels of other health promotion volunteers.

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[in Japanese]

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