After the annual health examination provided by a city was carried out in 1973, author made an interview survey on recognition of health and ill health, attitude towards health examination, and action taken for ninety of 60 years old and over, who were classified as to need medical care, living in Koza City of Okinawa. The results were as follows: 1. Although they were diagnosed as to need medical care, 81.1 per cent were diagnosed themselves as to be normal state of health, and had recognized their health and ill health subjectively and sensuously. 2. One third had recognized their disease at first at the annual health examination, but 23.3 per cent were aware of it nine years and over before. It shows that diseases of the old are trending in general towards long term and stability. 3. Their attitude towards the examination were mostly passive and had health examination at the nearest clinics geographically. 4. Of those who were directed medical care were classified into two groups; one who needs treatment at clinics or hospitals and another who were required health care at home. Fifty per cent of those who were directed treatment at clinics were under medical care in fact, but the rest had discountinued or no medical care at all. 5. Members of the old people's club, a nation-wide organization, had mostly discontinued medical care as compared with non members. But it seems to be only statistical differnce and not to be a true significance. 6. Main reasons of discontinuance of treatment or no medical care were due to disappearance or improvement of subjective symptoms. It shows that the old has diagnosed their state of health themselves on the basis of the subjective and sensuous reality. 7. Since the present annual health examination service for the old provided by each municipality results only in the scteening of diseases, it must be developed into the comprehensive health care service in order to meet actual needs of the old. 8. Of the current classification of the result of the examination as normal, need close examination, and need medical care, the last item covers a wide area and therefore it needs more practical classification for following health care programs for the old.
Studies on cardiovascular mortality in Japan, U. S. A. and England & Wales for the years around 1950, 1955 and 1960 were previously presented. Presently, similar analytical studies of the vital records were done for the 4 Scandinavian countries, Sweden, Denmark, Finland and Norway, for the years 1951, 1955, and 1960. Four selected causes of death for the study are “vascular lesions affecting the central nervous system, ” “chronic rheumatic heart disease, ” “arteriosclerotic and degenerative heart disease” and “ other diseases of heart”. (Seventh Revision of the International List of Diseases and Causes of Death) 1. Among those countries Finland tends to have the highest death rates in all forms studied except “chronic rheumatic heart disease.” 2. Norway tends to have the lowest mortality rate in most forms of the cardiovascular diseases studied, yet the death rates for “ chronic rheumatic heart disease” is the highest for this population. The mortality trends in the 10 years course for "vascular lesions affecting the central nervous system" tends to show increasing tendency in this country alone. 3. Denmark also appears to have lower death rates, although the death rates for “other diseases of heart ” is relatively high. 4. In the 10 years course, tendency for decrease in deaths due to cardiac causes in younger age groups under 30-40 years of age and for “ vascular lesions affecting the central nervous system” for the age groups over 30-40 years of age are observed in general according to age-specific death rates. Death rates for the selected cardiovascular diseases among the four countries were comparable with the age-sex-adjusted death rates, and also with that of Japanese population by index forms.
From the results of the investigation of 80 serious patients, mentally and physically handicapped, in our national sanatorium in Kofu City, Yamanashi Prefecture and 2, 716 patients abstracted from all the other national sanatoria in Japan, the following conclusions were drawn. 1) By ages, of the 80 patients in our sanatorium those of 1014 years stand first in number (45.00%) and those of 1519 years stand second (22.50%), while of the 2, 716 patients from all the other national sanatoria those of 5-9 years stand first (39.7%) and those of 1014 years stand second (29.3%). Nevertheless, the investigation of our patients was made in the 50th year of Showa and that of the latter patients was made in the 45th year of Showa. Accordingly, the age-composition of the two groups of patients is the same in reality. 2) By causes, in our sanatorium, cerebral palsy stands first in number (65.00%), the after-effects of encephalitis and cerebrospinal meingitis stand second (13.75%), and follow the after-effct of nucleojaundice (8.75%) and microcephaly (7.50%). In the other sanatoria, cerebral palsy stands first (64.9%), the after-effects of encephalitis and cerebrospinal meningitis stand second (13.0%), and follow the after-effect of nucleojaundice (7.9%) and microcephaly (5.9%). Namely, the order of causes is about the same in both cases. 3) As to evacuation, 95.0% of our patients and 96.5% of the others need to be tended.Namely, , both rates are almost the same. 4) As to communication, 17.5% of our patients and 17.3% of the others can speak a little. Namely, both rates are almost the same. 5) As to eatiny, 86.25% of our patients and 81.4% of the others need to be tended. Namely, both rates are about the same. 6) As to bodily movement, 47.50% of our patients and 32.9% of the others keep their beds. This shows that our patients are more severely handicapped than the others. 7) As to complications, pneumonia, chronic bronchitis, fever in summer, skin disease and symtoms of digestive organs rank high both in our sanatorium and in the other sanatoria. As mentioned above, the age-composition and the conditions of our patients are almost the same as those of the other patients, except that the grade of physical handicap of the former is higher than that of the latter. Generally speaking, more time is spent in their living guidance than in their medical treatment. Consequently, nurses are occupied in work of tendance rather than in their proper work of nusying. On the 1st of August, 1973, we made researches on the time of living of 10 nurses working in the ward of the physically and mentally handicapped of our sanatorium, of 10 nurses in the medical ward of the national hospital, and of 10 nurses in the medical ward of the pref ectural hospital in the same city, with the following results. The total time of nursing, housekeeping, and cooking spent by our nurses, by those of the national hospital, and by those of the prefectural hospital is 12 hours and 3 minutes, 10 hours and 53 minutes, and 10 hours and 33 minutes respectively. Namely, the working time of our nurses is the longest and that of those of the pref ectural hospital is the shortest. Moreover, the nurses of our sanatorium are older and those of the other are younger. The time of nursing is comparatively short and that of housekeeping is long in the former, while the time of nursing is long and that of housekeeping is short in the latter. Namely, they are antipodal. This fact is worthy of note, considering the problem of lumbago. By substance of the working time in hospital, the time of medical care, is I hour and 9 minutes, that is, the shortest, in our sanatorium, 3 hours and 38 minutes in the national hospital, and 3 hours and 48 minutes, that is, the longest, in the pref ectural hospital. The time of tendance in eating and excretion is 2 hours and 34 minutes, that is, the longest, in our sanatorium, 28 minutes in the