The purpose of this study is to assess the number and need of health and welfare services of the latent bedridden elderly in the community using the new criteria developed by the Ministry of Health and Welfare. A survey conducted in Ayase city revealed 145 bedridden elderly, out of which 52 were receiving home care (the home visit group), but 44 were the newly detected cases with not-receiving any services (the newly detected group). Comparing these two groups, conditions of the bedridden elderly seemed to be more severe for the home visit group, but there were no significant differences in conditions of caregivers for either group. For the newly detected group, information on health and welfare services had been provided by public health nurses, and more than half applied for some services. These results suggest that the role of public health nurses in both the case finding and delivery of the services is important.
The study examined the relationship between eating with others among elderly living alone and their positive food behavior and food related attitude. The study is on the first step to develop a new scale of the?gpositiveness?hof food behavior and food related attitude as a new index of QOL of the elderly. Data on 102 subjects living alone, 35 males and 67 females, in a survey on food behavior among the elderly, conducted in Japan in 1990, were analyzed. Results were as follows:1. Score of eating with others (Score) were calculated based on the frequency of 3 occasions of eating with others: eating with their children, eating with relatives and/or friends, and eating on the occasion of social activities. Subjects were divided into a high score group (37 persons), a medium score group (33), and a low score group (32).2. In comparison with the low score group, the high score group showed positive food behaviors for all 3 steps: preparation of meals, eating meals, and exchanging foods and information on food and nutrition. The high score group had good food frequency and they also showed positive attitudes for social contacts on food .3. Based on the degree of the?gpositiveness?hof food behavior and food related attitude, a new scale, Positive Score on Food Behavior (PSFB), was devised for trial .The PSFB is divided into 2 sub-scales: one is the Score on social contacts on food (Social PSFB), such as preparation meals on social occasion, and the other was the Score on personal food behavior (Personal PSFB), such as preparation of meals for themselves. Multiple regression analysis showed that the Score significantly correlatedwith PSFB and the Social PSFB. But there was not significant correlation between the Score and the Personal PSFB. The results suggested that there is the necessity to develop a new scale such as PSFB including social and personal aspects of food behavior and food related attitude and that the new scale will have some possibilities to evaluate QOL of the elderly from the view point of the ecology of human and food.
As the aging of the population of Japan is estimated to accelerate in the coming three decades, problems regarding the care of the frail elderly will become serious due to, in particular, shortage of care personnel and small housing space. The aim of this study is to clarify the prefecture-based area features associated with care of the elderly and to examine the relation between these features or indicators. Analyses of 19 indicators from 47 prefectures were performed by prinicipal component analysis and cluster analysis, and they were classified into six groups called A to F. The prefectures in southwest Japan and Hokkaido (group A) had low rate of aged livingwith their cildren, high rates of institutional beds, and many care personnel. The opposite trend was observed in those of the central and eastern Japan. Prefecture groups E and F had smaller number of institutional beds and care personnel than average; group E which included Nara, Ibaraki, Saitama prefectures in the outskirts of megalopolises was characterized by low rate of bed-ridden elderly, while group F, including such prefectures as Akita, Nigata, and Yamagata by high rate. Group C was intermediate in formal care indicators. The prefectures of megalopolises (group D) had small housing space, a small number of institutional beds and a large amount of home health aid.
The government of Japan is now implementing a policy aimed at reducing the occupational working hours, for all types of labor in Japan, to 40 hrs/week and 1, 800 hrs/year. The implementation of this policy began in 1988 and is scheduled to be completed in 1997. In fact, average working hours have decreased, reaching 1, 904hrs/year in 1995, a level comparable to those of the USA and the United Kingdom. Physicians have, however, been dealt with differently from other hospital workers. Even physicians employed in large hospitals seem to work harder for a longer time than ever. The authors attempted to ascertain the working conditions of physicians employed in large hospitals in Gunma Prefecture, Japan. Twenty-four male physicians in their 30s of age, working in national university hospitals and relatively large private and public hospitals, were randomly selected from the membership list of the alumni association of a national medical school in the same prefecture. A questionnaire was prepared to include the following items: working hours, number of holidays, annual income, actual time budget on seven successive days. The questionnaire was distributed by an interviewer after obtaining each subject's consent to participate in the survey. After a week or more the interviewer retrieved the filled-in forms. Intotal, 19 physicians responded. Average working hours for 11 university hospital physicians (UP) and 8 other hospital physicians (HP) were 2, 781 and 2, 346 hrs/year, or 66.3 and 57.7 hrs/week, respectively. Average weekly working hours of approximately 5, 000 general and non-general physicians sampled in the USA were 51 hrs in 1980, based on a periodic survey conducted by the American Medical Association.Numbers of holidays per year for UP and HP were 57.8 and 69.6 days, respectively, though the number for workers employed in Gunma Prefecture was 107.5 days. Incomes per year for UP were 3.79 million yen from the university hospital and 4.86 from hospitals employed as part timers, a total of 8.65 million yen, while that of HP was 12.56 million yen. The UP time budgets for primary (sleep, etc.), secondary (work, etc .) and tertiary (learning, etc.) activities were 70.4, 71.2 and 24.4 hrs/week, respectively; these figures were almost the same as those of HP. The longer the secondary activity time the shorter the primary and tertiary activity times. The shift system and the team approach for physicians employed in hospitals are so inadequate that they cannot take enough holidays and have little time to study or to refresh the knowledge essential to their professional lives.