This paper focuses on 'Paternalism' which has been negatively interpreted in the social welfare context. I classified the criteria for justification of paternalism into five categories through a review of previous studies and theories. The most remarkable criterion was 'Autonomy-Respecting Paternalism' which has been discussed in the aspect of autonomy for recipients of paternalistic interventions. According to this criterion, interferers can avoid oppressive interventions and develop the autonomy of the interfered recipients. Therefore it can be adapted to the social welfare paradigm. Although justified paternalistic interventions have been discussed in many studies, the meanings of paternalism are not fully understood in our society. The negative aspects of paternalism can be summarized as three meanings. Moreover I revealed the difference between the necessity and the criticism for paternalism. However 'Autonomy-Respecting Paternalism' can not be justified, because the theory of autonomy has diverse meanings and value judgments. In conclusion, the criterion of' Autonomy-Respecting Paternalism' is likely to be abused oppresssively by interferers under the name of autonomy-respecting.

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The purposes of this paper are to explain the "coexistence" of welfare policy and police policy for homelessness in America in recent years, and then to consider the meaning of this "coexistence". The paper first analyzes the relationship of both policies in terms of the cognition and the object of each policy. It is concluded that the object of the welfare policy and the police policy is not same and the relationship of both policies is based on the principle of antinomy. Both policies, nevertheless, seem to target the same object since the object of the police policy is highly correlated with life-sustaining conducts of the homeless in public. Secondly, the recognition of the homeless is subservient to that of the non-homeless since each policy primarily deals with the interest of the non-homeless. It is further considered that the "coexistence" of each policy shows the contradictory message of the policies, in which the homeless "deserve" both benefit and punishment, although avoiding the contradiction institutionally. The representation of the homeless through the "coexistence" of each policy, therefore, becomes conflicted. That is the evil of the "coexistence".

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This research was conducted on aspects of regional service provided at children and family support centers in which the role divisions were not clearly defined. The specific focus of activities concerning children and families differed, depending on the kind group work, counseling and support conducted at the centers. These special functions were implemented with particular and specific purposes. The research was conducted by means of investigative interviews at advanced activity centers. All centers (cities, towns, villages) that had such administrative facilities, inclusive of child welfare consultation offices, were surveyed and the collected data was analyzed using multiple regression analysis and covariance analysis. The results of analysis showed that centers having numerous organized activities and frequent counseling were much more highly developed in comparison to centers that did not have any kind of organized activities, (cities, towns, villages) in their administrative facilities. The analyzed results further demonstrated that the children and family support centers are in accordance with the needs of the area's inhabitants, and their special function is clearly shown. Therefore, in the future, the role of interface between the administrative facilities and the inhabitants' welfare needs should be the focus of attention in order to achieve a successful outcome.

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This article, aiming to illuminate partially the situation in which the challenged and their parents have been located, surveys newspaper reports after WWII, of murder cases in which the challenged are killed by their parents. The survey confirmed the following facts : first, on the one hand, children's murder cases decreased after 1980, but on the other hand adults' cases have been increasing after the 90's; second, mentally retarded murder cases have been increasing after the same decade; third, simultaneously, mentally retarded adults' cases have been rapidly increasing; fourth, most cases were committed when the challenged were living in the same residence with parents, but there were some cases committed even though the challenged resided in institutions; fifth, after the 90's, aged parents' committing cases have been increasing. After confirming these facts, the author places them in historical context, and concludes that there are serious contradictions in the welfare system which charges the parents with caretaking responsibility for the challenged.

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The purpose of this study was to examine the factors related to helping behaviors of the speech-to-text interpreters for the hard of hearing people and late deafened people (hard of hearing and late deafened people, hereafter). Sixty speech-to-text interpreters were asked to describe their helping behaviors and cognitions concerning the hard of hearing and late deafened people in order to develop questionnaire items. The questionnaire about helping behaviors and cognitions concerning the hard of hearing and late deafened people was administered to speech-to-text interpreters and 116 responses were selected. As a result of developing scales, the author constructed two scales about helping behaviors and cognitions of the speech-to-text interpreter to the hard hard of hearing and late deafened people. The helping behavior scale of the speech-to-text interpreter was composed of 3 factors and the cognition scale was composed of 2 factors. In order to examine the factors related to the helping behaviors, a multiple regression analysis was performed. The results showed that there were relatively strong relationships between the helping behaviors and the cognitions.

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The objective of this study is to clarify the factors influencing the competitive employment of people with intellectual disabilities based on the theory of "competence", the ability which effectively allows one to influence the environment. The analysis reveals the following findings: (1) the development of working competence brings out "the development of the will and ability to work", "the development of positive and objective self-recognition", "the development of socialization", and "the promotion of the will to live independently"; (2) the factors obstructing competence development are three-fold as follows: " supporter-centered support", "supporters' negative attitude regarding the competitive employment of people with intellectual disabilities", and "lack of both supportive system and supportive environment for the supporters". In conclusion, two findings are clarified in this study. First, if people with intellectual disabilities receive appropriate responses, they'll be highly likely to succeed in participating in the competitive workplaces and retaining their jobs. However, secondly, if they receive inappropriate responses, they'll be highly likely to fail to get competitive employment and suffer from poor job retention.

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The purpose of this study was to propose requisites for education and training of caregivers in unit-type and conventional special nursing homes. For this purpose, adaptation of caregivers to the workplace was examined with respect to their manner of care giving and years of experience. In this study, a questionnaire was administered as well as a time study performed. Questionnaires were completed by 22 caregivers working in conventional special nursing homes and 36 caregivers working in unit-type special nursing homes. These nursing homes had all been established by the same corporation. The time study was made on a total of 16 caregivers (8, conventional; 8 unit-type) . Nursing homes had approved of their participation in this study. The degree of adaptation was studied with respect to years of experience and manner of care giving by the caregivers. Results of the questionnaire showed that in unit-type nursing homes, stress between less experienced caregivers and users was significantly greater than that between highly experienced caregivers and users. This result seemed to be correlated with the finding in the time study that the time spent by less experienced caregivers in caring for each user in his or her private room was significantly shorter than that spent by highly experienced caregivers, and could consequently be proposed as a requisite for education of caregivers. In conventional nursing homes as well, less experienced caregivers burned themselves out at significantly higher rates than did highly experienced caregivers. The importance of continuous educational consideration and support for new caregivers was suggested.

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A draft 'scale for user satisfaction with home help services' was created, with examined reliability and validity, for evaluating the quality of home help services based on the helping relationship; then a double survey was conducted to verify its cross-validity. A factor analysis, based on users' responses and conducted on each survey showed that the factor structure gave the same results as in the previous survey, confirming cross-validity. When analyzing the factors affecting the scale focusing on the helping relationship, it was shown that the difference among respondents (client or family member) and care personnel assignment system (frequency of personnel changes) have a bigger influence than attributes such as gender and degree of assistance needed. An existing assumption that the satisfaction ratings fall when clients have physical disability was not confirmed when users' responses and the assignment system were taken into consideration, but was confirmed when respondents were limited to those needing physical care only. It was suggested that not only the quality of care personnel but the administration of the service (eg. turnover of care personnel) affected user satisfaction with home help services.

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Job burnout is a prolonged response to chronic job stressors and consists of three dimensions : emotional exhaustion, depersonalization, and reduced personal accomplishment. Although burnout among people working in human services has been explored in some depth, there are very few studies of gerontological care managers in Japan. This study reports burnout, stressors, coping behaviors, social supports, and job satisfactions among 562 care managers by examining qualitative and quantitative data. The results show that care managers have lower personal accomplishment than gerontological care workers and social workers. A regression analysis indicated that care manager's services and work environment were predictors of emotional exhaustion and depersonalization, whereas the number of cases was a predictor of reduced personal accomplishment. In addition, it revealed that some specific factors contribute to burnout such as heavy workloads, supervisors without understanding, insurers dumping work on care managers, and difficulties in coordinating with service providers. There was some degree of relationship between burnout and moderators such as social supports and coping behaviors.

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The Izumibashi charity hospital introduced hospital social work for the first time in Japan. The background of this introduction of hospital social work, the contents of practice and the factors under which practice continues were examined. The hospital social work of this hospital influenced social work in Japan of those days, when new knowledge and activity from Europe and the United States were taken in, and casework activity was seen as a simple form. The social service was introduced into an organization that supported the hospital. It was managed with the support of the director and the head official who was a central person of the hospital management. The social worker was employed as a paid professional and received evaluation as a professional. The content of the consultation included various topics: solving the difficulty in life which daused the sickness, and utilizing a variety of social resources including the social woker's "skill" and "private network". The "mediation function", "conference function" and "vicarious execution function" were mentioned as functions of a social worker.

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The present study explores the relationships and effects among leadership (LS) style and empowerment (EP) and job satisfaction (JS) of the care staff in order to examine Human Resources Management to promote high quality service provision in Health-Social service facilities. Questionnaires were sent to individuals working in geriatric care facilities and responses were returned from a total of 604 males and females. Results indicated the comparatively large and relative evidence that Performance (P) and Maintenance (M) leadership were positively related to JS, and they effected JS positively and accounted for a comparatively large amount of the variance. However, cotrary to several reserchers, EP has no moderating effect between LS and JS, and there was little significant difference in EP between licenced and unlicenced staff or among their levels of education. Of all EP, Meaning and Competence were related to JS, as were P and M LS. These results suggested that LS behaviors with high P and high M are important for JS of care staff and improvement of service quality. The authors conclude with directions for future research.

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This study was aimed at examining the background and extant situation related to interprofessional education (IPE) within the health and social care systems in the UK, by reviewing the available literature and field survey data of the IPE project administered primarily by the University of Southampton. Factors affecting IPE that are considered important are as follows: Firstly, restructuring of service delivery systems has been undertaken in response to difficulties that have arisen in response to the un-collaborative nature of national and local governments. Secondly, the findings of public inquiries focused attention on the need for changes in interprofessional working. Thirdly, the effective and efficient delivery of services requires collaboration. Thus, IPE initiatives need to be conducted at the time of pre-qualifying education. As for actual IPE initiatives, group studies involving a variety of professionals, and practice-based learning have been designed in stages, each relying on user-oriented experience. The process is based on a training programme of practice teachers, a strategy group responsible for collaborating with various stakeholders, an influential steering group, combined with practical use of an e-learning system. This project could serve as a model for the restructuring not only of pre-qualified education, but also service delivery systems.

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The purposes of this study were to evaluate the quality management system in U. S. nursing homes, and to examine possible applications of the U.S. experiences to nursing homes in Japan. Twelve staff members including managers at three nursing homes in California were interviewed. Most participants stated that the quality management system would contribute to improving the quality of care in nursing homes. This study revealed six factors in improving the quality of care in nursing homes using the quality management system: 1) nursing home's obligation to submit assessment data, 2) selection of the elements in agreement with nursing homes, 3) development of methods which improve the process of care at the resident level, 4) development of quality indicator/measures which compare the quality of care among nursing homes, 5) application of Quality Indicators to the nursing home inspection process, and 6) disclosure of nursing home information to the public. However, there were some challenges, including risk adjustment of Quality Indicators. This study suggests the following for Japan: 1) examining of a data collecting process, 2) developing comparable process/outcome indicators among nursing homes, 3) reconsidering of the inspection process.

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