Social welfare studies in the last few decades have been arguing the nature of respecting client autonomy. Since these studies focused on the methodology for the realization of autonomy-respecting, neither the definition of autonomy nor the object that one should respect has been fully investigated. Therefore, in order to clarify these points, both the theoretical concept of autonomy and the clients' competence in relation to it need to be clarified. The aim of this paper is to reveal both the theoretical concept of autonomy and the respect for it, which are considered to be important from the ethical point of view in social welfare. After reviewing previous studies on this topic, I have developed the concept of autonomy as competence composed of four internal factors: "agency", "preferences", "rationality", and "expression". Moreover, I have referred to "environment" as an external factor, which has an immense influence on the four internal factors. This approach enables us to realize what is deficient in the so-called non-autonomous people discussed in previous studies and how such people should be supported. Additionally, this paper suggests an alternative perspective against dominant theories that suggest that the ability of self-determination is regarded as highly valued.

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This study sought to clarify the structure of and factors associated with problems in daily life faced by mothers of children with severe motor and intellectual disabilities (SMID). Subjects were 154 mothers of children with SMID residing in the suburbs of Tokyo. Results of analysis indicated the following. Seven factors were identified as comprising problems in daily life: a restricted lifestyle, difficulty communicating with specialists and specialized facilities, concerns about the child's disabilities, the inconvenience of living arrangements, difficulty attending to other family members, mental and physical burdens, and problems in relationships with family members and relatives. Among these, mothers most often experienced a restricted lifestyle and mental and physical burdens. Role captivity and household income had a significant impact on a restricted lifestyle, and the number of times a child was institutionalized in a year and caregiving demand had a significant impact on mental and physical burdens. Role captivity had a far-reaching impact, increasing the incidence of problems in daily life in many areas. In contrast, spousal support reduced the incidence of those problems.

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This study reports the analytical findings from a quantitative survey titled, "Survey on the Social Recognition of Children Born through Gamete Donation", conducted as a part of research which serves the purpose of protecting the welfare of children born from gamete donation, and the observation results derived from such findings. As a result of this survey, it was concluded that, by the targets of the survey listening to the voices of children born from donor insemination (DI children) that forms the basis of the hypothesis to be proven in this study, namely that "a structure of human rights infringement that can be referred to as 'Social Abuse' exists in the nature of anguish experienced by DI children", the environment DI children are exposed to in the meaning of the aforementioned structure can be understood. If that is the case, there is a possibility that, by listening to the voices of DI children, the objective and the focus to free DI children from the 'Social Abuse' that they are experiencing may be identified.

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The purpose of this study was to develop the Activity and Daily Life Satisfaction Scale for the Elderly. Data for 296 older adults aged 65 to 84 years were obtained from a mail survey in Ichikawa City, Chiba Prefecture. Four items, "having pleasant activities", "having meaningful activities", "useful leisure time spending", and "having activities of great interest", were extracted from the item pool of this study. A confirmatory factor analysis of a one-factor model with 4 items showed that this model fitted well. Concurrent validity was established by comparing the scale with four variables. The Cronbach's coefficient alpha was 0.83, and coefficient omega was 0.86. The mean and standard deviation of the scale (the score ranges from 4 to 20) was 12.9±4.1. Multiple regression analyses revealed that the score of the scale was positively associated with each of the four social activity variables. These findings suggest that the Activity and Daily Life Satisfaction Scale for the Elderly had adequate validity and reliability.

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In order to evaluate the impact of the reformed, long-term care insurance system on those certified for support, we investigated the following. (1) Proportions and characteristics of people facing difficulties in coping with cutbacks in home help services. (2) The relationship between changes caused by the reformed system and everyday anxieties, and characteristics of those who were more affected by the cutbacks. We conducted face-to-face interviews with people who were eligible for support Levels 1 or 2, at a selected district of a municipality in Tokyo. Data from people eligible for long term care insurance before the reforms (n=101) indicated that those who were 80 years or more, and those who had ADL disabilities were more likely to be dependent on their family members and out-of-insurance services to make up for cutbacks in home help services. In addition, those who experienced more changes by the reformed system reported more anxieties in daily life. Especially, a strong relationship between the reformed system and anxieties in daily life was seen among low-income people. These findings suggest that the reformed system had exerted significant impacts on the very-old, disabled, or low-income elderly and thus application of the new preventive benefits to these elderly groups requires advertent consideration.

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In order to enhance the quality of home help services, sufficient and effective staff education is important. Service delivery managers of home help service agencies often take the role of educating home helpers in the agency. At the same time, service delivery managers also have their own learning needs. The study question is: what topics are prioritized as learning topics for service delivery managers? Using Delphi methodology, an expert panel of home help services completed three successive questionnaires to identify a set of learning topics. In round 1, experts on home help services completed the open-ended questionnaire on important learning topics for service delivery managers. Analyzing their descriptions, 41 learning topics were identified. In round 2 and round 3, experts were asked to rate each of the 41 topics on a 1-5 scale. Mean priority ratings and quartile deviation were calculated. As a result, 16 top learning topics were identified. Among highly prioritized topics were several topics related to roles of service coordination such as making home-help service plans. Several other topics were related to roles of managing and educating home helpers, including the enhancement of good relationships among home helpers.

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