In current psychiatric practice, there are patients who are obliged to stay in hospital despite there being no medical therapeutic need ("social hospitalization"), causing problems such as affecting healthcare expenditure and threatening patients dignity. The Ministry of Health, Labor and Welfare announced that social hospitalization of 172,000 cases should be resolved in the following decade; and the healthcare is being transformed from hospital-based to community-based. However, many patients have difficulty with discharge because of various reasons, resulting in prolonged hospital stays. Some patients have prominent hospitalism and negative symptoms in addition to an unstable clinical condition, and have defects in thinking independently. Negative attitudes to discharge as well as social skill defects including personal relationships and monetary management despite discharge-intention hamper discharge. Some patients who have difficulty with discharge are overaccustomed to the hospital environment, and lose sight of the goals, which lead to reduced motivation; protracted monotonous lifestyle; and reduced social relationships, resulting in impaired quality of life. In this study, we investigated what sort of defects in social skills and associated anxiety hamper the discharge, and performed the social skills training (SST) in eight patients to promote discharge. Ikebuchi describes that "the intervention of SST is performed as a result of a lack of assurance of social life skills (referred to as social skills, interpersonal skills, societal skills, etc.) towards others who have some broad social life difficulties; thus, the goal is their acquisition (or reacquisition) based on learning theory. The targets, therefore, are schizophrenia, and a host of other mental, developmental and intellectual disabilities, and this is spreading widely to adaptive support for children at school and corrective education for those who run afoul of the law." In a prior trial, Yamaguchi addressed the effect of team-based intervention through SST in the group-based discharge support for long-term inpatients. However, no previous studies incorporated living conditions in a geographic region where SST is performed for the assessment of effectiveness. Hospital X is located in a mountainous area with a paucity of public transport system, where the management of patient-owned money is supervised by hospital staff. This study is aimed to determine the effect of SST in those hospital conditions on patients who had difficulty with discharge, and suggest a STT program adapted to hospital conditions. The program taking the hospital characteristics into account was effective and therefore could be recommended for other hospitals with similar conditions to Hospital X. The skill-acquisition can reduce stresses associated with personal relationships in social life, although that effect does not directly lead to hospital discharge. In addition the improvement in social skills seemed to be discharge-promoting.

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In the present study, we analyzed the accounts of individuals who had supported elderly disaster victims living in rural areas from the perspective of living out one's life in one's hometown, in order to clarify such victims' environment and related issues. We surveyed Kinan area in Mie prefecture designated by the Act on Special Measures for Promotion of Independence in Underpopulated Areas (the "rural area"). It was also specified as an area extensively damaged by typhoon No.12 in September 2011. A total of 7 individuals (presidents of residents' associations, children's social workers, and medical welfare professionals supporting elderly people ["supporters"]) participated as subjects in this study. The study period was between October 2012 and April 2013. Semi-structured interviews were conducted with these subjects in order to clarify the influence of a disaster on the health and lives of affected residents. Their accounts were analyzed in a qualitative manner. A discussion on such data was formulated based on the activity theory. Verbatim transcripts of the accounts were made, from which a total of 284 segments were extracted. These segments were then classified into 4 categories comprising 12 subcategories. We formulated a discussion on changes in the lives and environment of elderly disaster victims that had taken place from before the disaster until after they had resumed to a normal life, based on the activity theory and from the viewpoint of supporters. Our findings suggests the following: 1) elderly people living in rural areas need to lead their lives independently (e.g., being able to use a stove properly, and not being demented), 2) it is important for disaster victims to be financially secure in order to be able to reconstruct their houses and return to a normal life, 3) education needs to be provided from early on so that the public will be able to protect themselves in the event of a disaster, 4) forging a favorable relationship with community residents will lead to a reduction in the impact of disasters, and 5) in order for elderly disaster victims to lead their lives independently, it is necessary to resolve disaster-related issues (e.g., increasingly aging leaders of post-disaster reconstruction activities, the lack of successors for such leaders, and disaster victims' financial constraints).

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<Aim>The purpose of this research is reveal of psychiatric nurse's mental health and occupational stress. <Methods>Objects are 156 nurses who work at a psychiatry hospital (114 people of collection, 73%). This investigation used GHQ28 and BSJS-Ns. Mental Health of the nurse who works at psychiatry was good compared with a nurse of a general medical department, and The stress by the amount of the nurse's work to work at psychiatry is low compared with a nurse of a general medical department. But a qualitative stress tended to be high by the ethical dilemma by which patient nurse relations are complication and isolation.

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Objective: To identify mothers' ratings of the structure of personal growth in children whose sibling is hospitalized and whose mother subsequently rooms-in with the sibling. We also developed and evaluated the reliability and validity of a scale to assess this type of growth. Methods: We obtained consent to conduct our research at 63 medical institutions in Japan, and the anonymous self-administered questionnaire was answered by the mothers of children with a hospitalized sibling. Participants rated on a 4-point Likert scale 26 items that were identified from content analysis in a previous study as being indicative of children's positive changes. Exploratory factor analysis was performed and the scale's structure was identified, and the reliability and validity evaluated. Results: Participants (N=254) with siblings aged between 2 and 18 years were analyzed. After factor analysis, the measure, which we named the Siblings' Personal Growth Scale (SPGS), comprised 22 items divided across three factors of altruistic behavior, development of emotional and social skills, and self-control, and the scale's structure was identified. Cronbach's coefficient alpha value indicated high reliability (.897-.940), and the Kaiser-Meyer-Olkin value (.940) and Bartlett's test of sphericity were significant (p<.001), supporting the sampling adequacy. The content validity was confirmed by a research team comprising experts in pediatric nursing and clinical psychology. The criterion-related validity was evaluated by a Pearson product-moment correlation coefficient comparison between the SPGS and the internal behavior subscale of the Child Behavior Checklist/4-18. It was found to be significant at .217 (p=.029) for males aged between 4 and 11 years, but not for any other groups. Conclusions: The structure of the SPGS was identified and the future feasibility of the scale supported.

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Little information is available on the relationship between body mass index (BMI) and functional limitation in Japanese elderly people. A population-based cross-sectional study was conducted in Nanporo Town, Hokkaido, Japan. The age of the participants ranged from 65-79 years of age and the fully completed questionnaire rate for men was 83% (n=515) and 77% for women (n=547). The self-administered questionnaire including items related to height and weight, and self-reported physical function consisted of 4 domains (mobility, balance, manipulation, posture-change). Multiple regression analysis was used to estimate the risk (odds ratios) of functional limitation according to the level of BMI, with adjustment for age, smoking, alcohol intake and chronic diseases. In the women, the limitation risk for several activities relating to mobility and balance were significantly greater not only in the high BMI group (≧25.0) but also in the low BMI group (≦20.9), as compared with the referent BMI category (21.0-22.9). On the other hand, in the men, significantly higher limitation risks were observed only in the low BMI group (≦20.9). The risk of functional limitation relating to mobility and balance increased in lean and overweight women, and lean men in this cohort. In order to extend healthy life expectancy, attention should be paid not only to those with excessive weight but also to those with low weight.

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