Objectives: The present study aimed to explore the structure of occupational health nurses' support for return-to-work to workers with depression. Methods: Semi-structured interviews were conducted with 10 occupational health nurses who support workers returning to work. Data were analyzed using the Modified Grounded Theory Approach. Results: The qualitatively analyzed data was grouped into 9 categories. The support for return-to-work was divided into 3 periods: (1) the first priority for recovery, (2) preparation for return-to-work, and (3) adaptation to work. There were indirect supports to workers such as "environmental arrangement for medical treatment," "connection," and "support form parties concerned about workers," and direct supports such as "readiness for medical treatment," "overcoming social and psychological problems," and "working life independence. " Direct support was facilitated by "construction of the relationship. " The occupational health nurses' philosophy was to support "profitable return-to-work for both the worker and the employer. " These processes were "support of confidence recovery process " to regain confidence lost through absence from work because of depression and to accomplish a smooth return-to-work. Discussion: There were problems in each period corresponding to the return-to-work conditions, and occupational health nurses supported the employees in overcoming each problem. Moreover, it was said that cooperation with the parties concerned in the office would greatly influence the success or failure in the return-to-work support, and it was thought that direct supports and indirect supports to employees with respect to adjustment with the parties concerned in the office were necessary. Conclusions: The structure of occupational health nurses' supports was to support the confidence recovery process of workers by indirect and direct support at each period of return-to-work.

Objectives: The purpose of this study was to evaluate the appropriateness and usefulness of the first aid training program developed for occupational health nurses (OHNs) to improve their basic skills of first aid treatment. Methods: This was a case-control study. The subjects were 69 nurses who were stationed in workplaces in Japan (intervention group: n=35; waiting-list control group: n=34). The training program was developed using the method of instructional design (ID) and composed of basic life support (BLS) training, basic first aid training, and simulation training. This study was conducted from April to August 2012. The training was evaluated using the Kirkpatrick model of training evaluation: level 1 (reaction), level 2 (learning), level 3 (behavior), and level 4 (results; this level was omitted). For level 1, the training contents were evaluated on a visual analog scale (VAS) of 0 to 10 points on the basis of whether the programs' contents were interesting, understandable, and applicable in the workplace. For level 2, a knowledge test (15 true/false questions) was used. For level 3, the practical application of activities relating to the emergency system was evaluated. Results: There were no significant differences in the attributes and characteristics of the subjects of the workplaces between the intervention and the waiting-list control groups. The score for reaction (level 1) were 8.5-9.7 points. In the knowledge test (level 2), there was no significant difference in the score before training between the intervention (11.0 points) and the waiting-list control groups (11.1 points). However, the score three months later showed a significant difference between the intervention (12.5 points) and the waiting-list control groups (11.0 points). The score after training was significantly higher than the score before the training that the intervention group received. For evaluation of behavior (level 3) three months later, the ratios of implementation of management and review of necessary items, review of task, and discussion with OHNs on emergency systems were significantly high in the intervention group. Conclusions: The evaluation of the first aid training programs for OHNs in this study showed high satisfaction of the participants and indicated improved knowledge and contributions to the waiting-list control group. We consider the contents of the program as appropriate.

Objective: The purpose of this study was to clarify the causes of low back pain among workers in care facilities for the elderly after the introduction of welfare equipment. Methods: We conducted anonymous questionnaire surveys among administrators and care workers in eight elderly care facilities. The questionnaires were designed to investigate the status of both the care workers and facility. In reference to the care facility, the questionnaires were comprised items for investigating basic information, occupational safety, and health activities. For care workers, in addition to basic information, occupational safety, and health activities, the questionnaires also comprised items for investigating resident transfer and bathing methods, low back pain, and occupational stress. Results: Completed questionnaires were returned by eight care facility administrators (response rate: 100%) and 373 care workers (response rate: 92.3%), among which 367 were used for analyses. Many care workers participated in a variety of occupational safety and health activities that were conducted in the facilities. Various types of welfare equipment were introduced into the care facilities and subsequently used by many care workers during resident transfer and bathing. As a result, 89.9% of the care workers reported having only slight or no low back pain. The remaining 10.1% reported having serious low back pain that interfered with their work. On the basis of logistic regression analysis, low back pain was associated with the following variables: failure to provide the appropriate method of care to each resident, failure of colleagues to discuss methods for improving care, lack of instructions regarding the use of welfare equipment, and inappropriate job rotation. An association was also found between low back pain and poor posture, poor resident-lifting technique, insufficient time to complete work, and a shortage of workers to assist with resident transfer or bathing. Conclusion: Although care workers received instructions on the health and safety activities extracted from the surveys, an association was still found between these activities and low back pain. This was thought to result from some care workers not establishing the appropriate method of care for each resident, not discussing methods for improving care with other colleagues, not using the welfare equipment, and failing to practice appropriate job rotation. These results suggest that low back pain among care workers in the facilities for the elderly that have introduced welfare equipment is caused by a failure to sufficiently conduct appropriate care methods.