Journal of Japan Academy of Community Health Nursing
Online ISSN : 2432-0803
Print ISSN : 1346-9657
Volume 5, Issue 1
Displaying 1-10 of 10 articles from this issue
  • Mayumi Nagai
    Article type: Article
    2002Volume 5Issue 1 Pages 7-13
    Published: May 15, 2002
    Released on J-STAGE: April 20, 2017
    JOURNAL FREE ACCESS
    The purpose of this study was to find the means by which public health nurses, could help empower self-help groups for intractable disease patients, and to clarify the characteristics of care provided by public health nurses. The subjects were fifteen leaders of self-help groups supported by public health nurses. The data of the development process of the groups and care provided by public health nurses was collected during semi-structured interviews given to the subjects, and then analyzed by constant comparative analysis. Three stages were found to develop into the groups, which were preparing for activities in stage 1, establishing a group system in stage 2, and taking action,and change in stage 3. The relationships between the groups and public health nurses were developed according to the three stages, dependent-independent in stage 1, cooperative in stage 2, and interactive in stage 3. Nine roles of public health nurses to empower the self-help groups were found. Those were to identify people with needs for making groups in the community, the reduction of stress, the promotion of personal health, assistance in making daily life more pleasurable, supporting autonomous activities, supporting the formation and maintenance of the group system, supporting the making of connections with social resources, and establishing the groups as social resources within the health care system in the community. It was found that public health nurses not only provided the clinical care as specialists, but also improved the quality of life of the patients through providing care with general and common sense. It was also found that public health nurses empower the community as individuals and the groups.
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  • Kiyomi Higashi, Chizuru Nagata
    Article type: Article
    2002Volume 5Issue 1 Pages 14-20
    Published: May 15, 2002
    Released on J-STAGE: April 20, 2017
    JOURNAL FREE ACCESS
    Purpose : In the first report (Journal of Japan Academy of Community Health Nursing, Vol.2, No.1), focusing on the power of care to facilitate growth, as described by M. Mayeroff, we analyzed the elements necessary for home care and the abilities of visiting nurses. The analysis was performed by using the data of 6 nonvoluntary cases who were under home care, and their visiting nurses. Upon analysis, we found another 10 elements in additionto the 8 identified by Mayeroff. Among these elements, intervention with certain intentions, getting involved, remaining involved, and withdrawing are characteristic in the field of home care. Their validity, however, were not clarified because of the shortage in the number of cases. So, in the present study, we aimed to examine the validity of the elements necessary for home care by analyzing additional cases. Method : The subjects of this study were 5 nonvoluntary cases and 4 visiting nurses. The cases were reported at the annual case conference in 1999. We used the same method as used in our first report. The nurses' oral presentations to the meeting were written down as faithfully as possible, Without any added interpretations. The printed records were then confirmed and corrected by the presenting nurses. The data thus obtained was analyzed using content analysis, with an emphasis on studying growth in the cases and the nurses. The validity of the selected elements was examined considering the results of our first report. Result : Sixteen elements of care were selected. They were listening, changing rhythms, courage, getting involved, remaining involved, coordination, empowering, acceptance, withdrawing, practical use of professional knowledge, skill, responsibility, humility, touching, safety, balancing, and intentional participation. All of the elements, except practical use of professional knowledge, skill, responsibility, safety, and balancing had been found in the first report. Among them, the following 4 elements were also extracted in the first report : intentional participation, coordination, empowering, and remaining involved. Since these 4 elements were also common to all cases in this study, they are thought to have high Validity. Among these, intentional participation, which was regarded merely as one of the elements, was evaluated to be the host category which subsumes the other 15 elements in the present study. In other words, "intentional participation" is the prerequisite for longterm home care. A newly identified element of "balancing" was extracted from a case in which there was a gap between the clients' needs and the care provided, due to insufficient assessment of the family's ability to cope. Therefore, as for the validity of "balancing", the necessity of subsequent examination was suggested.
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  • Naoko Sakurai, Minako Sasaki, Keiko Kono, Yoshiko Yamaguchi, Noriko Ni ...
    Article type: Article
    2002Volume 5Issue 1 Pages 21-27
    Published: May 15, 2002
    Released on J-STAGE: April 20, 2017
    JOURNAL FREE ACCESS
    The purpose of this study was as follows; Clarifying the requisites to strengthen and expand partnerships between community health services and occupational health services in local governments, and suggesting concrete schemes for making and supporting collaborations. In 2000, we conducted a postal survey about present collaborations between community health and occupational health, sending postcards with a reply-paid card to all Health Care Centers and local governments in Japan. Selecting those which actively were collaborating with occupational health or providing health care for employees of small enterprises. We also interviewed 5 local governments. Among those interviewed, we selected five local governments which continued collaboration with occupational health systematically, and analyzed the collaboration patterns along 5 Health Promotion Strategies in Ottawa Charter namely Build Healthy Public Policy, Create a Supportive Environment, Strengthen Community Action, Develop Personal Skills & Reorient Health Services. The results were : (1)Local governments made efforts to set up a system for collaborations between community health and occupational health, and to give skills support and financial support to strengthen the linkage between community health and occupational health. (2)Public health nurses attached importance to "Keeping to close relationship with occupational health personals", "Visiting worksite", "Prioritizing the needs and benefits of companies". It was suggested that the most important factor to promote the linkage of both was "making the system for collaborations between community health and occupational health".
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  • Kazuko Saeki, Hisako Izumi, Noriko Hirano, Kinko Kato
    Article type: Article
    2002Volume 5Issue 1 Pages 28-35
    Published: May 15, 2002
    Released on J-STAGE: April 20, 2017
    JOURNAL FREE ACCESS
    The number of nursing universities in Japan has been increasing and students are required to learn the basic community nursing courses that have been added to the previously established program. An educational assessment model based on the "community as a partner" model in community nursing was developed. It was to facilitate the understanding for assessing the community and their clinical judgment skills. Procedure : A trial model was used for lectures, exercises, and community nursing practicums. One hundred and six nursing students participated in the evaluation of the model based on its accuracy and usefulness using a questionnaire in 1999 through 2000. In addition, 30 clinical supervisors and four public health nursing educators evaluated the degree of accuracy and appropriateness of the students' community assessment since this model aimed to facilitate nursing students to learn and apply community assessment skills in the course of community nursing. Then, the model was revised to S2000. Results : Students indicated the effectiveness of the S2000 for assessing community health conditions, and clinical supervisors and educators evaluated the model as a potentially effective tool for educating the community health nursing. Conclusion : The new educational model of the community assessment in the community health nursing was positively evaluated by nursing students, clinical supervisors, and public health nursing educators. Further improvement of the model such as the increased facilitation of nursing students' understanding and their assessing of community health related factors, easily understanding technical terms, establishing standardized assessment points, as well as improving assessment items, and applying results for clinical interventions were suggested.
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  • Miho Tonai, Yoshitaka Murakami, Shuji Tonai
    Article type: Article
    2002Volume 5Issue 1 Pages 36-42
    Published: May 15, 2002
    Released on J-STAGE: April 20, 2017
    JOURNAL FREE ACCESS
    Purpose: The purpose of this study was to develop a visualized model and to assess its usefulness. We developed a model to express the relationship between factors involved in elderly home care. We created a questionnaire for the construction of the model, and investigated the inter-rater reliability of the questionnaire between caregivers and professional caregivers. We then gathered opinions about the model from professional caregivers. Methods : The finished model consists of four elements: the level of care needed, ability of caregiver, caregiver burden, and the comfortable environment of the elderly receiving care. To measure these elements, we made up a questionnaire covering four areas, each consisting of either four or five questions. There were 20 items in the questionnaire. To construct the questionnaire, we drew upon the questionnaire from the Cost of Care Index (Japanese version). To test the inter-rater reliability of the questions, both relatives of the elderly under supervision and the professional caregivers independently evaluated the elderly in their care using the questionnaire. Kappa coefficients and proportion of agreement were used for assessing the inter-rater reliability. We also gathered opinions about the model from 29 professional caregivers by self-administered questionnaire. Results: With the exception of one item (the relationship between caregiver and the care recipient), the Kappa coefficients and proportion of agreement were quite high. Based on the opinions from the professional caregivers, some of them accepted the model for its simplicity, They also noted some problems : lack of utility of model for care planning, discrepancy between the model and present condition of the elderly care recipient. Conclusions : We developed the model to express the relationship among factors involved in caring, for the elderly. To measure these factors, we drew up a questionnaire, and examined the inter-rater reliability of the items between relatives and professional, caregivers. The simplicity of the model and difficulty of assembling detailed information drew the attention of the caregivers.
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  • Tomoko Kamei, Yoko Uchida
    Article type: Article
    2002Volume 5Issue 1 Pages 43-49
    Published: May 15, 2002
    Released on J-STAGE: April 20, 2017
    JOURNAL FREE ACCESS
    Critical path for visit frequency and content during the early period at home were developed. For the purposes of delivering efficient and high quality nursing care during home visits to persons newly started on home oxygen therapy (HOT) at early period. The HOT path provided for four visits at seven to thirty day intervals for two months. For this study, evaluating outcomes for clients and the cost effectiveness ratios for services at total of 20 clients were randomly assigned to 10 clients for HOT path and control groups, and analyzed except one client for HOT path group due to readmission. Three measures were developed for this study. Outcome attainment ratios calculated for 14 care concerns were one measure of service effects. A second measure of effect was goal attainment with regard to five transcending client or nursing concerns. To calculate nursing service costs for each client's hours of direct care and management and coordination related to the client were multiplied by the hourly cost of nursing service. Results: 1) Outcome attainment ratios were higher for the HOT path group, and significantly higher for the care concerns of disease management, physiotherapy, self-care, excretion, and cleanliness; 2) Goal attainment was significantly higher for the HOT path group for "home oxygen therapy can be safely carried out", and "resuming daily life before the home oxygen therapy started; 3) The cost-effectiveness ratios were higher for the HOT path group, outcome attainment ratios and goal attainment were significantly higher in comparison to the control group. These results suggest the overall effectiveness of the HOT path, but we need to examine additional clients to solidify our results.
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  • Hisae Nakatani, Setsu Shimanouchi, Mie Izumune, Naomi Namiki, Nanako A ...
    Article type: Article
    2002Volume 5Issue 1 Pages 50-55
    Published: May 15, 2002
    Released on J-STAGE: April 20, 2017
    JOURNAL FREE ACCESS
    The purpose of this study was to clarify the whole of needs and expression and characteristics of needs of clients that public health nurse and home visiting nurse used home care services. Subjects were 160 public health nurses (132) and home visiting nurses (28) who were responsible for care management of the clients living in "Y" prefecture to became home care clients in 1998 and 2000. After three-month follow-up of their clients services under the care management system of the long-term care insurance, the care managers filled-in the questionnaire and returned them to us. It consisted of demographic variables of clients and care manager's, needs and assistant goals described in care plan, and, services the clients actually received. For an analysis of the needs, seven nurses who have home care experiences for more than 9 years classified the need cards by the KJ method. A need, its assistant goals and a kind of service were described in each card that represented the needs for one analysis unit. As a result, we obtained, responses to 142 clients from 109 public health nurses (84) and home visiting nurses (25). 142 clients had 862 needs, and there were 11 areas in large, 47 items in small classifications. Health management (24.0), care (15.9) and activities of daily living (15.4) were common in large classification. There were mainly two methods to express the needs ; expressing the noun (0.9) and the sentences (99.1). The characteristics of needs were (1) briefly summarizing points, of the obvious problems and future prediction, (2) the expression of the professional word in medical treatment uses. There results suggest that care managers require techniques and competencies to appropriately assess and easily explain the clients' needs.
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  • Reiko Okamoto, Kimiko Nakayama, Misa Shiomi, Saori Iwamoto, Yuko Okita
    Article type: Article
    2002Volume 5Issue 1 Pages 56-64
    Published: May 15, 2002
    Released on J-STAGE: April 20, 2017
    JOURNAL FREE ACCESS
    The purpose of this study was to develop a tool that enables community care specialists, such as public health nurses, to perform comprehensive assessment to identify elderly people in whom future health care needs may develop, and also enables elderly people themselves to simply assess factors that affect healthy long life. To collect items for comprehensive assessment, we conducted a group interview with 8 public health nurses and evaluated the literature. From the obtained items, some were selected by the researchers and the public health nurses, and a survey was performed on public health nurses (effective replies, 137) with 5 or more years of experience to perform weighting of each item and determine the validity of the contents. As a result, 50 items associated with care prevention needs were divided into the following 8 categories: 1) health promotion by elderly people themselves, 2) physical condition, 3) nature of daily living, 4) social contact, activity, 5) housing and surrounding environment, 6) family conditions, 7) changes in the surroundings or feelings, and 8) supporters and the use of services. This assessment tool contained items from the professional view of community nursing that are not incorporated in the existing assessment tools, such as health promotion by elderly people themselves, living rhythm, and life events. Further studies are necessary on assessment criteria and measures to make the best use of obtained results for the activities of public health nurses.
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  • Chisako Sakakibara, Hiroko Furuzawa
    Article type: Article
    2002Volume 5Issue 1 Pages 65-69
    Published: May 15, 2002
    Released on J-STAGE: April 20, 2017
    JOURNAL FREE ACCESS
  • Masako Kaneko, Hiroko Endo
    Article type: Article
    2002Volume 5Issue 1 Pages 70-77
    Published: May 15, 2002
    Released on J-STAGE: April 20, 2017
    JOURNAL FREE ACCESS
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