Japanese development and testing of the network establishment practices scale for community and public health nurses.

The practices required by community and public health nurses to establish community networks mainly involve communicative competencies. Assessment through development and testing of such competencies is necessary for community and public health nurse educators and practitioners around the world to create and maintain a mutual support network. The purpose of this study was to develop and test a scale for community and public health nurse practices to establish and maintain community networks, and to then determine construct validity in a factorial structure model. The participants were 3970 community and public health nurses in Japan. A 43-item list was developed from a literature review, individual interviews, and repeated examinations. The secondary structural model consisted of four factors with 21 items. The internal consistency of the 21 items was highly reliable (Cronbach's α = 0.915). Confirmatory factor analysis by structural equation modeling showed the fit criteria to be statistically significant. Attributes of the community and public health nurses (age, years of experience, work municipalities, work positions, and educational institutions) showed significant relationships with the scale scores. The findings validated the efficacy of the Network Establishment Practices Scale to assess community and public health nurse practices to establish community networks.

Validity and reliability of the community-environmental index regarding daily living among the mental disorders in community: an assessment instrument based on community nursing activity.

The purpose of this study was to examine validity and reliability of a community-environmental assessment instrument analysing community-environmental conditions among the mental disorders in a community. Thirty-three factors were extracted from the data based on a nationwide investigation by the factor analysis. The principal component analysis was applied to these extracted factors, and the first principal component score (1PCS) was interpreted as a synthetic index regarding daily living of the mental disorders in the community. Then, validity and reliability of 1PCS were confirmed. The item analyses from a viewpoint of statistics processing were adopted. As a result, coefficient alpha of the reliability was calculated from the scores and variances, and its value was 0.96. Next, kappa statistic was calculated in order to confirm whether two indices derived from the 52-item and 33-item questionnaires had the correspondence of the actual conditions with 1PCS in regard to the population scale of the municipality. As a result, the kappa was 0.94. In this study, we proposed the 33-item questionnaire composed of 33 factors. This was called as the Morita's community-environmental index (MCEI). It was suggested that the MCEI was useful to assess community-environmental conditions regarding daily living of the mental disorders in the community.

Postural stability and physical performance in social dancers.

This cross-sectional study examined the benefits of social dancing on postural stability and physical performance in dancers aged 50 years or more. Walking speed, lower limb reaction time and low back flexibility were measured in 202 social dancers and 202 community-dwelling comparison subjects aged 50-87 years. The results showed that dancers who were older than 60 years had better postural stability and faster leg reaction times, whilst dancers aged 50-59 showed only better flexibility, when compared with the controls. Male dancers had greater low back flexibility and leg reaction time compared to controls. In contrast, female dancers had superior performance only for leg reaction time when compared with controls. The results indicate that social dancing is associated with enhanced postural stability and physical performance in older adults.

Multidimensional structures of comprehensive accessibility of community support for people with mental disorders in Japan: a nationwide investigation.

The purpose of this study was to define the concept of comprehensive accessibility of community support for people with mental disorders and to clarify the multidimensional structures of comprehensive accessibility. We developed a self-administered questionnaire consisting of 47 items. A complete list of the municipalities in Japan was prepared, and the questionnaire was mailed to 3310 municipalities. Principal component analyses were applied to valid data in order to analyse the index and multidimensional structures of comprehensive accessibility. As a result, 14 principal components of community support for people with mental disorders were extracted. These principal components were interpreted as the scales for the evaluation of comprehensive accessibility. The two first principal component scores were interpreted as the index indicating the level of comprehensive accessibility. The other 12 principal components were interpreted as the scales constituting the multidimensional space of comprehensive accessibility.

The effects of Tai Chi Chuan on physiological function and fear of falling in the less robust elderly: an intervention study for preventing falls.

The aim of this report is to investigate the effects of 8 weeks of intensive Tai Chi Chuan (TCC) training on physiological function and fear of falling (FOF) in the less-robust elderly. Forty-nine community-dwelling elderly, aged 60 or older, were classified randomly into a TCC training or control group. Physical performance measures (including one-leg stance, trunk flexion, and walking speed) and interviews were conducted before and after the intervention. The TCC group showed significant improvements in balance and flexibility, and a reduced FOF, when compared with the control group after the intervention. However, walking speed did not change significantly. The results suggest that a high-frequency, short-term TCC training program can improve balance, flexibility, and increase the confidence of less-robust elderly. These suggest the effectiveness of TCC for intervention as a means to prevent falling among high-risk elderly populations.

Nationwide study of environmental assessment for people with schizophrenia in Japan.

The purpose of the present study was to develop an environmental assessment tool related to the living of the mentally disabled and to examine the health care professionals' perception of the current situations and its importance. The relationships between the current and ideal environmental situations were analyzed. The survey was conducted at 3310 municipalities nationwide by mailing self-report questionnaires, which consisted of 52 items developed by specialists for the mentally disabled and their families. The 52-item questionnaire was rated with a five-point scale for both current and important environmental situations. The main findings included statistically significant differences between the mean scores of the current and important environmental situations, items perceived as important at a similar degree, and those suggesting the largest gap between the current and important situations related to learning opportunities. These results could be useful for implementation in community health nursing.

[A quantitative and qualitative study on effective information flow for infectious disease control in welfare facilities for the elderly].

OBJECTIVES: To clarify factors associated with effective information tranges among staff of welfare facilities for the elderly, and to propose measures for an appropriate information flow system in welfare facilities and public health centers, communication channels and methods, and encouraging factors and barriers were investigated in terms of a printed medium on the control and management of scabies infections. METHODS: A self-administered questionnaire survey and an interview survey were conducted with the staff of welfare facilities for the elderly where "Control and management manual of scabies infection" had been distributed by the Tama-Tachikawa Public Health Center in Tokyo. A self-administered questionnaire was sent to managers and chief practitioners of 66 facilities. Respondents were obtained from 66 managers and chief practitioners (response rate: 84.8%), and 831 practitioners (response rate: 53.1%). The questionnaire consisted of 20 items for managers and 18 items for chief practitioners, including experience of scabies epidemics in facilities, training experience for the use of "Control and management manual of scabies infection," measures for information gathering, and current information flow within the facility. A semi-structured interview survey was conducted with the manager and/or chief practitioner and practitioners in five facilities. The number of respondents was 10. The interview questions included job description, scabies control measures, dissemination of the manual to the staff, use of the manual, flows of health-related information, and factors associated with information flows. Summarized codes were extracted from the transcriptions from tape recording and were categorized repeatedly according to similarity. RESULTS: In the questionnaire survey, differences of Community information flow by types of facilities and professional backgrounds were found. Variation was detected in measures for information gathering and focuses in information management between managers/chief practitioners and practitioners. Practitioners wanted opportunities for information exchange while managers/chief practitioners mainly focused on prioritization of information collected. In addition, many respondents felt that information networks outside the facilities were poorly organized. From the interview survey, three major categories were extracted, that is, 'Information flow system,' 'Personal qualification,' and 'Factors related to the information flow system.' As factors related to the information flow system, the following 7 subcategories were extracted. 1. Interest in information; 2. Working style and workload; 3. Information networks outside the facility; 4. Information management in the facility; 5. Environment for information sharing; 6. Budget for the information system; and 7. Interpersonal communication. CONCLUSIONS: For an effective information system, welfare facilities for the elderly should work on staff training, building their own information flow systems and improving the environment for information sharing and networking with specialized agencies, such as public health centers. At the same time, public health centers should support networking, interpersonal two-way communication and training of welfare-facility workers.