[Cancer screening rates and characteristics of low-participating groups in Sapporo city].

Objectives　The purpose of this study was to assess the situation of regional cancer screening of individuals in Sapporo city through an independent survey and to identify groups with low cancer screening rates.Methods　We conducted a self-administered questionnaire survey on 3,000 men aged 40 to 69 years and 4,000 women aged 20 to 69 years living in Sapporo (response rate = 32.4%). The contents of the survey were quoted from the health slips of the Comprehensive Survey of Living Conditions related to cancer screening, as well as basic and cancer-related attributes. We analyzed the relationship between cancer screening participation rate, basic attributes, and cancer-related attributes using the χ2 test or logistic regression analysis.Results　The screening rates recorded in this study for gastric, colon, and lung cancers were 67.4%, 59.2%, and 66.1%, respectively in men, and 48.7%, 47.7%, and 53.4%, respectively in women. The screening rates were 52.7% and 56.1% for uterine and breast cancers, respectively.　The participation rate of non-working individuals and those who had National Health Insurance was significantly lower for all cancer types among both men and women. Regarding attributes and cancer screening, the odds ratio of working to non-working individuals was 3.00 to 3.09 in men and 1.41 to 2.46 in women. The odds ratio of non-National Health Insurance individuals was 3.47 to 4.26 in men and 1.47 to 2.52 in women. In addition, there was a significant association between awareness and rates of Sapporo city cancer screening in both men and women, with the exception of stomach cancer screening in women. Furthermore, the odds ratio of awareness was 1.41 to 1.74 in men and 1.24 to 1.48 in women.Conclusion　The cancer types with screening rate below 50% were gastric and colon cancers in women. In men, the screening rate for gastric, colon, and lung cancers exceeded 50%. The cancer-screening rate was found to be low among both non-working men and women, those with national health insurance, or those who do not recognize the Sapporo city cancer screening (regional screening). The characteristics of the group with low participation status in Sapporo city, which was the only parameter not reported in the Comprehensive Survey of Living Conditions, has been clarified.

Developing a comprehensive career development scale for public health nurses in Japan.

OBJECTIVES: This study aims to develop a scale that can comprehensively measure public health nurses'(PHNs) career development and to verify the validity and reliability of that scale. DESIGN AND SAMPLES: This study is a cross-sectional investigation. The participants were 1,009 PHNs working in a government facility in Japan. A total of 586 participants who had been working for more than 3 years as PHNs were analyzed. MEASUREMENTS: Anonymous self-response questionnaires included items on professional awareness, practical competency, and job satisfaction. We conducted exploratory factor analysis and confirmatory factor analysis to clarify the construct validity of the scale. The reliability was examined by the Cronbach's α coefficient. The validity was examined by an external reference relevant validity and the known-group method. RESULTS: The scale was structured with 32 items covering three factors: "community activities, policy, and management," "PHN identity," and "foundations as a PHN." The Cronbach's α coefficients were all greater than 0.9. In confirmatory factor analysis, the scale showed acceptable goodness of fit. CONCLUSIONS: The comprehensive career development scale for PHNs proved its reliability and validity. This scale may be useful to promote PHN identity and competency comprehensively in basic education and in-charge education.

[Risk perception of tsunamis and the willingness to evacuate of junior high school students living in coastal areas].

Objective　Students find it difficult to take the decision to evacuate from tsunamis. This study explores junior high school students' risk perception regarding tsunamis and their willingness to evacuate.Methods　The study surveyed 251 junior high school students from the 7th to 9th grades in Town B, located at the east coast of Prefecture A, Japan, using data from an anonymous questionnaire that was administered with parental consent. Demographic factors (school, grade, and gender), willingness to evacuate, risk perception, tsunami experiences, recognition of tsunami hazard households, and household preventive actions were evaluated. Pearson's chi-squared test and Fisher's exact test were used to analyze the relationship between risk perception and willingness to evacuate. The study was approved by the Ethics Committee of Hokkaido University.Results　Valid data were collected from 158 students (62.9%). Of these, 141 (89.2%) were enrolled in a school located in a coastal area. Male students accounted for 81 responses (51.3%) and female students for 77 (48.7%). As for willingness to evacuate, 147 (93.0%) responded that they would evacuate if they heard an evacuation order and 112 (70.9%) responded that they would evacuate if they experienced a persistent tremor. Regarding household altitude, 66 (41.8%) of the students live in houses located less than 15 meters above sea level. The results indicate that 125 (79.1%) of the students discuss tsunamis with their family members. The primary factor promoting the willingness to evacuate after hearing an evacuation order is living in a household under 15 meters in altitude (100% vs. 82.4%, P<0.001) and the major factors for willingness to evacuate after feeling a persistent tremor are living in a household under 15 meters in altitude (84.8% vs. 35.3%, P<0.001) and discussing tsunamis with their families (76.8% vs. 48.5%, P=0.001).Conclusion　The results suggest that to promote a willingness to evacuate immediately, recognizing the household's altitude is important, as it can give junior high school students a clearer sense of the danger of tsunamis. In addition, the study suggests that discussing the matter within families is a significant factor that promotes willingness to evacuate.

Social activities of older men who require daily support and the purpose of such activities.

Objectives The purpose of this study was to analyze the social activities of older men who require daily support, and to clarify the purpose of such activities, in order to develop effective living support and preventive long-term care service, suitable for this population.Methods Individual, semi-structured interviews were conducted with 17 older men. Data were analyzed using inductive and qualitative methods.Results Four categories of social activities were identified, and four categories of purposes of these social activities were extracted. The following were the identified social activities: maintenance of "comfortable relationships with others," including family, relatives, friends, and neighbors; "participation and use of services and programs with clear objectives and relationships with others," such as long-term care insurance system services, clubs for the elderly, and hobby groups; maintenance of "relationships with former colleagues, depending on their experience of working with them," where some individuals actively participated in gatherings with former colleagues, while others did not keep in touch at all; and participation in "activities to enrich their feelings and quality of life within their living space," such as reading, watching TV, and doing household chores. The purposes of the observed social activities were to build "relationships with society through communication with other people" and to have a "sense of security by spending time with people of the same age and with those older than them." Hence, participants engaged in clubs for the elderly, as well as in hobby groups. In addition, participants made time for exercising regularly, which maintained their cognitive function and was intended for the "maintenance and activation of their physical functions by continuing to exercise," and "continuing to learn by thinking." Furthermore, participants engaged in the exercise or hobby groups that they were interested in, in order to "utilize their time in a meaningful way" that lead to pleasure and enjoyment.Conclusion The following were the characteristics of the observed social activities: (1) the activities helped participants to maintain relationships with their coworkers, (2) participants had comfortable relationships with others, with these relationships exhibiting different levels (i.e. intimate relationships or casual), and (3) participants actively followed current events. They have clear purpose join and participate in social activities. In addition, it is suggested that this population engage in social activities to enrich physical function and overall quality of life.

[Relationship between personal trust and parental feelings of parents of children aged 3 years. Differences between the characteristics of fathers and mothers].

OBJECTIVES: In modern society, which is said to lack human relationships, an individual's personal ability to build relationships has gained great importance. The purpose of this study was to define the relationship between the parental feelings of parents of children aged 3 years and a personal trust (PT) scale developed by the author. We also clarified the differences between fathers and mothers with regard to PT. METHODS: The study sample comprised 329 parents (134 fathers, 195 mothers) of children who underwent the health examination for children aged 3 years in 2008 in City A, Japan. We distributed questionnaire forms to the participants before the examination and collected the completed forms on the day of the health examination. The PT scale consists of 3 subscales: (1) strategic trust for building bonds (ST), (2) universal trust toward the general public (UT), and (3) trust toward specific persons (TS). First, subscale scores were summed up for fathers and mothers. Next, confounding factors were investigated by comparing the median subscale scores obtained for different demographic groups. Next, we performed logistic regression analysis to investigate the influence of PT, which was evaluated using the 3 subscales, on parental feelings. RESULTS: We identified the confounding factors by comparing the median scores of each subscale for different demographic groups. A group of parents whose birthplace was City A had a high ST score. Next, compared to unemployed mothers, working mothers had higher ST and TS scores. Furthermore, mothers of male children had higher ST scores than those of female children. We performed multivariate logistic regression analysis to investigate the psychological parental variables affected by PT calculated using each of the subscales. The results indicated the ST and TS scores affects parental feelings of fathers. However, the UT scores had no effect on parental feelings of fathers. In the case of mothers, the ST, TS, and UT scores affects parental feelings but the ST scores had no effect on parental feelings after adjusting for confounding factors. CONCLUSION: The PT scale reflected the socializing patterns of parents with various communities. We confirmed that PT promoted parental happiness and buffered parenting-related stress. However, there was a difference between the characteristics of fathers and mothers in relationships between parental feelinfs and PT. For example, in the case of fathers, there was no significant relationship between parental feelings and UT.

Social prescription for isolated parenting in Japan: Socioeconomic characteristics of mothers with weak social connectivity in their community.

The social connection of mothers is important for the sound development of children and the prevention of child maltreatment. Understanding the attributes of mothers at risk of isolation enables community workers to support vulnerable mothers. This cross-sectional study aimed to identify the socioeconomic predictors of isolation risk for mothers and was conducted in Japan between December 2018 and February 2019. The self-administered questionnaire included the Social Connectivity of Mother Scale along with maternal age, marital status, employment status, education, number of children, years of child-rearing experience, whether childcare or kindergarten was used, family structure, years of residence, housing type, family finances, and level of neighbourhood interactions. There were 510 valid responses (51.6%). In the multiple regression analysis, five socioeconomic characteristics were associated with mothers' low social connectivity: the standardised coefficient of the maternal age of 20-24 was -0.12 (p = 0.004), lack of childcare or kindergarten usage, -0.09 (p = 0.032), and poor family finances, -0.09 (p = 0.031); mothers' perception of neighbourhood interactions was found to be poor at -0.29 (p < 0.001). The model did not take into account the effects of family finances, and the scores were low when the highest level of education of the mother was junior high or high school. Mothers' perception of neighbourhood interactions was a significant predictor of isolation risk, along with maternal age, education level, and financial comfort. Our findings give policymakers, community workers, and community leaders an insight into the importance of cultivating interactions among neighbourhood communities.

Doctors' contributions to primary care in outpatient clinics in depopulated areas within Hokkaido.

Objective: To examine how doctors who work in outpatient clinics in depopulated areas in Hokkaido contribute to the provision of primary care to residents. Methods: The study adopted a qualitative research design. Six doctors, all of whom were men and in charge of medical clinics located in depopulated areas in Hokkaido, participated in a semi-structured interview. The interviews were recorded using a digital voice recorder. The data were transcribed and classified into codes, subcategories, and categories, and analyzed. Results: A qualitative analysis yielded the following five superordinate categories: (1) clinical praxis in accordance with residents' lifestyles and life stages; (2) innovative care provision based on residents' conditions; (3) provision of routine care in partnership with other healthcare providers and associated stakeholders; (4) beliefs and feelings of pride associated with working as doctors in clinics in depopulated areas; and (5) difficulties in guaranteeing reliable and continuous operation of clinics in depopulated areas. Conclusion: This study successfully identified the specific contributions of doctors working in outpatient clinics in depopulated areas to primary care, as well as the related challenges that they face. Moving forward, researchers should continue to examine how the issues faced by clinics in depopulated areas can be addressed using regional medical care plans.

Social capital in Japan: What characteristics do public health nurses see in their communities?

AIM: A concept of social capital that accounts for a community's cultural background and incorporates social capital into public health nursing practice are needed. This study aimed to describe the characteristics of social capital in the context of public health nursing in Japan. METHODS: The study interviewed 11 veteran public health nurses from five municipalities across Japan and undertook a qualitative research analysis. A digital voice recorder was used to collect qualitative data by using a background data sheet and semistructured interviews. Trustworthiness in interpreting the data was ensured by conducting 13 additional interviews with residents and collating the two sets of results. RESULTS: All the participants were female: 10 were veterans with ≥15 years' experience. Nine worked in management. The methods yielded six categories: (i) the richness of the interactions among the residents; (ii) the community residents who showed concern for those in need; (iii) community civic activities; (iv) the residents' willingness to contribute to the community; (v) the health promotion volunteers who work alongside the public health nurses; and (vi) an enriched community environment. CONCLUSION: The results contribute to an understanding of social capital in the context of public health nursing activities and further research on social capital. It also is discussed how social capital can be incorporated into public health nursing activities in the future.

Relationship-Building Skills of Child-Rearing Mothers in Japanese Communities.

This study elucidated the skills of mothers who used to build positive interpersonal relationships with people they met through child-rearing. The research method was qualitative descriptive study. The participants were 24 mothers who had children between ages of one and four years. These participants were recruited at child-rearing salons and childcare centers located in various municipalities in Japan. The survey period was from September 2013 to July 2014. The mothers' interpersonal relationship-building skills were described by six categories: "ability to strive for new encounters," "ability to try to interact socially with others," "ability to choose compatible people," "ability to continuously maintain good relationships," "ability to take action suitable to a situation," and "ability to build positive relationships with parents-in-law." Cognitive aspects of assessing and understanding the interactions that occur during exchanges and behavioral aspects guided by these cognitions were identified within these skills. This study contributed to providing a framework to understand mothers' interpersonal relationship-building skills for public health nurses involved in child-rearing support.