[Activities of Japanese Occupational Health Service Centers].

OBJECTIVES: Although both occupational health centers and occupational health service centers (OHSCs) support small-scale enterprises in Japan, the activities of OHSCs are not well detailed. This survey aimed to clarify the activities and subjective evaluation by directors and coordinators of OHSCs, with a focus on improving occupational health services in small-scale enterprises. METHODS: The survey was conducted by mailing questionnaires to 377 directors and 507 coordinators at 344 OHSCs in Japan from September 2016 to January 2017. The survey items comprised questions about director and coordinator characteristics, OHSCs' systems and activities, and subjective evaluations of OHSCs' activities. RESULTS: Responses were obtained from 290 directors (76.9%) and 413 coordinators (81.5%) of OHSCs. Of the directors, 66.2% were occupational health directors of medical associations. The average number of years' experience for coordinators was 5.7 years, and 44.6% were specially qualified, most as health officers. The percentage of OHSC staff who were not coordinators was 22%, and 29.8% of OHSCs had a public health nurse. The Office of Labor Standard's guidance was most often cited as the reason why small-scale enterprises decided to use OHSCs. At least 90% of OHSC directors and coordinators evaluated OHSCs' activities as "good". Directors not consulted by a coordinator evaluated OHSCs' activities as "very good" significantly more often than directors who were consulted by a coordinator (p<.001). Similarly, directors not consulted by occupational health centers' members evaluated OHSCs' activities as "very good" significantly more often than directors who were consulted by occupational health centers' members (p<.006). Coordinators who were in charge of two or more regions medical associations evaluated OHSCs' activities as "very good" significantly more often than those who were in charge of only one regions medical association (p=.014).Coordinators who had qualification of occupational health evaluated OHSCs' activities as "very good" significantly more often than coordinators who had not (p=.007). Coordinators who conducted public relations activities evaluated OHSCs' activities as "very good" significantly more often than those who did not (p=.011). Similarly, coordinators who conducted public relations activities via email and homepage promotions evaluated OHSCs' activities as "very good" significantly more often than those who did not (p<.001). In addition, coordinators who used the consultation record evaluated OHSCs' activities as "very good" significantly more often than those who did not (p<.001), whereas coordinators who consulted with a director evaluated OHSCs' activities as "very good" significantly more often than those who did not (p=.028). Coordinators who thought doctors were fit for the OHSCs' activities had significantly higher percentages of qualifications than those who did not think this way (p=.032). Likewise, coordinators who conducted public relations activities had significantly higher percentages of qualifications than those who did not (p<.001), whereas coordinators who used the consultation record had significantly higher percentages of qualifications than those who did not (p=.006). CONCLUSIONS: This survey clarified OHSCs' activities and suggested that systems and activities are not the same across OHSCs. We found that coordinators need to master knowledge of occupational health and work support. In addition, improving the relationship between directors and coordinators, enhancing public relations activities, and utilizing tools such as a chart improved OHSCs' activities.

[Correlates of mental health in Japanese caseworkers employed at social welfare offices].

OBJECTIVES: The aim of this study was to evaluate the correlation between the mental health status of caseworkers at welfare offices and factors affecting mental health (i.e., working conditions, participation in training courses and workshops, lifestyle habits, presence of illness, social support, and self-efficacy). METHODS: The welfare offices in Japan (1,230 locations) were arranged in descending order according to their establishment and region. Systematic sampling was then conducted to select 20% (n =246) of the welfare institutions for this study. A total of 1,230 caseworkers on welfare (five from each institution) were administered anonymous self-completed questionnaires. The questionnaires involved the General Health Questionnaire (GHQ)-28 Japanese version and questions regarding basic attributes, working conditions, social support (i.e., family, friends, superiors, and colleagues), participation in training courses and workshops, presence of illness, lifestyle habits, mental health, and self-efficacy. Subjects were divided into the following 2 groups: low-score group (GHQ-28 score ≤5) and high-score group (GHQ-28 score ≥6). Data were analyzed using a t-test, χ(2) test, and Fisher's exact test. The GHQ-28 high- and low-score groups were considered gender-specific dependent variables due to the sex differences observed in the univariate analysis. Significant variables in the univariate analysis were considered independent variables in the multiple logistic regression analysis (forward stepwise selection). RESULTS: Five hundred and six people (410 male and 96 female) provided valid responses. Most respondents had poor mental health (66%, high-score group; 34%, low-score group). Both men and women who worked ≥10 hours/day had significantly poorer mental health than individuals who worked ≤9 hours/day. Individuals with low self-efficacy had significantly poorer mental health compared to people with high self-efficacy. Men who were able to maintain moderate hours of sleep and received support from colleagues, friends, and family had good mental health. Among women, mental health deteriorated with age. Furthermore, women who devoted most work time to home visit had good mental health. CONCLUSION: The mental health of caseworkers at welfare offices can be improved by reducing overtime work hours, ensuring sufficient hours of sleep for each worker, and fostering supportive communication and self-efficacy in the workplace. Furthermore, sex differences should be considered when assessing the mental health of workers at welfare offices in Japan.

Effects of exercise on the prevention of conditions leading to the need for long-term care.

BACKGROUND: Intervention strategies for 'prevention of conditions leading to the need for long-term care' (prevention of long-term care status) that have physically and mentally proven effects are needed. OBJECTIVE: The aim of this randomized controlled trial was to clarify the physical and psycho-social effects of an exercise program, easily performed at home and in communities using inexpensive equipments for prevention of long-term care status. METHODS: A cluster of 196 participants was randomly assigned to the intervention group that performed the exercise for 8 weeks and the control group. Both groups received tests for physical strength and endurance and interview surveys at baseline and 9 weeks later. The exercise consisted of six types of stretching exercises, six types of muscle strength training, two types of balance training and toe stretching in order to improve ambulatory, balance and stability ability of elderly. The physical aspects of the subjects were assessed by balance assessment, activities of daily living (ADL), timed up-and-go test (TUG), functional reach test (FRT), sit and reach. The psycho-social aspects were assessed by the fall prevention self-efficacy scale (FPSE), instrumental activities of daily living (IADL), degree of houseboundness, and assessment at the end of intervention. RESULTS: The intervention and control groups consisted of 101 and 81 persons at the baseline and 92 and 74 after intervention, respectively. The intervention group showed significantly higher values than the control group after exercise in the FRT, the FPSE and degree of houseboundness. CONCLUSION: This exercise program can promote physical and psycho-social aspects of the health in the elderly, and may reduce the amount of care that the elderly require.

Retraction: Effects of exercise on the prevention of conditions leading to the need for long-term care.

The paper entitled "Effects of Exercise on the Prevention of Conditions Leading to the Need for Long-term Care" by M. Ohtake et al, which was published online on 2 November 2010, has been withdrawn at the authors' request.