Development of a Social Activities Scale for Community-Dwelling Older Men Requiring Support in Japan

Aim: We developed a scale to measure the social activities of community-dwelling older men requiring support. Methods: The participants were a group of 134 men, ≥65 years old, who required support and were living in Hokkaido, Japan. An anonymous questionnaire was administered through individual interviews. Valid responses were obtained from 121/134 interviewees. The construct validity of the resulting scale was assessed by exploratory factor analysis (EFA). Criterion-related validity was tested with Spearman’s rank correlation test based on the Social Activities Index for Elderly People (SAI-E). Reliability was assessed by Cronbach’s alpha. Results: A Social Activities Scale for Community-dwelling Older Men Requiring Support (SASOMS) scale was created, comprised of the following three subscales: daily interactions with familiar people;intimate relationships with family members;and interactions with others through activity programs (e.g., exercise, games, recreation, etc.). The created SASOMS scale correlated with the SAI-E (r = 0.557), and its criterion-related validity was confirmed. The alpha coefficient of the new scale was 0.791, and its internal consistency was confirmed. Conclusions: The reliability and validity of the developed SASOMS scale was confirmed, demonstrating that it can be used to assess social activities specifically in older men requiring support. Our results suggest that the scale can be used effectively by care providers who support older men requiring care. The usability of the SASOMS should continue to be improved, and it is necessary to verify its validity in longitudinal studies.

Evaluation of the effects of a leader-training program on public health nurse leadership for staff in Japan

This paper is a report of a study of the effects of a leader-training program, focusing on how public health nurse (PHN) leaders manage staff. In Japan, a system of training after graduation or training after acquisition of the PHN license has not been established. At present, PHN leaders are unable to devote as much time as they previously could to in-service education, and this has made it difficult to establish a suitable full-fledged in-service education system. Therefore, it is paramount for PHN leaders to acquire the necessary competence to train staff efficiently and, ultimately, play a more prominent role in the in-service education of novice PHNs. The effecttiveness of this program was evaluated before and after conducting the program over a 1-year period. A total of 145 leaders working for local government agencies in Japan participated in the program, and data from 87 participants were analyzed. Before the training program, Plan-Do-Check-Act cycle activities were less frequent than after the program. Intervention using a leader-training program that combines group and on-the-job training is effective for PHN leaders.

Public health nurse observations of behavioral characteristics of fathers who contribute to the emotional instability of mothers, as presented in cases of infant abuse

The objective of this study is to look at the understanding and perceptions of public health nurses (PHNs) related to behavioral characteristics of fathers that contribute to emotional instability in mothers by reviewing abuse cases involving infants and very young children. A qualitative descriptive design was applied to the data analysis, based on a semi-structured interview administered to three experienced PHNs who had been in charge of maternal and child health services for at least five years at a public health department or health center;with the data obtained in the interview narratives analyzed. In the observations of the experienced PHNs, the behavioral characteristics of fathers who are instigators of child abuse can be classified into five categories, fathers who are: “Talking to others about marital problems without attempting to solve these by themselves”, “Working on learning about childcare seeking to correct childcare methods”, “Taking the initiative in childcare at cross purposes with mothers”, “Stressing the effort they (the fathers) put into childcare”, and “Failing to notice the own family situation and problems”. The findings of the study suggest the necessity for PHNs to understand fathers, to be aware of the difficulty of building a supportive relationship with fathers, and to improve skills enabling the PHNs to help fathers form good relationships with other family members.

Psychosocial Characteristics of Fathers Who Have Abused Their Children as Seen by Public Health Nurses

This study aims to identify details of the psychosocial characteristics of fathers who have abused children as they appear to public health nurses (PHNs). In this study a qualitative descriptive design was applied to the data analysis. Interviewees were 10 public health nurses (PHNs), in charge of maternal and child health services for 5 or more years at public health centers. The study analyzed 13 cases reported in the PHNs interviews. The characteristics of the fathers who had abused children as seen by the PHNs were the psycho-social characteristics of ‘weak suppression and control of impulsiveness’, ‘cognitive dissonance in the fatherhood role’, ‘poor social sensitivity’, ‘unbalanced relationship with other members of the family’ and ‘weak relationships with people around the father’. The father’s impulsiveness and cognitive dissonances in the fatherhood role are associated with weaknesses in the family relationships and social adaptation. Conversely, the weakness in the strength of family relationships and social adaptation affects the father’s ability to control impulsiveness and give rise to the cognitive dissonance in the fatherhood role. These in turn interact to create a negative downward spiral, a steadily worsening situation. The findings of this study suggest the necessity for PHNs to focus on the background to the cognitive dissonance in the fatherhood role and to work to educate and guide the fathers.

Depression prevention program for workers of private companies: A randomized controlled trial

Objective: The aim of this study was to examine the effects of a depression prevention program based on stress inoculation training (SIT) for workers of two private companies, by means of a randomized controlled trial. Method: Ninety three workers of two private companies were assigned to intervention and control groups, and two sessions were conducted in the intervention group of each company at an interval of four weeks. The sessions included lectures on responses to stress and coping skills, problem-solving training, cognitive restructuring training, relaxation, group discussions and self-monitoring. After completing the sessions, two follow-up letters were sent to the participants at two-month intervals. Data from 38 intervention subjects and 39 control subjects were analyzed. Results: There were no major differences between the variables of intervention subjects and control subjects. After two sessions, there was a marginally significant increase of seeking social support in the intervention group (P = 0.052) and a significant decrease of avoidance in both groups (P < 0.05). Concerning the depression score changes, the “Improvement” group of the intervention subjects showed an adjusted OR of 6.83 that was higher compared to the control group, indicating a marginally significant difference (P = 0.083). Conclusion: The results suggest the possibility that the SIT-based program of this study was effective for improving coping and preventing depression. Further research is necessary to develop a depression prevention program adjusted to gender, individual, occupational and other differences of subjects.

Support Provided by Public Health Nurses for Fathers Who Have Abused Their Children—As Observed in Cases of Child Neglect and Physical or Psychological Abuse

This study aims to identify the support to provide to fathers who have abused children as reported by public health nurses (PHNs). In this study, a qualitative descriptive design was applied to the data analysis. Interviewees were 10 public health nurses (PHNs) in charge of child abuse services for at least 5 years at public health centers. The study analyzed 13 cases reported in the interviews. Measures to support fathers who abuse their children as suggested by PHNs were classified into direct support to the father, support to other family members, and support to be provided by others involved including related organizations. The direct support to the father includes “gaining an in-depth understanding of the abusive situation and psychological states of those involved”, “refraining from involvement in areas where it is difficult to understand the personality of the father”, and others. Support of other family members includes “understanding the marital relationship and assessing the qualities of the relationship”, “refraining from matters that will involve divorce”, and others. Support to be provided by others including related organizations includes “understanding the value of social exchange and assessment of the ability to create and maintain interpersonal relationships”, “establishing support arrangements to enable intervention when necessary”, and others. The interviews report that PHNs arrange support measures that enable intervention as it becomes required, and that this enables learning about child-abuse preventing activities.