世古 留美

OBJECTIVE: To clarify the practical actions that experienced nurses working at community general support centers perform to provide comprehensive community care that supports the lifestyles of residents, including older adults. METHODS: The participants were full-time nurses with at least 9 years of experience working at community general support centers in Japan. Semi-structured in-person interviews were conducted between August and December 2023, and the results underwent qualitative descriptive analysis. RESULTS: Ten core categories, twenty-six categories, and eighty-eight subcategories were identified as actions that nurses at community general support centers performed. The 10 core categories were assessment for care prevention, communication that builds trust, networking, promotion of nursing care prevention, coordination of the care team, creation of projects and resources that can be locally implemented, creation of a local care system, teamwork among professions at the community general support center, self-improvement to improve one's expertise, and operational management for implementing effective support. CONCLUSIONS: Nurses performed practical actions to both provide individual support and community development. The results suggested that nurses used the networks they had built through performing their daily work duties, including providing support to individuals, to support community resources. They also utilized community resources in local communities to create care systems in the community.

OBJECTIVES: To compare the characteristic competencies of public health nurses working for the older adult's health and welfare in public administration ("PA") with those at community general support centers ("CGSC") in Japan. METHODS: We conducted a questionnaire survey by mail for PA and CGSC public health nurses. A competency list that was developed to compare three groups (PA, CGSC experts with ≥5 years of experience, and CGSC newcomers with ≤2 years of experience) was used. The following characteristics were examined: (1) competencies acquired early after arriving at the CGSC, (2) competencies acquired through a certain amount of CGSC experience, (3) common competencies, (4) competencies that even experts lacked, and (5) competencies that the newcomers lacked. RESULTS: We examined the responses of 171 PA nurses, 185 CGSC expert public health nurses, and 165 CGSC newcomer public health nurses. The results of comparison of the three groups showed that (1) had no applicable items; (2) had nine items for individual support associated with preventive care management; (3) had 14 items including teamwork among three professionals (social workers, senior care manager, public health nurse)/other professionals and self-improvement; (4) had three items for community development, (5) had two items for individual support and 16 items for community development. CONCLUSION: Initiatives for preventive care and coordination of care teams should be supported and suggested as characteristic competencies for CGSC public health nurses.

OBJECTIVES: Employment support for working age people with disease is important. We investigated the intention to work among outpatients with malignant neoplasms, ischemic heart disease, and cerebrovascular disease. METHODS: We used anonymous data from the 2007, 2010, and 2013 Comprehensive Survey of Living Conditions in Japan, a self-administered nationwide questionnaire survey. Data for 154,445 participants (76,059 men and 78,386 women) aged 20-64 years were analyzed using logistic regression models adjusted for covariates. RESULTS: The number of outpatients with malignant neoplasms, ischemic heart disease, and cerebrovascular disease was 851, 1,037, and 716, respectively. The adjusted odds ratio for not working in people with the intention to work was significantly higher among outpatients with the three diseases than among non-outpatients, for both men and women. The adjusted odds ratio for intention to seek permanent work in unemployed people with the intention to work was lower among outpatients with cerebrovascular disease than among non-outpatients for men (p=0.093), and was significantly higher among outpatients with malignant neoplasms than among non-outpatients for women (p=0.007). CONCLUSIONS: This study identified a high proportion of unemployed people with the intention to work among outpatients with these three diseases, and suggests that there are disease-associated differences in employment type sought.