永嶺 仁美

BACKGROUND: In occupational health, the maintenance and promotion of workers' health, especially lifestyle motivation-based interventions, have gained considerable attention and are actively implemented. Motivational theories include self-determination theory, and some studies focus on healthy lifestyles. However, the effectiveness of health promotion interventions varies depending on the health awareness and motivation of the participants. Therefore, this study aimed to clarify the processes by which workers are motivated to improve their health and to identify the need for and type of support according to their motivation. METHODS: Using a mixed-research design, an initial questionnaire survey of 94 employees (mean age = 40.97 ± 9.65) at a multicenter company in Japan, followed by semi-structured interviews with 16 employees (mean age = 40.13 ± 9.45) from the high- and low-motivation groups, were conducted. Multiple regression analysis followed by modified grounded theory-based analysis of the results of the first stage was used and the quantitative and qualitative results were integrated. RESULTS: In the first stage, autonomous motivation scores were predicted by the behavioral change stage and relatedness satisfaction/frustration. The second stage revealed that "the process of reflecting and managing one's own health while receiving support and feedback for maintaining and improving health" was the motivational process of workers. Result integration revealed that motivation increased through repeatedly escaping and adjusting to real problems and situational coping until the behavioral change. Despite interruptions during behavioral change, receiving feedback from others could increase motivation and continued behavioral change. CONCLUSION: Regardless of their level of motivation for health behaviors, workers indicated that support from others was essential. The nature of this support was found to range from providing information to offering feedback. Interventions individualized by the identified process could enable customized motivation-driven health guidance.

BACKGROUND: In the process of community building, it is important to create a place for multigenerational exchanges. To promote multigenerational exchanges in regional locations, it is essential to clarify whether such exchanges are related to government infrastructure, regional characteristics, and social capital, and how these exchanges contribute to community building. METHODS: A cross-sectional questionnaire study was conducted with representatives from 455 Chiiki no Cha-no-Ma (literal translation "community living room," and hereafter "Cha-no-Ma") in Niigata City, Japan. Responses were received from 405 representatives (response rate: 89.0 %), and 401 agreed to participate (4 declined). The survey details included basic information (e.g., date each location was established, frequency of meetings, number of caretakers and participants, qualifications of the representative), activities reflecting local culture, a social capital scale, the effects of the Cha-no-Ma implemented by the representative (12 items), challenges for management (16 items), and the implementation of multigenerational exchanges. RESULTS: Most of the age groups that participated in the Cha-no-Ma were elderly, and multigenerational exchanges took place in 125 locations (31.5 %). Items that had a significant connection to the implementation of multigenerational exchanges were "Frequency of meetings" (p < 0.001) and "Activities reflecting local culture" (p = 0.026). Binomial logistic regression analysis indicated that a high frequency of meetings was associated with the implementation of multigenerational exchanges (Odds ratio = 3.839). There was a significantly higher ratio of implementation of multigenerational exchanges when the effects were a "connection with the region" (p = 0.006) and "conversations with different generations" (p = 0.004), and when the challenge was "no support from residents" (p = 0.002). CONCLUSIONS: Cha-no-Ma participation is low among young people. The following ideas can be considered in order to increase multigenerational exchanges in regional locations. These exchanges may be promoted by increasing the frequency of meetings with qualified personnel and by adding activities that reflect local culture, such as festivals and making local foods. This community-based study clearly indicates that implementing multigenerational exchanges is an important activity for community building because it is related to connection within the community.

本研究の目的は、小学生の保護者の食行動に関連する要因を理解し、保護者を対象とした健康的な生活習慣を支援するプログラムの示唆を得ることである。小学生378名の父親と母親を対象に食行動尺度(EBS)、生活習慣、健康意識、主観的健康感、一般向けヘルスリテラシー尺度(CCHL)の項目からなる質問紙調査を実施し、278家庭を分析対象とした。保護者の健康意識、父親のヘルスリテラシー、母親の適切な体重を維持する習慣と主観的健康感が食行動に関連する要因として抽出された。保護者の健康意識や父親のヘルスリテラシーの高さ、母親の適切な体重を維持する習慣や主観的健康感の高さは、良好な食行動の関連要因となることが示唆された。これらの結果は、同様の環境で生活を共にする子どもの食行動へも影響することが考えられる。子どもの生活習慣は保護者の影響を受けやすいことから、子どもの健康的な生活習慣を確立するためには、子どもだけでなく保護者に対する教育が必要である。保護者の健康を意識するきっかけを作り、父親ではヘルスリテラシーの向上、母親では適切な体重の維持や主観的健康感の改善に焦点を当てた教育を実施することは、保護者の食行動をより良い方向に導く可能性がある。(著者抄録)

目的:文献レビューにより精神障害をもつ人のニーズアセスメント尺度を比較し,実用性を検討する.方法:PubMed,CINAHL,医学中央雑誌を用い,"mental disorders""needs assessment""tool"「精神障害」「ニーズアセスメント」をキーワードとして2018年11月までに発表された文献を検索した.結果:海外文献からニーズアセスメント尺度が9種得られた.その中でCamberwell Assessment of Need(CAN)が広く使用されている信頼性の高い尺度であった.CANのアセスメント項目や評価段階を増加する試みも見られたが,新たな尺度で臨床における実用性が改善したものは見られなかった.国内文献からはニーズアセスメント尺度は見当たらなかった.考察:今後CANの和訳と改良を検討し,精神障害をもつ人の支援に活用できるよう検討することが必要である.(著者抄録)

本研究では，全国1,815か所の学童保育を対象に，高齢者との世代間交流プログラムの現状と今後の期待について明らかにし，都市規模別に比較・検討することを目的とした． 本研究では，学童保育を「大都市」「人口10万人以上」「人口10万人未満」「郡部」の都市規模別に区分し，世代間交流活動の「実施群」「未実施群」の層化分析を行った．世代間交流プログラムの関心は，大都市では「将棋・囲碁」，人口10万人以上の都市では「昔遊び」「楽器演奏・音楽鑑賞・合唱」「体験談」「読み聞かせ・紙芝居」が高かった．人口10万人未満の都市では，「料理・おやつ作り」が高かった．今後の課題として，その地域における学童保育側から高齢者への期待，また高齢者の生活意識などの点から，お互いに参加しやすくニーズに合った世代間交流プログラムを構築する必要があることが示唆された．

AIM: To determine the effects of a primary diabetes prevention programme created for healthy young adults. DESIGN: This study was a non-randomized controlled trial. METHODS: The participants were 20-39-year-old employees of two automobile sales companies. The intervention group (N = 154) received six original educational brochures and films created specifically for young adults, while the control group (N = 157) received none. Data were collected pre-intervention and immediately after and 10 weeks after intervention. Change in knowledge about diabetes, its prevention and health management were measured. RESULTS: Overall, 129 interventions and 141 controls completed the trial. In items related to diabetes prevention, the intervention group increased their knowledge relative to controls (all p < .05). Awareness of susceptibility to diabetes also increased more in the interventions (p = .029). The interventions also improved more with items related to dietary behaviour (p < .05). This trial has been registered with UMIN-CTR clinical trial (UMIN000023749).

本研究の目的は、成人若年期における糖尿病に関する知識の程度および保健指導希望の有無への影響要因を明らかにすることである。自動車販売会社に所属する20～39歳の335名に質問紙調査を実施し、322名を分析対象とした。糖尿病に関する知識の程度に影響する要因として「婚姻状況」「定期的に自分の健康状態をチェックする」が挙げられた。配偶者の存在や、体重などのセルフチェックの習慣化が疾病予防への関心に繋がることで、糖尿病に関する知識を習得することが示唆された。保健指導希望の有無に影響する要因として「年齢」「家族や身近な人に脳血管疾患の罹患者がいる」「運動」「野菜の摂取量を増やす」「間食・甘味飲料を摂取しない」が挙げられた。身近な人の生命の危機に直面した恐怖が予防的健康行動への意識を高めたことや、健康的な生活習慣への関心が、保健指導希望に影響することが示唆された。一般的に20～30歳代は未婚者が多いため、彼らが配偶者の影響から受動的に疾患や健康管理の知識を身に着けることを期待するのではなく、その年代をターゲットとした保健指導を実施する必要がある。その保健指導には、食習慣や運動習慣に関しての実用的な内容、それらの根拠となる糖尿病という疾患についての情報を含む必要があると考える。(著者抄録)