ABSTRACT
Objective: Physical frailty has been considered a risk factor for certification of long-term care needs (hereafter referred to as Certification) under Japan’s long-term care insurance (LTCI). Therefore, assessment of frailty in elders should be studied from multiple perspectives. The Kihon Checklist (KCL) is widely used to identify need for support/care among Japanese older adults. This study aims to examine the relationship between changes in KCL items and Certification among Japan’s young-old and old-old.Material and Methods: The KCL responses of 7,092 participants were assessed in April 2012 and March 2016, along with gender, age, and living environment. Deaths, Certifications, and relocations were tracked until March 2018. Changes in KCL items were categorized as bad, worse, improved, or good.Results: Between March 2016 and March 2018, about 7.3% of respondents obtained Certifications. KCL item changes increased the risk of new Certification for bad and worse groups, while improved cognitive function among the old-old possibly reduced the risk of new Certification.Conclusion: Therefore, rather than administering the KCL once, identifying KCL changes among people at risk could help prevent or delay their need for long-term care.
ABSTRACT
The objective of this study was to develop a scale that measures job satisfaction in public health nurses (PHNs) employed in the public sector and to test its reliability and validity. Results of semi-structured interviews with PHNs employed in the public sector and findings in literature review were assessed for content validity. A preliminary scale consisting of 74 items was thus developed, and its reliability and validity were tested in 1,030 PHNs employed in the public sector. Valid responses obtained from 422 PHNs (valid response rate, 41.0%) were subjected to item analysis followed by exploratory factor analysis using the principal factor method with promax rotation. Accordingly, 3 factors and 18 items were extracted, and the hypostatic factors were named “duties and responsibilities of PHNs”, “senior staff's understanding and environment facilitating personal development”, and “thoughts and trust in residents”. Confirmatory factor analysis confirmed the goodness of fit of the hypothetical model. Cronbach’s t was 0.907 (0.847-0.900 for subscales), confirming the reliability of the scale. The intraclass correlation coefficient (r) by the test-retest reliability method was .847 (.727-.830 for subscales), confirming stability. The criterion-related validity was confirmed by positive correlations of the draft scale with a general job satisfaction scale (r = .642, p.001), a self-esteem scale (r = .452, p.001), a self-efficacy scale (r =.411, p.001), an interpersonal support ability scale (r = .452, p.001), and a scale for ability to support and manage the community (r =.532, p.001). In sum, we developed a scale consisting of 3 factors and 18 items that measures job satisfaction in PHNs employed in the public sector. The contents of this scale will contribute to aspects of job satisfaction in diverse human resource development of the future. Thus, this scale is expected to be useful as a human resource development tool for PHNs employed in the public sector.
ABSTRACT
The purpose of this cohort study is to clarify the risk factors of low well-being of elderly people who residing in a local city of a super-aging country, Japan.Subjects are people, who have selected randomly from healthy elderly people resided in Kizugawa City, Kyoto Prefecture, in 2010, followed until 2015. Question survey was conducted in both year, and questionnaire consisted of items such as basic attributes, lifestyles (health practices, consultation behaviors, social activities and so on) and well-being (WHO-5). In analysis we made multi-logistic regression analysis using lifestyle variables as an independent variable and well-being as a dependent variable.The results were as follows.1. Risk factors were not to exercise, knowledge of appropriate diet, subjective feeling of stress for at least a month, not to participate in voluntary activities, age and bad subjective feeling of health.2. Risk factors in regard to changes of lifestyles using good-good lifestyles as a reference were sustainment of having no time for hobby or relaxation, sustainment or deterioration of subject feeling of stress for at least a month, sustainment or deterioration of having no time for relaxation and deterioration of having no activities with pleasure or aim. A factor promoting well-being is to have more frequencies for going out home.This study shows that in a longevity society it is important for community-dwelling elderly Japanese to have good health practices, appropriate consultation behaviors and good social activities for the purpose of keeping good well-being, and that these results are contributed to health promotion policy for community-dwelling elderly people.
ABSTRACT
The increase in dementia is becoming a serious health-related issue in Japan. The Ministry of Health, Labour and Welfare has indicated that the most effective method for preventing dementia is to detect and manage mild cognitive impairment (MCI). Accordingly, this study focused on “low physical activity”, which is a risk factor for dementia, and aimed to clarify the correlation between physical activity and MCI by analyzing the amount of physical activity among community-dwelling elderly adults sampled randomly from a cohort. A door-to-door survey was conducted of 26 physically housebound elderly adults and 26 physically nonhousebound elderly adults matched for sex, age, and living quarters who were randomly sampled from a 2013 cohort. Housebound status was assessed using a basic checklist. The survey was conducted at the participants’ homes. Components of the survey included basic attributes, basic checklists, the International Physical Activity Questionnaire, Japanese version of the Montreal Cognitive Assessment (MoCA-J), Kohs Block Design Test (Kohs), Revised Hasegawa’s Dementia Scale, Geriatric Depression Scale─Short Version-Japanese, Instrumental Activities of Daily Living Scale, and grip strength. The chi-squared or Mann─Whitney U test was used for comparisons between the elderly adults with low physical activity and those with high physical activity. The chi-squared test was used to compare the relationships between physical activity and MCI assessments (MoCA-J, Kohs). Statistical analysis was performed using SPSS for Windows, with significance established at p < 0.05. Physically inactive elderly adults were engaged in significantly physical activities and had significantly more inactive periods compared with physically active elderly adults. The inactive elderly adults did not fulfill the level of physical activity needed to maintain fitness. In addition, a significantly higher percentage of inactive elderly adults had MCI compared with active elderly adults according to MoCA-J score. When MCI was assessed using the Kohs, on the other hand, there was no significant difference between the active and inactive elderly adults. Inactive elderly adults were not able to fulfill the level of physical activity necessary to maintain fitness and prevent MCI. There is a need to urgently consider ways to identify inactive community-dwelling elderly adults and to detect and manage MCI at an early stage.
ABSTRACT
The aim of this study was to analyze the relationships among various characteristics such as personal attributes, health status, and social functioning in socially isolated elderly people according to a new classification based on intentionality in social choices, and to clarify the characteristics and issues of these individuals living in the community. We conducted a questionnaire survey of all healthy elderly people in Town A, which is located in a rural area. We classified respondents as non-socially isolated, intentionally socially isolated, or accidentally socially isolated. We then compared the three groups. Correspondence analysis was used to examine relationships among personal attributes and physical, mental, social functioning in the three groups. Valid responses were received from 1,284 respondents. Results showed that intentional social isolation was associated with living alone and poor physical functioning but not with medical history. Thus, intentional social isolation requires interventions for improving lifestyle, physical activity, nutrition, and oral care to prevent frailty among elderly people living in the community. Accidental social isolation was associated with depression and cognitive decline, and therefore requires mental health intervention. In addition, the accidentally socially isolated elderly tended to have low socioeconomic status, so it is necessary to create a mechanism for the early identification of high-risk individuals during monitoring and intervention provided by health and welfare professionals in various fields.
ABSTRACT
Objective: The rates of care-needs certification were mainly compared between two cohorts: 7,820 specific health checkup examinees/basic checklist respondents and 29,234 non-examinees/non-respondents.Subjects and Methods: Among approximately 37,000 elderly citizens of X City, the number of individuals newly certified as requiring long-term care were observed from the date of the first specific health checkup in 2008 to March 31, 2013. The aggregated totals of these individuals and associated factors were evaluated.Results: 1. Support Required 1, Support Required 2, and Long-term Care Required (level 1) certified individuals accounted for approximately 80% of newly certified individuals aged 65–74 years. Newly certified individuals aged 75 years and over had similar results with 37.2% of them being certified Support Required 1, 19.4% certified Support Required 2, and 22.9% certified Long-term Care Required (level 1). 2. The primary factors for care-needs certification in individuals aged 65–74 years were arthritic disorder in 27.6%, falls and bone fractures in 11.3%, and malignant neoplasm and cerebrovascular disease, among others. This was similar for individuals aged 75 years or over. 3. Of the 7,820 specific health checkup examinees/basic checklist respondents, 1,280 were newly certified as requiring long-term care (16.4%) compared to 7,878 (26.9%) of the 29,234 non-examinees/non-respondents. Therefore, the latter cohort had a significantly higher rate of individuals who were newly certified as requiring long-term care.Conclusion: Both specific health checkups and basic checklists are effective health policies to protect frailty in community elderlies.
ABSTRACT
The purpose of this study is to elucidate the correlation between social capital and frailty of homebound community-dwelling elderly individuals without certification for long-term care. Subjects were 47 homebound and 47 age- and sex-matched, non-homebound elderly individuals evaluated from July to November, 2016. Variable parameters were physical, mental, and social frailty, Tilburg Frailty Indicator score, and social capital. The correlation between social capital and frailty in home-bounded elderlies was analyzed using the χ2 Test. Social capital was significantly correlated with mental frailty among homebound elderly individuals. In contrast, social capital was significantly correlated with all types of frailty among non-homebound elderly individuals. Among community-dwelling elderly individuals, social capital is related to prevention of comprehensive frailty and mental frailty. On the other hand, screening and intervention for prevention of long term-care are necessary for homebound elderly individuals.
ABSTRACT
This study aimed to verify whether the incidence of frailty in elderly individuals is higher among those who are housebound than those who are not. This study found no correlation between elderly people’s houseboundedeness and physical, mental, social, and overall frailty. However, the Tilburg Frailty Indicator (TFI) frailty score and grip strength value were higher in non-housebound elderly persons than in housebound elderly ones. This suggests that being housebound may lead to frailty. On the other hand, it is thought that individual interaction with family and friends, and lack of anxiety about falls correlates with the prevention of frailty in housebound elderly persons. The results of the study also suggest that the basic checklist may be effective for ascertaining the actual situation of housebound elderly people who may be manifesting frailty.
ABSTRACT
<p><b>Objective:</b> This study aimed to examine the factors influencing the requirement of a certificate of long-term care using a basic checklist and items listed in the Special Health Checkup.</p><p><b>Method:</b> This study included 7,820 individuals living in Uji city, who were selected from among 8,000 elderly individuals who, in 2008, underwent a specific health checkup (hereafter referred to as the ‘specific health checkup for the old-old elderly individuals’) for those aged 75 years and above. They answered questions from basic checklists at the time, and 180 individuals were excluded as they had already qualified for requiring the certificate of long-term care at the time of the checkup. The follow-up period extended from the day of the specific health checkup for the old-old elderly individuals to March 31, 2013. The data were analyzed using the certificate of needing long-term care as the response variable. The explanatory variables were the basic attributes, items listed in the specific health checkup for the old-old elderly individuals, interview sheets, and basic checklists. Cox proportional hazards regression analysis was conducted.</p><p><b>Results:</b> In total, 1,280 elderly individuals qualified for requiring the certificate of needing long-term care. The risk factors for the young-old elderly individuals aged 65 to 74 years were as follows: hepatic dysfunction (hazard ratio {HR}=1.69), the presence of subjective symptoms (HR=1.41), an above-normal abdominal circumference (HR=1.36), old age (HR=1.13), a reduced frequency of going out since the previous year (HR=1.87), the use of support for standing up after being seated on a chair (HR=1.86), no deposit or withdrawals made (HR=1.84), the anxiety of falling down (HR=1.50), an inability to climb stairs without holding a railing or wall (HR=1.49), as well as an increased difficulty in eating tough food items compared with 6 months prior (HR=1.44). The risk factors for the old-old elderly individuals were as follows: a positive reaction on proteinuria (HR=1.27), anemia (HR=1.18), old age (HR=1.10), inability to travel on a bus or train by themselves (HR=1.53), the inability to climb stairs without holding a railing or wall (HR=1.48), weight loss (HR=1.36), a reduced sense of appreciation of the activities they had previously participated in, over a span of 2 weeks (HR=1.30), the use of support for standing up after being seated on a chair (HR=1.23), and the anxiety of falling down (HR=1.20).</p><p><b>Conclusion:</b> The items listed in the specific medical checkup as well as the basic checklists were found to be risk factors for both the young-old elderly individuals and the old-old elderly individuals, indicating the need to utilize these lists for the prevention of nursing even in the late stages of life. Moreover, these results suggest the importance of screening elderly individuals suffering from hyperkinesis using the basic checklist and conducting preventive interventions in order to maintain and improve their physical functions.</p>
ABSTRACT
In a cohort study of 7,820 elderly residents, we explored whether the priority items of the basic checklist predict new issuance of a certificate of needed long-term care. We analyzed data using Cox’s proportional hazard regression, with new issuance of a certificate of needed longterm care as the dependent variable, need for secondary prevention services (determined by the basic checklist results) and required level of specific health guidance as independent variables, and sex, age, place of residence, and use of long-term care prevention services as moderator variables. The results were as follows. The priority items of the basic checklist to assess need for secondary prevention services were useful for screening in both the younger and older elderly populations. Also, more certificates of needed long-term care were issued to those individuals who received secondary prevention services. Furthermore, partial functional impairment was also significantly associated with issuing a new certificate.
ABSTRACT
The process of creating health promotion activities in the community was analyzed by means of document examination. The results showed that the process has four periods, namely, the preparation period, consensus period, planning-implementation period, and continuation period. Based on our results, we propose a general-purpose design for community resident-centered health promotion activities in areas with different characteristics.
ABSTRACT
<b>Objectives:</b> The purpose of this study was to evaluate the effects of a coaching program on saliva cortisol sensitivity in normal healthy mothers with young children.<br><b>Methods:</b> A randomized controlled trial (RCT) was conducted with objective and subjective outcome measurements of the stress indicator. A postal survey to assess emotional intelligence (EI) was administered by random sampling to mothers of young children aged 3 months to 6 years in Japan. A total of 74 mothers with median EI scores or lower were enrolled in a RCT involving the coaching program. The intervention group received a 3-month coaching program. The control group was given the coaching program at follow-up. Stress state outcomes (saliva cortisol level, EI score, and Profile of Mood States (POMS)) were measured at baseline and immediate follow-up, with salivary cortisol measured again at a one-month follow-up.<br><b>Results:</b> Significant differences were found for saliva cortisol level and the EI score within and between the intervention and control groups. Some POMS subscale scores were significantly different within the intervention and control groups.<br><b>Conclusions:</b> The participants in the coaching program had significantly reduced saliva cortisol levels and better secondary outcomes than those in the control group.
ABSTRACT
This article released online on December 6, 2014 as advance publication has been retracted by the Editorial Board of Journal of Rural Medicine due to the Printer’s error.
ABSTRACT
This article released online on December 6, 2014 as advance publication has been retracted by the Editorial Board of Journal of Rural Medicine due to the Printer’s error.
ABSTRACT
This study was carried out to clarify the effects of the sense of community and living environment on elderly citizens’ mental health. We conducted a self-administered questionnaire survey targeting 820 men and women aged 65 and over, who were a member of “A” seniors’ club or participant of a daily service event organized by “A” Council of Social Welfare. Valid responses came from 577 people, who were enrolled in this study. Univariate and multivariate analyses revealed that elderly citizens’ life satisfaction was positively correlated with “subjective sense of well-being”, “hypertension”, “junior high school district”, “love for the region”, “social supports&rdqul;, and “no medical problems”, and negatively correlated with “neuroticism” and &ldqip:stress”. In addition, risk factors for depression were “single life”, “neuroticism”, and “stress”, whereas improvement factors were “subjective sense of well-being”, “hobby”, “fine views”, and “sociability”. Our findings showed that elderly adults’ mental health status was associated with various factors such as their “love for the region” “living environment with fine views”, “subjective sense of well-being”, and “personality”. These results suggested that community networks could favorably affect elderly people’s mental health.
ABSTRACT
<b>Objectives:</b> The purpose of this study was to evaluate the effects of a coaching program on saliva cortisol sensitivity in normal healthy mothers with young children.<br><b>Methods:</b> A randomized controlled trial (RCT) was conducted with objective and subjective outcome measurements of the stress indicator. A postal survey to assess emotional intelligence (EI) was administered by random sampling to mothers of young children aged 3 months to 6 years in Japan. A total of 74 mothers with median EI scores or lower were enrolled in a RCT involving the coaching program. The intervention group received a 3-month coaching program. The control group was given the coaching program at follow-up. Stress state outcomes (saliva cortisol level, EI score, and Profile of Mood States (POMS)) were measured at baseline and immediate follow-up, with salivary cortisol measured again at a one-month follow-up.<br><b>Results:</b> Significant differences were found for saliva cortisol level and the EI score within and between the intervention and control groups. Some POMS subscale scores were significantly different within the intervention and control groups.<br><b>Conclusion:</b> The participants in the coaching program had significantly reduced saliva cortisol levels and better secondary outcomes than those in the control group.
ABSTRACT
【Objectives】A study was carried out to examine the relationships between community consciousness and the health of the middle-aged in a rural area, and to explore how to support their effort to promote health through behavioral modification.【Methods】A questionnaire survey was conducted on 2,336 people, aged 30-64, in town A. We received effective responses from 763 people (32.7% valid response rate). The investigative tool Self-administered questionnaires were sent out by asking them about their identity, community consciousness (attitude toward community, relationships with neighbors, social participation), physical health (health conditions, health behaviors, attitude toward health actions), and mental health (life satisfaction, depression). An analysis was made to find the relationship between the subjects’ attitude toward community and physical or mental health. In addition, we performed a multivariate analysis with physical health and mental health as the objective variables and the items, in which a significant difference was mainly observed in a univariate analysis, as the explanatory variables.【Results】Respondents with a higher score on the attitude toward community scale also had higher scores for health condition, health behaviors, and attitude toward health actions. Those people with higher scores on the attitude toward community scale had higher life satisfaction scores and lower depression scores.【Conclusion】These results revealed a close association between community consciousness and the health of the middle-aged in the rural area. It is necessary to interpret the assessment in consideration of the fact that in rural areas community consciousness is generally high and contributes to healthy support of the middle-aged.
ABSTRACT
This study was conducted to clarify whether the health locus of control (HLC) is associated with body weight change after adjusting effects of different factors in a general adult population. In male subjects with a normal weight, external locus of control was associated with weight gain, whereas internal locus of control was not significantly correlated with weight loss, after adjusting the effects of factors related to body weight change. Although the external locus of control was associated with weight gain, HLC had a limited effect on body weight change in adults. Besides HLC, the factors significantly correlated with body weight change. Skipping breakfast, napping, and a weight cycling are related to weight gain, whereas obesity and stress were connected with weight loss. A look at gender differences showed that weight gain was associated with marriage, skipping breakfast, napping, and a variable body weight, whereas weight loss was associated with obesity and the declaration of weight reduction in male subjects. In female subjects, weight gain was associated with eating speed and smoking.
ABSTRACT
<b>Objective:</b> The purpose of this study was to examine the relationship between the emotional intelligence quotient and health-related quality of life using structural equation modeling.<br><b>Methods:</b> A self-administered questionnaire survey was conducted among 1,911 mothers who visited the Health Center for an infant medical examination. A hypothetical model was constructed using variables of the emotional intelligence quotient, social support, coping, parenting stress, and perceived health competence.<br><b>Result:</b> There were a total of 1,104 valid responses (57.8%). Significant standardized estimates were obtained, confirming the goodness of fit issues with the model. The emotional intelligence quotient had a strong impact on physical and psychological quality of life, and showed the greatest association with coping. This study differed from previous studies in that, due to the inclusion of social support and explanatory variables in coping, an increase in coping strategies was more highly associated with emotional intelligence quotient levels than with social support.<br><b>Conclusion:</b> An enhanced emotional intelligence quotient should be considered a primary objective to promote the health of mothers with infant children.
ABSTRACT
This study evaluates the quality of life (QOL) for elderly community residents on both health-related and subjective QOLs, while comparing QOL-related factors between so-called “younger old” (residents in the age bracket of 65-74) and “older old” (those in that of 75 and over) in regard to QOL-related factors. Questionnaires were distributed to 929 residents in both age groups who affiliated themselves with a senior citizens’ club in City “K” in 2009. Data on 596 persons were analyzed in this study. Results pertinent to basic attributes, health status, lifestyle habits, social exchange, and QOL were analyzed in a multivariate method. Among residents in the age bracket of 65-74, the subjective sense of well-being, the frequency of going out, gender, the frequency of conversations with neighbors, financial security, and bedtime hours were looked upon as factors contributory to improvements in QOL, whereas low back pain, the frequency of mutual support among neighbors, high GDS scores, personal activities, and numbness were taken in as factors deteriorative to QOL. Among the over-75s, the subjective sense of well-being, cardiac disorders, and financial security were regarded as factors contributory to improvements in QOL, whereas low back pains and cardiac disorders were looked upon as factors deteriorative to QOL. To improve the elderly’s QOL, it is considered essential to step up their efforts to manage and relieve depression and low back pains.