54

No. 23

Japan Academy of Community Health Nursing
Established October 15, 1997

Topics of Japanese Community
Health Nursing

APRIL 2024

in health insurance, receipt data submitted by
medical institutions to health insurance associations
has already been archived nationwide. The portalsite (https://myna.go.jp/html/index_en.html) allows

1. Current status and prospects ofpersonal health record (PHR)
utilization in community nursing
practice and research

individuals and healthcare institutions to accessmedical treatment under health insurance andvaccination records. The utilization for information
sharing between hospitals and clinics andemergency medical history verification is expected.

1) Trends of Personal Health Record (PHR) in
Japanese Public Health

System adoption by medical institutions is alreadymandatory in principle, and the challenge lies inpromoting the use of Individual Number Card

Masayasu Okajima(published by local government) as the health

Chief Researcher, SOMPO Institute Plus Inc.

insurance card to comprehensively leverage thissystem.

The utilization of Personal Health Record(PHR), where individuals manage their own health

2. Corporate Health Management Initiatives

information, has become an international topic.

In Japan, conducting annual health examination

Previously, individual health information wasfor employees has been a legal obligation for

dispersedly managed by healthcare institutions andcompanies. Previously, health examination results

individuals. The utilization of PHR involves thewere managed without being digitized at thedevelopment of an environment that is centeredcompany level. Efforts are now underway to digitize

around the individual’s agreement, focusing on

and share health examination results with healthcentralized data management and population

insurance associations, to promote individuals’

analysis. This has the potential to contribute to thehealth. Expectations are high that health insurance

improvement of community nursing and public

associations can provide crucial evidence byhealth. In this newsletter, three trends in Japan’s

analyzing PHR data in developing health promotion

initiatives are highlighted.

strategies for lifestyle-related diseases. With asevere labor shortage in Japan, the success of

1. Government Initiatives in Medical DX

health promotion strategies is expected to contribute

The Japanese government is prompting theto enhancing corporate productivity. These initiatives

construction of a data linkage and analysis system

are spreading not only among large corporations but

for information generated by healthcare providers.

also among small and medium-sized enterprises in

Given that almost all citizens in Japan are enrolled

local regions.

日本地域看護学会誌

Vol.27 No.1, 2024

Health examination results shared with health

In Japan, the national government is actively

insurance associations are also accumulated in the

promoting digital transformation through thegovernment’s medical DX system. In this way, they

establishment of the Digital Agency in 2020. As partcan contribute to the enhancement of communityof this policy, a novel electronic system is being

nursing and public health.

developed to efficiently manage, integrate, and use
personal health records (PHRs). These records

3. Initiatives for Information Collaboration

include a range of health-related data, including

Infrastructure in Local Governments

medical expenses, vaccinations, maternal and childSome local governments are building

health, and various medical examinations, all linked

information collaboration infrastructure involving

to a unique personal number assigned to eachregional governments, medical institutions, andcitizen. Administrative agencies in Japan are

private enterprises, following the government’s

expected“Digital Garden City” Plan. Through thistransformation, and integrate and use the new

infrastructure, resident information, vaccinationelectronic system, drawing on anonymized

records, maternal and child health information held

information from PHRs to support evidence-basedby local governments, and medical information heldpolicy making.

to

move

forwardwithdigitalby healthcare institutions are shared according to

It seems likely that in the future, community

the plans of each local government. These services

health nurses within Japanese administrative

contribute to the improvement of community nursing

agencies will need to use PHRs and other pertinentand public health, such as the provision of healthdigital data. This will help to quantify the impact ofmanagement apps in the region, utilization incommunity health nurses’ interventions on

emergency medical care, and digitization ofindividuals and communities, and support thematernal and child health information, including

ongoing assessment of their work. To fully

infant health examinations.

understand the effects of the work of community
health nurses, it is important to bring together PHR

PHR

facilitates

individual

information

data with information on the nature, extent, andmanagement and generates valuable population

timing of nurses’ activities. These data are available

analyses. Challenges are standardization of thefrom the nurses’ daily activity records, but these

confirmation procedures for individual consent andrecords in Japan are often not digital or

the use of convenient personal identification

standardized. This may hinder the optimal use of

information such as Individual Number and healthrecorded data in both practice and research.

insurance number, which are legally allowed to be
used for specific domains only.

To address these challenges, we have focusedon the digitization and standardization of community
health nurse records. Our interdisciplinary research

2) Research on the utilization of public healthteam includes specialists in community healthnurse records and PHR for promoting thenursing, medical informatics, and information

PDCA cycle of public health nurses’

technology, alongside working community healthactivities in the maternal and child healthnurses. This collaborative research aims to enhancethe efficiency, quality, and usability of community

Eiki Akatsuka, Madoka Osawa, Atsuko Taguchi

health nurses’ records. We are using the Patient

Faculty of nursing and Medical Care, Keio University

Condition Adaptive Path System (PCAPS), a quality

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engineering methodology, to systematize theproviders.

process of community health nurse activities andidentify a framework for optimizing their electronic

The use of PHRs in community health nursing

records. This involves representing their activities inholds great potential for promoting health anda flowchart and organizing the content ofpreventing disease among community residents.

interventions and assessments by these nurses atCommunity health nursing professionals can use

each step within the chart. Through these studies,

PHRs to develop personalized health guidance andour future objective is to establish an electroniccare plans based on individual health information.

record system that enables data-driven evaluation

For example, in Nishinomiya City, efforts are being

and continuous improvement of daily community

made to prevent the worsening of diabetes byhealth nurse practices.

combining health examination data, hospital test

Future activities among community healthdata, pharmacy dispensing data, and data stored onnurses should be linked to the development of

personal wearable devices. In managing the healthefficient and high-quality health services through theof residents with chronic diseases, the regularpromotion of ‘plan–do–check–act’ cycles groundedrecording and analysis of health status can enable

in insights from data from both PHR and community

early detection and intervention of worsening

health nurses’ records. To achieve this, it will be

conditions. Furthermore, health education programs

necessary to visualize the practices of community

utilizing PHRs can also improve the health literacy ofhealth nurses, and generate evidence of thesecommunity residents.

activities. This requires close collaboration between
researchers and practitioners.

However, there are several challenges to the
spread and use of PHRs, including ensuring privacy

3) Prospects for Community Health Nursing

protection and data security, improving the digital

Research in Accordance with the Utilization

skills of users, and standardizing information sharing

and Spread of PHRs

between patients and healthcare providers.
Additionally, strict regulations on the handling ofTomoya Itatani

personal information are necessary when using

Department of Nursing, faculty of Medicine,

PHRs.

University of Miyazaki
Future community health nursing research
Personal Health Records (PHRs) are digital

should explore empirical solutions to thesetools that allow individuals to manage their own

challenges. Specifically, research on effective

health information and share it with healthcare

methods of introducing PHRs, developing

providers. With the proliferation of smartphones andeducational programs to promote the use of PHRs

wearable devices in recent years, the use of PHRs

among community residents, and improving privacy

has rapidly expanded. PHRs include a wide range ofprotection and data security are needed. Moreover,health information, such as medical history,

long-term follow-up studies on the use of PHRs andtreatment history, test results, and immunization

their impact in communities are also required.

records. The spread of PHRs is expected to makepatients the main actors in their health management

The spread and use of PHRs hold greatand improve communication with healthcare

potential in community health nursing. However, to日本地域看護学会誌

Vol.27 No.1, 2024

fully utilize these benefits, it is essential to addressfor nuclear disaster was “being concerned about thethe challenges mentioned above. This requires

responsibility of PHNs in the nuclear zone tocollaboration among experts from various fields. A

anticipate emergency situations.” The main theme

comprehensive approach from technological,

consisted of two domains: “adhering to roles as

ethical, and educational perspectives is needed for

officers in a small municipality in the nuclear zone”

the development of PHRs, with community healthand “bearing in mind the awareness to protect lives

nursing playing a connecting role. The future role ofand living of residents as a nursing profession”.

community health nursing research is to discover

PHNs have become increasingly aware of the risk

methods for utilizing PHRs in a manner centeredafter the accident in Fukushima, and of thearound the residents.

necessity of preparing and protecting the lives ofresidents while feeling uneasiness.

【Reference materials】

Discussion: PHNs have felt the responsibility of1) Ministry of Internal Affairs and Communications

preparing health activities while suppressing their“Ministry of Internal Affairs and Communications’feelings and awareness due to the organizational

efforts toward building a data infrastructure for health,climate and their own views on the nuclear power

medical care, and nursing care” https://www.kantei.
go.jp/jp/singi/keizaisaisei/miraitoshikaigi/
suishinkaigo2018/health/dai6/siryou2.pdf (April, 2019)

plant, which had financed the lives of the residents
and the municipality’s administration. Because of themunicipal characteristics, it is difficult for PHNs totake the initiative in conducting health activities and2. Best Research Awards of JapaneseCommunity Health Nursing

preparing for disaster. The implication from thisresearch includes building partnerships among
PHNs in nuclear zones and to demonstrate

1) Ethnographical study on preparations forexpertise of PHNs within municipality offices by

nuclear disaster perceived by public healthproviding wider regional support at regional andnurses in the zone of nuclear power plants

national level.
【Key words】nuclear disaster, disaster preparedness,
public health nurses, true state of affairs, ethnography

Junko Omori
Graduate School of Medicine,
Department of Public HealthNursing,Tohoku University2) Development of a Scale that Impedes theUse of Specific Health Guidance by Specific
Health Guidance Relevant Individuals

Objective: To describe the culture and true state ofaffairs as to how public health nurses (PHNs)
perceive preparation for a nuclear disaster.
Method: Interviews were analyzed along with field

exploration, and participant observation according to
the ethnographical methodology.

Yaeko Akabori
Faculty of Health care, Takasaki
University of Health and Welfare

Results: Nine PHNs were selected as key

informants out of 25 participants near nuclear power

Objective: The present study aimed to develop aplants. The extracted theme of PHNs’ preparations

scale for measuring factors that hinder the use of

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specific health guidance (Scale of factors that hinder

3) Relationship between the number of older

the use of specific health guidance) by specificpeople living alone that local volunteers

health guidance relevant individuals.

monitor and satisfaction with or burden of

Method: The 50-item factors that hinder the use ofmonitoring activities and monitoring-related

specific health guidance Measurement Scale wasactivities

designed based on previous studies and publisheddata. A questionnaire survey was conducted on
3,738 individuals requiring specific health guidancein two cities, one town, and one village and scale

Yuka Nishi
Matsubara City Community
Health Division

reliability, construct validity, and concurrent validity
were investigated.
Results: A total of 1,849 (49.5%) questionnaires

were returned, of which 1,459 were valid. Item andPurpose: This study aimed to clarify the relationshipexploratory factor analysis identified 18 items within

between the number of older people living alone thatthe following 4 factors: feeling of futility regarding

local volunteers monitor and satisfaction or burden

altering lifestyle habits; values prioritized above

regarding monitoring and monitoring-related

perfect health; negative feelings regarding healthactivities.

guidance; and pride in own judgement regarding

Method: An

personal health. Overall and subscale Cronbach’s αquestionnaire survey was conducted with 1,812

coefficients were 0.904 and 0.737-0.845,(100%) local volunteers monitoring older people

respectively. Goodness of model fit values were as

living alone. The survey items consisted of basic

follows: goodness of fit index GFI=0.951; adjusted

characteristics, number of older people living alone

AGFI=0.935; comparative fit index=0.952; and rootthat they monitor in a month, monitoring activities,

mean square error of approximation=0.053. A

monitoring-related activities, scale of social

significant association was found using the known-

activities, and scales of satisfaction and burdengroups method and a significant negative correlation

regarding monitoring activities. The number of older

was observed regarding concurrent validity.

people living alone that they monitor in a month wasConclusion: The present 4-subscale 18-item scaleclassified into three groups: zero, one to five people,

is useful for measuring the factors that hinder theand six or more people. χ2test was performed foruse of specific health guidance.

items of basic characteristics and monitoring-related

anonymous self-administeredactivities, and one-way covariance analysis and【Key words】specific health guidance, use, inhibitors,

multiple comparison tests were conducted todevelopment of a scaleexamine satisfaction with or burden of monitoring
activities according to each group.
Result: The number of responses analyzed was 749(41.3%). The percentage of those who performed
monitoring-related activities and scores on scales ofsocial activities and satisfaction were highest in thegroup of six or more people (p<.001). The burden
score was lowest in the group of one to five people
compared with the other groups (p<.001).

日本地域看護学会誌

Vol.27 No.1, 2024

Conclusion: The results suggest that the large

create a better research poster in less timenumber of older people living alone that local(#betterposter Generation 1)” (URL: https://www.

volunteers monitor was related to a high degree of

youtube.com/watch?v=1RwJbhkCA58) particularly

satisfaction and monitoring-related activities, andhelpful.

that local volunteers monitoring one to five people
might be most appropriate.

The Opening General Session featured
presentations by Katalin Karikó, Ph.D., recipient of
the 2023 Nobel Prize in Physiology or Medicine, and【Key words】local volunteers, older people living alone,

Admiral Rachel Levine, MD, the 17th Assistantmonitoring activities, monitoring-related activities,

Secretary for Health for the US, whom I discovered

satisfaction regarding monitoring activities, burden

through the Healthy People 2030’s film. Dr. Karikó

regarding monitoring activities

delivered a humorous speech, quipping, “I failed toretire, but I’m enjoying it,” while emphasizing the

3. Brief reports of Participants

importance of decisive leadership and trust incolleagues, which resonated with me for future1) American Public Health Association 151th
Annual Meeting & EXPO (APHA 2023)
Atlanta / Nov.12-15, 2023

endeavors.
Taking place in Atlanta, the birthplace of Martin
Luther King Jr. and the heart of the civil rights
movement, the conference commenced with a drum

Satoko Okawa

march performed by children of diverse ethnic

Kansai Medical University

backgrounds, which received an immense round of
applause.

I presented a poster at the 151st American

Now, let’s examine the crucial poster

Public Health Association Meeting in Atlanta, US, inpresentations. The format at this conference

November 2023. The acceptance rate for thisrequired standing in front of the poster for an hour,

conference is 60–70%. Because of a previous

fielding questions from the audience. Before myrejection, I was careful in selecting my researchpresentation, I wondered whether there would be

category during submission. My presentation was

any attendees interested in the ACE situation intitled “Which induces more social disadvantage inJapan. However, over 10 individuals approached me

Japanese mothers’ parenting: Adverse childhood

with questions. The questions asked by theexperiences (ACEs) or teenage pregnancy?”, andattendees were wide-ranging. For example, how tofell under the subject of “Maternal and Child Health”

select ACE items and the reasons for it, the actualwith potential perspectives on “Social Disparity”.

living conditions of teen mothers in Japan, and the

However, I opted for “International Maternal andsupport and educational content in schools andChild Health” as my subject because I believed thecommunities. Some remarked on the interesting link

US audience would be interested in a comparison

between ACEs, social disadvantage, and teen

with the local situation.

mothers. ACE research at this conference primarily

The conference committee provided various

comprised secondary analyses of existing surveys,

resources for presenters, including guidance onwith limited studies incorporating teen mothers due

abstract writing and instructions for making posters/

to their relatively small population size. This may

oral presentations after acceptance of the abstract. I

have contributed to the interest in our study. As

found the #BetterScience YouTube video “How tothere were several similar secondary analyses and

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systematic reviews by first- and second-year Ph.D

question, I learned about the situation of nurses instudents in the poster presentations, researchers

hospitals abroad. I was also able to obtain

conducting similar studies may consider this as an

information on the methods of support for nurses

opportunity to present their work.

adopted in other countries.

My only small disappointment at the conference

I am not good at speaking English. However,stemmed from the lack of practical reports. Upon

since EAFONS attracts people from countries wheresharing this observation with a colleague in the US,

English is not the native language, they will try to

she recommended The Association of Community

listen even if the grammar is different. Therefore,

Health Nursing Educators (ACHNE). For those

EAFONS is a great opportunity for first-time

interested in presenting practical reports in the US, I

presenters at overseas conferences. I utilized aencourage considering ACHNE as an option.

variety of tools to create my presentation materials,
and with the development of AI, Internet translations

2) 26th East Asian Forum of Nursing Scholars

also provide natural English. I also utilized tools to(EAFONS 2023)

prepare this letter. In this way, I managed to prepareTokyo / Mar. 10-11, 2023

my presentation even though I am not good atEnglish. We encourage you to take up the

Yuta Himeno

challenge. Our daily practice is of great interest to

Oita University of Nursing and Health Sciences

practitioners

andresearchers

overseas.

Unfortunately, because the conference was held in
I attended the 26th East Asian Forum ofJapan this year, I was not able to go abroad andNursing Scholars (EAFONS) in Tokyo on March 10

enjoy the conference while experiencing the local

to 11, 2023. The experience was very exciting forfood and culture, but I was able to eliminate myme. This forum consisted of keynote speeches, oral

sense of rejection of the idea of presenting at anpresentations, and poster presentations. I presented

international conference after giving this“Attempt to Elucidate the Structure of Challenging ofpresentation. I am also the only one who feels that I

Nurses Working in a Medium-Sized Hospital: An

cannot speak well at an international conference

Analysis of Two Case Studies (Himeno et al)”. In

where no one knows me. I think I can enjoy various

mid-size hospitals, it has become clear that bythings because nobody knows me.

taking care of patients with various diseases andLet’s participate in the international conference

conditions at the same time, nursing feels like tasks,

together and enjoy the food overseas while

and is difficult to connect with patients as adelivering about nursing in Japan. There are many

rewarding experience. To solve this problem, I

things you can see and learn from different

believe that it is necessary to take time tocountries. It isn’t easy to make encounters byunderstand the meaning of the nursing care we areourselves, but international conferences are theproviding. During the Q&A session, I was asked

most accessible opportunities to do so. Why don’t

about the situation of the medium-sized hospital in

you join us at an international conference where you

Japan. Although there are many small and medium-can talk with people with various ideas to improve

sized hospitals in Japan, I realized the importance ofyour practice and research? If you have any

showing the situation of nurses working there

problems or questions, please text me anytime.

compared to those in large hospitals. Through this

日本地域看護学会誌

Vol.27 No.1, 2024

The 27th Annual Research Conference of JACHN
Main Theme： Community Social Innovation
Date：June 29-30, 2024
Venue：AER, Sendai, Miyagi, Japan.

https://www.sendai-aer.com

Chairperson：Junko Omori（Professor of Tohoku University School of Medicine）
Program：◆ Chairperson’s speech: Junko Omori◆ Educational lecture ◆Symposium ◆Keynote speech ◆Online session ◆Workshop ◆Special discussion◆ Board planning seminar ◆Research seminar ◆Relay talk.

Website：https://jachn27.yupia.net/index.html

The 8th International Nursing Research Conference of the 8th WANS
Main Theme： Nursing around the World: Bringing Excellence in Global Healthe
Date：August 21-22, 2024
Venue：Prime Park Hotel & Convention Lombok, Indonesia.
Chairperson：Harif Fadillah（The Indonesian National Nurses Association）
Website：https://wans-icinna.org/

7th International Conference of the Global Network of Public Health Nursing
Main Theme：Building Resilience and Innovative Solutions: Amplifying Impact and Advancing Positive Global Public
Health Change
Date：July 29-31, 2025
Venue：Calgary, Alberta, Canada
Chairperson：Dr. Aliyah Dosani (Mount Royal University) and Dr. Zahra Shajani (the University of Calgary)Website：https://www.gnphn.com/7th-international-gnphn-conference
Program：◆ Leveraging partnerships to tackle global health security.
◆ Healthy recovery after COVID-19◆ Global leadership on public health science and data
◆ Climates and Environmental Change◆ And many more interesting lines of inquiry that will be confirmed shortly.

Publisher: International Exchange Promotion Committee

Secretariat of JACHN:

Kaoru Konishi (Osaka University),

Ozawa-building 2F, 4-1-1, Kagurazaka, Shinjuku-ku, Tokyo

Satoko Okawa (Kansai Medical University),

162-0825, Japan

Takashi Naruse (Sompo Institute Plus Inc.),

TEL: +81-(0)3-5206-7431 FAX: +81-(0)3-5206-7757

Yuko Fujimoto (Oita University of Nursing and Health Sciences),

E-mail:office@jachn.net

Natsuki Yamamoto (Keio University)

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