Japan Academy of Community Health Nursing (JACHN)
Established: October 15, 1997
JACHN Newsletter No.10

Topics 1
Upcoming Revision to the Regulation on the Designation PHN,
Midwife and Nurse Training Institutions
Committee for Promoting International Exchange Activities
Since the Act on Public Health Nurses,
Midwives and Nurses was revised on 9 July
2009, extending the minimum periodrequired for PHN training/education fromsix to twelve months, the Ministry of
Health, Labour and Welfare has been
considering necessary revisions to theRegulation on the Designation of PHN,
Midwife and Nurse Training Institutions in
its Commission on the Content and Methodology of Nursing Education. The Commission, at a meeting held on 4
October 2010, agreed to increase the number of credits required for the PHN training/educational curriculum from23 to 28. The most significant impact of this modification is the shift of the core subject group from “community
health nursing” to “public health nursing,” with the latter comprising 16 credits (up from 12 currently) for theory
and five credits (up from four currently) for practice (see Table 1).
In the remarks column, the term “including school health and occupational health” will be deleted, since publichealth nursing (as defined by the MHLW) now includes “school health” and “occupational health” as well as“administrative health.” Instead, the term “including health crisis management” will be added to the remarks
column, in view of the necessity of developing practical proficiency in response to the emerging health needs
today such as health crisis management. The term “including continuous health visits” in the remarks column forclinical training will be replaced with “including continuous health guidance,” on the grounds that the inclusion of
the word “organization” in the subject name renders the word “visit” irrelevant. This change naturally elicited
objections.
Most of the PHN teachers believed and requested, to no avail, as a minimum requirement for addressing
national health needs, that the number of credits should be set at 30 or over, six of which should be allocated topractice, based on the following arguments: (1) any PHN training/educational institution running a 12-month
curriculum actually provides 34 credits for the curriculum; (2) the Working Group on PHN Training/Education of
the Commission on the Enhancement of Basic Nursing Education reported in 2007 that 40 credits should be
required for PHN training/education, including 8 credits for practice; and (3) public health nurses will be required
to perform increasingly sophisticated tasks in the future. Looking ahead, it is essential that all teachers andpractitioners continue to gather and discuss how best to achieve “the level of practical proficiency required of
public health nurses (see Table 2)”, within the minimum framework of 28 credits.
1

Table1. The Regulation on the Designation PHN, Midwife and Nurse Training Institutions
2007

2012

Subjects
Community health nursing
Introduction to community health nursing
Living support for individual/family/group
Development of community health nursing activities
Management of community health nursing

Credits
12
2

Subjects
Public health nursing
Introduction to public health nursing
Support for individual/family/group/organization
Development of public health nursing activities
Management of public health nursing

10

Remarks: Including school health and occupational health
Epidemiology
Health statistics
Health, welfare and public administration

Credits
16
2
14

Remarks: Including health crisis management
Epidemiology
Health statistics
Health, medical, welfare and public administration

2
2
3

Clinical training
4
Community health nursing practice4
Practice for living support for individual/family/group
Practice for development of community health nursing activities
Practice for management of community health nursing

2
2
3

Clinical training
5
Public health nursing practice5
Practice for support for individual/family/group/organization
Practice for development of public health nursing activities
Practice for management of public health nursing

2
2

Remarks: Including the practice of public health center and municipality
Including continuous health visits
Total credits 23"Individual/family:" attained level at graduation in providing care for individuals or families"Group/community:" attained level at graduation in providing care for groups (members of residents' associations,elderly groups needing nursing care, administrative groups, primary school classes, etc.) and forcommunities (municipal governments, workplaces, schools, etc.)■Attained level at graduation
I: Implementation with limited advice
II: Implementation with guidance (under supervision of guidance PHN or instructor)
III. Implementation in intramural practice sessions (simulated planning and implementation using case examples, etc.)
IV: Understanding as theoretical knowledge

Objectives demanded at graduation
Major
level

Medium level

Detailed level

1

I. Proficiency
to identify
community
health needs
and prepareplans

1. Identify
community
healthneeds andprepareplans

A. Assesslivelihoodand healthofcommunity
peoplecontinuously fromvariousperspective
s

2
3
4
5
6
7

B. Identify
existing
and latent8
9Collect and assess objective/subjective information fromphysical, mental and socio-cultural aspects
Collect information, and make assessments of social
resources
Collect information on, and assess natural and living
environment (climate, pollution, etc.)
Make assessments on community people and groups towhich they belong, both individually and collectively
Consider the perspective of those with health needs inmaking assessmentsCollect systematic and chronological information forcontinued assessment
Assess information thus collected to identify community
characteristics
Define existing health needs
Identify people with health needs who have not recognized,
have not expressed, or have not been able to express them

2

3

Remarks: Including the practice of public health center and municipality
Including continuous health guidance
Total credits 28

Table2. Practical proficiency required of public health nurses andattained level/objectives demanded at graduation

Practical
proficiency
required of
PHNs

2

Attained
level
Indi
vidu
al/fa
mily

Grou
p/co
mmu
nity

Ⅰ

Ⅰ

Ⅰ

Ⅰ

Ⅰ

Ⅰ

Ⅰ

Ⅰ

Ⅰ

Ⅰ

Ⅰ

Ⅰ

Ⅰ

Ⅰ

Ⅰ

Ⅰ

Ⅰ

Ⅱ

community
health
needs

10
11
12

C. Plansupport foraddressing
community
health
needs

13
14
15
16
17
18
19
20

II. Proficiency
to provide
continued
support forindividuals,
families,groups andorganizations
andimplement
collaborative/systematic
activities andtheirevaluation tobuildcommunity's
healthpromotion
capacity21

2. Solve/
improve
health needsincollaboration
withcommunity
people tobuild theirhealthpromotion
capacityD.
Implement
activities

24
25
26
27
28
29
30

E. Work with
community
people/stakeholders/orga
nizations

F. Evaluate
and follow
up on
activities
G. Develop
systems forhealth crises
management
and take
precautionar
y measures

III.
Proficiency
to manage
community
health crises

22
23

3. Ensuremanagementofcommunity
health crises

31
32
33
34
35
36
37
38
39
40
41
42

H.
Respond toany healthcrises

43
44
45
46
47

Identify latent health needs and predict possible health
needs
Identify the capacity of community people (capacity torecognize and solve/improve health needs problem and topromote health)
Prioritize health needs
Set purposes and objectives for solving/improving healthneeds
Select appropriate methods to provide support forcommunity people
Clarify procedure for attaining objectives targets andprepare action planSet valid evaluation indexes, method and timing
Protect lives, health, human dignity and rights of community
peopleConduct activities geared to local life style and culture
Collect and manage personal information properly to ensure
protection of privacy
Provide empowerment to draw out the potential ofcommunity people
Provide support to facilitate decision-making by community
peopleProvide support through home visits and consultations
Provide support through health education
Provide support to develop community organizations/self
help and support groups, etc.
Provide information on available social resources, potential
partner organizations and human resources
Mobilize social resources in accordance with support
purposes
Organize teams comprised of stakeholders and relevant
professionals/organizations
Combine as appropriate individual/family support,systematic approach, etc.
Conduct activities in compliance with laws, regulations andpolicies
Record progress in activities against purposes
Build relationships of trust through communication to ensurecollaboration
Share necessary information and purposes of activities
Work together based on recognition of each other's role
Evaluate public health nursing activities
Incorporate evaluation result into next activities
Identify subjects requiring continuous supports
Conduct sustained activities for necessary targets
Take precautionary measures against health crises(infectious diseases, abuse, DV, suicide, disaster, etc.)
Make proposals on development/improvement of living
environment
Develop systems for management of area-wide healthcrises (disaster, infectious diseases, etc.)

Ⅰ

Ⅱ

Ⅰ

Ⅰ

Ⅰ

Ⅰ

Ⅰ

Ⅰ

Ⅰ

Ⅰ

Ⅰ

Ⅰ

Ⅰ

Ⅰ

Ⅰ

Ⅰ

Ⅰ

Ⅰ

Ⅰ

Ⅰ

Ⅰ

Ⅱ

Ⅱ

Ⅱ

Ⅰ
Ⅰ

Ⅱ
Ⅱ

Provide education on prevention of healthcrisesRespond promptly to health crises (infectious diseases,
abuse, DV, suicide, disaster, etc.)
Develop systems to ensure timely collection of health crises
information
Ensure communication and coordination with relevant
stakeholders/organizations to clarify their respective roles
Utilize healthcare provision systems efficiently
Identify causes of health crises and take measures for theirelimination/control
Prevent the spread of health damage

3

Ⅲ
Ⅰ

Ⅰ

Ⅱ

Ⅱ

Ⅱ

Ⅱ

Ⅱ

Ⅱ

Ⅰ

Ⅰ

Ⅰ

Ⅰ

Ⅰ

Ⅱ

Ⅰ
Ⅱ
Ⅰ
Ⅰ
Ⅰ
Ⅱ

Ⅱ
Ⅱ
Ⅰ
Ⅰ
Ⅰ
Ⅱ

Ⅱ

Ⅲ

Ⅲ

Ⅲ

Ⅲ

Ⅲ

Ⅱ

Ⅱ

Ⅲ

Ⅲ

Ⅳ

Ⅳ

Ⅲ

Ⅲ

Ⅳ

Ⅳ

Ⅳ

Ⅳ

Ⅳ

Ⅳ

I. Respondtopost-healthcrisissituation

48

Provide support for restoration of health (response to PTSD,
rebuilding of living environment, etc.)

Ⅳ

Ⅳ

49

Evaluate and rebuild systems for response to, andmanagement of health crises

Ⅳ

Ⅳ

50
J. Develop
socialresources

51
52
53
54

K.
SystematizeIV. Proficiency
to ensuresocialresource
development,
systematizatio
n andpolicy-making
to upgrade
community
health

4. Promote
equitable
use and
distributionof socialresources forlivelihoodand healthimprovement
to ensure thegood healthofcommunity
people

55
56
57
58
59

L.
Policy-maki
ng

60
61
62
63
64

M.
Manage/mobilizesocialresources

65
66
67

V.
Proficiency toensureprofessional
autonomy andcontinued
quality
improvement

5. Improve
the quality ofpracticethroughvoluntary,continuous
learning of
up-to-dateexpertise/techniques
related tohealthcare,welfare andsociety ingeneralN. Utilize
research
findings

68
69

Identify available social resources and problems in
mobilizing them
Provide opportunities, forums and methods for community
people to participate spontaneously in organizational orsocial changes
Build networks among community people and relevant
agencies/organizations
Develop community organizations and services as essential
resources
Assess the need for systematization to solve health needs
Find ways towards systematization, working with relevantorganizations and community people
Evaluate whether mechanisms are functioning
comprehensively
Understand policies, while ensuring consistency with basic
policies/basic plans of organizations (local governments,
workplaces, schools, etc.)
Understand laws and regulations forming the basis ofpolicies
Collect necessary information for policy-making
Document evidence supporting the necessity ofpolicy-making
Based on documented evidence, explain the necessity ofpolicy-making to community people and relevant
agencies/organizations
Consult and negotiate with relevant agencies/organizations
for policy-making
Policy-making based on the characteristics and needs ofcommunity people
Understand the budget mechanism and prepare a draft
budget based on evidence
Ensure coordination of activities and human resources(placement, procurement, etc.), working with relevant
agencies/organization towards policy implementation
Announce and account for the results of policies, activities
and projects
Continue evaluation and improvement to ensure fair andsmooth provision of healthcare/welfare services
Invent methods of solving/improving health needs bytransferring research findings into practice
Conduct research and development on PHN activities inaccordance with social situation and community health
needs

Ⅰ
Ⅲ
Ⅲ
Ⅲ
Ⅰ
Ⅲ
Ⅲ
Ⅲ
Ⅲ
Ⅰ
Ⅰ
Ⅲ
Ⅲ
Ⅲ
Ⅲ
Ⅲ
Ⅲ
Ⅲ
Ⅲ
Ⅲ

O.
Continuelearning

70

Continue spontaneous learning on social situation,
expertise and techniques

Ⅰ

P. Fulfil PHN
dutiesresponsibly

71

Identify one's own challenges to fulfil PHN duties
responsiblyⅣ

1st Report of Commission on Contents and Methods of Nursing Education, Nursing Division, Health Policy Bureau, MHLW, 10 Nov 2010(English translation by JACHN)

4

Topics 2
Guidelines on the Training of New Nursing Staff:
Public Health Nurses
Kazuko Saeki
Faculty of Health Sciences,Hokkaido University

The revision of the Act on Public Health Nurses, Midwives and Nurses and the Act on Assurance of Work
Forces of Nurses and Other Medical Experts in July 2009 introduced nonbinding obligations, including clinicaltraining, for new nursing staff starting work from 1 April 2010.
The Guidelines, which focus on the services provided by public health nurses, are designed to create a systemenabling all institutions hiring new public health nurses to provide training on basic practical skills, regardless offield (health, welfare, nursing care) and scale of the hiring institution.
In principle, emphasis is placed on continuity with basic PHN education, as new PHN training should ensurethat newly hired public nurses develop a professional attitude and practical skills, building on what they havelearned in the basic curriculum.
It is important to develop effective training and guidance systems to allow continuous self-learning. Thus, theGuidelines clearly state the roles of newly hired public health nurses, preceptors, trainers, training officers andorganizations for program planning and management, and illustrate how training programs should be implemented
in coordination with healthcare centers and other core organizations involved in human resource development.
The attainment objectives include four objectives on “competency to work in an organization,” 23 objectives on“professional skills,” and four objectives on “self-management and self-development,” all indicating the skills andlevels of achievement to be attained by newly hired public health nurses within one year of experience andlearning.
As regards methodology, the Guidelines present the concept and method of training evaluation, and explain
OJT and Off-JT as well as their effective combination.
Technical guidance on home visits and community diagnosis is now illustrated in detail, along with leadershipdevelopment.
The nationwide development of training systems for newly hired public health nurses, coupled with a uniform
standard for their development, will help improve public health activities.

5

Voice from Young Researcher

Report on APHA Annual Meeting 2010
& Conference at the University of Colorado
Azusa Arimoto, PhD, PHN, RN
Department of Community Health Nursing,
Graduate School of Medicine, The University of Tokyo

I visited Denver, Colorado, from 5 to 10 November 2010.
On the first day of my visit, Professor Kathy Magilvy of the University of Colorado College of Nursing(UC) invited me to a conference which she had organized at UC. In total, 20 participants attended theconference, including the UC faculty members, Japanese students studying at UC, and faculty members
and graduate students from three Japanese universities. The morning session consisted of presentations anddiscussions on the current status of nursing activities and education in Japan and the results of research at
UC. At lunchtime, an instructor of community health nursing demonstrated the e-learning activity
conducted at UC. A website run by a publisher contains explanations, video clips and pop quizzes on
lectures. Thus, students can visit the website to study at any time and as many times as they want.
A campus tour was organized in the afternoon, taking in the library, laboratories and lecture rooms. All
the laboratories, were equipped with state-of-the-art facilities, where practical sessions and examinations
are held with the participation of standardized patients. The laboratory for home care nursing was modeled
to look like an apartment, complete with a living room, kitchen, dining room and bathroom. Indeed, it was
based on the home care laboratories of some Japanese universities. I was greatly inspired by the ingenuity
incorporated into the educational environment and methodology.
The 138th Annual Meeting of the American Public Health Association was very lively, with the 12,000
participants actively discussing the theme of “social justice.” The session organized by the PHN Section
featured group works by all participants on two topics: “What is social justice for you?” and “Where is theorigin of social justice for you?” While being reminded of the persisting social and health inequalities
caused by racial disparity, I strongly felt that public health nurses are in a position to address suchinequalities in health from the perspective of social justice. In the poster session which followed, I had theopportunity to exchange views directly with researchers working in the same field, regarding the findingsof my research. I also had the honor to talk with some renowned researchers. I believe that one of the
major benefits of participating in an international academic meeting is gaining firsthand knowledge of thelatest information and trend reported in textbooks or research papers. I would like to continue with myresearch and to contribute further to such international meetings.

6

【Greetings from the Conference Chair】
It is my great pleasure to host the Second Japan-Korea Joint Conference on
Community Health Nursing here in Japan.
The previous Conference was held in Seoul, Korea in November 2007, and with morethan 100 participants from Japan provided an excellent opportunity for the two countries todeepen mutual exchange. In both countries, although situations differ slightly, there are regional
residents young and old who live with a range of health problems. Nursing professionals
working in communities are tasked with addressing health issues involving individuals,
families and communities , and offering support toward improvement. This Conference will
provide an arena for sharing the challenges and future prospects for developing
community-based nursing, and discussing their practical applications to education, research and practice in the fieldof community health nursing,
I sincerely hope this Conference will contribute to better the health and welfare of people in both Korea andJapan.
I look forward to as many of you as possible participating in the conference.
Dr. Katsuko Kanagawa
Date: July 17 (Sun)・18 (Mon), 2011
Venue: Kobe City College of Nursing (3-4 Gakuennishi-machi, Nishi-ku, Kobe)
Main Theme: Challenge and Innovation on Community Based Nursing
Chair: Katsuko Kanagawa (President, Kobe City College of Nursing )Organized by: Japan Academy of Community Health Nursing
Korean Academy of Community Health Nursing
Program○Keynote speech○Special Lecture○Symposium 1○Symposium 2“Challenge and Innovation on Community Based Nursing.”“Day- to- Dayness and View of Health in Japan.”“Strategies for Effective Community Development for Health Promotion.”“Distinguishing Activities of Community Based Nursing： its Implementation and
Prospects.”○Information exchange 1 “Supporting the Infirmed Elderly and Their Family Dwellings in theCommunity under Long Term Care Systems within Japan and South Korea.”○Information exchange 2 “Strategy of Public Health Nursing Action on Child Health：Collaboration with Related Agencies. “○General Presentation (Oral and Poster)Organizing Secretariat: Kobe City College of Nursing, Community & Home Health Nursing
FAX: 078-794-8434 E-mail: jkjcchn2@tr.kobe-ocn.ac.jp【Web site】 http://jkjcchn2.umin.jp/en/index.html

7

The 13th Annual Research Conference of JACHN was held in Hokkaido, Japan on 10th-11th, July, 2010
The conference was held at Hokkaido Citizens Activities Promotion Center in Japan. The chairperson was Kazuko
Saeki (Professor, Faculty of Health Sciences, Hokkaido University).
A total of 491 people attended the conference. Among them 360 participants were from JACHN members and 131
from JACHN nonmembers.
The main theme of the conference is “Propose the policy for reforming health disparity of society by the community
health nursing”. Speeches, symposiums, oral and poster presentation, round table session and workshops were held toallow members to present their practical exercise as well as results of educational and research activities, and to
exchange opinions on them.
There were 45 general oral research presentations, 110 poster presentations, 6 round table sessions and 7 workshops.
The participants discussed areas of common concern for public health nursing, occupational health nursing and homecare nursing .

（By M.Hirano）

Secretariat of JACHN:
Department of Community Health Nursing,
Graduate School of Medicine, The University of Tokyo
7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan 113-0033
Fax: +81-3-5841-3648
E-mail: chikango-acd@umin.ac.jp

Publisher: Committee for Promoting International Exchange Activities
Reiko Okamoto (Okayama University), Kiyomi Asahara (St. Luke's College of Nursing),
Mikiko Ito (Osaka University), Saori Iwamoto (Kobe City College of Nursing),
Miho Ono (Kawasaki University of Medical Welfare), Mari Okada (Okayama University)
Graduate School of Health Sciences, Okayama University
2-5-1 Shikata-cho, Kita-ku, Okayama, Japan 700-8558
Fax: +81-86-235-6865
E-mail: reiko@md.okayama-u.ac.jp8