86

Vol. 16APRIL 2017

Japan Academy of Community Health Nursing
Established October 15, 1997

Topics of Japanese Community
Health Nursing

The progression status varies from place toplace: large cities with stable total population andrapidly growing population of over 75 elderly, andtowns and villages with a decrease of total

1. Community-based Integrated Care
Systempopulation but gradual increase of population over
the age of 75.
It is necessary for municipalities, as insurers of

Kumiko Morita

the Long-term Care Insurance System, as well as

Graduate School of Health Care Sciences, Tokyo

prefectures, to establish the Community-based

Medical and Dental University

Integrated

Care

Systembasedonregional

autonomy and independence.
In Japan, since the establishment of thelong-term care insurance system in 2000, thepopulation over the age 75 has increased rapidly

2. Seamless Support from Pregnancy
through the Child-rearing Period

and this increase will continue up to 2025.
From around 2030, the rapid growth of the

Chikage Tsuzuki

population over age 75 will level off but theFaculty of Nursing Sciences, Kobe City College of

population over age 85 will continue to increase for

Nursing

another 10 years.
Facing this situation, a structure called ‘the

In Japan, a society with aging population andCommunity-based Integrated Care System’ will be

low birthrate are progressing. The number of live

established.

comprehensively

births per year has continued to decrease in recent

ensures the provision of health care, nursing care,Thisstructure

years, and had dropped to one million, with a total

prevention, housing, and livelihood support. By this,fertility rate of 1.46 in 2015. In comparison withthe elderly could live the rest of their lives in theirvarious countries of Europe and America, this value

own ways in environments familiar to them, even if

is the low standard in Japan. There are several

they become heavily in need of long-term care.

factors to this background. Firstly, because theAs the number of elderly people with dementia

number of female workers has been increasing,is estimated to increase, establishment of thethey have to deal with multiple tasks. Secondly, theCommunity-based Integrated Care System ispopulations

important to support the community life of themales/females and the numbers of nuclear families

elderly with dementia.

have been increasing. Other factors include the1ofunmarried

or

late

married日本地域看護学会誌

lack

of

childcare

supportforthechildcareVol.20 No.1, 2017

all pregnant women and mothers is followed up

generation and the isolation of child-rearing.

continually from early pregnancy. Public healthndnurses perform home visits and consultation as"Healthy parent and children 21 (2 )" is arearingneeded and are concerned with the needs ofpromotion in Japan. The policy aims for "the society

family, parent and child. They focus on providing

into which all children grow healthily" for the

careful and intimate support to families withdecade starting in 2015. One of the targets ischildren, while promoting the development of a“seamless support from pregnancy through thecommunity which can watch over children’s healthy

child-rearing period”. The goals are reduction andgrowth and provide a supportive network forearly detection of risk of abuse by dealing withfamilies with children.

policyofmaternal/family

and

child

anxiety concerning child-rearing, and isolation.
Concretely, this means the enhancement ofmaternal and child health measures throughout

3. Recent Movement in Public Health
Nurses Education

pregnancy, delivery and childcare. Furthermore,
the cooperation system between each project andMasako Kageyama

the related organizations are being strengthened,

Osaka University Graduate School of Medicine

includinganationwide

establishmentofcomprehensive support centers as a one-stop
consultation base for maternal and child health.

As of 2014, approximately 50,000 publichealth nurses (PHNs) have been employed at

A public health nurse is stationed in eachplaces of work. The majority (approximately 70%)

municipality with a population of 5,000-20,000of them work at public health centers, municipal

people and is concerned with residents’ health care

offices, or other similar public institutions in Japanin each charge area. At the start of pregnancy, a(Public Health Administration Report 2014 by the

pregnant woman notifies the municipality of her

Ministry of Health, Labour and Welfare).

place of residence, and of her pregnancy, and a

The enactment of Regulations on Publicmaternal and child health handbook is issued.

Health Nurses in 1941 provided a regulatory

During the pregnancy, there are a further 14 times

framework for certifying PHNs. The first National

for prenatal health check, and various subsidies for

Public Health Nursing Examination was conducted

the cost of childbearing are available. Afterindelivery, home-visit guidance is provided by public

colleges/universities sharply increased and many

health nurses for all infants. Furthermore, 3 times

4-year(infant, 18 and 36 months old) of health checkups

include a training program for PHNs.

has

becomealegalrequirement

in

1952.

Since

1992,

college/university

four-year
education

nursing
programsall

In these years, enhancement of nursing

municipalities. The participation rate of healthservices has been required to meet advanced andchecks in the municipalities exceeds 90 percent.

diversified healthcare, an aging society with fewer

Public health nurses are conducting healthchildren, and diversification of citizens’ needs. In

checks, various kinds of health guidance and2009, amendment bills for the Act on Public Healthconsultation for maternal and child health in the

Nurses, Midwives and Nurses gained approval for

health centers of the municipalities. The situation of

the first time in 60 years. The amendments specify

2

87

88

graduation from a 4-year college in the opening of
the provision on the eligibility to take the nurse’s
examination, and extend the minimum period

4. Current Situation and Educational
Approaches in Home-visit Nursing
in Japanrequired for PHN training/education from six
months to one year. The ministerial order was

Noriko Yoshiyuki

revised and enforced in 2011, when the number ofDepartment of Home Health Care Nursing, Osaka

credits required for the PHN training/educational

City University

curriculum was increased from 23 to 28. Under
these

major

revisions

of

the

PHN

With the aging population and rising needs for

curriculum,many

4-yearlong-term care services in Japan, there has been a

programshaveparadigm shift in healthcare from hospitals tochanged to educate only selected nursing students.

community settings. Home-visit nursing is antraining/educational
college/university
The

education

training/educational

important community-based service, which provides

curriculum has the following four types: (1) nursing

care for individuals living at home. This article

colleges/universitiesstudents

current

fornursescolleges/universities

PHN
provideandprovideeducation

toalldescribes the current issues and strategic education

PHN;

nursing

approaches of the home-visit nursing workforce intoJapan.

(2)

educationallstudents to become nurses but limited students for

1) Shortage and Demand for Home-visit Nursing

PHNs; (3) one-year course provided by three-year

Despite a great demand for home-visit nursing,colleges or training institutions; and (4) two-year

the majority of nurses in Japan work in hospital

master’s course. According to the Ministry ofsettings. The percentage of the home-visit nursing

Health, Labour and Welfare, there are 258 PHN

workforce has not changed in recent decades,

training/education institutes as of November 28th,

consisting only of 2% (41,000 home-visit nurses, in

2016. Over eighty percent of them are 4-year2013) of the total nurse workforce in Japan.

colleges/universities.

Home-visit nursing supply and demand could

The Ministry of Health, Labour and Welfare

become even more problematic in the next ten years,

has published 2035 Japan Health Care Vision.

when baby boomers reach 75 years old. In order toJapan has faced the fastest aging society withmeet the future demand for a home-visit nursing

fewer children under a tough economic situation.

workforce, it is estimated that at least 50,000

To manage limited resources and solve difficult

home-visit nurses are needed: moreover, to improvehealth problems, there are great expectations of

the current home death rate in Japan (13%) to that

PHNs. In the grand design declared by the Japanof the Netherlands (30%), an estimated 150,000

Academy of Public Health Nursing (JAPHN), thehome-visit nurses will be needed by 2025.

Academy is promoting PHN training/education toThis home-visit nursing shortage relates not only

the level of master’s course as one of the strategies

to numbers, but to an overall skills’ deficit in theto prepare for challenges in the years up to 2035.

workforce. The average age of home-visit nurses isMore PHNs students need to be educated to47, which is older compared to hospital-based

master course level to gain greater competency.

nurses, whose average age is 37. In addition, themajority of Japanese visiting nursing agencies

3

日本地域看護学会誌

generally have less manpower, with an average ofopportunities,

4.7 nurses per nursing agency. These factors,

training, hands-on hospital training, e-learning,

coupled with the staff shortage, have resulted in

career counseling, and skill assessment. Suchdifficulty of maintenance of skills and development ofeducation programs enable new graduate nurses tospecialties within home-visit nursing. Therefore, thedevelop their competencies, knowledge, skills, andcurrent issue of home-visit nursing is to ensure theattitudes, and contribute to the recruitment andquantity and quality of manpower.

retention of new graduate home-visit nurses.

on-the-job/off-the-job

In the next decade, the role of home-visit2) Aligning Education and Training with theHome-visit Nursing Practice Environment

includingVol.20 No.1, 2017

nursing,asaprofession

which

can

deliver

There are two possible approaches, focusing on

appropriate clinical care and enrich the quality of life

education and on training for home-visit nurses, as aof individuals in the community, will be even morestrategy for strengthening the home-visit nursing

vital.

workforce in Japan.

community-based health care system, action and(1) Continuous Professional Development

investment in the improvement of the home-visit

With

rapid

changesincommunity-based

In

order

to

establishasustainablenursing workforce are urgent.

healthcare, it is critical for home-visit nurses to
update their professional knowledge and skills, toKorea-Japan 3rd Joint Conference
on Community Health Nursing in
Pusan, Korea

ensure the continued delivery of high quality, andeffective evidence-based care. However, many
home-visit nursing agencies are not able to offer
continuing education, due to deficit in resources. To
tackle this problem, nursing organizations such as

1. Overview

the Japanese Nursing Association, and localrdHome-visit Nursing Associations are playing a

The 3 Korea-Japan Joint Conference on Commu-

critical role in curriculum development, by identifying

nity Health Nursing in Busan, Korea

job needs and vacancies, advertising programs, andBusan, Republic of Korea on 1th-3th, July, 2016providing equipment and materials for training.
Furthermore, there are some career development

Yukiko Kanaya

opportunities like Certified Nurse Specialist (CNS)

Department of Home Health Care Nursing, Osakaand Certified Nurse (CN) in the fields related to

City University

home-visit nursing.
(2) Education Initiative for New Graduate Nurses

The conference was held at Bexco Convention

In recent years, education programs for new

Center in the Republic of Korea, hosted by thegraduate nurses have been developed around the

Korean Academy of Nursing Science (KACHN) andcountry to respond to the shortage of young

the Japan Academy of Nursing Science (JACHN).

manpower in this field. In many programs, local
Nursing

associations,educational

institutions,

hospitals, as well as home-visit nursing agencies

A total of 362 people registered and attended
the conference. Among them 170 participants werefrom Japan, 190 from Korea.

collaborate with each other to provide learning

4

89

90

Awardee, Ms. Sawa Teraoka

Awardees, Ms. Yukiko Anzai (second from left)
and Ms.Mina Ishimaru (third from left)

The theme of the program was “Future

pursue PHN’s health care practice improvement andDirections: Disaster Preparedness and Nursing”. A

PHN’s learning and professional development. In

number of keynote speakers were invited to present

addition, we would like to continue to work on faculty

aspects of their research that represented different

development. Thank you very much.

perspectives on disaster preparedness. There were
22 general oral research presentations and 224

Yukiko Anzai (Awardee of poster presentation)

posterSchool of Nursing, Miyagi University

presentations.

Among

them,

7

oral

presentations and 119 posters were by Japanese
We were awarded best poster presentation atnurses. Awards for the oral and poster presentations
were given to three Japanese participants.

the Third

Korea–Japan Joint Conference on

Community Health Nursing for our study of

2. Awardees in Japanese Presentators

Earthquake Disaster Support Activities of Public
Health Nurses. This study was conducted toMina Ishimaru (Awardee of oral presentation)

elucidate public health nurse activities during

Graduate School of Nursing, Chiba University

earthquake

disasters

based

on

experiences

obtained during the Great East Japan Earthquake
I feel honored to receive the Best Oraland its immediate aftermath. First, we interviewed

Presentation Award on ‘Using faculty self-reflection

public health nurses and analyzed public healthto construct a research support model for publicnurse activity contents. Then we administered two

health nurses.’ I am proud of our collaborative

questionnaire surveys for which we carefully

relationships between universities and public healthselected activity contents. This report described thenurses in Chiba over the last 40 years, and among

analysis and findings of the second survey.
This

the universities which contributed to this research.

study

was

conducted

through

Furthermore, we will continue to provide researchcollaboration of seven researchers and many public

support as best we can.

health nurses. We have gratefully accepted thisThrough this research support, we would like toaward for our study on behalf of all contributors. We

5日本地域看護学会誌

Vol.20 No.1, 2017

extend our sincere gratitude to the academic

community health centers. Such activity includes

meeting board.

dentistry and medical examination of elderly people
or students, classes on lumbago prevention and

Sawa Teraoka (Awardee of poster presentation)other things. Community health centers have been

Graduate School of Medical Sciences, Kyushu

using Chinese medicine effectively. In maternal andUniversity

child health care, the community health center holds
baby massage and classes for pregnant women.

This time, I am very honored to receive theBest

PosterPresentation

Award of

rd

The 3

The center also distributes diapers and milk to
low-income families

Korea-Japan Joint Conference on Community

Hopo is carrying out the maintenance and

Health Nursing. In this study, we examined the effectmanagement of the subway No. 2 line. 150

on the cognitive function of horticultural activities of

employees work every day, and there are two public

the elderly with dementia. Our results led us tohealth nurses. In Hopo, Public health nurses carrysuggest that the effects on cognitive function wereout health education to the workers twice per month.

different

In South Korea, heavy drinking is a big health

from

the

existenceofhorticulturalproblem. Hopo put up a banner and a signboard to

experience in the past.
From now on, encouraged by this award, wewarn people against heavy drinking.
I think community health activity does not differ

would like to develop this study in order to create amuch between Japan and South Korea. However, I

program that can be utilized in the field.
Finally, I would like to thank from the bottom of

was impressed with the additional support to families

my heart everyone who gave me so much support

in need. Similar awareness and support is also

and cooperation.

needed in Japan for families in need, now and in the
future.

3. Brief Reports of Participants
Ayako Okochi
Satoko Okawa

Graduate School of Medicine, Yokohama City

School of Nursing, Osaka Prefecture University

University
rd

The 3

I participated in a professional visit to the Jin-gu

KJJCCHN was held on 1-3 July atcommunity health center, and the Hopo Rolling

Bexco in Busan, attended by 400 delegates, owing

Stock maintenance office. In this report, I focus on

to the Chair and President of KACHN, Prof. Kyung

these two facilities.

Ja June. Japanese delegates included President of

There is no qualification of public health nurse

JACHN, Prof Misako Miyazaki. Busan is the secondin South Korea. The nurse who works in a publiclargest city in Korea and also a scenic port city. With

health section is carrying out a role of public healththe theme “Challenges and future directions:nurse.

Disaster preparedness and nursing”, the conference

Based on the Community Health Law, healthcare

activity

Community

focused on how Korean and Japanese academies ofisperformed

in

South

Korea.

community health nursing are leading to community

healthactivityiscarriedoutbuilding for disaster preparedness. For this theme,

in

6

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92

Naomi Fukushima
Department of Health and Welfare, Izumi City
Municipalrd

I attended the 3

KOREA-JAPAN Joint

Conference on Community Health Nursing, in Busan,
Korea on July 2-3, 2016. The theme of thisconference was Challenges and future directions:
Disaster

preparedness

and nursing, and thecontents were very interesting for me because I had
carried out health activities against disaster for a
the program included groundbreaking lectures,month as a public health nurse at the time of Greatseminars

East Japan Earthquake in 2011.

andpresentations

thattheoreticalfindings

comprehensivebalanced
andMany of the participants in this conference

practice-based research that consequently signified

were

the partnerships between community, professionals

universities,

andacademia.

andapparently

students

very

few

from
were

similarly

participants from practical workplaces like me as amassivedisaster:municipal public health nurse, but I enjoyed the

MERS-CoV outbreak and Sewol ferry disaster; theconference very much and learned a lot from thegreat East Japan earthquake. This joint conference

academic researchers.

elaborately

and

and

teachersJapanexperienced

Korea

academic

unprecedented

andpurposefully

discloses

theseThis time, I gave a poster presentation with thedisasters’ health effects and clues to solutions in thetheme of “Drinking status among ambulatory frail

past, present and future.

elders living at home”. I was able to obtain much

One of my main objectives of attending thissignificant

knowledge

from

many

other

conference was to moderate the oral session with apresentations of researchers that appeared to be

Korean moderator, Prof. Young Ko. The Concurrent

useful for my future practice.

session 2 consisted of three presentations that

In addition, at the welcome reception held

depicted child health, health behaviors and nurses’

during the conference, I was very impressed with thedisaster management core competencies. The

heartfelt hospitality including a lot of delicious

presenters and audiences discussed Japanese

Korean cuisine, music performance by students, andchildren’son

so on, and I got to know new research colleagues. I

cardiovascular disease and the development ofwill make an effort to make use of the precious

disaster preparedness ability. I deeply appreciate

experience of participation in this conference for theProf. Ko for her thoughtful handling of the session,

future community health activities in Japan.

obesity,theinfluence

of

diet

and the expression of hospitality that I found in thecollaboration

among

KoreanandJapanese

Finally, I would like to express my sincere
gratitude to the Korean and Japanese people who

researchers and in Korean student volunteers’

weresmiles.

conference.

7

committed

tothepreparation

of

this

日本地域看護学会誌

Vol.20 No.1, 2017

Ryo Horiike

health at the level of geographical characteristics.

Osaka University Graduate School of Medicine

Additionally, Korean researchers’ posters at thevenue really stimulated me and inspired me. Thisrd

inspiration will help me and improve my research. At

KJJCCHN. The venue was beautiful and very large,night, many Koreans were walking quite fast along

there were many posters and a lot of participants

the promenade, which lay alongside the sea shore. I

listened to the lectures. The lectures were reallyhave never seen a scene like this. I felt strongly that

helpful and I spent a precious and meaningful timecommunity health nursing must be in accordance

there.The title of my poster presentation was “GIS

with a country’s culture and I’ll put that experience toanalysis for community health nursing diagnosis”.

use for my next international conference.

I participated and presented at The 3

GIS focuses on geographical characteristics. The

Continuously

researchingandupdating

geographical characteristics of Busan are different

information makes possible good research andfrom Japan (e.g., Town planning, building, nature,presentation. The 3

transportation, and road). This was very impressive

participating and I am grateful to everyone involved

for me and made me think deeply about community

in this conference.

rd

KJJCCHN was really worth

The 20th Annual Research Conference of JACHN
Theme： “Advanced and Creative Community Health Nursing within a Comprehensive Community Health Care
Framework”
Date：August 5-6, 2017 (Saturday - Sunday)
Venue：Beppu International Convention Center B-CON Plaza
Chair：Sachiyo Murashima (Oita University of Nursing and Health Sciences)
Program：◆Chairperson’s Speech: Sachiyo Murashima“Construction of Discipline of Community Health Nursing to Support the Future of the Community”
th◆The 20 Anniversary of JACHN Special Lecture: Kathy Magilvy (University of Colorado)“Ideas for a New Community Health Nursing Based on Community-based Aging Care and Research in the US”
th◆The 20 Anniversary of JACHN Special Symposium - Board of Directors Planning Seminar“Community Health Nursing and Social Implementation: Is Research in Community Health Nursing Being Put
to Use in Practical Reform?”◆Symposium ◆Educational lecture ◆Open lecture ◆The appointed workshop ◆Poster presentations◆Workshops ◆Free assemblies ◆Reception
Website：http://jachn20.umin.jp/
Publisher: International Exchange Promotion Committee

Secretariat of JACHN:

Ayumi Kono (Osaka City University), Kaoru Konishi (Osaka

162-0825 2F Ozawa-building, 4-1-1, Kagurazaka,

University), Chikage Tsuzuki (Kobe City College of Nursing),

Shinjuku-ku, Tokyo

Kumiko Morita (Tokyo Medical and Dental University),

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

Yukiko Kanaya (Osaka City University)

E-mail:ckango@zfhv.ftbb.net

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