日本地域看護学会誌

No. 18APRIL 2019Japan Academy of Community Health Nursing
Established October 15, 1997

Topics of Japanese Community
Health Nursing

Vol.22 No.1, 2019respect the intention and decision-making of theperson's own future medical care. In addition,
people have to talk about their wishes concerning
future care with health care professionals before

1. Current Status of Advanced Care
Planning in Japan―Comparison with the UK―

their cognitive function is reduced.
In the UK, NPO organizations that support
dissemination of ACP knowledge to citizens, suchas information provision of ACP and educational

Miho Hamayoshi

activities about ACP, are active. As a result, ACP is

School of Health Sciences, Bukkyo University,

gradually penetrating to the general public.

Department of Nursing

NHS also recommends ACP for people withdementia, and in addition to preparing guidelines

Advanced Care Planning (ACP) is important in
the future of medical care and nursing care.
Even in Japan, interest has been increasing
little by little in the medical field.

on practical methods, they are making efforts to
expand its implementation.
However, because various professionals areunable to share the contents of ACP implementation

ACP confirms the hope for future health careafter the actual implementation of ACP, the care thatand is regarded as an important involvement inthey decided by the ACP is sometimes not selected

continuing care that respects the will of theat the actual moment of decision.

individual: implementation has been promoted
around the world mainly in Western countries.

Care My Coordinate (CMC) is developed todeal with this problem. It is a system that shows

Recognition of this necessity in Japan has

hope for care of oneself in the cloud systems andbeen increasing in recent years, but the actual

can confirm this hope even when the person is

implementation is still in the trial-and-error stage,transported to an emergency room or different

and research on ACP is underway. In the "survey of

hospital.

consciousness at the final stage of life" by the

As ACP implementation will be progressing in

Ministry of Health, Labor and Welfare, it is also

Japan in the future, we think that development ofclear that the necessity of consciousness of ACP

such an information-sharing tool will be required.

implementation is high among both medical

There are laws concerning ACP in the UK, otherprofessionals and the general public, but theparts of Europe and the United States, by which

number actually implementing is very low.

future hopes decided through discussion with care

The most important viewpoint of ACP is toprofessionals

must berespected.

In

Japan,

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however, ACP is not yet accepted by law, andfuture wishes on decisions regarding ACP are still

disaster.
For public health nursing education programs inparticular, a notable point is that we have to makenot protected by law.
In the future, study of the situation of ACP

necessary adjustments after checking the situation

developed in other countries, including problemsof disaster damage in municipalities within theconcerning legal development, and discussion of aprefecture and consider modifications to practicalframework of ACP implementation suitable totraining locations, student placements, and curricular

Japanese culture is required.

content. Moreover, it has become clear that theconditions

2. School Administration and Education
Security in Times of Disaster at
Public Health Nursing Educational
Institutions

surrounding

insuranceforpractical

training carried out in hospitals are different fromthose for practical training carried out at locations
outside of universities or hospitals. Sometimes,
coverage of insurance does not apply in the lattercase. While simultaneously caring for their own

Yuko Toyama

homes and families, faculty and staff continue toFaculty of Medicine, University of the Ryukyus

remain engaged with measures to address school
administration

In the aftermath of the 2011 Great East Japan

andeducation

security

duringaftershocks, often in a state of sleep deprivation.

Earthquake and 2016 Kumamoto Earthquakes,

Potential preparations for education security indisaster countermeasures as well as education

normal times include improving the facilities andsecurity and support frameworks in times ofsystems of educational institutions, creating crisis

disaster have been investigated by the Japan

management manuals for use during practical

Association of Public Health Nurse Educational

training,

Institutions (JAPHNEI) and the Japan Association

coverage.

andarrangingadequate

insuranceof Nursing Programs in Universities (JAPNU). This

Potential improvements to educational institutions’

report presents a summary of school administration

facilities and systems chiefly include establishingguidelines

educational

disaster prevention plans for the educational institution

institutions for public health nurses in times ofas a whole, improving teaching and researchdisaster. The report was prepared by JAPHNEI’s

infrastructure (e.g., earthquake-proofing), improving

Project Committee with reference to personalcrisis managements systems, formulating disasternarratives and records from faculty and staff withprevention and crisis management manuals, collecting

personal experience of disaster situations.

information on class hours and practical trainingforschoolsafetyat

For educational institutions, the occurrence ofa disaster entails the need to confirm student

arrangements in times of disaster, and maintaining
stock inventory and requisite budgets.

safety, to modify the academic year and class

Crisis management manuals for use duringschedules, to inspect and repair teaching andpublic health nurse practical training will require

research facilities, and to perform rapid response

principles corresponding to seismic intensity andactivities in parallel with support activities on behalf

the formulation of flowcharts for communicationof students and local residents affected by thesystems and actions corresponding to the timing of日本地域看護学会誌

Vol.22 No.1, 2019a disaster (e.g., while in transit to the site offamily members or services under the long-term

practical training or during practical training itself).

care insurance program at home. In response to

In practical training guidelines, it will also be

this rapid increase in the number of old adults withnecessary to list items to bring to practical training

dementia, seven provisions (New Orange Plan)

locations (e.g., drinking water and food), steps forhave been implemented since 2015, with theconfirming the safety of practical training facilities

overall policy of “realizing society where persons

and travel routes before and after practical training,with dementia have their intentions respected andand actions to be taken when a disaster occurs.

live in a pleasant and familiarized environment in a

In terms of insurance, as mentioned above, it

way that they desire as long as possible.”will be necessary to arrange insurance coverage

Introduced in this article are two of the sevenfor students as well as faculty and staff thatmeasure provisions that are being addressed byincludes a natural hazard liability clause consistentcommunity comprehensive care centers, whichwith natural disasters and the characteristics ofplay the central role in community comprehensive

practical training locations other than schools or

care for the elderly.
The first such provision is “raising awarenesshospitals.
repeatedand promoting understanding of dementia.” At

earthquake disasters in recent years, emphasis has

community comprehensive care centers, they are

been placed on reducing disaster risk and building

working to raise awareness of dementia, promoteresilience against disasters. Similarly, with school

educational activities on the disease, and train

administration, the impossibility of completelydementia

preventing disasters means that it is necessary tounderstanding

prepare on a daily basis to maintain school safety

community.

Based

on

the

experienceoffollowing earthquakes and mitigate the impact ofthe damage on students and staff.

supporters,
of

in

a

dementiabid

todeepenthroughout

their

For example, community comprehensive carecenters organize dementia supporter training
seminars for students through cooperation with

3. Dementia Care at Community
Comprehensive Care Centers

local elementary and lower secondary schools. For
elementary students, a DVD is used containing My
Grandma, a story that tells the tale of a child whose

Yukiko Kanaya

grandmother succumbs to dementia, thus ensuring

Department of Home Health Nursing, Osaka City

that they gain knowledge on dementia and know

University

how to respond appropriately to old adults withdementia. This seminar is offered to the faculty

As the Japanese population is aging by leaps

members and caregivers, as well as children, withand bounds, dementia has become one of the mostthe content tailored to each group, in order toprevalent diseases in the country, and by 2025,

encourage them to discuss dementia at school andabout one out of every five adults aged 65 or older

home.

are expected to be suffering from dementia. Now,

The second provision is “creating age- andabout seventy percent of such older adults withdementia-friendly community.” Activities here

dementia are receiving long-term care by their

include support of daily life, establishment of a

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comfortable living environment, and assurance ofaway from work, the economic poverty associatedsafety for persons with dementia. In one community,with the separation from work is regarded as aforproblem. According to the Basic Survey ofexample,community

comprehensive

care

centers organize workshops for the residents andEmployment

Structure

in

2017,

there

were

professionals involved in health and welfare

approximately 3.66 million people who care for theirservices in each district to determine challenges

families while working (hereinafter referred to asthat may prevent the residents from continuing to" working caregivers "), with the numbers of bothlive in the district when they succumb to dementia

men and women increasing after the age of 40 andso that they can be addressed and solved. In

peaking in the latter half of their 50s There are

District A, they chose to deal with the challenge ofmany people in this situation in their 50s and early

not knowing where in the district they can send an

60s. Working caregivers are in the generation thatSOS when something happens to a person withis the center of economic and career development,

dementia and developed a community resource

and the economic loss to Japan is great due to themap that shows facilities, shops, and private

turnover among caregivers.

houses from which they could seek help. In District

In addition, employees leaving work in order toB, they addressed the challenge of not knowing

carry out caregiving tend to be alone in a situation

how they should treat and watch their familyof decreasing household in come and increasing

members or neighbors who may have succumbedsocial isolation. Those with low economic status

to dementia and organized a workshop using role

are strongly mentally distressed, physical healthplaying in their community.

decreases early in their lifetime, and as their age

Community comprehensive care centers are

becomes higher, the disparity expands. This

providing persons with dementia with care bysituation is also said to be a trigger of abuse to thecreating a community where they may live

elderly and even a cause of caregiving murder. The

peacefully,

results show that the effects of leaving workinadditiontooffering

individual

supports for them and their family members.

adversely affect the physical and mental health andlife of caregivers.

4. The Current Situation in Japan of
Family Caregivers Who also WorkA

characteristicfeatureoftheworking

caregivers is that because of the high level of carerequired of the elderly, and the continuously

Kaori Fukayama

increasing difficulty of continuing such a heavy

Graduate School of Nursing, Osaka Prefectureburden of home care, there is a tendency to cut

University

back on work by shortening hours or changing theworkplace. Meanwhile, it has also been shown that

In Japan, "Zero turnover by caregiving" is citedcontinuing to work provides some time to escapeas one of the driving forces of economic growth.

from nursing care, and it has the added significanceApproximately 100 thousand people are leaving forofreasons of caregiving (hereinafter referred to as

recipients, self-existence, and mental stability.

maintaining

good

relationships

with

care

employees leaving by caregiving), and since less

Considering these circumstances, it is necessary

than half of them can be reemployed once they getto support the decision-making and working

日本地域看護学会誌

Vol.22 No.1, 2019caregivers with diverse lifestyles and values to

Scholars 2019 was conducted in Singapore on

make choices about living with care recipients with

17-18 January 2019.

due consideration for their own health and life. It isannual conference was “Preparing a New Decade

important to consider that nurses have a viewpointof Doctoral Education and Research: Innovation,of care management considering the life and living

Transformation and New Dynamism” and nursingof their families, which leads to compatibility

scholars and doctoral students from East Asia

between work and caregiving. For care recipients,

sharedbecause of the time spent alone during theexchanged scientific knowledge and the latest

caregiver's working hours, it is necessary to utilize

research findings. Many nursing scholars fromtheir strengths while securing safety and support

Japan, including members of the Japan Academy

towards autonomy.

of Community Health Nursing, participated in the

ideas

and

The main theme of theacademic

insights

andMeanwhile, for working caregivers, it is difficult

conference. One highlight of the scientific programfor nurses to meet directly or talk with them, and itof the conference was the research methods

is difficult to grasp exactly what kind of tasks the

symposium dedicated to the development andworking caregivers actually have to carry out.

innovation in research methodology of scientific

Therefore, it is necessary to infer the appearance ofinquiry and the workshops for publication andlife from the environment of the home and tometa-regression. It also included a plenary session

assess the working caregiving in collaboration withaddressing geriatric, palliative care and women’scare managers and others. It is also necessary nothealth research and challenges. There were more

only to improve service coordination but to reducethan 620 poster presentations and 65 oral

the burden of direct nursing care of working

presentations covering a wide spectrum of nursing

caregivers, and at the same time to extend as

and health-related topics including community

much support as possible, especially for mental

health nursing and various other areas of specificstabilization so that they can continue working.

nursing expertise, including approximately 400

The 22nd East Asian Forum of
Nursing Scholars 2019 in
Singapore

presentations from Japanese participants. Participants
exchanged and shared their experiences and research
results on all aspects of the transformation or
innovation of nursing and healthcare practice and the
dynamism of doctoral education.

1. Overview
The 22nd East Asian Forum of Nursing

2. Brief Reports of Participants

Scholars 2019
Singapore on 17-18 January 2019.

Yuko

Fujimoto

Kobe City College of Nursing
Ayumi Kono
Department of Home Health Care Nursing, Osaka
City University

I participated in EAFONS, held in Singapore
for two days on 17-18 January 2019. There were
presentations from an extremely wide range ofThe 22nd East Asian Forum of Nursing

fields, including public health nursing, home-visit

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nursing and disaster nursing. There were many

international conferences.
Singapore is an amazing country. The foodpresentations from Japanese researchers, and Iby

was delicious and I enjoyed walking around in theJapanese researchers on nursing research in Asia.

evenings taking in the fantastic night view. Of

My presentation was entitled “Differences in thecourse, I also visited the Merlion. It was a brilliant

knowledge and skills recognized as necessary by

two days.

appreciatedthestrenuous

efforts

made

Next year’s EAFONS will be held in Thailand.

mothers and grandmothers for raising grandchildren
in Japan”. “Raising grandchildren” is strongly

All

you

young

researchers

shouldconsiderinfluenced by the social background of Japan, so I

attending this conference as your first foray into thewas worried that my presentation would not draw

world of international conferences.

the interest of anyone but Japanese researchers,
but many researchers viewed my poster withMika Hokiinterest. I was able to glean valuable suggestions

Graduate School of Health Care Sciences, Tokyothroughdiscussions

Medical and Dentist University

countries

with

with

different

researchers
culturalandfromsocialbackgrounds to Japan, which I would not have

The 22nd East Asian Forum of Nursing

been able to gain in conferences held in Japan.

Scholars 2019 was conducted in Singapore, on

The time spent in lively exchange of opinions with

17-18 January 2019. The main theme of theresearchers from various Asian countries was aconference was “Preparing a New Decade oftruly significant time for me as a researcher.

Doctoral Education and Research - Innovation,

Participating in this EAFONS has widened my view

Transformation, New Dynamism”. Professor Ann

of research. I also felt the need to have a global

Kurth, USA, gave a lecture on doctoral education

view of research. This was my first presentation at

and research as the keynote address. She noted

an international conference, but I learnt a great deal,

that the number of people who got DNP (Doctor ofincluding during my preparation for participating in

Nursing Practice) is increasing in the US than Ph.D.

the conference. I would like to use this as an(Doctor of Philosophy). DNP is primarily a US

opportunity to participate more proactively in future

degree,

and

there

is

littlepublishedabout

development and existence of DNP programs
across the globe. As individuals and families
diversify, there are not enough Doctor of Nursing
Practice degree holders to provide high quality
care.

Developing

nursing

through

doctoraleducation and research can transform nursing andhealthcare practice and policy.
In student-led roundtable discussion, participants
discussed academic development and researchleadership. There were positive discussions on how
people felt about the talks before them. The panel
discussion on mentorship announced representatives

日本地域看護学会誌

Vol.22 No.1, 2019of Hong Kong, Japan, South Korea, Taiwan, Thailand.
The cultural differences were very interesting.
The research methods symposium included alecture on mixed methods study and qualitative
methods. It was made easy to understand by theuse of mixed fruit salad photographs. Scholars
actively called on participants to deepen theirunderstanding of this area.
There were about 60 oral presentations andthe number of posters exceeded 600. There was agood exchange of opinions among researchers.
Through the presentations, I learned about the

University of Singapore was held on January 17-18,

cultures and situation of various countries. This

2019. EAFONS is an international forum forraised my morale as fellow researcher, feeling for

graduate students and young researchers of

the accomplishing research. It was a valuable

nursing universities in East Asia. In addition toexperience to meet people who I could not meet in

Japan, there were participants from Korea, China,

my usual life. I would like to make use of what I

Thailand and other Asian countries. The research

have learned in my research and nursing.

areas were also diverse, including topics such as

I am grateful to all the people who organized
the conference. I really appreciated having wonderful
encounters and participating in the academic conferencein safe, clean and IT-evolving city Singapore.

Community Health, Women's Health, Oncology &Palliative Care and Education Research.
I made a poster presentation on the theme"Relationship between violence to visiting nurses
by service users and community cooperation of

Yukari Take

visiting nursing station in Japan." Because the time

Department of Nursing, Kansai Medical University

in front of the poster is limited, we prepared

Schoolhandouts for participants to take home. Whensome people came to get these handouts, theyThe 22nd EAFONS sponsored by Nationalfound none left. After returning Japan, I was able to

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interact with researchers who I could not meetmany points that can be referred to from the aspect

directly at the EAFONS, and this method was veryof ethnicity and culture in the research of the Asian

good.

region, and I felt that such opportunities for

In Particular, I am impressed is that it wasinternational exchange are very important.

easy to participate as a place of international

The buffet style lunch, Chinese and Indianexchange, because there was a warm andfood was very delicious. Singapore was a hot andwelcoming atmosphere even for presentations byhumid season in summer, but I had a pleasant andresearchers unfamiliar with English. There aremeaningful time.

The 22nd Annual Research Conference of JACHN
Theme：Healthy City Based on Reciprocity; The Role of Nurses in Aiming for Community Empowerment
Date：August 17-18, 2019 (Saturday-Sunday)
Venue：PACIFICO Yokohama Conference Center (Yokohama city)
Chair：Masako Kaneko (Professor, Faculty of Nursing And Medical Care,
Graduate School of Health Management, Keio University)
Program：◆Chairperson’s speech: Masako Kaneko
Community Organization Activities by Public Health Nurses Aiming at Community Empowerment◆Special lecture: Satoshi Kojima (Professor, Faculty of Sustainability Studies, Graduate School of Public Policy
and Social Governance, Hosei University)◆Educational lecture ◆Symposium ◆Appointed workshop ◆Poster session ◆Workshop ◆Open lecture◆Reception
Website：http://jachn22.yupia.net/

Publisher: International Exchange Promotion Committee

Secretariat of JACHN:

Ayumi Kono (Osaka City University), Yukiko Kanaya (Osaka City

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

University), Kaoru Konishi (Osaka University), Chikage Tsuzuki (Kobe City

Tokyo

College of Nursing), Kumiko Morita (Tokyo Medical and Dental University)

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