日本地域看護学会誌

Vol. 14

Japan Academy of Community Health Nursing
Established October 15, 1997

Initiative for Comprehensive
Community Care Systems
1. Developing a comprehensive community
care system
Japan is aging faster than any other country in
the world. The number of those aged 65 or over,which already exceeds 30 million (almost aquarter of the total population) will peak at some39 million in 2042, followed by a further increasein the share of the population aged 75 or over.
Accordingly, the demand for medical andlong-term care is expected to accelerate from2025 onwards, when some 8 million baby-boomers will be aged 75 or over.
In this light, the Ministry of Health, Labour andWelfare (MHLW) is promoting the development ofsystems for providing comprehensive community
support and services (comprehensive community
care systems) targeting 2025, with the objectives ofmaintaining the dignity and providing support for the
independent living of the elderly, so that they may
continue to live the rest of their lives in theirhometown, where possible. The development ofcomprehensive community care systems is crucial
because the number of elderly with dementia is also
expected to increase, requiring further support forcommunity life.
Significant differences in the aging structure
have emerged in different areas, particularly between the metropolitan area, where the total
population will stabilize with a rapid increase in
the proportion of those aged 75 or over, and rural
areas, where the total population will decline andthe number of people aged 75 or over will stabilize. Comprehensive community care systems
need to be developed at the initiative of local
insurers, i.e. municipal and prefectural governments, based on the characteristics of the communities concerned. Indeed, the municipal governments are required to build by 2025 their own

Vol.17 No.3, 2015

MARCH 2015

Contents
・Initiative for Comprehensive Community
Care Systems
・Basic Directions of Health Japan 21 (Phase
2)
・Activities of Public Health Nurses Following
the Eruption of Mt. Ontake
・Current Research: Vol. 17 (1)-(3) of
JJACHN・Announcement of the 18th Academic
Conference of the JACHN
・Announcement of the 6th ICCHNR

comprehensive community care systems bydrawing up and implementing three-year
long-term care insurance projects, based on theprinciple of community ownership and in accordance with local characteristics.
2. Concept of comprehensive community
care systems (report of the research project on the vision of sustainable long-termcare insurance and comprehensive community care systems, “Issues for Future
Discussion on the Development of Comprehensive Community Care Systems,” financed by the FY2012 MHLW grant for thepromotion of health-care programs for theelderly, March 2013)
The objective of long-term care insurance is tomaintain the dignity and provide support for the
independent living of the elderly. Traditionally, acomprehensive community care system designed
to attain this objective by providing comprehensive support and services to enable the elderly tocontinue to live in their hometown wheneverpossible, is defined as “any local system that canoffer appropriate livelihood support services, including welfare services, as well as medical andlong-term care to ensure personal safety, security
and health in daily living, based on the provisionof housing to meet the needs of the elderly.” Five
key components of a comprehensive community

97

98

care system have been identified: housing,
livelihood support, long-term care, medical careand prevention. Based on this idea, the Long
Term Care Insurance Act, revised in 2011, provides that the national and local governments
shall strive to develop comprehensive community
care systems (Article 5(3)2 of the Long Term
Care Insurance Act).
3. Components of comprehensive community
care systems
A comprehensive community care system is
supposed to cover an area of daily life (juniorhigh school district) where necessary services
can be provided within approximately 30 minutes.
Professional services including long-term care,
medical care and prevention, as well as housing
and livelihood support/welfare services, which
are preconditions for such professional services,
are the components of comprehensive community care systems that should ensure home assistance through close interactions.
 Housing and lifestyleComprehensive community care systems depend on the development of necessary housing
as basic infrastructure to ensure that the elderly
can maintain the lifestyle that meets their preferences and financial resources. The living environment thus developed should fully respect theprivacy and dignity of the elderly.
 Livelihood support and welfare services
Livelihood support should seek to ensure thatlife can continue with dignity despite any deterioration in mental or physical capacity, financial
conditions, or family relationships.
Livelihood support covers various activities tobe conducted by various parties, ranging frommeal preparation and other tasks that can behandled by service providers to informal support
including engagement and observation byneighbors. For the poor and vulnerable, livelihood
support may be provided as a welfare service.
 Long-term care, medical care and prevention
Services including long-term care / rehabilitation, medical / nursing care and healthcare /prevention should be provided by professionals.
From the perspective of care management, suchservices may be integrated with livelihood support as necessary.
4. Choice and awareness of the elderly andtheir family members

This is a crucial element in the support ofcommunity care systems. As a substantial proportion of the elderly population live on their own
or with another aged household member, it isimportant that the elderly and their family members understand the meaning of living at home
before making their choice, and prepare themselves for what will be required.
Notice: English translation by JACHN

Basic Directions of HealthJapan 21 (Phase 2)(An excerpt from Chapter 3 of the referencematerial on implementation of Health Japan 21(Phase 2))
This article sets out the basic directions of
Health Japan 21 (Phase 2), to be introduced in
FY2013, in light of the current status of healthpromotion measures in Japan and issues raisedin the Final Assessment of Health Japan 21.
1. Identification of 10-year “goal” based on
the vision
The “goal” should be built on the forecast ofdemographic changes in the next 10 years, inview of the socio-economic changes and therapid aging of population caused by the declining
birthrate in Japan in recent years.
 Background Japan enjoys a world-class average, andhealthy life expectancy.
 Total population has been declining, resulting in
rapid aging.
 The family structure has been transformed,
marked by the declining birthrate, the rising
percentage of people remaining single
throughout their life, and the increased numberof divorces, etc.

日本地域看護学会誌

 The economic downturn has caused the unemployment rate to rise to 5%. The increase inirregular employment points to the hardships
still facing young workers.
 The number of single-member households has
been increasing, including among the elderly.
 The relative poverty ratio has risen to 16.0%,
with 2.09 million people living on welfare – arecord high.
 The education continuance rate has improved,with one in two children going on to college.
Meanwhile, over 100,000 primary/middle
school-age children refuse to go to school.
 Cases of lifestyle diseases, including cancer,
have been increasing, with total healthcare
costs exceeding ¥30 trillion.
 The number of suicides remains around 30,000,
pointing to serious problems facing the working-age population as attested by deaths fromoverwork (karo-shi).
 The number of consultations concerning childabuse is growing steadily, exceeding 50,000
cases.
 70% of the population feels concerned or insecure in their daily life, particularly about
post-retirement life planning and current healthconditions.
2. Ten-year goal
A society where every citizen can lead ahealthy and happy life with mutual support
 A society giving hope to every child and adult A society providing the elderly with something
to live for A society placing priority on health as the basis
for hope and a reason for living
 A society where even those afflicted with disease or requiring long-term care can lead asatisfactory life in their own way
 A society with functioning mutual aid within
local communities and among generations
 An inclusive society where everyone has access to health resources A society able to halt and then reverse thewidening health gap among the population by
improving the social environment
3. Basic directions
In light of these views, the Working Group andthe Expert Committee adopted the vision of asociety where every citizen can lead a healthy
and happy life with mutual support, and proposed
the following five basic directions for Health Ja-

Vol.17 No.3, 2015

pan 21 (Phase 2): (i) extension of healthy life
expectancy and reduction of inequality in health;(ii) prevention of occurrence and worsening ofmajor lifestyle diseases; (iii) maintenance andimprovement of necessary functions for social
life; (iv) development of the social environment tosupport and maintain health; and (v) improvement of lifestyle and social conditions related tonutrition/diet, physical activity/exercise, rest,
drinking, smoking and dental/oral health.
The chart below shows the correlation between
the 10-year vision and basic directions. In summary,the project seeks to: prevent the occurrence andworsening of major lifestyle diseases by improving
the lifestyle habits of individuals and the surrounding social environment; improve the quality of life bypreventing the deterioration of social life functions;facilitate access to health resources and ensure
equality; and raise the quality of the social environment through increased opportunities for social
participation, thereby extending the healthy life expectancy and reducing inequality in health.
Notice: English translation by JACHN

Activities of Public Health
Nurses Following the Eruptionof Mt. Ontake
Mt. Ontake erupted on 27 September 2014 at
11:52 (Japan Standard Time). The eruption
caused the worst volcanic disaster in post-war
Japan, with 57 killed and seven persons still unaccounted for.
Ontake, located on the border between Nagano and Gifu Prefectures, is the westernmost
mountain in Japan with a height of over 3,000m.
Ranked as one of the Top 100 Mountains in Ja-

99

100

pan, it is popular among mountain climbers due
to its easy routes despite the significant altitude.
The eruption occurred in the middle of the seasonof fall colors, when the number of climbers canreach several thousand a day.
Following the eruption, the families of victims
waited in the base town of Kiso for information
about the whereabouts of their loved ones. Publichealth nurses and other personnel dispatched by
the prefectural government provided mental andphysical care for the victims’ families at the waiting and accommodation facilities around theclock. Those activities were reported by the Asahi
and Mainichi newspapers. According to thesearticles, the PHNs from the prefectural government, in cooperation with other nurses sent by
the Japanese Red Cross Society, gave the families of missing climbers 24-hour support to detectany mental or physical problems. Reportedly,
nurses also gave advice on health problems forthe family members, who complained of insomnia,
headaches and severe stress, and referred them
to a hospital where necessary.
No one knows when a disaster may strike. The
sudden, unexpected loss of a family member orfriend is a traumatic experience for the survivors,
with substantial impact on their mental and physical well-being. The response of nurses following
the eruption of Mt. Ontake confirms the importanceof PHN support for victims’ families in coordination
with medical institutions and other parties at thetime of disaster.

Current Research :Vol. 17(1)-(3)of JJACHN
Vol. 17 (1)Preface
Emiko Saito: Introduction of the 6th International
Conference on Community Health Nursing
Research. 17(1): 3, 2014.
Original Articles
Yasufumi Osono, Sakiko Fukui: Characteristics ofHome Nursing Agencies for Nurses Which Recognize That They Provide Quality Terminal Care.
17(1): 4-12, 2014.
Jun Okahisa, Noriko Nishikido: Coordination by
Occupational Health Nurses to Support Workers with Cancer. 17(1): 13-22, 2014.
Research Report

Chizuru Nagata, Ikuko Kitamura: Functions andIssues of Community-based Services for Aging-in-Place under a Community Comprehensive Care System. 17(1): 23-31, 2014.
Informations
Midori Mimaya: Factors Associated with Visiting
Nurses’ Intent to Continue Working. 17(1):32-39, 2014.
Kazue Yoshihara, Naoka Kamio, Akiko Akiyama:
Factors Influencing Accidents of Infants WhichOccur within the Third Months of Life. 17(1):40-43. 2014.
Committee Report
JACHN Project for Improvement of Disaster Relief: Medium-and-long Term Health Influence of
the Radiation Hazard from the Nuclear Plant
Accident and Public Health Nursing Activities.
17(1): 44-53, 2014.
Vol. 17 (2)PrefaceKazuko Saeki: The Establishment of a New Entry-level Community Health Nursing in the
Nursing Curriculum. 17(2): 5, 2014.
Special Issue
Katsuko Kanagawa: The Significance of a
Non-profit Organization in Community HealthNursing Activities. 17(2): 6-9, 2014.
Original Articles
Junko Sasaki, Mineko Nanba, Kazue Ninomiya:Management
Difficulties
PerceivedbyHome-visit Nursing Administrators. 17(2):10-18, 2014.
Michiyo Hirano, Kayoko Kawahara, Kazuko
Saeki: Development of a Scale to Measure theSocial Activities of Older Women Requiring Daily
Support. 17(2): 19-27, 2014.
Naomi Fukushima, Ayumi Kono: The Relationship between Drinking and Functional andPsychosocial Characteristics among Male Elders Certified as Support Level in theLong-Term Care Insurance System. 17(2):28-35, 2014.
Research Report
Masako Kageyama, Keiko Yokoyama, Yukako
Nakamura, Sayaka Kobayashi: Factors Related to Family Groups’ Intention Regarding Continuation in a Family Peer-education Programon Mental Disorders. 17(2): 36-44, 2014.
Information
Azusa Arimoto, Etsuko Tadaka: Literature Re-日本地域看護学会誌

view on Public Health Nurses’ Activities andChallenges in Preventing Child Abuse in Japan.
17(2): 45-54, 2014.
The 17th Annual Conference of JACHN:
Presidential Address
Reiko Okamoto: Action Research in Community
Health Nursing; Succession and Change.
17(2):55-61, 2014
The 17th Annual Conference of JACHN: The
Board of Director’s Seminar
Kazuko Saeki, Akiko Ozaki, Tamae Sato: Definition of Community Health Nursing and Community Health Nursing Education in Nursing
Curriculam. 17(2): 62-74, 2014.
Committee Report
JACHN Science Committee: Definition of Community Health Nursing. 17(2): 75-84, 2014.
Vol. 17 (3)Preface
Sanae Haruyama. For Further Enhacement ofIn-service Training for Community Health
Nurses 17(3): 3, 2015.
Original Articles
Keiko Koide, Reiko Okamoto, Yasutoshi Nekoda,
Mari Okada: Effect on Public Health Nurses of a
Reflection-based Health Guidance Skills Improvement Program. 17(3): 4-13, 2015.
Waka Itoi, Tomoko Kamei, Etsuko Tadaka,
Fumiko Kajii, Yuko Yamamoto, Kiyoto Hirose:
Development of the Community Intergenerational Observation Scale for Elders （CIOS-E）
and Children（CIOS-C）and Test of Their Reliability and Validity. 17(3): 14-22, 2015.
Takehiko Kasejima, Etsuko Tadaka, Rie Taguchi,
Azusa Arimoto, Yuka Dai, Yuki Imamatsu:
Subjective Well-being and Related Factors for
Healthy Longevity among Community Dwelling
Elderly People. 17(3): 23-29, 2015.
Research Reports
Keiko Ono, Eiko Ogasawara: Evaluation of
Seminar Program for Home Health Care Nursing in Foundation Education. 17(3): 30-40,
2015.
Reiko Okahisa, Toshiko Tada: The Strengths of
Adult Men Who Received Health Guidance in
the Process of Lifestyle Transformation. 17(3):41-50, 2015.
Yuki Imamatsu, Etsuko Tadaka: Qualitative
Study on Professional Methods by Public Health
Nurses for Encouraging Behavioral Change andVol.17 No.3, 2015

Sustainability for Healthy Lifestyle for Persons
at High-risk of Lifestyle Related Diseases.
17(3): 51-59, 2015.
Shinobu Makino, Asami Tatsumi, Toshiko
Otsuka: The Experience of Elementary School
Teachers’ Support of School Non-attendingChildren Neglected by Their Parents. 17(3):60-69, 2015.
Informations
Mai Hosoda, Hisae Nakatani, Kazuko Ikeda: Relationship of Lifestyle and Purpose in Life ofWorkers at a Manufacturing Plant. 17(3): 70-77,
2015.
Kumi Inomata, Yayoko Kawana: Expectations to
Universities by Training Instructors in Occupational Health and Nursing Practicum. 17(3):78-83, 2015.
Index for Utilization in Community HealthNursing
Etsuko Tadaka: Preface to “Index for Utilization in
Community Health Nursing”. 17(3): 84, 2015.
Mariko Kawaharada: Social Capital. 17(3): 85-88,
2015.
Tomomi Maruo: Behavioral and PsychologicalSymptoms of Dementia. 17(3): 89-92, 2015.
Kyoko Yoshioka-Maeda : Practical Competencyof Public Health Nurses. 17(3): 93-96, 2015.
NEWS FROM JACHN
17(3): 97-104, 2015.

101

102

Announcement ofof thethe 18th
18th Academic
Academic
Announcement
Conference ofof thethe JACHN
JACHN
Conference

Dates:111–––222AugustAugust2015
2015
Dates:
Dates:
August2015
Venue:
ConferenceCenterof
PACIFICO
Venue:Conference
ConferenceCenter
Centerof
ofPACIFICOPACIFICO
Venue:
Yokohama
Yokohama
Yokohama
EtsukoTadaka,
Tadaka,PhD.,
PhD.,RN,
RN,PHNPHN
EtsukoChairofofthe
the18th
18thAcademic
AcademicConference
Conferenceofofthe
theJapanJapanAcademy
AcademyofofCommunity
CommunityHealth
HealthNursing
Nursing
Chair
Department
ofNursing,
Graduate
SchoolofMedicine,
Yokohama
City
University
Department of Nursing, Graduate School of Medicine, Yokohama City University

Welcomeaddress:
address:
WelcomeWearearedelighted
delightedtotowelcome
welcometotoyou
youtotothe
the18th
18thAcademic
AcademicConference
Conferenceofofthe
theJapanJapanAcademy
AcademyWe
12
August2015.
ofCommunity
HealthNursing(JACHN),in
Yokohamaonof Community Health Nursing (JACHN), in Yokohama on 1- 2 August 2015.
Since1997,
1997,led
ledby
bythe
thepresident,
president,Dr.
Dr.Katsuko
KatsukoKanagawa
Kanagawa(Former(FormerProfessor
Professoratatthe
theUniversity
University
Since
Tokyo),JACHNJACHN has
has pursued
pursued its
its objective
objective ofofcontributing
contributing toto human
human healthhealth andand well-being
well-being
ofof Tokyo),throughthe
theacademic
academicdevelopment,
development,education
educationand
anddissemination
disseminationofofcommunity
communityhealthhealthnursing,nursing,
throughsuccessfullyauthorized
authorizedas
asaageneralgeneralincorporated
incorporatedassociation
associationinin2014.
2014.The
The18th
18thAcademic
AcademicConConsuccessfully
ferencewill
willmark
markthethenew
newstart
startofofJACHN.
JACHN.
ference
TheConference
Conferencewill
willbebeheldheldunder
underthethetheme:
theme:“Grand“GrandChallenges
ChallengesofofCommunity
CommunityHealth
HealthThe
Nursingtowards
towardsaaHealthy-Longevity
Healthy-LongevitySociety”.
Society”.The
Thetermterm“Healthy-Longevity“Healthy-LongevitySociety
Society” ”means
meansaa
Nursingcommunitywhere
whereeacheachresident
residentcan
canleadleadaahealthy,
healthy,fulfilling
fulfillinglife
lifeevenevenininthe
theprocessprocessofofaging.
aging.And
And
community“Grandchallenges”
challenges”means
meansnotnotmerely
merelyroutine
routineacademic
academicquestions
questionsororpracticalpracticalproblem
problembut
butbigbig“Granddirectivesandandgoals
goalswhich
whichhave
havetotobe
beachievedachievedininthe
thefuture.
future.
directives
Nor must
must we
we forget
forget various
various challenges
challenges ifif wewe support
support ourour societysociety toto attainattain aa peacefulpeaceful
Nor
Healthy-Longevity
Society.
Therefore,the
18th
Academic
Conference
of
the
JACHN
will
make
Healthy-Longevity Society. Therefore, the 18th Academic Conference of the JACHN will makeeveryeffort
efforttotoidentify
identifysignificant
significantchallenges
challengesand
andprospects
prospectsfor
forsuchsuchaasociety,society,engaging
engagingininactive
activeevery
discussionsand
andexchanges,
exchanges,andandutilizing
utilizingwisdom
wisdomand
andinsightinsightininpartnershippartnershipwith
withvarious
variousfields
fieldsandanddiscussions
citizens.
citizens.
Wewillwillprovide
provideaalarge
largespectrum
spectrumofofoutstanding
outstandingevents
eventssuch
suchasasspecial
speciallecture,lecture,educational
educational
We
lectures,symposium,
workshops,
seminars,
andothereventscovering
a
wide
range
diverselectures, symposium, workshops, seminars, and other events covering a wide range ofofdiverse
perspectivesrelated
relatedtotoaaHealthy-Longevity
Healthy-LongevitySociety.
Society.We
Wewillwillalso
alsoaddress
addresssome
somenew
newinitiatives,
initiatives,
perspectives
includingaapre-conference
pre-conferenceevening
eveningseminarseminarfor
forpractitioners
practitionersas
asaapostgraduate
postgraduateeducation,
education,and
andaa
includingthenext
nextgeneration.
generation.
studentcafé
caféasasananundergraduate
undergraduateeducation
educationtotocommunity
communityhealthhealthnurses
nursesofofthe
student
PACIFFICOYokohama,
Yokohama,thethevenue
venueofofthe
theConference,
Conference,isisaaconvention
conventioncomplex
complexlocatedlocatedininthe
the
PACIFFICO
centerofofYokohama
Yokohama(Minato(MinatoMirai
Miraidistrict),
district),an
aninternational
internationalcity
citywith
withvarious
varioussightseeing
sightseeingspots
spotsinincentercludingthose
thoserelated
relatedtotothe
thehistory
historyofofmodern
modernJapan
Japanopening
openingup
uptotothetheoutside
outsideworld.
world.We
Wehopehope
cluding
thatparticipants
participantswill
willhave
havethethetimetimetotoappreciate
appreciatethe
theattractions
attractionsofofthe
thecity
cityafter
afterthetheConference.
Conference.
that
Wehopehopetotosee
seeyouyouininAugustAugust2015
2015ininYokohama!
Yokohama!
We

66

日本地域看護学会誌

Vol.17 No.3, 2015

Main Theme: Grand Challenges of Community Health Nursing towards
a Healthy-Longevity Society
Presidential Lecture: Etsuko Tadaka, Professor
Department of Nursing, Graduate School of Medicine, Yokohama City University
Title: Grand Challenges of Community Health Nursing towards a Healthy-Longevity Society
Special Lecture: Wataru Omori, Professor emeritus at the University of Tokyo and the headof the NPO Community-Care Policy Network
Title: Prospects and Challenges for Community Care Policy and Human Resource Development towards a Healthy-Longevity Society
Educational Lecture I: Zentaro Yamagata, Professor
Department of Health Sciences, Basic Science for Clinical Medicine, Division of Medicine,
Graduate School Department of Interdisciplinary Research, University of Yamanashi
Title: Community-Based Lifelong Health Promotion and Social Capital
Educational Lecture II: Hiroshi Haga, Professor
Graduate School of Gerontology, J. F. Oberlin University
Title: Community Intervention in the Health of the Aged and the Formation of a Social Network
Symposium I
Title: Building a New Community in a Depopulating Society: Creation of Public goods andCollaboration
Masako Akiyama, Representative Director
Cares Center Inc. Hakujuji Home-visit Nursing Station
Noboru Sugiyama, Administrative Director
Urban Housing and Community Renovation Association NPO
Emiko Kishi, Professor
Department of Nursing, Faculty of Medical Technology, Teikyo University
Symposium II
Title: Ensuring the Sound Development of All Children: Lifelong Self-Care Capacity-building
from Childhood
Takashi Asakura, Professor
Division of Arts and Sports Sciences, Tokyo Gakugei University
Yukie Takahashi, Director, PHN
Yokosuka City Children’s Guidance Center
Mie Yokoyama, Professor
Community Health Nursing, Graduate School of Nursing, Osaka City University
Workshop I: Hirofumi Takagi, Professor
International Health and Nursing, School of Nursing, Toho University
Title: Community Health Nursing as a Science: Focus on Qualitative Study
Workshop II: Hitoshi Miyazawa, Associate Professor
Graduate School of Humanities and Sciences, Ochanomizu University
Title: Community Visualization and Statistical Analysis: Application of GIS to Community
Health Nursing

7

103

104

<< 2 Days Program List >>









Opening remarks and orientation
Presidential Lecture
Special Lecture
Educational Lecture
Symposium
WorkshopSeminar organized by the Board of Directors
Open Lecture










Joint Seminar
Discussion Session
Student Café
Pre-seminar
Poster Session
Round Table Discussion
Exhibition
Reception

Announcement of the 6thInternational Conference on
Community Health Nursing
Research Dates: 19th – 21st August 2015
 Venue: Cultural Centre, Seoul National University, Seoul, South
Korea
 Theme: Knowledge Translation into Community Health Nursing
Practice: Health Promotion through the Life Span Chair: Insook Lee, Ph. D., Seoul National University
Important notice: Early bird registration will open till the 31st May 2015.
 The last possible date for registration for presenters of accepted
abstract presentations is 31st May 2015.

Publisher: Committee for Promoting International Exchange Activities
Emiko Saito (Tokyo Metropolitan University), Takako Ishihara (Gifu University),
Shizuko Omote (Kanazawa University), Kanako Murata (Showa University), Chu
Hyang Oh (Tokyo Metropolitan University)
Graduate School of Human Health Sciences, Tokyo Metropolitan University
7-2-10, Higashiogu, Arakawa, Tokyo, 116-8551, JAPAN
Phone +81-3-3819-1211

Email:saito@tmu.ac.jp8