98

No. 17APRIL 2018

Japan Academy of Community Health Nursing
Established October 15, 1997

Topics of Japanese Community
Health Nursing

Based on the nature of their qualification, theprimary duty of Public Health Nurses is to engage
in long-term care of elderly individuals from aperspective of prevention. However, in accordance

1. A Simple Introduction of Community
Comprehensive Care Centers, andthe Role of Public Health Nurses in
Dementia Measureswith the Japanese government’s Comprehensive
Strategy to Accelerate Dementia Measures (NewOrange Plan), many Public Health Nurses now
promotedementia

measuresascommunity

dementia support workers. The Comprehensive
Yumiko Mimura

Strategy to Accelerate Dementia Measures was

Minami-azabu Community Support Service Center

jointly formulated in 2015 by the Ministry of Health,

Kumiko Morita

Labour and Welfare and other relevant government

Graduate School of Health Care Sciences, Tokyo

ministries as an effort to realize the goal of creating

Medical and Dental University“a society that respects the decision of people withdementia and that enables them to continue to live

Community comprehensive care centers are

their lives comfortably in their familiar communities

institutions established upon the 2006 amendment

as long as possible” put forth in the Five-Year Planof the Long-Term Care Insurance Act to improvefor Promotion of Measures against Dementia

health care and comprehensively support the(Orange Plan) published by the Ministry of Health,promotion of welfare for community residents byLabour and Welfare in 2012. Based on theproviding the aid needed for maintenance ofphilosophy described above, community dementia

physical and mental health and stability in daily life.

support workers support the cooperation between

These community comprehensive care centers

medicalcomprise three types of professionals: social

providers, and community support institutions inworkers, chief care managers, and Public Healthaccordance

Nurses. Approximately 70% of all community

community; provide consultation for the sake ofcomprehensive care centers are managed by

supporting dementia patients and their families;

privateand hold events such as dementia support training

businesses

commissioned

by

the

corresponding municipality; these centers are

institutions,
with

the

long-termcarecircumstances

serviceofthecourses and Alzheimer Cafés.

insurance

Here is an example. A Public Health Nurse isoperations in the municipality in which they are

informed of persons of interest by community

located.

residents who have attended a dementia support

responsibleforlong-term

care1日本地域看護学会誌

Vol.21 No.1, 2018training course. The Public Health Nurse visits thecommunity. It is estimated that the number of suchhouse and realizes that the persons of interest arechildren is approximately 17,000. Some of thesean elderly couple living by themselves. Both ofchildren depend on complex medical technologies

them boast of being in good health and not needing

such as mechanical ventilation and gastrostomy,

to go to the doctor. However, for the last six

renal dialysis or intravenous drug therapies, formonths, the wife has been buying the same thing

their survival.
Children are constantly growing, progressing,

every time she goes shopping. The husband’s
nutrition is poor; he is very thin. When they show

andchanging.

Consequently,

pediatrichome

the Public Health Nurse around their home, there

medical care differs from adult care in that it must

are half-rotten vegetables piled around the stove.

support the changes in the children’s life stages as

The Public Health Nurse, who is also a specialist in

well as their development and progress. Therefore,

community dementia care, makes arrangements

people with a wide variety of occupations in eachfor the elderly couple to receive a visit from an earlyfield of medical, welfare, education, healthcare anddementia intensive support team, who will guide

administration need to work as a team in thethe couple to examination at a medical center forcommunity to support home care. In such adementia and related disorders. At the same time,community team, home-visit nurse is an important

the Public Health Nurse also invites the couple toposition to support children and their families.

the community salon for persons with dementia,

Home-visit nursing agencies first opened ininterviews them about their daily lives, and1992. Currently, the number of agencies hasrecommends the use of long-term care insurance

reached 8484 (as of April 2016). Today, home-visit

service to them if necessary in order to allow themnursing services are covered mainly by long-term

to live their lives as they wish. Although things docare insurance (approximately 70%); and thenot often go so smoothly, Public Health Nurses goremainder is covered by medical insurance.

about their duties every day in the hope ofPediatric home-visit nursing services are covered

achieving the sort of outcome described above.

by medical insurance. Currently, the number ofchildren (0-9 years old) with medical complexity

2. Issues and Views of Pediatric Homevisit Nursing in Japan

receiving home-visit nursing has increased by 9.5
times compared to such visits in 2001. However,the number of home-visit nursing agencies with

Yumi Sakagami

children's populations under the age of 18 are less

School of Nursing, Mukogawa Women's University

than half of all agencies. Home-visit nursing
agencies in a pediatric home medical care system

In Japan, advances in medicine have led to

are not enough. In order to enhance home-visit

increased survival rates for pre-term infants andnursing services, it is important to promote thethose born with congenital impairments andsecuring and training of human resources who

improved the prognosis for children with chronic

practice home-visit nursing for children.

diseases and cancer. Currently, the number ofHome-visit nursing is required to provide

children with complex and continuing health care

support according to the growth of the child andneeds

lifestyle of the family, and enhance collaboration

has

been

rapidly

increasing

in

the

2

99

100

between medical, welfare, education, healthcare

training in public administration, business, andand administration. In Japan, the most pressing

education. The majority of this practical training

need of children receiving home medical care andtakes place in public administration, where I had

their families is to be able to receive more respite

the opportunity to engage deeply with a single

care (short-term admission to care facility andcommunity

daytime temporary support) services. However,individual cases, enabling me to conduct practical

there are not sufficient numbers of facilities thattraining in a deliberate manner. I also had theprovide such respite care service. Long-term

chance to take joy in building trusting relationships

home-visit nursing was provided reimbursement

over time with Public Health Nurses, other staff, andfromLong-term

residents, thereby enriching my learning experience.

home-visit nursing is expected to become an

Students in the graduate school can also

thegovernmentofJapan.

important role as one resource of respite care.
the

or

was

continuously

involvedin

conduct research in their areas of interest as they

All children have a right to education. However,undergo practical training. I researched drinking

guardians

problemsofhighlymedically-dependent

among

university

student

groups.

children may be required to attend schools withThrough my research, I was able to understand thetheir children. Currently, there is a new kind oftrue states of people who need support. I was also

support, whereby the home-visit nurse visitsable to learn more deeply about the importance ofchildren’s schools on behalf of their parents andworking on problem-solving with these types ofpractices nursing for children. Home-visit nurses

people from the perspective of a Public Healthare required to share information and collaborate

Nurse.

with the school teacher. Expanding the role of

I also appreciate what an incredibly valuable

home-visit nursing services is an urgent issue, notexperience it was to have the chance to participate

only for the happiness of children, but also so thatin academic conferences while I was a graduate

families can lead full lives.

student. When presenting posters, I felt that I had
the chance to utilize the skills I had cultivated in

3. Learning and Future Perspectives of
the Course of Public Health Nurse
Training of the Graduate School

graduate school lectures and practical training
conferences up to that point: namely, how topresent material in an easy-to-understand manner,and how to give oral explanations. At the academic

Ikumi Wayama

conference, five students including me in the

Tohoku University Graduate School of Medicine

Tohoku University Graduate School of Medicine
Public Health Nurse Training Course held a

The Tohoku University Graduate School ofworkshop with the aim of building a network of

Medicine Public Health Nurse Training Course

graduate students enrolled in courses for obtaining

incorporates a curriculum to develop Public Healthpublic health nursing licenses: the workshop was

Nursesmultifacetedattended by graduate students from multiple

understanding of individuals, families, and local

universities. I feel that this network will be useful incommunities. One of the characteristics of this

my work as a Public Health Nurse. I will always

curriculum is the approximately 1 year of practicalcherish this network, along with the personal

who

are

capableof3日本地域看護学会誌

Vol.21 No.1, 2018

connections I have made through my practical

the Japan Visiting Nurse Foundation and thetraining and research. In graduate school, it is

National Association for Home-Visit Nursing Care

necessary to take things on independently in all

have advocated for the training of new nursing

sorts of situations. I had experienced many things

school graduates with no clinical experience aspassively, so I struggled quite a bit. However, I

home-visit nurses. Behind this recommendation,

think I was able to accomplish what I did because I

there is the common belief that it is difficult for new

was surrounded by people who also wanted to be

graduate nurses to work as home-visit nurses, given

Public Health Nurses. I’m glad that I was able tothat the job typically involves visiting patients’ homes,

haveencountering

usually alone, and determining, implementing anddifficulties I couldn’t have overcome alone andevaluating care. Even if some nurse students wished,succeeding thanks to the presence of others.

they conventionally have been required to have 3‒5

firsthandexperienceofGoing forward, as the needs of residents are
predicted to become more diverse and complex, I

years or more of clinical experience to be hired as ahome-visit nurse.

intend to continue my efforts as a Public HealthBecause, in general, basic nursing education in

Nurse while also searching for support methods

Japan provides limited opportunities for students tothat will help residents to lead better lives. I intend

practice their nursing skills with patients, they

to use what I learned in graduate school in various

acquire most of their skills as they accumulate

fields in the future, with never-ending gratitude topractice in clinical settings after obtaining their

the professors who taught me and to the seniornursing license and starting to work. As a result, newstudents, classmates, and junior students who

graduates tend to worry that if they were to start

supported me; and with the attitude with which I

working at a visiting nurse agency straightaway, theyand my classmates studied and researched

may not acquire all the skills they need for a nursing

together for two years as the inaugural class of the

career. In addition, one also hears from visiting

Tohoku University Graduate School of Medicine

nurse agencies, the employers, that the operational

Public Health Nurse Training Course.

burden of hiring new graduates, who need to be
trained before they can be effective workers, is

4. On Training New Nursing School
Graduates to be Home-Visit Nurses

significant, and that they don’t have the necessary
human resources or time to spare for training. In an
attempttoaddress

thissituation,

regional

Ai Kobayashiorganizations, such as nursing schools, visiting

School of Nursing, Kobe Women's University

nurse agencies, hospitals and the Visiting Nurse
Agency Association, have begun trying to create

In Japan, meeting the need for home-visit

new graduate training programs. To eliminate thenurses has become an urgent issue as the demandanxiety of nursing students and employer issues

for community-based home care is expected toassociated with training new graduates, it isincrease significantly in the future. To resolve thisessential to organize a system for training in whichissue, in their 2009 10-Year Strategy for Home-Visit

all the relevant parties work together, including

Nursing Care and 2014 Home-Visit Nursing Action

visiting nurse agencies, teaching hospitals, nursing

Plan for 2025, the Japanese Nursing Association,schools and municipalities.

4

101

102

Training new nursing graduates has more thaninternational collaboration and networking in nursing

just downsides. Besides increasing the number of

research to improve global health outcomes. A lot of

home-visit

also

nursing scholars from Japan, including members ofcontribute to enhancing the educational capability of

the Japan Academy of Community Health Nursing

home-visit nursing care industry overall? At theparticipated in the conference and JACHN is aagency level, staff can benefit from the opportunities

member of the WANS. They had more than 600 oral

for reflection they get as they verbalize nursingorpractices while training new graduates. Furthermore,

approximately 200 presentations from Japanese

the organization can profit from the opportunity toparticipants. Participants exchanged and shared

re-examine its systems for training and sharing

their experiences and research results on all aspects

information. In any case, it’s likely that a nationalof global health and nursing innovations. Moreover,training program will eventually be established forthey provided several forums to discuss the issues

the industry. As the variety of strategies for theand trends of nursing related to global health,training of new graduates expands, the kinds ofespecially our academy member, Prof. Hiroko

innovations that arise will be something to look

Nagae (Tokyo Women’s Medical University) and her

forward to.

colleaguenursesavailable,

doesn’tit

TNMC & WANS International
Nursing Research Conference 2017
in Bangkok, Thailand

posterpresentations,introduced

which

presentations

includedregardingcommunity-based care to support end-of life care in
the forum on “elderly care in Japan”.

2. Brief Reports of Participants

1. Overview

Yoko Tanaka

TNMC & WANS International Nursing Research

Graduate School of Nursing, Osaka City University

Conference 2017
Bangkok, Thailand on 20-22, October, 20171) Public Health Nurse (Thailand)
In Thailand there is no Public Health Nurse

Ayumi Kono

qualification. After graduating from the 4th Faculty of

Department of Home Health Care Nursing, Osaka

nursing university, those who complete the nursing

City University

graduate course work as Public Health Nurses orwork in government. Nurses working in the

TNMC (the Thailand Nursing and Midwifery

community are called community health nurses.

Council) & WANS (the World Academy of Nursing

In 1984, Doctor of Public Health (Public HealthAcademy of Nursing Science) International Nursing

Nursing)was the first established doctoral education

Research Conference 2017 was conducted in

Program at the Faculty of Public Health, Mahidol

Bangkok, Thailand, on 20-22 October 2017. The

University. In 1990, the first doctoral degree inmain theme of the conference was “Culture,

nursing was established as a collaborative program

Co-creation and Collaboration for Global Health”

between four major universities (Mahidol University,and nursing academic scientists, researchers andChiang Mai University, Khon Kaen University andresearch scholars from worldwide gathered to foster

Prince of Songkla University) led by Associate5日本地域看護学会誌

Vol.21 No.1, 2018

Professor Dr. Tassana Boontong, Associate Dean,(WANS) were held from 20 to 22 October 2017 inFaculty of Nursing, Mahidol University. Fifty eight

Bangkok, the capital city of the Kingdom of Thailand.

Doctor of Nursing Science degrees (DNS) have

It had been over a year since Thailand’s beloved

been conferred under this program.

King Bhumibol Adulyadej passed away at the age of2) Teenage Pregnancy

88, and the five-day- long royal funeral ceremony

Teenage pregnancies. Dr.Siriporn, Ms.Beena

was about to start. Big altars were seen everywhere(UNICEF, Thailand), Dr.Warisa (Intarnational Healthin the city and also at the conference site, and each

Policy Program, Ministry of Public Health, Thailand)of them was decorated with yellow marigold flowers.

introduced a very interesting theme for Special

Participants were requested to dress in black for theIssues. Thailand has seen a rise in pregnancy rates

conference and during the stay in Thailand in orderamong teenagers. In the background of teenage

to show their sympathy. I was deeply impressed by

pregnancy in Thailand are problems such as drugs

how Thai people showed their respect and offeredandcondolences to the late King.

homelessness.

Meanwhile,

Thai

HealthPromotion Foundation is running a project called

Of the keynote speeches I attended, the one“Prevention and Dealing with Teenage Pregnancy atinterested me the most was entitled “Global Health:

Provincial Level”. In applying 10 of UK’s strategy, 9Lessons Learned from MDGs to SDGs”. The

missions were introduced. The 9 missions consisted

Millennium Development Goals (MDGs) were theof: 1) development of integration mechanism, 2)

eightparents’ skill on talking about sexuality with kids, 3)

measurable

comprehensive sexuality education, 4) analysis of

improving the lives of the world’s poorest people byadolescentof

2015. The Sustainable Development Goals (SDGs)

adolescent sexual health and birth control, 6) youth-build on the success of the MDGs and aim to go

friendly sexual health services, 7) health service

further to end all forms of poverty. It was suggested

system connection, 8) establishing a creativethat the rate of visiting hospital of children withplatform for adolescents, and 9) development ofsuspected pneumonia is higher in urban areas thandata

capacityrural areas in Thailand, and that income disparity

building. It is a 3-year project (2015-2018) in which

affects this rate. Access to clean and safe water is

19 provinces are participating. This project isstill difficult, and in some areas woman have to bringpromoted through collaboration between UNICEF

a bucket of water to the birth clinic when giving birth.

and Dr. Siriporn. Dr Siriporn reported that it isThis affects child and maternal mortality. I havenecessary to prepare the environment (legislation,

learnt that we still have so much to do as a Nurse,

measure, policies, interventions, services) to support

Public Health Nurse or Midwife to achieve the goal

teen pregnancy.

for the next generation.

Takahiro Inoue

Keiko Ono

Faculty of Nursing, Kwassui Women’s University

Community & Home Health Nursing, Department oftargetedgroups,5)

system/mentoring/evaluation

campaign

forinternationaltargets

development
and

clear

goals

with

deadlinesfor

Nursing, Musashino University
The Thailand Nursing and Midwifery Council
I participated in the International Nursing(TMNC) and the World Academy of Nursing Science

6

103

104

Research Conference on “Culture, Co-creation andCommittees for the 2017 to2018 Fiscal Term

Collaboration for Global Health,” 20-22 October
2017. The conference was held at The Miracle
Grand Convention Hotel, Bangkok, Thailand. The

List of Committee Members（◎：Chair, ○:Co-chair）

purpose of the three-day conference was to bring

1. Editorial Committee

together international researchers and practitioners◎ Masae Ueno

Osaka Prefecture University

who are interested in all aspects of global health and○ Mitsuko Kitayama

Gifu College of Nursing

nursing innovations. At first, the Mourning Ceremony

Mikako Arakida

International University of Health and Welfare

in Remembrance of His Majesty the Late King

Hisako Izumi

Kobe University

Bhumibol Adulyadej was held before the Opening

Akiko Ozaki

Tohoku University

Ceremony. Afterward, impressive keynote speeches

Tomoko Kamei

St. Luke’ s International University

were presented. Next, there was Refreshment

Yoshiko Kudo

Health Sciences University of Hokkaido

beforeYumi Sato

Gunma University

presentation and snack time. At that time, I gave a

Chikage Tsuzuki

Kobe City College of Nursing

poster presentation on “Utilizing the interRAI

Satoko Nagata

Keio University

Assessment for Making Care Plans for the Elderly

Mariko Nishijima

Ehime University

by Japanese Nursing Students” and discussed

Teruko Yoshimoto

Chiba University

lunch,

includingExhibition&

Posternursing education. Coincidentally, I met Thai Alumni

2. Committee on Research Promotion

friends from my PhD graduate school in the U.S. I◎ Masako Kaneko

Keio University

was so glad to see my alumni friends again. I○ Junko Omori

Tohoku University

promised to meet them in the future to discuss our

Yoshiko Ohno

Josai International University.

research and education. I expressed my sincere

Miki Sato

Keio University

Yumi Sato

Gunma University

Takae Morita

Yamaguchi University

gratitude for the conference not only for updating
advancesinnursing

research,

practice,

management, and education concerning global
health issues, but also for contributing to fosteringinternational

collaboration,

networking,

3. Public Relations Committee

andpartnerships in nursing research in global health.
The Day Three programs concerned special issues
in research methods and their implications. I
participated in the Mixed Methods Research. I
thought it was interesting that the issues were same

◎ Chieko Ide

Oita University○ Sugako Tamura

University of Toyama

Tazuyo Shiga

Oita University

Mika Hasegawa

University of Fukui

Kieko Yasuda

Nagano College of Nursing

4. Education Committee◎ Sachiyo Murashimaaround the world. After the closing ceremony, I

Oita University of Nursing and Health
Sciences

received an email declaring “You are the winner!”○ Reiko Okamoto

From a pool of evaluations through a mobile

Kotomi Akahoshi

application, I was the winner of a lucky draw. I

Osaka University
Oita University of Nursing and Health
Sciences

picked up my prize, a cute pouch, which reminds meof the conference where I enjoyed programs andmet many friends.

7

Tomoko Ando

Chiba Institute of Science

Miyuki Ishibashi

Chiba University日本地域看護学会誌

Vol.21 No.1, 2018

Akiko Ozaki

Tohoku University

Etsuko Fuchita

Nagoya University

Emiko Kishi

Toho University

Megumi Hobo

Yokohama-City Welfare Service Association

Noriko Sato

Chiba

Prefectural

Universityof

7. Thesis Award Committee

HealthSciences◎ Tadaka Etsuko

Yokohama City University

Masae Ueno

Osaka Prefecture University

Nursing Care Station

Mitsuko Kitayama

Gifu College of Nursing

Health Science University

Asami Tatsumi

Hamamatsu University School of Medicine

5. International Exchange Promotion Committee

Satoko Nagata

Keio University

Takae Suwabe

Yoko Yamazaki◎ Ayumi Kono

Asakusa

Medical

Association

Home-visit

Osaka City University

8. Committee for Improvement of Disaster Relief

Yukiko Kanaya

Osaka City University◎ Sanae Haruyama

Jichi Medical University

Kaoru Konishi

Osaka University○ Yukiko Anzai

Miyagi University

Chikage Tsuzuki

Kobe City College of Nursing

Mari Ueno

Shonan University of Medical Sciences

Kumiko Morita

Tokyo Medical and Dental University

Yuko Ushio

University of Hyogo

6. Committee of the Social Insurance Union Societies Related to Nursing

Hiroko Okuda

National Institute of Public Health◎ Mikako Arakida

International University of Health and Welfare

Minako Sawai

Shonan University of Medical Sciences○ Misako Miyazaki

Chiba University

Hiroko Shimada

Jichi Medical University

The 21st Annual Research Conference of JACHN
Theme：The Reform of Community Health Nursing Practice in Cooperation between Practitioners and Educators
Date：August 11-12, 2018 (Saturday-Sunday)
Venue：Nagaragawa Convention Center (Gifu city)
Chair：Mitsuko Kitayama (Professor, Gifu College of Nursing)
Program：◆Chairperson’s speech: Mitsuko Kitayama
Enrichment of “Education” and “Research” about Community Health Nursing and Reform of Community
Health Nursing “Practice”◆Special lecture: Takayoshi Kusago, Ph.D.(Professor, Social System Design, Faculty of Sociology, Kansai
University)
Collaboration of Citizen and Local Government for Cultivating a High Well-being Community: Potential of
Action Research◆Educational lecture ◆Symposium ◆Appointed workshop ◆Poster session ◆Workshop ◆Open lecture◆Reception
Website：http://jachn21.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

8105