In this study, we conducted text analysis to clarify the “feelings and considerations about the community (thoughts on the community)” of aged individuals in depopulated rural districts with low birth and high death rates, to identify a basis for public health nurse activities that contribute to improved functioning of aged individuals in rural areas. Quantitative text analysis was performed on free descriptive data collected from 362 aged individuals in rural districts; a co-occurrence network was created and correspondence analysis was performed. Six categories were extracted by analyzing the structure of the co-occurrence network: “loneliness because of the increasing number of unoccupied houses with few children and young people around”, “changes in the neighborhood and relationship with neighbors over time”, “continuous aging and depopulation of the village”, “preciousness of living with and spending time with family”, “maintaining good health and healthy aging”, and “difficulties and worries about inconvenient access to hospitals, public administrative offices, and shops”. Correspondence analysis of extracted words identified “inside the town”, “difficult”, “depopulation”, and “town” as factors strongly contributing to the principal component. The categories revealed by text analysis in this study may indicate an approach to develop the community, through objectively analyzing and then best utilizing self-care and mutual care in aged individuals in rural districts and social solidarity and governmental care (e.g., public health services).

The aim of this study was to elucidate the current status of and problems with the in-service nursing education system at medical institutions in depopulated areas. Responses to a selfadministered questionnaire were requested from the director of the nursing service department at each of 29 national health insurance clinics and hospitals in Prefecture A. Completed questionnaires were returned by 18 medical facilities (5 hospitals and 13 clinics). Regarding educational methods for nurses, the largest number of responses concerned “participation in workshops held by the prefecture or municipalities”, followed by “training in external institutions or related facilities.” Thus, out-of-hospital education was predominant. The main reason for not dispatching nurses for out-of-hospital education was “difficulty securing time for the dispatch”. Problems with human resource development included “difficulty developing human resources because of human resource shortage” and “a loss of staff motivation”. In depopulated areas, the human resources pool includes nurses with various work experience; therefore, learning opportunities should be provided for nurses according to their practical abilities and in cooperation with many facilities. Educational methods that can connect out-of-hospital education with inhospital education should also be examined.

The objective of this study was to investigate associations between societal mutual assistance and vital functions among Aged People in rural Districts. This cross-sectional survey used questions based on the Anderson Behavioral Model, including relevant items such as “Individual characteristics (predisposing, enabling, and need factors)” and “Community characteristics (physical factors)”. We distributed questionnaires to 2,500 people and used 974 valid responses for study analyses. Our results showed that older adults in rural districts with lower levels of societal mutual assistance tended to have lower vital functions levels. Also, actual lower vital functions levels appear to be associated with lower levels of “Living in harmony with nature” and “No available social groups to participate in” at the group or community level, which define vital functions. It is necessary to objectively review self- and mutual-assistance roles of older adults living in rural areas as well as the mutual and public assistance functions that are typically involved in public health services.

Objective: This study aimed to clarify the association between social mutual aid and psychological stress among residents in a rural district.Materials and Methods: A cross-sectional study based on Andersen’s Behavioral Model of Health Care Utilization was conducted on 2,500 residents of City A in Akita Prefecture who were aged 65 years or older. The study was conducted from April 8 to May 15, 2017. Participants were administered a questionnaire containing items on individual characteristics (predisposing, enabling, and need) and contextual characteristics (physical factors).Results: Responses were obtained from 1,236 participants, and data from 974 valid questionnaires were analyzed. Factors related to the high level of psychological stress were “maintenance of confidential relationships that could only be formed in the rural district (low)” and “social support (low)”, which are forms of social mutual aid. Use of health services had no association with psychological stress, whereas when psychological stress was high (5 points or higher), the rate of “not participating in community groups (no)” was also high.Conclusion: The findings of this study indicate the need for the objective evaluation of the roles of self-help and mutual help among elderly adults living in a rural district and the mutual help and public help functions represented by health services. It is also important to develop districts that promote the enhancement of social mutual aid so that such help can be fully utilized.