The objective of this study was to develop a scale that measures job satisfaction in public health nurses (PHNs) employed in the public sector and to test its reliability and validity. Results of semi-structured interviews with PHNs employed in the public sector and findings in literature review were assessed for content validity. A preliminary scale consisting of 74 items was thus developed, and its reliability and validity were tested in 1,030 PHNs employed in the public sector. Valid responses obtained from 422 PHNs (valid response rate, 41.0%) were subjected to item analysis followed by exploratory factor analysis using the principal factor method with promax rotation. Accordingly, 3 factors and 18 items were extracted, and the hypostatic factors were named “duties and responsibilities of PHNs”, “senior staff's understanding and environment facilitating personal development”, and “thoughts and trust in residents”. Confirmatory factor analysis confirmed the goodness of fit of the hypothetical model. Cronbach’s t was 0.907 (0.847-0.900 for subscales), confirming the reliability of the scale. The intraclass correlation coefficient (r) by the test-retest reliability method was .847 (.727-.830 for subscales), confirming stability. The criterion-related validity was confirmed by positive correlations of the draft scale with a general job satisfaction scale (r = .642, p.001), a self-esteem scale (r = .452, p.001), a self-efficacy scale (r =.411, p.001), an interpersonal support ability scale (r = .452, p.001), and a scale for ability to support and manage the community (r =.532, p.001). In sum, we developed a scale consisting of 3 factors and 18 items that measures job satisfaction in PHNs employed in the public sector. The contents of this scale will contribute to aspects of job satisfaction in diverse human resource development of the future. Thus, this scale is expected to be useful as a human resource development tool for PHNs employed in the public sector.

The aim of this study was to analyze the relationships among various characteristics such as personal attributes, health status, and social functioning in socially isolated elderly people according to a new classification based on intentionality in social choices, and to clarify the characteristics and issues of these individuals living in the community. We conducted a questionnaire survey of all healthy elderly people in Town A, which is located in a rural area. We classified respondents as non-socially isolated, intentionally socially isolated, or accidentally socially isolated. We then compared the three groups. Correspondence analysis was used to examine relationships among personal attributes and physical, mental, social functioning in the three groups. Valid responses were received from 1,284 respondents. Results showed that intentional social isolation was associated with living alone and poor physical functioning but not with medical history. Thus, intentional social isolation requires interventions for improving lifestyle, physical activity, nutrition, and oral care to prevent frailty among elderly people living in the community. Accidental social isolation was associated with depression and cognitive decline, and therefore requires mental health intervention. In addition, the accidentally socially isolated elderly tended to have low socioeconomic status, so it is necessary to create a mechanism for the early identification of high-risk individuals during monitoring and intervention provided by health and welfare professionals in various fields.

The increase in dementia is becoming a serious health-related issue in Japan. The Ministry of Health, Labour and Welfare has indicated that the most effective method for preventing dementia is to detect and manage mild cognitive impairment (MCI). Accordingly, this study focused on “low physical activity”, which is a risk factor for dementia, and aimed to clarify the correlation between physical activity and MCI by analyzing the amount of physical activity among community-dwelling elderly adults sampled randomly from a cohort. A door-to-door survey was conducted of 26 physically housebound elderly adults and 26 physically nonhousebound elderly adults matched for sex, age, and living quarters who were randomly sampled from a 2013 cohort. Housebound status was assessed using a basic checklist. The survey was conducted at the participants’ homes. Components of the survey included basic attributes, basic checklists, the International Physical Activity Questionnaire, Japanese version of the Montreal Cognitive Assessment (MoCA-J), Kohs Block Design Test (Kohs), Revised Hasegawa’s Dementia Scale, Geriatric Depression Scale─Short Version-Japanese, Instrumental Activities of Daily Living Scale, and grip strength. The chi-squared or Mann─Whitney U test was used for comparisons between the elderly adults with low physical activity and those with high physical activity. The chi-squared test was used to compare the relationships between physical activity and MCI assessments (MoCA-J, Kohs). Statistical analysis was performed using SPSS for Windows, with significance established at p < 0.05. Physically inactive elderly adults were engaged in significantly physical activities and had significantly more inactive periods compared with physically active elderly adults. The inactive elderly adults did not fulfill the level of physical activity needed to maintain fitness. In addition, a significantly higher percentage of inactive elderly adults had MCI compared with active elderly adults according to MoCA-J score. When MCI was assessed using the Kohs, on the other hand, there was no significant difference between the active and inactive elderly adults. Inactive elderly adults were not able to fulfill the level of physical activity necessary to maintain fitness and prevent MCI. There is a need to urgently consider ways to identify inactive community-dwelling elderly adults and to detect and manage MCI at an early stage.

The purpose of this cohort study is to clarify the risk factors of low well-being of elderly people who residing in a local city of a super-aging country, Japan.Subjects are people, who have selected randomly from healthy elderly people resided in Kizugawa City, Kyoto Prefecture, in 2010, followed until 2015. Question survey was conducted in both year, and questionnaire consisted of items such as basic attributes, lifestyles (health practices, consultation behaviors, social activities and so on) and well-being (WHO-5). In analysis we made multi-logistic regression analysis using lifestyle variables as an independent variable and well-being as a dependent variable.The results were as follows.1. Risk factors were not to exercise, knowledge of appropriate diet, subjective feeling of stress for at least a month, not to participate in voluntary activities, age and bad subjective feeling of health.2. Risk factors in regard to changes of lifestyles using good-good lifestyles as a reference were sustainment of having no time for hobby or relaxation, sustainment or deterioration of subject feeling of stress for at least a month, sustainment or deterioration of having no time for relaxation and deterioration of having no activities with pleasure or aim. A factor promoting well-being is to have more frequencies for going out home.This study shows that in a longevity society it is important for community-dwelling elderly Japanese to have good health practices, appropriate consultation behaviors and good social activities for the purpose of keeping good well-being, and that these results are contributed to health promotion policy for community-dwelling elderly people.

Objective: Cervical dystonia (CD) is a clinically under-recognized symptom occurring at the later- to end-stages of Parkinson’s disease (PD). The frequency of CD and its influence on prognosis have not been well studied. Here, we conducted an in-depth examination of CD incidence and impact on disease progression in later-stage PD. Methods: We retrospectively reviewed the clinical features of 22 deceased patients with sporadic PD treated at a hospital in Japan from 1983 to 2008. Results: The most common cause of death in PD was pneumonia. CD, in particular retrocollis, was frequent in the later stages of the disease in elderly patients (9/22, 40.9%). Pneumonia incidence increased sharply in the later period with CD. There was a positive trend between CD duration and duration of pergolide use. Conclusion: Analysis revealed that CD increases markedly in late- to end-stage PD, which may be associated with aspiration pneumonia due to dysphagia. Pathological mechanisms underlying CD might be influenced by treatments including dopamine agonists. Prevention of CD may increase quality of life and prolong survival of PD patients.

This study aimed to verify whether the incidence of frailty in elderly individuals is higher among those who are housebound than those who are not. This study found no correlation between elderly people’s houseboundedeness and physical, mental, social, and overall frailty. However, the Tilburg Frailty Indicator (TFI) frailty score and grip strength value were higher in non-housebound elderly persons than in housebound elderly ones. This suggests that being housebound may lead to frailty. On the other hand, it is thought that individual interaction with family and friends, and lack of anxiety about falls correlates with the prevention of frailty in housebound elderly persons. The results of the study also suggest that the basic checklist may be effective for ascertaining the actual situation of housebound elderly people who may be manifesting frailty.

The purpose of this study is to elucidate the correlation between social capital and frailty of homebound community-dwelling elderly individuals without certification for long-term care. Subjects were 47 homebound and 47 age- and sex-matched, non-homebound elderly individuals evaluated from July to November, 2016. Variable parameters were physical, mental, and social frailty, Tilburg Frailty Indicator score, and social capital. The correlation between social capital and frailty in home-bounded elderlies was analyzed using the χ2 Test. Social capital was significantly correlated with mental frailty among homebound elderly individuals. In contrast, social capital was significantly correlated with all types of frailty among non-homebound elderly individuals. Among community-dwelling elderly individuals, social capital is related to prevention of comprehensive frailty and mental frailty. On the other hand, screening and intervention for prevention of long term-care are necessary for homebound elderly individuals.

Objective: The rates of care-needs certification were mainly compared between two cohorts: 7,820 specific health checkup examinees/basic checklist respondents and 29,234 non-examinees/non-respondents.Subjects and Methods: Among approximately 37,000 elderly citizens of X City, the number of individuals newly certified as requiring long-term care were observed from the date of the first specific health checkup in 2008 to March 31, 2013. The aggregated totals of these individuals and associated factors were evaluated.Results: 1. Support Required 1, Support Required 2, and Long-term Care Required (level 1) certified individuals accounted for approximately 80% of newly certified individuals aged 65–74 years. Newly certified individuals aged 75 years and over had similar results with 37.2% of them being certified Support Required 1, 19.4% certified Support Required 2, and 22.9% certified Long-term Care Required (level 1). 2. The primary factors for care-needs certification in individuals aged 65–74 years were arthritic disorder in 27.6%, falls and bone fractures in 11.3%, and malignant neoplasm and cerebrovascular disease, among others. This was similar for individuals aged 75 years or over. 3. Of the 7,820 specific health checkup examinees/basic checklist respondents, 1,280 were newly certified as requiring long-term care (16.4%) compared to 7,878 (26.9%) of the 29,234 non-examinees/non-respondents. Therefore, the latter cohort had a significantly higher rate of individuals who were newly certified as requiring long-term care.Conclusion: Both specific health checkups and basic checklists are effective health policies to protect frailty in community elderlies.

　　In a cohort study of 7,820 elderly residents, we explored whether the priority items of the basic checklist predict new issuance of a certificate of needed long-term care. We analyzed data using Cox’s proportional hazard regression, with new issuance of a certificate of needed longterm care as the dependent variable, need for secondary prevention services (determined by the basic checklist results) and required level of specific health guidance as independent variables, and sex, age, place of residence, and use of long-term care prevention services as moderator variables.　　The results were as follows. The priority items of the basic checklist to assess need for secondary prevention services were useful for screening in both the younger and older elderly populations. Also, more certificates of needed long-term care were issued to those individuals who received secondary prevention services. Furthermore, partial functional impairment was also significantly associated with issuing a new certificate.