Community General Support Center Research Articles

Turnover Intention among Staff Who Support Older Adults Living Alone in Japan: A Cross-Sectional Study

Older adults in Japan traditionally rely on family members for care. However, the growing number of older people living alone has increased staff burden in community general support centers (CGSCs), which provide care for older people in Japan. This study aimed to identify factors linked to turnover intention among CGSC staff. Of 1002 staff invited to participate, 283 completed a survey (response rate: 28.2%). Logistic regression analysis of 183 valid questionnaires examined demographic, job-related, and attitudinal factors associated with turnover intention. The results showed that the perceived difficulty of supporting older adults living alone was the main predictor of turnover intention. Staff reporting high perceived difficulty levels were more likely to consider leaving. Negative attitudes toward supporting this population also increased turnover risk. These findings highlight a pressing need for targeted interventions to strengthen the ability of CGSC staff to manage the challenges of caring for isolated older individuals. Addressing staff perceptions and providing essential training and resources could reduce turnover rates and increase the quality of care for this vulnerable group.

Comparison of characteristic competencies of public health nurses working at a community general support center and health and welfare in public administration in Japan.

To compare the characteristic competencies of public health nurses working for the older adult's health and welfare in public administration ("PA") with those at community general support centers ("CGSC") in Japan. We conducted a questionnaire survey by mail for PA and CGSC public health nurses. A competency list that was developed to compare three groups (PA, CGSC experts with ≥5 years of experience, and CGSC newcomers with ≤2 years of experience) was used. The following characteristics were examined: (1) competencies acquired early after arriving at the CGSC, (2) competencies acquired through a certain amount of CGSC experience, (3) common competencies, (4) competencies that even experts lacked, and (5) competencies that the newcomers lacked. We examined the responses of 171 PA nurses, 185 CGSC expert public health nurses, and 165 CGSC newcomer public health nurses. The results of comparison of the three groups showed that (1) had no applicable items; (2) had nine items for individual support associated with preventive care management; (3) had 14 items including teamwork among three professionals (social workers, senior care manager, public health nurse)/other professionals and self-improvement; (4) had three items for community development, (5) had two items for individual support and 16 items for community development. Initiatives for preventive care and coordination of care teams should be supported and suggested as characteristic competencies for CGSC public health nurses.

Evaluate a comprehensive geriatric assessment service framework targeting frail older people who had high risk of requiring long-term care services in Japan: a community-based pilot study

BackgroundFrailty has become a key concern in an aging population. A comprehensive geriatric assessment (CGA) service framework was developed and evaluated aiming to target and connect frail older adults who are at high risk of requiring long-term care services.MethodsA community-based pilot study was conducted in fiscal year 2016 and 2017 in Kure city, Hiroshima, Japan. Participants aged 65 and over living in Kure city, and 393 persons were extracted from the Kihon Check List (KCL) responses. Among the eligible individuals, 101 consented to participate and received CGA and referred to services based on individual health needs. The efficacy was evaluated by referral rate of services, continuity of the service usage, evaluation of participant’s health condition and the quality of life (QoL) after the 6-month follow-up.ResultsNinety-nine (98.0%) participants needed support for the instrumental activity of daily living, 97 (96.0%) were categorized as locomotive syndrome, and 64 (63.4%) had a depressive tendency. Afterward, 60 participants (59.4%) subsequently accepted the referral services, however, 34 (33.7%) used the services and the remaining 26 (25.7%) did not use the services. The health condition improvements in the service-uses group were statistically significant (p < 0.001), however, QoL score did not change between the baseline and 6th -month.ConclusionKCL extracted high-risks older people, and CGA revealed related diseases and health conditions. However, the high refusal rate of referral services indicates a necessity to modify the service framework such as by collaborating with community general support centers, which could increase the efficacy of service framework.

Care needs of caregivers of the elderly with early-stage dementia.

This study aimed to identify the care needs of family caregivers of elderly patients with early-stage dementia and examine support measures. We conducted a self-administered questionnaire survey with 115 primary caregivers of outpatients who visited A City Community General Support Center or B University Hospital Department of Neurology for memory loss consultation. The questionnaire content included demographic characteristics, the care needs scale for caregivers of the elderly with early-stage dementia (Care Needs Scale), and the Japanese short version of the Zarit Burden Interview. The Medical Ethics Committee of Fukuoka University approved this study (approval number: M047). Of the 115 participants, 104 were included in the analysis after excluding 11 respondents with missing data. We divided the participants into a young group (under 65 years of age) and an old group (65 years of age or older) and compared the variables and each scale score using the Mann-Whitney U test. We also compared the correlations between the total score and subscale scores of the Care Needs Scale and each variable, in addition, we performed multiple regression analyses using the total score of the Care Needs Scale as the dependent variable. The young caregivers wanted to know how to take care, prevent deterioration, and deal with symptoms of early-stage dementia. They were trying to balance caregiving with work and housekeeping and reduce the stress and burden of long-term care. Older caregivers were confused about caregiving and wanted someone to talk about their situations. Both groups shared that the family's lack of understanding about caregiving and personal and role strains were associated with the care needs of caregivers of the elderly with early-stage dementia.

Characteristics of ethical dilemma and behavior in the support process of older adults and their families among nurses at a community general support center in Japan

Objectives This study was aimed at clarifying characteristics of ethical dilemmas and behaviors in the support process of older adults and their families among nurses at community general support centers.Methods A self-administered questionnaire survey was mailed to 449 nurses at community general support centers in Tokyo. Question items enquired their age, employment license, years of experience as a nurse, the presence of ethics-related organizations, number of cases in which nurses faced difficulties in supporting older adults and their families in decision making over the past year, the ethical dilemmas they experienced and their situations, and ethical behavior in the process of supporting older adults and their families.Results From the 143 responses (response rate: 31.8%), 135 (valid response rate: 30.1%) nurses were analyzed. Overall, 43.0% and 27.4% of the participants were in their 50s and 40s, respectively. Of these, 77.0% and 23.0% were nurses and public health nurses, respectively. In total, 52 (38.5%) respondents had an ethics-related organization. The average number of cases in which the respondents faced difficulties in supporting older adults and their families in decision making over the past year was 8.3 (standard deviation, 12.5). Of these, the average number of cases in which they faced difficulties in making ethical decisions was 4.1 (standard deviation, 6.0). Regarding the perception of ethical dilemmas, 113 (83.7%) answered "often" or "sometimes." Ethical dilemma situations included "the intentions of the user and family were different, and I had trouble deciding what to respect" 95 (84.1%); "the user's intention was different from my judgment as a professional, and I had trouble deciding what to respect" 64 (56.6%); and "the intention of the user and neighbors were different, and I had trouble deciding what to respect" 56 (49.6%). Ethical behaviors included "I observe the management rules in my organization regarding personal information data" 116 (85.9%); "I provide easy-to-understand explanations appropriate to the user's situation" 115 (85.2%); and "I decide on a support policy with several staff members when self-decision making is difficult due to the user's situation" 113 (83.7%).Conclusion More than 80% of the nurses perceived ethical dilemmas. Characteristics of the situations were that users and their families, users and professionals, and users and their neighbors had different intentions. Further research should be conducted on ethical issues related to community-based integrated care.

The expected role of Dementia Support Doctors in dealing with complex cases of older people with dementia

The present studyinvestigated the roles expected of Dementia Support Doctors (DSDs) in dealing with complex cases. The participants were attendees of the education programs organised by the Center for Promoting Dementia Support and the Medical Center for Dementia at the Tokyo Metropolitan Geriatric Hospital from April 2021 to March 2022. A self-administered postal questionnaire survey was conducted. The questionnaire included items on the basic attributes of the participants, their experiences with the issues associated with complex cases, and role expectations of consulting/collaboration partners when dealing with complex cases. The valid response rate was 49.3%. DSDs were expected by primary physicians, Community General Support Center staff and administrative staff to diagnose dementia and give advice on support strategies for complex cases. Primary physicians further expected them to initiate pharmacotherapy with anti-dementia drugs and address the pharmacotherapy needs for managing Behavioral and Psychological Symptoms of Dementia. It was also found that DSDs' experience with complex cases was comparable to that of the staff at the Medical Centers for Dementia. Of note, DSDs were mentioned less frequently as consulting/collaboration partners than Medical Centers for Dementia and primary physicians. The study showed that DSDs play an important role in dealing with complex cases. The roles of DSDs and ways to collaborate with them need to be communicated through interprofessional education.

Building Relationships Between Community Care Professionals and Convenience Stores in Japan: Community-Based Participatory Research.

Convenience stores play an important role in supporting community-dwelling older adults' lives. We started community-based participatory research (CBPR) in Nerima City, Tokyo Metropolitan area in Japan to develop a collaborative relationship to support older adults in the community-based integrated care system. This study aimed to describe the CBPR process and evaluate building face-to-face relationships between health/social care professionals and the owners/employees of convenience stores. Using CBPR, health/social care professionals in community general support centers (CGSCs) directly approached convenience stores based on the public support agreement between the convenience store chain company and the municipality. To evaluate the face-to-face relationship building between convenience store owners/employees and CGSCs' staff, we administered questionnaire surveys to convenience stores in Nerima City and two control cities from 2017 to 2019, and about 100 convenience stores completed the survey each year. Statistical analyses showed significant improvements in their knowledge for relationships with the CGSCs in Nerima City, including "knowledge of the CGSCs' function" (P = 0.001), "knowing individual professionals in the CGSCs" (P = 0.023), and "knowledge of when to contact the CGSCs" (P = 0.002), compared with control cities. Helping behavior for older adults at convenience stores also increased significantly in Nerima City (P = 0.034). The CGSCs' direct approach based on the public support agreement would effectively promote building relationships at convenience stores, leading to an age-friendly community.

Current Situation of the Business Continuity Plan Preparation in Japan: Community General Support Centers

Objective: This study aims to clarify the actual situation of the business continuity plan (BCP) preparation in the community general support centers in Japan. Method: In September 2021, a survey was administered to 5,391 community general support centers all over Japan using a self-input Web questionnaire. Results: 577 responses were obtained, for a response rate of 10.7%, among which “BCP has been created” accounts for 9.5%; “BCP has not been created, and there is no plan to create any,” 22.0%; “it is currently being examined whether to create BCP,” 47.0%; and “BCP is now being created,” 21.5%. The community general support centers that “have not determined the division of roles” with their municipalities in responding to disaster account for 64%. Conclusions: This study clarifies the situation of the community general support centers in Japan, based on which they cannot be said to be prepared for a disaster. From the word network of answers to our questionnaire, we can see reasons why the BCP has not been created: lack of knowledge and busy work. Centers that have not prepared a BCP, understand the need to create one, but they are too busy and are unaware of how to do so. We discuss measures to promote the creation of BCPs by community general support centers in the future, given the current situation.

Forensic Characteristics of Physical Elder Abuse and Current Status and Issues of Collaboration between Forensic Medicine Departments and Related Institutions in Japan.

This study sought to clarify the characteristics and trends of physical elder abuse and the status of collaboration between forensic medicine departments and related institutions in Japan. Questionnaires were sent to 82 forensic medicine departments and 2857 institutions randomly selected from hospitals, municipalities and public community general support centers. The survey period was February to June 2021, including an extension period for collection. Responses from 675 facilities were analyzed. The most common finding in cases of physical elder abuse at forensic medicine departments was subcutaneous hemorrhage on the head (85.7%), with mixed old and new injuries most commonly observed in the lower limbs (70%). There were few cases in which there was collaboration between forensic medicine departments and other institutions. Among the issues identified, there is a need to provide related institutions with information obtained in forensic medicine departments. A new collaboration system is needed to achieve this.

Coordination Practice for and Issues Encountered by Public Health Nurses in Community General Support Centers Regarding Life Support Provided to Older Adults with Dementia

Coordination Practice for and Issues Encountered by Public Health Nurses in Community General Support Centers Regarding Life Support Provided to Older Adults with Dementia

Effects of Recommended Consultation Practice Using Fracture Risk Assessment Tool and Fracture Evaluation Questionnaire for Early Detection of Osteoporosis at Community Pharmacies

As one of the strategies for the early detection and treatment of osteoporosis, we have recommended visiting a hospital, based on the Fracture Risk Assessment Tool (FRAX®) and evaluation questionnaire for osteoporotic fracture risk. In this study, we evaluated the impact of intervention by community pharmacists by integrating our data for the FRAX® and questionnaire. The measurement of FRAX® and the questionnaire survey were conducted through participation in health seminars organized by a community general support center from June 2018 to December 2019. Participants with a FRAX® score more than 15% and at least one item in the questionnaire were considered to have "suspected osteoporosis" were recommended medical consultation. The medical treatment status for the participants considered to have "suspected osteoporosis" aged 40-90 years were analyzed. Of the 84 participants, 54 had a FRAX® score more than 15%, and 44 participants fulfilled at least one item in the questionnaire. Medical consultation was recommended to 26 of these 44 participants, excluding 18 under treatment. Of the 25 participants, six (excluding one who disagreed) received consultation, and medical treatment was started for four of them (66.7%). However, consultation with the attending physician was recommended to five of the 18 participants who were initially on treatment but discontinued it at the time of the survey. Consequently, two participants resumed their osteoporosis treatment. Our data suggest advantages of community pharmacists' intervention using FRAX® and a questionnaire for osteoporotic fracture risk measurement for early detection and medical treatment.

Perception of use of interpreters for foreign older adults among care providers working at community general support centers

Perception of use of interpreters for foreign older adults among care providers working at community general support centers

Nationwide Survey Rerated to the Implementation Status of Bereavement Supports by Community General Support Centers in Japan: Characteristics of Community General Support Centers that Provided Bereavement Support

Nationwide Survey Rerated to the Implementation Status of Bereavement Supports by Community General Support Centers in Japan: Characteristics of Community General Support Centers that Provided Bereavement Support

Conduct and Evaluation of Case Conference Training to Promote Interprofessional Collaborative Support in Community General Support Centers

Conduct and Evaluation of Case Conference Training to Promote Interprofessional Collaborative Support in Community General Support Centers

Support Provided by Nurses at a Community General Support Center for Older Adults with Suspected Dementia Who are Living Alone

Support Provided by Nurses at a Community General Support Center for Older Adults with Suspected Dementia Who are Living Alone

Dementia education is the first step for cooperation: An observational study of the cooperation between convenience stores and community general support centers.

The dementia supporter training program is conducted by community general support centers (CGSCs) to raise dementia awareness. Convenience stores are widespread throughout Japan, and they play an important role in the daily lives of older adults. We examined whether participation of convenience stores in the program promotes cooperation between the stores and CGSCs. Using data from a nationwide survey, we conducted a longitudinal observational study. Participation of stores in the program and cooperation with CGSC were measured. The proportion of cooperation with CGSCs in 2017 and 2018 were compared between stores that had already participated in the program in 2016 (participation group) and those that did not (non-participation group). Of the 14 884 stores, 542 stores participated in the program in 2016. In 2017 and 2018, 8.1% and 7.2% of the participation group cooperated with CGSCs, while 3.2% and 4.0% of the non-participation group did. Dementia supporter training programs could be an opportunity to promote cooperation between convenience stores and CGSCs to support older adults. Geriatr Gerontol Int 2020; 20: 956-960.

地域包括支援センターにおける高齢者の支援困難事例に関する文献レビュー ―2005～2017年に発表された論文に焦点を当てて―

地域包括支援センターにおける高齢者の支援困難事例に関する文献レビュー ―2005～2017年に発表された論文に焦点を当てて―

Initial-phase intensive support team and community general support center: From the perspective of coordination and networking of social support

社会支援のコーディネーションとネットワーキングは，「認知症とともに暮らせる社会」を実現するための鍵概念である．認知症初期集中支援チームや地域包括支援センターの本来業務はコーディネーションとネットワーキングに他ならない．地域の特性に応じて，コーディネーションとネットワーキングのあり方を深化させ，現存する縦割りの事業を効果的に整理・統合していくことが，地域共生社会の実現をめざすこれからのわれわれの課題である．

Development of a Coordination Scale Focused on Life Support of Elderly People with Dementia for Public Health Nurses in Community General Support Centers

Development of a Coordination Scale Focused on Life Support of Elderly People with Dementia for Public Health Nurses in Community General Support Centers

Recognition of occupational therapists by the Community General Support Center staff through Quantitative Text Analysis

Recognition of occupational therapists by the Community General Support Center staff through Quantitative Text Analysis