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【目的】人口減少が著しい過疎地域の高齢者の健康度とソーシャル・キャピタル（以下、SC）の地域特性を明らかにし、良好なSC を醸成するための条件を明らかにすることを目的とした。【方法】主観的健康観、SC 項目（市民参加、社会的連帯、互酬性）、地域特性項目について質問紙調査を行った。対象は、人口密度が低い過疎地域２町に住む高齢者614名（有効回答者）である。【結果】過疎地域は、日本老年学的評価研究が行った全国調査と比較して市民参加率が低く、ロジスティック回帰分析の結果、主観的健康観には市民参加及び社会的連帯が関連していた。また、SCの醸成には、生活の不便さ、集う場所及びバス停の有無と相関があった。【結論】過疎地域でも、市民参加は主観的健康観を維持する重要なSC 項目である。一方で、JAGES の研究結果である都市部と比較し過疎地域では市民参加率が低い。これは、インフラが乏しく、市民参加の場が都市部より少ないことが一因であると考えられ、住民参加の場である通いの場等の地域支援事業は貴重な場になっているが、過疎地域では担い手の確保が課題である。今後、住民参加の場を維持するために、貴重な転入者や外部人材が住民参加できるよう、価値観が異なる人が疎外されない橋渡し型のSC が醸成されるよう介護予防に携わる保健師等の専門職が介入する必要がある。さらに、住民参加の場が集約され、参加が困難にならないよう、今後さらに人口減少が進むことを踏まえ、全国一律の制度設計ではなく、住民参加の場への交通手段の支援も検討する必要がある。 This study identifies factors that contribute to the reconstruction of life in the recovery process five years after the Kumamoto Earthquake and determines how professionals could help create a healthy community. A self-administered anonymous questionnaire was administered to 130 residents in Area H, Mashiki-machi, Kumamoto, and 100 residents in Area F, Kosa-machi. Of the 113 responses received （collection rate: 49.1%）, the answers of 112 respondents were analyzed after excluding 1 respondent, who suffered no damage. Multiple regression analysis was performed with “reconstruction of life” as the dependent variable and “community connection/support outside the community, etc.” as the independent variable. The results showed that “support outside the district” contributed positively and “community connection” contributed negatively （R2 = 0297）. A total of 92 respondents （82.1%） answered “Yes” to the question of whether there was something that made them feel positive after the earthquake. No statistically siginficant differences were observed among respondents by age group （p = 0.424）. “Presence of family” and “growth of children” were the most common in all age groups, followed by “local shrines” and “community events,” selected by respondents aged 75 years or older. Respondents under 60 years old selected “scenery of hometown” and “reconstruction of Kumamoto Castle.” “Provision of information” was selected most by those under 60 years old（ 18.8%）. The results indicate that a strong “community connection” reinforces mutual aid relationships but simultaneously encourages people to sacrifice their private lives, which has a negative impact on the reconstruction of life. Moreover, the sense of burden was reduced by the support provided by those outside the community. To create a healthy community, “loose community connection” is required, and in addition to local community activities, it is necessary to establish new values and systems that afford residents daily interactions with people outside the community through a volunteer system.

地域貢献は教育・研究と並ぶ大学の使命であり，大学における地域貢献の意義と課題を明らかにすることは使命を果たすうえで重要である。本研究は，地域住民の健康増進に資する大学の地域貢献のあり方についての基礎資料を得るために，15年間継続している介護予防事業に着目し，大学における長期間での地域貢献の意義と課題を明らかにした。 介護予防事業の効果としては，参加者の身体機能維持及び介護予防効果，学生の実践力を身に着ける場としての教育効果，教員の教育・研究指導の充実，が示された。また，大学における長期間での地域貢献の意義は，①運動の場，集う場の提供による介護予防の意義，②学生・教員の教育研究の場の提供としての意義，③社会的評価の高まりにつながる意義があることが示唆された。課題は，限られた人的・資金的資源の中で，有効かつ持続可能な事業を展開するためには組織体制の確立と支援がより求められること，公益性の担保について検討を要することが示唆された。, Community contribution is the mission of the university, along with education and research. The purpose of this study was to clarify the significance and issues of community contribution to a project aimed at preventing long-term frailty of older adults in the community, which has been ongoing for 15 years.The project's effects were the maintenance of participants' physical function and the preventive effect of long-term care, increasing educational outcomes by providing a place for students to acquire practical skills, and enhancing teachers' education and research guidance for students. In addition, the significance of the university's long-term contribution to the community is (1) preventative care by providing a place for exercise and gathering, (2) providing a place for education and research for students and teachers, and (3) contributing to an increase in public esteem. The challenge is to create and support an organizational structure that can develop an effective and sustainable project with limited human and financial resources and to constantly ensure public benefit.

NUHM015, This study used the Kihon Checklist, Daily Life Performance Checklist and Interest Checklist toward 337 healthy elderly persons in the community to examined their perception of inconveniences to daily life performance as well as the daily activities which they are ‘doing,’ ‘want to do’ and are ‘interested in doing.’ Among 377 healthy elderly participants, 20.0% were found to be qualified for the Secondary Prevention Program, 49.3% experienced inconvenience to ‘get up from the floor,’ 42.7% suffered inconvenience to do ‘weeding,’ 38.7% recognized inconvenience to ‘go up and down stairs,’ and 54.7% recognized ‘forgetfulness.’ Both the qualified and the unqualified elderly were ‘interested in’ and ‘want to do’ ‘haiku,’ ‘painting and writing picture-letters,’ ‘calligraphy,’ and besides ‘dance’ and ‘volunteer’ were drawn as the daily life performance that the qualified persons for the Secondary Prevention Program are ‘interested in doing’ and ‘want to do.’ The perception of inconveniences and interests to daily life performance of the elderly people qualified for secondary prevention program.

近年、鍼施術による痛みや運動器の傷害に対する有効性が認められている。鍼施術は補完代替医療に位置付けられているが、近代西洋医学に統合した治療的介入も試みられている。超高齢社会において、予防医学や介護予防の領域が一層重視されてくると思われる。本稿の目的は、介護予防領域での鍼灸師の取り組みに焦点をあて、これまでに報告されている文献を通して、鍼灸師による介護予防の取り組みの現状と可能性について検討することである。医学中央雑誌、科学技術情報発信・流通総合システム（J-STAGE）、メディカルオンライン、全日本鍼灸学会学会誌検索システム等を介して鍼施術の効果及び鍼灸師による介護予防に関する文献を収集した。検索のキーワードは「鍼灸」「介護予防」である。レビューによって、これらの文献を、鍼灸の効果を示すもの、介護予防活動に関する実践報告、他職種との連携に関するものの３つに大別し、考察した。鍼灸師による介護予防の分野における専門性として、鍼や東洋医学的知識を用いて痛みを緩和するとともに、心理的・精神的、身体的にも効果をもたらす可能性が考えられる。これまで鍼灸師による介護予防に焦点を当てた研究は少なく、医療や介護予防分野における鍼灸や鍼灸師の業務に対する認知度は低い。一般的に鍼灸や鍼灸師の業務に対する理解が得られていないことが、認知度が低い最大の要因であろう。鍼施術は健康の維持増進に向けて予防法としての活用も期待されている。鍼灸師による介護予防活動に関するエビデンスを蓄積するとともに、一般に広く普及させることが重要であると考えられる。, Recently, acupuncture has been the focus of many studies due to its potential usefulness in the treatment of pain and musculoskeletal disorders. Although acupuncture is classified as a type of alternative complementary medicine; it is a therapeutic intervention that tries to achieve the same results as modern western medicine. In an aged society, preventive medicine and care prevention play a greater role. This study aims to investigate the current status and possibilities of care prevention for elderly people by acupuncture therapists using the information provided in the existing literature. The online database of the Japan Medical Abstracts Society, J-Stage, JJSAM was searched for the following keywords: "acupuncture" and "care prevention". The studies obtained in the search results were classified into three categories: effects of acupuncture therapy, practical reports of care prevention activities by acupuncture therapists, and collaboration with other occupations. Expertise in the care prevention field was defined as an acupuncture therapist practicing acupuncture with a knowledge of oriental medicine, which was considered to be effective not only in reducing pain but also in maintaining the patients' pschological, mental, and physical health. It is significant to note that acupuncture and acupuncture therapists are not understood well by the medical community at large. Acupuncture is considered a preventive intervention for maintaining and promoting general health. Our literature review revealed that, at present, there are few, lesser-known studies that investigate elderly preventive care in terms of acupuncture. It is important to accumulate further evidence of acupuncture efficacy and popularize the delivery of care prevention for elderly people by acupuncture therapists.

佐藤式加圧トレーニングが今では一般的になり，筋力トレーニングではトップアスリートから一般人に，リハビリテーション分野，高齢者の介護予防分野など幅広くトレーニング方法として使用されている．今回は，佐藤式加圧トレーニングを進化させたマルチカフ加圧トレーニング（センサーを組み込んで加圧トレーニング中に加圧強度を自動調整できる器械式加圧トレーニング）が，佐藤式加圧トレーニングと同じような効果が得られるかを検証した．対象は高齢者6名(男性4名，女性2名．平均年齢73.7＋4.41歳)．トレーニング方法は自体重でのスクワットとしマルチカフで大腿部を加圧した．トレーニング頻度は週2回，2か月間とした．結果，短期間で佐藤式加圧トレーニングと同じように筋力向上，体力向上（10m障害物歩行，6分間歩行）がみられた．, The purpose of the study was to verify whether or not the MC training produced the similar effects to the Sato kaatsu-training. Sato-type kaatsu-training was commonly used for a muscle strengthening method from the top athletes to the general public. The training was also utilized in the fields of rehabilitation and prevention of injuries in the elderly. MC kaatsu-training was developed from Sato kaatsu training. The device gave pressure during strengthening exercises and it automatically adjusted the intensity of the pressurization. The subjects were six elderly people (4 males and 2 females, average age 73.7 + 4.41 years). The training method was a squat with its own weight. The thigh was pressurized with MC and the frequency of the regiment was twice a week for two months. As a result,the study found that the improvement of the muscle strength and physical strength (10m obstacle walking, Six-minute walking) were similar to the Sato kaatsu-training

本研究の目的は，わが国における地域在住高齢者の IADL 維持・低下に関連する要因をシステマティックレビューにより明らかにし，統合的な見解を得ることである。医中誌 Web および MEDLINE を用いてわが国における地域在住高齢者の IADL 維持・低下に関連する要因を観察研究により検討した論文を選定した。その後，選定基準を満たした論文から IADL 維持・低下に関連する要因を抽出しカテゴリ化を行った。結果，対象論文は 35 件であった。これらから 45 個の要因が抽出され，「基本属性」，「健康状態」，「身体・認知機能」，「心理面」，「活動能力」，「環境」，「ライフスタイル」，「社会参加」,「成人期の労働経験」といった 9 つのカテゴリに整理された。本レビューは地域在住高齢者のIADL 維持に向けた施策およびプログラム開発の一助になると考える。, The purpose of this study is to conduct a systematic review of factors associated with the maintenance and decline of IADL among community-dwelling elderly people in Japan to obtain an integrated view. We extracted literatures which examined factors associated with the maintenance and decline of IADL among community-dwelling elderly people using “Ichushi-Web” and “MEDLINE” and each factor was categorized according to those similarity. As a result, 45 factors were extracted from 35 literatures, and 9 categories such as demographics, health status, physical and cognitive functions, psychological aspects, activities, environment, lifestyle, social participation and experiences of adulthood were generated. This review will help to develop local policies and programs to maintain IADL of community-dwelling elderly people., 東京都立大学学位論文甲第1161号 副論文

This study aimed to clarify the variability in the independence profiles of specific activities of daily living (ADL) among older men and women. The research subjects were 5872 older adults (1143 men and 4729 women) certified as requiring nursing care or support (based on data obtained from the nursing care insurance certification survey database) who could be surveyed in both 2009 and 2018. Using item response theory, this study compared longitudinal data of difficulties faced by older adults during ADL. The results indicated that among the long-term care insurance-certified persons, in 2009, men had higher ADL difficulty than women in all ADL items, and in 2018, there was no significant difference in items other than dressing and excretion. Furthermore, the difference in the rate of ADL difficulty level over 9 years was significantly higher in women than in men. It was shown that the progression of ADL disability due to aging is faster in men on a yearly basis, but it increases in women with aging. Therefore, it was suggested that the rate of ADL difficulty varies depending on age and sex.

The purpose of this study is to reveal how high or low life purpose is related to QOL and ikigai (a meaning for life). Ikigai is “a sense of purpose and motivation in the daily lives of older people, a sense that they are capable and meaningful to their families and others, and that they should be”. Eighty-one community-dwelling older people (23 male and 58 female, mean age 77 ± 5.2 years) participated of their own will. The following items were measured: dementia test, exercise habits, life purpose, ikigai, and QOL. In the multivariate analysis of high and low life purpose, only ikigai was found to be related. In the multivariate analysis of ikigai, life purpose was also the most relevant, indicating that life purpose and ikigai are strongly interrelated. To improve QOL, it is also necessary to take into account life purpose in addition to the current nursing care prevention.

第1報に続き、高齢者の身体特性や運動能力の変化を調査し、介護度の進展予防の効果を検証することを目的としている。久慈市デイサービスセンターCaloreの利用者を対象に年間4回の測定会を行い、運動プログラムを提供した。平成26年5月〜平成30年6月まで継続して結果が得られた女性9名を分析対象とした。身体特性において有意な変化は見られなかった。運動能力においては最大歩行速度に平成26年と28年の間に有意な差が認められた。その他の運動に有意な差は認められなかったが記録の向上が見られた。最大歩行速度と運動能力の関連性は立ち上がり速度および開眼片足立ちの間に相関が認められた。加齢に伴い身体特性には低下が見られるが、介護認定者であっても運動能力の向上は可能であり、介護度の進展を予防できる可能性があることが明らかとなった。

Background Thailand is one of the most rapidly aging countries in Asia. Traditional family-based care, which has been the basis of most care for older people, is becoming unsustainable as families become smaller. In addition, women tend to be adversely affected as they still form the bulk of caregivers for older people, and many are likely to exit the labor market in order to provide care. Many family caregivers also have no or minimal training, and they may be called upon to provide quite complex care, increasing the proportion of older people receiving suboptimal care if they rely only on informal care that is provided by families and friends. Facing the increasing burden of noncommunicable diseases and age-related morbidity, Thai communities are increasingly in need of community-integrated care models for older persons that can link existing health systems and reduce the burden upon caring families. This need is common to many countries in the Association of Southeast Asian Nations (ASEAN). Objective In this study, we aimed to assess the effectiveness of a community-integrated intermediary care (CIIC) model to enhance family-based care for older people. Methods This paper describes a cluster randomized controlled trial comprised of 6 intervention clusters and 6 control clusters that aim to recruit 2000 participants in each arm. This research protocol has been approved by the World Health Organization Ethics Review Committee. The intervention clusters will receive an integrated model of care structured around (1) a community respite service, (2) the strengthening of family care capacity, and (3) an exercise program that aims to prevent entry into long-term care for older people. Control group clusters receive usual care (ie, the current system of long-term care common to all provinces in Thailand), consisting principally of a volunteer-assisted home care service. The trial will be conducted over a period of 2 years. The primary outcome is family caregiver burden measured at a 6-month follow-up, as measured by the Caregiver Burden Inventory. Secondary outcomes consist of biopsychosocial indicators including functional ability, as measured using an activity of daily living scale; depression, as measured by the Geriatric Depression Scale; and quality of life of older people, as measured by the EuroQol 5-dimensions 5-levels scale. Intention-to-treat analysis will be followed. Results The CIIC facility has been established. Community care prevention programs have been launched at the intervention clusters. Family caregivers are receiving training and assistance. However, the COVID-19 pandemic delayed the intervention. Conclusions Since ASEAN and many Asian countries share similar traditional family-based, long-term care systems, the proposed CIIC model and the protocol for its implementation and evaluation may benefit other countries wishing to adopt similar community-integrated care models for older people at risk of needing long-term care. Trial Registration Thai Clinical Trials Registry TCTR20190412004; http://www.thaiclinicaltrials.org/# International Registered Report Identifier (IRRID) DERR1-10.2196/20196

Background: This study attempts to determine whether a program focused on improving literacy in daily living is effective in preventing physical frailty, and to compare standard treatments for physical frailty. Methods: This study was designed as a pilot intervention study involving two groups. Twenty-five older adults aged 65 to 85 in Ward A, Tokyo, were randomly assigned to the literacy group or the exercise group on a regional basis and were given a 60- to 90-minute program twice a month, eight times over four months. The literacy group mainly used video materials to monitor learning, and the exercise group used a multifactor exercise program. Results: The LSI-Z, GAS-L, Maximum 5 m walking time, and TUG tests showed the main effects before and after the intervention in both groups (p < 0.05, p < 0.01). The WHOQOL26, Maximum 5 m walking time, and TUG tests also showed the main effects across both groups (p < 0.05). Conclusion: Both programs, when implemented independently, showed specific effects on subjective well-being, occupational performance, and physical fitness. However, QOL and physical fitness were significantly higher in the exercise group than in the literacy group. These results should be considered with caution because of the limited sample size of this pilot study.

Background The proportion of elderly in the population in Sweden is increasing. Older adults are more vulnerable to disease and disability which in turn increases the prevalence of negative events as pressure ulcers, malnutrition, falls, and oral health problems. Methods By using Senior Alert (SA), a quality registry for care prevention, analyze data concerning risks and adverse events and show the potential of the register for quality improvement and research in nursing homes and hospitals. Results There are differences in the prevalence of pressure ulcers and weight loss in nursing homes compared to hospitals, explained by different risk scores in the assessment tools used as well as differences in the populations with regard to age and days to follow-up. Falls are more prevalent in nursing homes. Fall prevalence decreases more with higher pressure ulcer risk due to factors such as degree of mobility; the fall prevalence decreases for even higher pressure ulcer risk. Conclusions The team around the older person needs a more inter-professional profile including healthcare such as physiotherapists, occupational therapists, dietitians, and dental health professionals. Trial registration The study is an observational retrospective register-based study, using data from SA during 2015.

久慈市在住の中高齢者に対して個人の運動プログラムを作成し、介護または介護度進展の予防の効果を検証した。岩手県久慈市デイサービスセンターCaloreと協同し、定期的な体力・運動能力測定会を実施した。対象者は平成26年5月〜平成29年6月まで継続して結果が得られた高齢者13名（77.6±6.2歳）とした。体脂肪率や筋肉量、骨密度等の身体特性において有意な差は認められなかった。最大歩行時間、最大歩行速度、ファンクショナルリーチなどの運動能力も有意な差は認められなかった。一方、開眼片足立ちと、立ち上がり速度の運動能力は向上を示した。以上の結果から個人に適した運動プログラムに基づく運動は要支援者や要介護者の介護度進展防止に効果が認められることが判明した。

本研究の目的は，わが国の高齢者介護予防プランに関するケアマネジメントの研究動向の明確 化と今後の課題を検討することである． 文献抽出は，医学中央雑誌web 版（2006 ～ 2015 年）で，keyword「介護予防ケアマネジメント」と 「介護予防プラン」を単独で，「高齢者」「介護予防」「ケアマネジメント」でand 検索を行い原著論文の 絞込みをした．分析対象は，得られた文献中19 件であった．文献はマトリックス方式を用いて整理した． この結果，文献の掲載年別では2011 年が最も多く，2006 年の介護保険改正法の全面施行に伴う介護 事業効果の見直しに関連した研究などが行われていた．対象者及び協力者は「高齢者」が多く，次いで， 「三職種（社会福祉士，介護支援専門員，保健師）」，「地域包括支援センターの職員」が多かった．文献 の中心テーマは【実態把握】と【システムの構築】が抽出された． 本研究の結果，短期間に見直し改正が行われる政策動向に伴い，現状の把握を行いながらも，システ ムの構築をめざす状況が明らかとなった．今後も当事者である高齢者や多職種との調整などの中心的役 割を担う看護職者を対象とした実態把握研究と，システムの構築に関わる介入研究が継続的に行われる 必要がある．

目的：本研究は，活動量計を用いて日常生活における身体活動量を明らかにし，要支援に対する介護予防リハビリテーションの一助とすることを目的に行った．対象：通所リハビリテーションの女性利用者で要支援1～2の各10ずつ，計20名（要支援1：80.1±5.2歳，要支援2：82.1±6.3歳）を対象とした．方法：日常生活において特別な制約はせずに，3軸式加速度計付き歩数計（オムロン社製HJ-326F）を約1ヵ月間装着してもらい，1日の歩数を計測した．結果：要支援1（3,223.1±1,977.3歩/日）に比べ，要支援2（1,494.4±1,649.5歩/日）において，1日当たりの歩数の平均値が有意に低下していることが認められた．結論：体格や年齢などに差のない要支援女性高齢者において，介護度の違いにより身体活動量の差が認められたことで，歩数などの身体活動量が身体機能以外の面から介護予防に対する評価指標となる可能性が示唆された．

【目的】地域支援介護予防事業の参加者を対象に、独居、同居における居住形態別の食生活習慣の実態について比較検討し、独居高齢者の適切な生活指導を行うための基礎的資料を得ることを目的とした。【方法】愛知県N市における介護予防対象者のうち、同意の得られた65歳以上の女性、計105名（平均年齢75.4±4.0歳）を対象とし、身体測定（身長、体重、BMI、ウエスト周囲長、体脂肪率、上腕周囲長、上腕筋皮下脂肪厚、下腿周囲長）、骨量測定（OSI：音響的骨評価値、Z-score、T-score）、食物摂取頻度調査（FFQg）、生活習慣等に関する調査を行った。【結果】対象者の居住形態別に各項目を比較した結果、栄養素摂取量では、エネルギー、たんぱく質、脂質、ナトリウム、カリウム、カルシウム、マグネシウム、リン、鉄、亜鉛、レチノール当量、ビタミンB1、ビタミンB2、ナイアシン、ビタミンB6、ビタミンB12、パントテン酸、コレステロール、食塩相当量において、独居群は同居群と比較して有意に低い値を示した。また、生活習慣等では、普段の食欲について「食欲がある」、咀嚼について「不自由なく物を噛める」、欠食について「欠食をしない」と答えた者が、独居群は同居群と比較して有意に少なかった。一方で、中食の利用について「中食を月1回以上利用する」と答えた者は、独居群は同居群と比較して有意に多かった。【考察】独居高齢者における栄養素摂取不足の要因として、咀嚼力を始めとする口腔機能の低下が、普段の食欲に影響を及ぼしている可能性が示唆された。今後、独居高齢者の口腔機能低下について着目し、低栄養状態にある高齢者には、適切な栄養素の摂取により栄養状態および身体機能の改善を推奨していく必要がある。, Purpose: Our purpose was to obtain basic data needed in order to provide appropriate lifestyle guidance for elderly people living alone by conducting a comparative investigation into eating habits according to residence status among people participating in community support care prevention projects.Method: We conducted investigations in 105 women of age 65 or above (mean age: 75.4 ± 4.0 years) who were receiving care prevention services in City N of Aichi prefecture, and who had provided consent to participate in the investigation. We performed body measurements (height, weight, BMI, waist circumference, body fat percentage, upper-arm circumference, triceps skinfold thickness, lower leg circumference), bone strength measurement (OSI: osteosono-assessment index, Z-score, T-score), and surveys such as a food frequency questionnaire (FFQg) and a lifestyle questionnaire.Results: As a result of comparison of all parameters between subjects of different residence status, in terms of nutritional intake, those subjects living alone showed significantly lower values for energy, protein, fat, sodium, potassium, calcium, magnesium, phosphorus, iron, zinc, retinol equivalent, vitamin B1, vitamin B2, niacin, vitamin B6, vitamin B12, pantothenic acid, cholesterol, and sodium chloride equivalent than those living with other people. With regard to lifestyle, etc., subjects who responded to questions on normal appetite, ability to chew, and skipping of meals with the responses of “have a good appetite,” “able to chew food without any difficulty,” and “don’t skip meals,” respectively, were significantly fewer among subjects living alone, compared with those living with other people. On the other hand, in response to the question on ready-made meals, the response of “eat ready-made meals at least once a month” was significantly more common among those subjects living alone than among those living with other people.Discussion: As a possible causal factor of insufficient nutritional intake among elderly people living alone, results suggested that reduction in chewing ability and other oral functions may reduce appetite. Attention must be given to the reduced oral function of elderly people living alone, and efforts must be made to promote the improvement of the nutritional condition and bodily functions of undernourished elderly people through appropriate nutritional intake.

本稿は「ふれあい・いきいきサロン」の活動から地域特性に着目した地域組織化活動のための要件を析出することを目的とする。地域類型は香川県坂出市の資料から単位自治会を調査し人口変遷と住宅地図によって類型化した。「ふれあい・いきいきサロン」の設立要件は、事業を実施している99組織の活動計画及び活動報告の資料、坂出市社会福祉協議会職員へのインタビュー調査から3 要件を析出した。その結果、地域類型は、過疎型地域、混住型地域、ニュータウン型地域に類型化した。「ふれあい・いきいきサロン」の設立は、リーダー、地縁関係、拠点の3 要件が析出された。過疎型地域は地域社会内の地縁関係に着目した活動、混住型地域には拠点の整備、ニュータウン型地域にはリーダーの養成が重要であり、地域特性に応じた働きかけにより地域組織化活動は設立を容易に行う事ができ、継続した活動が可能となる。This paper aims to analysis the requirement to organize the group activities for the elderly focusing on the communitytypes. Area tape was typology by the investigated population transition and housing map investigated from materials of Acity in Sikoku. Establishment requirement of the salon was precipitated 3important matter from the article in the action plan and activity report of the organization of 99 salon of the action plan and activity report interview investigation to social welfare council of staff. Area type was typology by Depopulation type region mix type region and new town type region. The establishment of the "fereai ikiiki" salon leader territorial relationship 3important matter of the site has been deposited. Depopulation type region activities that are focused on territorial relationships with in the community mix type region bases new town type region is important training of leader. Local organizing activity by encouraging in accordance with local characteristic can be performed easily established, it is possible to be continued activity.

【目的】二次予防事業の「運動器機能向上」「認知機能低下予防」の複合プログラムの効果を，基本チェックリストによる主観的評価と運動機能および認知機能測定値による客観的評価の両面から検証することを目的とした． 【方法】2014年4月から2015年 3月の1年間に二次予防事業に参加した佐世保市A地域在住の高齢者113人を対象とした．プログラムは3ヵ月間（12回）を1クールとし，週に1回2時間行われた．プログラム内容は筋力トレーニング，ストレッチ，脳トレーニングなどであった．この複合プログラム前後に，基本チェックリストの記入，主観的健康感の聴取，体力測定，認知機能測定を実施し，前後の比較を行った． 【結果】基本チェックリストの運動器の機能，認知症の症状，うつ症状および主観的健康感が有意に改善した．測定値では，5回椅子立ち上がりテスト，Timed Up and Go test，Mini-Mental State Examinationが有意に改善した． 【結論】「運動器機能向上」「認知機能低下予防」の複合プログラムを行うことで，運動機能，認知機能の向上が主観的評価値および客観的測定値によって認められた．, Locomotive syndrome and mild cognitive impairment are leading causes of the need for care, so early detection and treatments are central to care prevention for the frail elderly. The purpose of this study was to assess physical and cognitive function from the perspective of both subjective evaluation and objective measurements in a care-prevention program. Participants included 113 individuals (98 women, 15 men) ?65 years old living in Sasebo city, who were at high risk for needing care according to screened using a basic checklist. The intervention, which combined a program to improve physical function and a program to prevent declines in cognitive function, was conducted once a week for 12 weeks from April 2014 to March 2015. Assessments using the basic checklist, self-rated health, physical fitness tests, and cognitive examinations were made at baseline and after completing the intervention, and results were then compared. Our results revealed that status of motor function, status of dementia risk and status of depression risk in the basic checklist were significantly improved compared to baseline (p, 保健学研究, 28, pp.77-84; 2016

Masaki Nakagaichi,1 Yuya Anan,2 Yuto Hikiji,3 Sou Uratani4 1Sports and Life Sciences, National Institute of Fitness and Sports in KANOYA, Kanoya, Japan; 2Department of Nutritional Health, Kwassui Women’s University, Nagasaki, Japan; 3Department of Rehabilitation, Nagasaki Yuai Hospital, Kyoseikai Medical Corporation, Nagasaki, Japan; 4Nonprofit Organization Nagasaki Wellness Sports Research Center, Nagasaki, Japan Objectives: The purpose of this study was to identify a method for assessing physical fitness age that is easy to use with both frail and healthy elderly women and to examine its validity.Methods: Principal component analysis was used to develop a formula of physical fitness age from four motor function variables. The subjects comprised 688 (75.7±6.0 years) elderly women, in order to develop a physical fitness scale. The formula for calculating physical fitness age was expressed as physical fitness age =-0.419× grip strength -0.096×balancing on one leg with eyes open-0.737×30s chair stand +0.503×figure-of-8 walking test +0.47× chronological age +52.68.Results: Measures obtained from subjects in the frail elderly (n=11, 73.0±2.3 years) and exercise (n=10, 70.8±3.1 years) groups were used to examine the validity of the assessment. The mean physical fitness age of the frail elderly group (79.0±3.7 years) was significantly higher than its mean chronological age (73.0±2.3 years, p

Background: The proportion of elderly in the population in Sweden is increasing. Older adults are more vulnerable to disease and disability which in turn increases the prevalence of negative events as pressure ulcers, malnutrition,falls, and oral health problems. Methods: By using Senior Alert (SA), a quality registry for care prevention, analyze data concerning risks and adverse events and show the potential of the register for quality improvement and research in nursing homes and hospitals. Results: There are differences in the prevalence of pressure ulcers and weight loss in nursing homes compared to hospitals, explained by different risk scores in the assessment tools used as well as differences in the populations with regard to age and days to follow-up. Falls are more prevalent in nursing homes. Fall prevalence decreases more with higher pressure ulcer risk due to factors such as degree of mobility; the fall prevalence decreases for even higher pressure ulcer risk. Conclusions: The team around the older person needs a more inter-professional profile including healthcare such as physiotherapists, occupational therapists, dietitians, and dental health professionals. Trial registration: The study is an observational retrospective register-based study, using data from SA during 2015

本年度「うらやす市民大学」において,「うらやす市で豊かな人生を送るための介護予防実践（介護予防リーダー養成講座）」に講師として参加する機会を得た.本研究では,その活動内容から,その教育体制の概観を報告するとともに今後の課題を検討することを目的とした. 体力の効果測定では，教室で紹介したホームエクササイズ実施の前後に体力テストを行った．数値をWilcoxonの符号付順位検定で検討した結果，膝伸展がZ=－1.65(p, This year at "Urayasu City citizen's college" I had the chance to lecture in.”Care prevention practice for sending an enriched life to Urayasu City (a preventive care leader training course)." From the activities in this study, it was intended to report an outline on the education system and to examine future challenges. Home exercise was introduced to the classroom, performing physical fitness tests before and after to measure the effectiveness of physical fitness. The numbers were examined with the Wilcoxon signed-rank test results, leg extensions were Z=－1.65(p

[目的]男性高齢者の新たな介護予防の支援方法を見出すために、A島の民泊事業に参加している男性高齢者の当事者の誇りから“生きがい就労"の実態とニーズを把握することである。[方法]研究協力者は、A島の民泊事業に参加している男性高齢者4名である。方法は、民泊事業の就労内容と就労のニーズの語りから、キーセンテンスを抽出し、辻らの生きがい就労のコンセプトである[働きたいときに無理なく楽しく働ける]、[現役時代に培ってきた能力・経験が活かせる]、 [高齢者の就労が地域の課題解決の貢献につながる]に照らして帰納的に分析した。[結果]生きがい就労の実態は、辻らの生きがい就労のコンセプト[働きたいときに無理なく楽しく働ける]、 [現役時代に培ってきた能力・経験が活かせる]、[高齢者の就労が地域の課題解決の貢献につながる]を包含し、[共生の理解に貢献する]の新たなコンセプトが導かれた。生きがい就労のニーズは、民泊事業を《島の産業として組織的に取り組みたい》、《食事サービスの質を向上させたい》、《老い(身体機能)に合わせて民泊がしたい》であった。[結論]A島の民泊事業は、男性高齢者の生きがい就労につながっていた。生きがい就労のコンセプトに[共生の理解に貢献する]が加わっていた。男性高齢者は、地域の課題解決の主役としての役割が発揮できる存在であることを示唆していた。介護予防のために生きがい就労を推進するという新たな介護予防の支援方法が必要であると考えた。

[目的]男性高齢者の新たな介護予防の支援方法を見出すために、A島の民泊事業に参加している男性高齢者の当事者の誇りから“生きがい就労"の実態とニーズを把握することである。[方法]研究協力者は、A島の民泊事業に参加している男性高齢者4名である。方法は、民泊事業の就労内容と就労のニーズの語りから、キーセンテンスを抽出し、辻らの生きがい就労のコンセプトである[働きたいときに無理なく楽しく働ける]、[現役時代に培ってきた能力・経験が活かせる]、 [高齢者の就労が地域の課題解決の貢献につながる]に照らして帰納的に分析した。[結果]生きがい就労の実態は、辻らの生きがい就労のコンセプト[働きたいときに無理なく楽しく働ける]、 [現役時代に培ってきた能力・経験が活かせる]、[高齢者の就労が地域の課題解決の貢献につながる]を包含し、[共生の理解に貢献する]の新たなコンセプトが導かれた。生きがい就労のニーズは、民泊事業を《島の産業として組織的に取り組みたい》、《食事サービスの質を向上させたい》、《老い(身体機能)に合わせて民泊がしたい》であった。[結論]A島の民泊事業は、男性高齢者の生きがい就労につながっていた。生きがい就労のコンセプトに[共生の理解に貢献する]が加わっていた。男性高齢者は、地域の課題解決の主役としての役割が発揮できる存在であることを示唆していた。介護予防のために生きがい就労を推進するという新たな介護予防の支援方法が必要であると考えた。

本研究の目的は，特定高齢者における口腔機能向上プログラムの口腔機能向上の効果を評価することである。対象は，新潟県上越市の特定高齢者120名（平均年齢83.3±4.5）である。ベースライン時に舌苔の付着状況，口輪筋の引っ張り抵抗力（ボタンプル），および，オーラルディアドコキネシス「タ」および「カ」について４名の歯科衛生士が行った。口腔機能向上プログラムは，月１回の集団的口腔機能訓練と集団的口腔清掃指導，および，週１回の口腔体操である。追跡調査についてはベースライン（BL）調査と同じ方法を用いて，介入開始から３カ月後，６カ月後および９カ月後に行った。分析対象者は，３回の追跡調査を受けた51名（平均年齢 83.6±4.7）である。分析の結果，舌苔の付着量が少ない者の割合が経時的に増加していき，BLと比較し６カ月後と９カ月後に舌苔スコアの割合に有意差が認められた。ボタンプルにおいては平均値の経時的な増加が認められ，BLと６カ月後および９カ月後に有意差が認められた。同様にオーラルディアドコキネシスにおいても「タ」「カ」ともに平均値の経時的な増加が認められ，BLと３カ月後，６カ月後および９カ月後に有意差が認められた。したがって，口腔機能向上プログラムによって舌苔の付着量，口輪筋の引っ張り抵抗力，オーラルディアドコキネシス「タ」および「カ」のいずれにおいても改善が認められ，口腔清掃習慣の改善および口輪筋と舌機能の向上が示唆された。, The purpose of this study was to access the effectiveness of an oral health care program for improving oral functions in community-dwelling elderly with a risk of poor physical function (Tokutei-koureisya). The subjects were 120 persons (mean age; 83.3 ± 4.5) living in Joetsu city, Japan. Tongue coating score, lip strength against pulling of the strung button (button-pull) and oral diadochokinesis (DDK) [ta] [ka] were assessed by four dental hygienists at baseline investigation. The subjects took part in the oral health care program that was consisted of oral function training and oral hygiene instruction once a month by hygienists and short oral exercise once a week by caregivers. Follow-up investigations were carried out at 3-month, 6-month and 9-month. Fifty one persons (mean age; 83.6 ± 4.7) left in all follow-up investigations and to be analyzed in this study. The results were as follows: 1. The amount of tongue coating was significantly decreased at 6-month (p

平成18年4月介護保険法改正を受け、介護予防が重点化され保健師への期待は高くなっている。介護予防アセスメントツールは研究されてきているが試行段階であり、効果の評価は手探り段階にある。本研究では、A市B高齢者支援センターが支援を行っている要介護1までの事例で、支援期間中介護度が悪化せず維持しているプロセスを分析することから、介護予防に効果的な関わりを検討することを目的とした。結果は、支長期間における対象者の変化は(1)身体的には、介護予防の必要性の自覚、血圧等の自己管理などができるようになった、(2)精神的には楽しみ活動、趣味・日課となる活動を獲得していた、(3)社会的には閉じこもりの解消、外出の機会の増加、交流の拡大、身内以外の傾れる存在を獲得していたなどの変化があった。以下にこれらの変化を生じさせたと考える介護予防支援上の関わりを挙げる。1.対象者の最優先ニーズを満たすことを通して関係性の構築を図り、安心感の提供を行っていた 2.対象者ができることを一緒に考える姿勢で看護予防知識の提供、技術獲得支援を行うことを通して身体面の予防を図っていた 3.外出の機会となる場の提供や、仲間づくり・交流のきっかけづくり、家族や地域住民との架け橋になることを通して社会面の予防を図っていた 4.楽しみ・生きがい・趣味・日課となる活動の獲得支援によって精神面の予防を支援していた 5.普段の情報ネットワークから本人に適した情報を提供し、対象者に出来ることを一緒に考え保障した上で、対象者の変化に合わせ支援内容の変更を行っていた これら予防支援を複合的に組み合わせ、対象者と対象者を取り巻く人々に対し行うことが効果的な関わりであると考えられた。, Background: Long-term Care Insurance was revised in April, 2006, and preventive care was made an important point and public health nurses are expected higher. In this study preventive care assessment tools are studied, however the conclusion is uncertain. Objectives: The aim of this study is to examine effective supports for the preventive care. By analyzing the process by which it is ensured that care level 1 does not deteriorate during the support period, illustrated by the care of A City B senior citizen's support. Results: [The changes of the person] (1) Physical changes: The awareness that the preventive care is important e. g. Self-management of take blood pressure. (2) Mental changes: Engaging in pleasure activities and hobbies or daily work. (3) Social changes: Confronting the problem of indoor isolation, increase opportunity for going out, expansion of interpersonal interchange, and acquaintance with people which the subject is able to rely on other than relatives. [Supports for care prevention] 1. Satisfaction of the person's top priority needs influenced the construction of relationships and the prospect security. 2. Giving nursing prevention knowledge and support acquisition skills, with the attitude of cooperating in positive thinking which influenced ability to undertake preventive measures. 3. Offering a place in which she was able to go outside, to make friends, to have the opportunity of social exchange, and to act as go-between between her family and neighbors which influenced the prevention of deterioration of the subject's condition. 4. Supporting acquisition of activities which brought, motivations, hobbies and the daily work which influenced a positive mental state. 5. Support which coordinated the change in the subject by giving her feedback on herself by using available information networks and positive thinking. Discussion: It was thought that the combined support given to the subject by people in her environment contributed to the maintenance of her self-managed preventive care.

Resulting from changes in the Nursing Care Law of 2006, preventative nursing care became a focus due to the increasing numbers of persons needing early stage nursing care. Nutrition has become one of the more important preventative nursing care approaches. The present study sought to investigate the orientations toward food service in nursing facilities for the elderly. Our focus was on how these facilities assessed eating and how information was shared. We found that 55% of the facilities we reviewed used an assessment sheet, and that 80% of this subgroup actively share the information between various care givers. Items such as nutrition, medical care and physical characteristics were more prevalent in the assessments, where as items relating to QOL, such as pleasure or satisfaction of eating, were lacking. There is a need for development of assessments that are based on QOL.