Mental and physical effects of the 2011 Great East Japan Earthquake on School Children, and Health Support initiatives by YogoTeachers: Findings from a survey of high school yogo teachers 5 years after the disaster

Objective: To clarify the current mental and physical state of students 5 years after experiencing the Great East Japan earthquake, tsunami, and nuclear accident, and to shed light on the practical initiatives and issues faced by yogo teachers in supporting students’ health. Method: In May 2016, we conducted a mail-based questionnaire of yogo teachers at 15 prefectural high schools in Soma District and Futaba District (collectively, “Soso”) in Fukushima Prefecture, one of the areas most heavily affected by the Fukushima Daiichi Nuclear Power Plant accident.　The questionnaire focused on (1) health and school life of students; and (2) current initiatives and issues faced by yogo teachers in supporting student health. Results: We received responses from 8 of the 15 high school yogo teachers surveyed (response rate: 53.3％).Six yogo teachers (75％) responded that the “students are calm.” However, 6 yogo teachers (75％) recognized a tendency among students towards weight gain and obesity, as well as reduced physical stamina and sporting ability, while 4 yogo teachers (50％) indicated that some students were anxious about their future and career path, and were receiving personal support from the school counselor.　The yogo teachers provided support to students while attempting to ascertain their mental and physical well-being through greater health monitoring and questionnaires, and while coordinating with the school physician and counselor. Conclusion: Five years after the earthquake, high school students in the Soso district are now leading a more relaxed school life, but still feel anxious about their future health and career path due to lingering concerns about radiation, highlighting the need for long-term support by yogo teachers

Health Support Provided by Yogo Teachers for Adolescent Female Students with a Thin Body Type

Purpose: To clarify the realities and challenges involved in health support provided by yogo teachers to adolescent girls who have a thin body type. Methods: A semi-structured interview survey was conducted with yogo teachers at a Japanese high school with experience of providing health support to thin adolescent female students and the results of the survey were subjected to qualitative analysis. Results: With regard to health support provided by yogo teachers, the results of analysis found that the actual situation consisted of the five categories of 【sharing information throughout the school organization to investigate methods of support】,【 realizing studentsʼ situations through the provision of individual support】, 【referring students and parents to specialist agencies】,【investigating collaborations with parents with students ʼ consent】, and 【carrying out prevention and awareness-raising activities about thin physiques】.　 However, the analysis also found that the practical challenges for providing such health support consisted of the six categories of 【working with parents to liaise with medical institutions】,【continuous support in collaboration with specialist agencies】,【 educational health support that enables all students to manage their own health】,【 yogo teachersʼ professional knowledge and assessment of eating disorders】,【 support methods that students can engage with on their own initiative, according to their situation】, and 【creating a counseling- friendly environment to facilitate early detection】.Discussion: While yogo teachers had an overall grasp of studentsʼ situations through their organizational engagements in cooperation with faculty and school physicians, as well as individual support activities, it was clear that they faced difficulties and challenges in relation to working together with parents and specialist agencies.　In the future, improving collaboration with parents will require that they, too, be encouraged to recognize that being excessively thin represents a health problem for adolescent female students.　In addition, it will also be necessary to work towards building daily collaboration systems, such as by having yogo teachers keep track of potential partner medical institutions as a matter of routine.　It was further suggested that yogo teachers will need to provide educational and preventive health support oriented toward helping female students acquire the ability to manage their own health

小学校養護教諭が行う児童虐待対応に校内組織体制が与える影響

本研究の目的は，小学校養護教諭を対象に児童虐待に関する校内組織体制について調査し，児童虐待を疑ったり 気づいたりする経験との関連，校外機関との連携の現状を明らかにすることにより，今後の小学校養護教諭が行う 児童虐待対応の在り方について検討することである．A 県内の全公立小学校（344校）に勤務する全養護教諭を対 象とし，児童虐待に関する校内組織及び校外機関との連携について自記式質問紙調査を実施し，146人から回答を 得た．結果，児童虐待に関する校内組織体制の設置の有無が，児童虐待の早期発見に影響を与えていることが示唆 された．また，校内で児童虐待に気づいたり疑ったりした場合においても，児童相談所などの校外機関と連携をし なかった理由は，「児童虐待の確証がもてなかったり，相談又は通告後のことを不安に思ったりしている」などが 明らかとなり，児童虐待の対応や校外機関に関する知識や情報の不足が原因の一因であることも示唆された．今後 は，児童虐待の発見の遅れを防ぐために，校内組織体制の確立を難しくしている要因について明らかにするととも に，関係職種や校外機関が互いの役割を理解し，具体的にどのように連携を図ることが有効であるかを検討するこ とが必要である．With the aim of determining appropriate ways for elementary school yogo teachers to respond to child abuse, this study examined school organizational systems for child abuse with regard to their influence on how yogo teachers suspect and identify cases of child abuse and collaborate with external parties or organizations. Self-report questionnaires on school organizational system for child abuse and collaboration with external parties were distributed to every yogo teacher in all 344 elementary schools in Prefecture A. Questionnaires were collected from 146 yogo teachers (response rate 42.2%). Findings suggested that the existence of a school organizational system to handle child abuse was related to early detection of child abuse. The reason for not collaborating with external parties even when child abuse was suspected or identified was that the teachers either did not feel certain the abuse was happening or were concerned about the outcome of consulting or reporting the situation to external parties. This suggests yogo teachers lack of knowledge and information about the external parties involved in handling child abuse. To prevent delay in detecting abuse, future studies should explore factors related to difficulties in establishing necessary organizational systems, and examine how each discipline and involved party can better understand each other's roles and specifically how they can effectively collaborate with each other

保育所（園）における食物アレルギーによるアナフィラキシーショックに対する救急処置体制構築に必要な要素

本研究の目的は，保育所（園）の管理者が食物アレルギー児のアナフィラキシーショック時の対応に必要だと認識している要素とエピペン® を持参する子どもへの対応の課題を明らかにすることである．A 県内の認可保育所（園）419ヵ所の施設長を調査対象とし，郵送法により無記名方式のアンケート調査用紙を送付した．アナフィラキシーショック発現時の救急処置体制を作るために必要だと思われる要素について自由記述をしてもらった．結果，回収116件中66件の記述があり，120記録単位が得られた．得られた記録単位を質的帰納的に分析した．アレルギー児の緊急事態発生時の救急処置体制を作るために必要な要素は，【研修受講・実演訓練の実施】【迅速な対応のための園内・園外の連携体制整備】【マニュアル・アクションプランの作成】【職員・他職種間の情報共有】【危機管理意識】【緊急時のアセスメント力】【専門職の配置の改善】の7つのカテゴリーに分類された．また，エピペン® を持参する子どもを受け入れている保育所（園）11施設が苦慮していることや課題についての記述についても内容分析を行った．その結果，事故が起こった時の救急処置対応のマニュアルを整え，全ての職員が自己の役割を理解し，その役割を果たせるように全職員が研修を受講すること，シミュレーション訓練を行っておくこと，それらの教育的支援のために看護職配置を推進していく必要性が示唆された．The purpose of this study is to clarify the factors of emergency treatment systems corresponding anaphylactic shock by food allergies and the problems for prevention of food allergies of the child bringing EpiPens at nurseries.　Anonymous questionnaires were sent by mail to the directors of 419 certified nurseries in Prefecture A.　The questionnaire included also free space for description according to the factors of emergency treatment systems for cases of anaphylactic shock.　The description in the space was recognized to 66 of the 116 retrieved questionnaires, and the responses were divided into 120 records and analyzed by qualitative inductive analysis.　Items necessary for establishing emergency treatment systems for children with allergies were placed into the following seven categories:“ seminars and on-the-job training, ”“ internal and external emergency contact systems for quick response, ”“ creation of action plans and manuals, ”“ sharing of information among nursery staff and other professionals, ”“ awareness of crisis management, ”“ assessment skills for times of emergency, ” and“ improved placement of professional staff.”　The description according to actual problems in 11 nursery that accept child bringing EpiPens were also analyzed.　The results indicated a need to promote placement of nursing professionals to provide educational assistance for organizing emergency treatment manuals, a need for complete staff participation in training seminars so that all members understand their roles during an emergency, and a need for conducting simulation drills

保育所看護職者の配置形態の違いによる保育保健活動の現状と課題

本研究の目的は，保育所看護職者を対象に保育保健活動の担当状況を調査し，保育所での配置形態による関連を 明らかにし，今後の保育所看護職者の配置に関する課題を検討することである．A 県内の保育所に勤務する看護職 者71名のうちA 県保育協議会の研修会に参加した保育所看護職者41名を対象とし，自作の質問紙調査を行った． 保育保健活動30項目の担当状況を『子どもへの支援』『家族への支援』『多職種・関連機関との連携・協働』の3つ のカテゴリーに分類し，「クラス担当配置」と「フリー配置」の配置形態による差異を比較した．結果，3つのカテ ゴリーのいずれも，「フリー配置」の方が保育保健活動の担当状況の平均値が高かった．保育所看護職者が，その 専門性を発揮し保育保健活動を遂行するためには，配置形態の改善が必要であることが示唆された．The aims of this study were to examine the current responsibilities of nurses in child healthcare activities conducted at day care centers, clarify the relationship between their work responsibilities and style of work allocation at these centers, and discuss the issues relating to the work allocation of nurses at these centers for the future. Research was carried out with 41 nurses who participated in a workshop run by the childcare council in Prefecture A, out of a total of 71 nurses working in day care centers in the prefecture. The nurses responded to a questionnaire created by the authors. The 30 questionnaire items concerning the allocation of healthcare activities in the day care centers were divided into three aspects: support for children, support for families, and cooperation with various professionals and related agencies. Differences in the three aspects were compared between nurses responsible for particular classes and nurses not tied to responsibilities for particular classes. The results revealed that mean scores were higher for the nurses not tied to responsibilities of particular classes in all three aspects examined. This indicates that in order for nurses at day care centers to make best use of their specialized skills and knowledge, and carry out child healthcare activities, the styles of work allocation must be improved