[A quantitative and qualitative study on effective information flow for infectious disease control in welfare facilities for the elderly].

Objectives: To clarify factors associated with effective information tranges among staff of welfare facilities for the elderly, and to propose measures for an appropriate information flow system in welfare facilities and public health centers, communication channels and methods, and encouraging factors and barriers were investigated in terms of a printed medium on the control and management of scabies infections.

Methods: A self-administered questionnaire survey and an interview survey were conducted with the staff of welfare facilities for the elderly where "Control and management manual of scabies infection" had been distributed by the Tama-Tachikawa Public Health Center in Tokyo. A self-administered questionnaire was sent to managers and chief practitioners of 66 facilities. Respondents were obtained from 66 managers and chief practitioners (response rate: 84.8%), and 831 practitioners (response rate: 53.1%). The questionnaire consisted of 20 items for managers and 18 items for chief practitioners, including experience of scabies epidemics in facilities, training experience for the use of "Control and management manual of scabies infection," measures for information gathering, and current information flow within the facility. A semi-structured interview survey was conducted with the manager and/or chief practitioner and practitioners in five facilities. The number of respondents was 10. The interview questions included job description, scabies control measures, dissemination of the manual to the staff, use of the manual, flows of health-related information, and factors associated with information flows. Summarized codes were extracted from the transcriptions from tape recording and were categorized repeatedly according to similarity.

Results: In the questionnaire survey, differences of Community information flow by types of facilities and professional backgrounds were found. Variation was detected in measures for information gathering and focuses in information management between managers/chief practitioners and practitioners. Practitioners wanted opportunities for information exchange while managers/chief practitioners mainly focused on prioritization of information collected. In addition, many respondents felt that information networks outside the facilities were poorly organized. From the interview survey, three major categories were extracted, that is, 'Information flow system,' 'Personal qualification,' and 'Factors related to the information flow system.' As factors related to the information flow system, the following 7 subcategories were extracted. 1. Interest in information; 2. Working style and workload; 3. Information networks outside the facility; 4. Information management in the facility; 5. Environment for information sharing; 6. Budget for the information system; and 7. Interpersonal communication.

Conclusions: For an effective information system, welfare facilities for the elderly should work on staff training, building their own information flow systems and improving the environment for information sharing and networking with specialized agencies, such as public health centers. At the same time, public health centers should support networking, interpersonal two-way communication and training of welfare-facility workers.