Kawasaki University of Medical Welfare Institutional Repository

Vol.28 No.1
2022
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井上, 清香

中新, 美保子

香西, 早苗

松田, 美鈴

三村, 邦子

「口唇口蓋裂」の非当事者に対する意識調査 ―本疾患を知らないと回答した群の認識―

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小割, 貴博

種村, 純

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脳血管障害後に漢字の書字障害を呈した3例の漢字要素構成課題を用いた障害レベルの検討

川崎医療福祉学会誌編集委員会　
編集委員長
副委員長
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石　田　　　弘
細　川　貴　之
荒　井　佐和子
岡　本　宣　雄
笹　川　拓　也
古　賀　雄　二
藤　田　大　介
八　田　徳　高
上　野　浩　司
竹　井　泰　孝
立　花　博　之
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米　谷　正　造
用　稲　丈　人
坂　本　　　圭
渡　邊　佳　代
Tim Cleminson
平　野　　　聖
Michael Kremenik
（理学療法学科）
（視能療法学科）
（臨床心理学科）
（医療福祉学科）
（子ども医療福祉学科）
（保健看護学科）
（理学療法学科）
（言語聴覚療法学科）
（臨床検査学科）
（診療放射線技術学科）
（臨床工学科）
（臨床栄養学科）
（健康体育学科）
（リハビリテーション学科）
（医療福祉経営学科）
（医療情報学科）
（医療秘書学科）
（医療福祉デザイン学科）
（健康体育学科）


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P(論文)Original Paperdepartmental bulletin pape

SHIBAYAMA, Mayuko

155
Kawasaki Journal of Medical Welfare Vol. 27,  No. 2,  2022 155-160
＊1 Department of Health and Welfare Services Management, Faculty of Health and Welfare Services Administration
    Kawasaki University of Medical Welfare, 288 Matsushima, Kurashiki, 701-0193, Japan
    E-Mail: ueda@mw.kawasaki-m.ac.jp
Original Paper
1. Introduction
　In Japan, the aging rate (the ratio of the senior citizen population older than 65 years old to the total 
population) is rising. In 2020, we reached a society with 28.9% aged1), and the medical services that senior 
citizens use is increasing. However, healthcare organizations are struggling to cope with the growing 
global shortage of healthcare professionals2-5). As the demand for medical services increases and the needs 
also diversify, expected roles for healthcare providers are rising. In order to continuously provide high 
quality medical services, it is essential to secure and train medical personnel. Efforts to retain the existing 
workforce are negatively influenced by factors such as the chronic staffing shortages, higher patient acuity, 
and increasing patient caseloads6-8). Furthermore, it has been shown that career support, especially for 
women, can help prevent turnover9). The challenge is to provide systematic support for professional career 
development.
　Backed by such present conditions, this paper draws attention to professional career development at 
hospitals. The purpose of this study is to analyze advanced examples of career support and to identify 
the implementation status of career support. We will use case studies to categorize the phases of career 
A Study on Typology of Career Support in 
Hospitals and Analysis of Characteristics of 
Medical Institutions
Mayuko SHIBAYAMA＊1
(Accepted November 22, 2021)
Key words: career support, medical institutions, bed functions, establishing organization
Abstract
　In this paper, we focused on professional career development in hospitals. The purpose of this 
study is to analyze advanced examples of career support and to identify the implementation status 
of career support. Based on advanced case studies, we categorized the phases of career support in 
medical institutions. Then, we examined the current status and issues of career support from the 
perspective of the individuality of the medical institution, such as the function of the hospital bed 
and the establishment organization. As a result, we were able to first classify the career support 
provided by medical institutions into five categories: "support for WLB", "support for continuing 
learning", "career clarification", "support for skill development" and "management by objectives". 
Furthermore, when compared by hospital characteristics, it was found that there were significant 
differences in the current status of the initiatives depending on bed functions and establishing 
organizations.
156 Mayuko Shibayama
support in medical organizations. Then, we will look at the current status and issues of career support 
from the perspective of the individuality of medical organizations such as bed functions and establishing 
organizations. In this study, we will perform:
(1) Coding of textual data of a case study
(2) A presentation of a "career support standard" for hospitals  
(3) An analysis of basic characteristics in relation to the "career support standard"
with the hope of identifying the current status of career support in hospitals.
2. Methods
2.1 Subjects and methods
　In this paper, we conducted a survey of case studies. The survey covers all cases with descriptions 
of career support posted on the "Iki Iki Working Medical Institution Support Web"10). This is a website 
established by the Ministry of Health, Labour and Welfare. The site introduces national and government 
policies and projects, as well as case studies of medical institutions, for managers and administrators of 
medical institutions. It also provides useful information for improving the working environment of medical 
workers. 52 cases (Referenced in January 1, 2021) were collected and included in the analysis.
2.2 Method of Analysis
　First, we coded the textual data of 52 cases. We analyzed the contents one case at a time. According 
to the career support code, we coded it as "1" if it was in place and "0" if it was not (Table 1). Secondly, to 
get the standard of professional career development, we performed a factor analysis for the coded data by 
using principal component analysis by promax rotation. Thirdly, we performed an analysis of the difference 
of career support according to the individual characteristics of each hospital. To do this we calculated the 
mean of the standard score according to the individual characteristics and compared the mean by the 
overall characteristics. One-way analysis of variance was used to compare the means. Fisher’s LSD post-hoc 
test was used for posteriori comparison. In this study, IBM SPSS Statistics (Version 25) was used for the 
statistical analysis, and the significance level was defined as less than 5%. However, for Fisher’s LSD post-
hoc test, a value of less than 10% was considered significant.
Table 1　Coding of the case study texts
Code　1 Code　2 Code　3 ‥ Code　12
Case 1 0 1 1 ‥ 0
Case 2 1 0 1 ‥ 1
: : : : ‥
Case 52 1 0 0 ‥ 1
3. Results
3.1 Career support code
　The text data were classified into 12 codes in Table 2. The results showed that 61.5% of the hospitals 
were involved in "Support for participation in training outside the facility". In addition, 57.7% of the hospitals 
were involved in "Provision of information on workshops". Furthermore, 48.1% of hospitals were working on 
"Consultation desk on balancing childcare and work".
3.2 Constituent factors of the career support standard
　A factor analysis of 12 items of the Career Support scale was performed using principal component 
157A Study on Typology of Career Support in Hospitals
analysis by promax rotation. Factors were derived according to the following conditions: the accumulation 
contribution rates were more than 50% with the eigenvalue higher than 1 and the factor loadings more 
than 0.5. The results are shown in Table 3. 
　We derived the 5 factors indicated below in the career support scale at hospitals.
Table 2　Fundamental statistics of case codes
Career support codes n M SD
1 Support for participation in training outside the facility 52 0.615 0.491
2 Promotion to conference presentations 52 0.173 0.382
3 Provision of information on workshops 52 0.577 0.499
4 Consultation desk on balancing childcare and work 52 0.481 0.505
5 Promotion of qualification acquisition 52 0.173 0.382
6 e-learning while on leave 52 0.115 0.323
7 Post-leave workshop 52 0.173 0.382
8 Short-term system for official staff 52 0.212 0.412
9 Contracted staff system for the term of business 52 0.173 0.382
10 Management by objectives 52 0.173 0.382
11 Create a career path 52 0.192 0.398
12 Promotion of participation in study sessions in the hospital 52 0.135 0.345
Table 3　Factor analysis results for career support
factor loading
1 2 3 4 5
support for 
WLB
support for 
continuing 
learning
career 
clarification
support for 
skill 
development
management 
by objectives
Contracted staff system for the term 
of business 0.931
-0.117 -0.098 -0.258 -0.008
Post-leave workshop 0.888 -0.219 -0.155 -0.273 -0.462
Short-term system for official staff 0.888 -0.103 -0.147 -0.293 0.019
e-learning while on leave 0.706 -0.459 -0.083 -0.230 -0.539
Provision of information on workshops -0.190 0.898 0.028 -0.028 -0.108
Support for participation in training 
outside the facility
-0.243 0.875 0.007 0.223 -0.237
Consultation desk on balancing 
childcare and work 0.074 0.770
-0.301 -0.032 -0.005
Create a career path -0.108 -0.152 0.801 0.015 0.120
Promotion of participation in study 
sessions in the hospital
-0.113 -0.015 0.763 0.053 0.127
Promotion of qualification acquisition -0.225 0.013 -0.204 0.830 0.203
Promotion to conference presentations -0.263 0.100 0.378 0.795 -0.225
Management by objectives -0.037 -0.271 0.177 -0.021 0.829
Factor contribution rate 28.176 20.605 11.581 9.949 8.499
Accumulation contribution rates 28.176 48.781 60.362 70.312 78.810
158 Mayuko Shibayama
3.2.1 Factor 1：support for WLB
　Factor 1 evaluates support for balancing work and family life, which is interpreted as "support for WLB" 
and consists of 4 questions, including "Contracted staff system for the term of business" and "Post-leave 
workshop".
3.2.2 Factor 2：support for continuing learning
　Factor 2 evaluates continued support for learning, such as training and childcare counseling, which 
is interpreted as "support for continuing learning" and consists of 3 questions, including "Provision of 
information on workshops" and "Support for participation in training outside the facility".
3.2.3 Factor 3：career clarification
　Factor 3 evaluates continued clearly identified careers of staff members, which is interpreted as "career 
clarification" and consists of 2 questions, including "Create a career path" and "Promotion of participation in 
study sessions in the hospital".
3.2.4 Factor 4：support for skill development
　Factor 4 evaluates provided support to improve skills by giving qualifications and conference 
presentations, which is interpreted as "support for skill development" and consists of 2 questions, including 
"Promotion of qualification acquisition" and "Promotion to conference presentations".
3.2.5 Factor 5：management by objectives
　Factor 5 evaluates provided staff with a sense of purpose, which is interpreted as "management by 
objectives" and consists of 1 question, including "goal management system".
3.3 Relationships between the career support standard and the characteristics of the subject groups
　We performed an analysis of the difference of Career Support according to the individual characteristics 
of each hospital such as the type of bed functions and establishing organizations. To do this we calculated 
the mean of the standard score according to the individual characteristics and compared the mean by the 
overall characteristics.
3.3.1 First characteristic: type of bed function
　We observed a significant difference of the mean (Table 4) of the standard score according to the types 
of bed function. There was a significant difference among chronic stage function, acute stage function and 
advanced acute stage function in the "support for continuing learning" and we found that chronic stage 
function, compared with acute stage function and advanced acute stage function, performed "support for 
continuing learning" more actively.
　There was a significant difference in "career clarification" among chronic stage function and acute stage 
function and we found that chronic stage function has an activity "career clarification" more than acute 
stage function. In addition, there was a significant difference between chronic stage function, and acute 
stage function for "support for skill development" and we found that chronic stage function has an activity 
"support for skill development" more than acute stage function.  
Table 4　The mean of the standard score according to the type of bed function
support for 
WLB
support for 
continuing 
learning
career 
clarification
support for 
skill 
development
management 
by objectives
n mean mean mean mean mean
Chronic stage function 11 -0.218 0.436 ab 0.487 a 0.455 a -0.353
Convalescent stage function 5 -0.027 0.613 -0.072 0.398 -0.254
Acute stage function 30 0.058 -0.136 -0.179 -0.179 0.147
Advanced acute stage function 6 0.133 -0.629 0.062 -0.271 0.123
a: Significantly different compared with Acute stage function by Fisher’s LSD test (p<0.1). b: Significantly different 
compared with Advanced acute stage function by Fisher’s LSD test (p<0.1).
159A Study on Typology of Career Support in Hospitals
3.3.2 Second characteristic: establishing organizations
　We observed a significant difference of the mean (Table 5) of the standard score according to each 
establishing organization. There was a significant difference among local government, medical corporations 
and others in the "support for continuing learning," and we found that medical corporations and others, 
compared with local government, performed "support for continuing learning" more actively.
　There was a significant difference in "support for skill development" among local government, public 
organizations and medical corporations and we found that medical corporations have an activity "support 
for continuing learning" more than local government and public organizations.
Table 5　The mean of the standard score according to establishing organizations
support for WLB
support for 
continuing 
learning
career 
clarification
support for 
skill 
development
management by 
objectives
n mean mean mean mean mean
National government 3 0.489 0.121 -0.493 -0.553 -0.508
Local government 9 0.305 -0.545 ab 0.237 -0.384 a -0.301
Public organizations 4 -0.319 -0.035 -0.543 -0.548 a -0.026
Social insurance bodies 2 -0.545 -0.788 -0.715 0.369 -0.003
Medical corporations 26 -0.047 0.152 0.150 0.359 b 0.028
Others 8 -0.078 0.289 -0.120 -0.345 0.453
a: Significantly different compared with Medical corporations by Fisher’s LSD test (p<0.1). b: Significantly different 
compared with Others by Fisher’s LSD test (p<0.1). 
4. Discussion
　We coded 52 cases of text data. As a result, we found that about half of the case study hospitals were 
working on career support such as "Support for participation in training outside the facility", "Provision of 
information on workshops" and "Consultation desk on balancing childcare and work". On the other hand, 
we found that "promotion of participation in study sessions in the hospital" and "e-learning while on leave" 
were not well implemented. In the future, it is suggested that "promotion of participation in study sessions 
in the hospital" and "e-learning while on leave" need to be strengthened as career support for hospital 
professionals.
　As a result of factor analysis, five factors, "support for WLB", "support for continuing learning", "career 
clarification", "support for skill development" and "management by objectives", were extracted.
　These career supports were consistent with the contents of "improvement of comfortable working 
environment" and "improvement of job satisfaction" among "improvement of employment quality" in the 
"management system for improvement of working environment" indicated by the Ministry of Health, 
Labour and Welfare11).
　We then examined the current status of career support by hospital bed functions and establishing 
organizations. As we have seen above, the "support for continuing learning", "career clarification" and 
"support for skill development" of chronic stage function are more active than other types of bed function. 
　Hospitals with chronic stage functions are in a situation of shortage of staff, especially nurses. Therefore, 
it can be inferred that this is the background to the various efforts that have been made to secure and 
retain staff.
　Moreover, we found that the "support for continuing learning" and "support for skill development" of 
medical corporations are more active than local government. Ikeda said, "Major medical corporation groups 
160 Mayuko Shibayama
make a lot of effort to train their management staff"12). It was suggested that medical corporations are 
actively engaged in career education for their staff.
5. Conclusion
　In this study, we analyzed the advanced practices of hospitals regarding career support. As a result, we 
found that the following five advanced initiatives are currently being implemented in hospitals. They are 
"support for WLB", "support for continuing learning", "career clarification", "support for skill development" 
and "management by objectives". Furthermore, we found that chronic stage function has more activity with 
"career clarification" than the acute stage function. In addition, we found that medical corporations have 
more activity for "support for continuing learning" than local government and public organizations.
References
1. Organization for Economic Co-operation and Development : Demographic references: Population age 
structure.
　  https://stats.oecd.org/index.aspx?queryid=30130, 2020. (September 1, 2021)
2. Kuhlmann E, Batenburg R, Groenewegen PP and Larsen C : Bringing a European perspective to the 
health human resources debate: A scoping study. Health Policy, 110(1), 6-13, 2013.
3. Kroezen M, Dussault G, Craveiro I, Dieleman M, Jansen C, Buchan J, Barriball L, Raffert M, …Sermeus 
W : Recruitment and retention of health professionals across Europe: A literature review and multiple 
case study research. Health Policy, 119(12), 1517-1528, 2015.
4. World Health Organization : Health workforce requirements for universal health coverage and the sustainable 
development goals. (Human Resources for Health Observer, 17)
　  https://apps.who.int/iris/handle/10665/250330, 2015.
5. Scheffler RM and Arnold DR : Projecting shortages and surpluses of doctors and nurses in the OECD: 
What looms ahead. Health Economics, Policy and Law, 14(2), 274-290, 2019.
6. Canadian Nurses Association : Tested solutions for eliminating Canada’s registered nurse shortage.
　  https://www.cna-aiic.ca/-/media/cna/page-content/pdf-en/rn_highlights_e.pdf, 2009. (September 1, 2021)
7. Sanavely TM : Data watch: A brief economic analysis of the liming nursing shortage in the United 
States. Nursing Economic$, 34(2), 98-100, 2016.
8. Unruh LY, Raffenaud A and Fottler M : Work-family conflict among newly licensed registered nurses: A 
structural equation model of antecedents and outcomes. Journal of Healthcare Management, 61(2), 129-145, 
2016.
9. Gregg MF, Hattori K, Yamamoto K, Arisue R, Nakamura F, Ikeda Y, Iwanaga J and Hamamoto K : 
Support for career development of clinical nurses based on organizational commitment. Bulletin of Kobe 
City College of Nursing, 13, 21-28, 2009. (In Japanese)
10. Ministry of Health, Labour and Welfare : Iki Iki Working Medical Institution Support web.
　  https://iryou-kinmukankyou.mhlw.go.jp/casestudy, 2015. (January 1, 2021) (In Japanese, translated by the 
author of this article)
11. Survey and Research Team for Establishing Methods to Improve the Working Environment of 
Medical Personnel : Improving the "Quality of Employment" in the Medical Field Work Environment Improvement 
Management System Introduction Guide. 
　  https://www.mhlw.go.jp/seisakunitsuite/bunya/kenkou_iryou/iryou/quality/dl/houkokusyo-03.pdf, 2014. 
(September 1, 2021) (In Japanese, translated by the author of this article)
12. Ikeda K : Building a career path for office managers: Necessity of career path and personnel evaluation. 
Byouin Rashinban, 192, 11-16, 2021. (In Japanese)


A Study on Typology of Career Support in Hospitals and Analysis of Characteristics of Medical Institutions

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A Harmony in the Community Maintained by Diverse Characters in Jane Austen’s Pride and Prejudice

川崎医療福祉大学博士（健康科学）令和3年度thesi

荒谷, 友里恵

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「口唇口蓋裂」の非当事者に対する意識調査 ―本疾患を知らないと回答した群の認識―

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A Study on Typology of Career Support in Hospitals and Analysis of Characteristics of Medical Institutions

エンパワメント実践の構造 ―ピアサポーターの事例をとおして―

A Harmony in the Community Maintained by Diverse Characters in Jane Austen’s Pride and Prejudice

コロナ禍における小児の手指衛生のための手洗い指導方法の開発

汁ものにおける塩分量・塩分濃度の変化

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