Purpose
For nurses who have mainly transferred to a health care facility from a region other than a detached island for nurses who are less than 5 years old, the nurses who had experience of nursing practical experience in their previous jobs, how to overcome embarrassment and difficulty after taking off from the solitary island by clarifying the actual situation from the story, we get suggestions on support for cross-cultural adaptation.
Method
Twelve interviews were conducted using 12 lifeline interview methods for 12 nurses who worked at solitary island remote medical institutions. After sectioning the talks according to purpose from there, categorized it.
Results
Initially, I got into a feeling of loneliness because I was puzzled by the difference in living aspects, and in my work I was often confused by the difference between my previous job and my job. However, I realized that only ‹I am stuck and troubled alone› can not be solved by themselves, and I began to [to disclose to my workplace and locals]. As a result, in the living side gradually gained [feeling that melted into the region], while at the workplace [convinced] on the local way, ‹you can actively practice your own nursing›also be able to do [respond] as I began to feel it, I began to feel like I could do it here. These processes were drawn on the U curve when put on the lifeline.
Discussion
To work in a remote area means that there are “ tasks for workplace adaptation for mid-career hires ” and “ issues for living adaptation for migrants ”, so that both the assigning and accepting cultural shocks I think that the findings of the theory will be useful.

Objective
The aim of this study was to clarify the way of culturally sensitive population approach programs, specifically to prevent life-style related diseases, focusing on the exercise programs.
Methods
Participant observation of three exercise programs provided in 3 satellite cities and semi-structured interview to 5 public health nurses (PHNs) and 45 community residents were conducted for 2 years. The data were analyzed qualitatively and inductively according to the following research questions; what community culture and how do PHNs consider for planning, implementing and evaluating the program? How do the community residents feel the effect of the program?
Results
5 ways for population approach were described from 33 categories of PHNs’ thoughts and actions; Spreading of exercises by adapting and acclimating to community’s tacit understandings, Valuing and harmonizing cares as local attachment, Using and enhance cultural sensitivities in the communities, Using and nurture the communities’ attitudes for symbiosis relationships, Steering and promoting the programs with considering comfort.
There were 10 categories about the effect of the program which the community residents felt such as ‘the expansion of their aspects of health’.
Community culture was described such as tacit understandings.
Conclusion
PHNs are required follows to provide culturally sensitive population approach programs for prevention of lifestyle related diseases; considering communities as the subjects of cultural nursing, making their activities rational adapting the tacit knowledge, making care deeply rootedin local attachment using exercise programs, using/enhancing communities’ cultural sensitivities and symbiosis relationships, proceeding community culture to inclusive one. Throughout the prosecco, consider community residents’ comfort and cultural humilities.

The purpose of our study was to investigate the relationship between “culture of sharing used items” and social capital for mothers raising children. In our study,“culture of sharing used items” was defined as giving and receiving used children’s clothes and nursery items. An anonymously conducted self-recording questionnaire survey was distributed to 1,244 mothers of 2 to 3-year-old infants attending certified nursery schools, kindergartens, or certified daycare centers in 3 regions of Japan with different social capitals, i.e., Shimane-Pref., Ishikawa-Pref., and central Tokyo (inside the 23 wards of Tokyo). Among 624 respondents (collection rate: 50.2%) (Sept. 2016 to Mar. 2017), 609 effective answers (effective answer rate: 49.0%) were analyzed by classifying them into two groups, based on experience of having received or given used items. Relationships of indices of cognitive social capital and structural social capital were assessed by Mann-Whitney’s U test and the chi-square test. Results showed that regions with high social capital, as defined in the survey by the Japanese Cabinet Office in 2002, showed correlation between cognitive social capital and receiving used items, and between structural social capital and giving used items. In regions with low social capital, correlation was noted between structural social capital and receiving used items. Our results suggest that the “culture of sharing used items” is possibly related with social capital for mothers raising children, and that “culture of sharing used items” is considered to be related with the degree of social capital in each local community.

Our study investigated Japanese culture-related aspects of home-visit nursing in support of mothers with 0 to 3-year-old infants of high medical dependency, especially for “thoughtful nursing” by carefully observing the state and overall environment of the mothers.
Subjects were 8 home-visit nurses in Prefecture A who started visiting homes of 0 to 3-year old SMID-MCDG infants, and continued home-visit support for 6 months or longer. Qualitative and inductive analyses were conducted after obtaining data through semi-structured interviews.
Results showed that the Japanese “thoughtful nursing” method consisted of 5 categories, based on observations and experience as a home-visit nurse: 1) Value every moment of the encounter to be trusted by the mother; 2) Consider the mental state of the mother based on the behavior of the mother; 3) Positively and attentively observe the mother for development of trust with the mother; 4) Provide mothers with strategic indirect and direct support by the consideration of home-visit nurses; and, 5) Prepare support measures considering the burden of the mother in caring the infant.
Our results suggest that home-visit nurses support patients’ mothers directly and indirectly, while establishing trust by considering a mother’s feeling in the human relations of people related to the mother. Home-visit nurses are also found to be a liaison between the mother and local community to reduce the burden imposed on the mother, as well as taking care of health condition of SMID-MCDG infants.

Aim
This study aims to clarify the experience of nurses who care for patients undergoing cancer treatment during the downward phase of the illness trajectory.
Methods
The study involved 5 nurses who worked at general hospitals without palliative care teams and had cared for patients undergoing cancer treatment during the downward phase of the illness trajectory. Data were collected through semi-structured interviews with 5 nurses and analyzed with qualitative synthesis method (KJ method).
Results
The experience structure of nurses comprised six characteristics as follows: [the practice of treating patients without the awareness or consideration of their personality because of hectic schedule], [the evocation of experiences that resonate with patients], [the exploration of patients’ personality on the basis of their history and pain suffered as a result of illness/treatment], [the clarification of values as nursing professionals who keep close contact with patients undergoing end-of-life cancer treatment], [the response for interdependence between patients and family/medical staff], and [the promotion of subjective decision making with regard to patient care].
Discussion
The nurses had a tendency to coordinate doctor-patient relationships, listen to patients, and treat the true need of patients, and these cultural characteristics ensured that they paid attention to patients’ personality when caring for them.
Conclusion
In a caring environment without palliative care experts, it is essential for nurses to accumulate opportunities that allow them to reflect on responses for interdependence and decision making with regard to patient care.

This study aimed to explore the values of older people living at home and family caregivers that impacts bowel elimination care provided by visiting nurses.
Semi-structured interviews were individually conducted with 14 visiting nurses who have 3 or more years of experience in home-visit nursing. The interview content covered the process of support given to older people living at home requiring care for bowel elimination (hereafter, older people) and the family caregivers. The support process for 22 cases of older people and family caregivers were described. An inductive, qualitative analysis was carried out on the acquired data.
As a result, eight categories were identified in the values of older people that impact bowel elimination care. They include “the importance of bowel elimination which becomes quite a problem if it doesn’t occur,” “the inability to ask for help even from family because the physiological phenomenon of bowel elimination is a private activity,” and “wanting the visiting nurse to control bowel elimination out of a desire not to jeopardize one’s own and the family’s lifestyles.” In addition, eight categories were identified in the values of family caregivers. They include “stool becoming packed in the bowels when bowel elimination doesn’t occur which becomes quite a problem,” “disliking helping with bowel elimination but being unable to refuse because of the relationship with the older person,” and “wanting to leave help with bowel elimination to the visiting nurse because it is especially burdensome.”
Given the above, this study indicated the importance of nursing support based on the considerable significance that bowel elimination has in the sense of contentment in the lives of older people, and the fact that decisions regarding bowel elimination are made on the basis of the relationship between older people and family caregivers.

Purpose: Japanese medical system and roles of nurses differ from in other countries. This study focuses on home-visit nurses’ perceptions of cooperation with doctors in Japan. It employs a review of the Japanese literature to explore home-visit nursing practices and problems experienced in such cooperation. Suggestions for more effective cooperation are then given.
Methods: A total of 25 relevant studies were identified in the Japanese Medical Abstracts Society’s Ichushi Web database. Qualitative data were extracted on home-visit nursing practice and nurses’ problems in cooperating with doctors. The data were analyzed using a qualitative approach.
Results: Five core practice categories and 17 categories were extracted. The five core categories were: reporting to doctors, negotiating with doctors, consulting with doctors, confirming with doctors, and communicating with doctors. Four core problem categories and 16 categories were extracted. The four core categories were: contact with doctors and medical institutions, doctors’ interest in home care, doctors’ knowledge and skill, and relationships with doctors.
Discussion: Home-visit nurses reported information to doctors, but they felt difficulty when contacting doctors and medical institutions. There appear to be three main reasons for this: (1) freedom of access to medical institutions in Japan, (2) there are no professionals specialized in collaborating with doctors, and (3) the range of nurses’ discretion in Japan. The history of nursing education and culture appear to be causes underlying relationships between doctors and nurses in Japan. The culture by which nurses obey doctors and entrust judgment to them is deeply embedded among nurses.

The course of “Okinawan culture and nursing” is offering in a university. Nursing students are experiencing Okinawan culture and doing exercises related to the culture inside the university and outside. The aim of this study was to clarify how they understood the culture and how they felt about application of the culture into nursing via cultural experiences. In addition, consideration for the significance of cultural experiences was an another goal of the study.
We extracted sentences that may associate with Okinawan culture and nursing from student’s reports and categorized them, then conducted a qualitative analysis. As a result, we excluded 59 key sentences, 10 sub-categories and four categories.
The students learned “understanding of others and a trusting relationship promoted by adoption of culture” was important via cultural experiences. They felt culture was the advantage and found it could be a tool to communicate smoothly. They also made “an idea to incorporate culture into practices of nursing”. Besides, they considered culture could extend to change of safety and zest for living and expected “culture would promote physical and mental health”.
Furthermore, the students recognized that nursing profession has a role to absorb cultures and hand down them to a lot of people when nursing is combined with cultures via the course. They also imagined “the image of nursing profession who continues to learn and adhere tightly to culture; they could image the relationship between culture and nursing.
Consequently, in the first semester in sophomore year in university when students can think flexibly, it can be referred the style of a course that precedes experience is utilized for cultivating the power to combine culture with nursing.

This study aimed to survey attitudes towards excretion among older people living in Okinawa, Japan, with a focus on generational differences, and to examine the way excretion assistance in nursing should be provided in a manner that reflects their culture. We interviewed 15 older people in Okinawa regarding their attitudes toward excretion using a semi-structured interview method.
The results of the interviews suggested that the subjects used the following as a guide to assess their stool condition: “a bowel movement in the morning helps to have a good day”, “stool is banana-shaped and not hard”, “excretion gives a refreshing feeling”, “have no fecal impaction”, and “I undergo examinations and check results”, etc. Some people wanted excretion care, such as by their families and professionals, while others did not want such assistance from anyone. The subjects expressed a desire to maintain their own rhythm of excretion, as well as to accommodate their caretakers’ schedule, as they are being provided with care that they need. Generational differences regarding excretion were found in “lowering trend in the age of toilet habit education”, “changes in excretion posture due to changes in toilet shape”, “fear of old toilets”, “increased cleanliness of toilets”, “changes in moral views of excretion”, “increased internal and external awareness about excretion”, and “decreased sense of shame in one’s private parts”. Older people living in Okinawa maintained their own rhythm of excretion, while making a judgment about their own condition, and being aware of generational differences regarding excretion. Whether these attitudes are characteristic in Okinawa or Japan remains unclear, but our findings suggested the need to understand the current excretion habits and ideas of the older, as well as to understand toilet experience and habits of the generation to consider suitable excretion methods.