The purpose of this study was to clarify the sense of coherence (SOC) and related characteristics among Japanese war-displaced orphans returned from China.
A cross-sectional survey of 128 orphans was conducted using an anonymous self-administered questionnaire: the Chinese version of the SOC-13 (7 items) and characteristics.
Seventy-five copies of the questionnaire were returned (collection rate: 58.6%), and sixty-nine copies were analyzed (valid response rate: 92.0%). The mean age of the orphans was 76.6 (SD 2.6) years, and the mean number of years since permanent return was 29.2 (SD 6.9) years. 42.0% could communicate in Japanese, 55.0% answered that they had experienced discrimination in China, and 65.1% answered that they had experienced discrimination in Japan. 63.7% said they had subjective anxiety, and 88.4% said they were happy now. The mean SOC score of the orphans was 59.7 (SD 10.7), which was lower than that of their Japanese and Chinese peers. Significant differences in SOC scores were found in the following five areas: “whether or not they can communicate in Japanese,” “whether or not they have experienced discrimination in China,” “whether or not they have experienced discrimination in Japan,” “how often they have experienced discrimination in Japan,” and “whether or not they go for medical checkups every year.”
More than half of the orphans had difficulty communicating in Japanese and had experienced discrimination in China and/or Japan, which was reflected in their SOC scores. On the other hand, there was a significant difference between going for medical checkups and SOC scores, suggesting that good health behaviors and habits can lead to strong SOC.

The purpose of this study was to clarify expanding roles and self-directed learning up to the fifth year after the certification of certified nurse specialists (CNSs) with more than 10 years of experience from the aspect of culture. Semi-structured interviews were conducted with 15 CNSs in seven specialized nursing fields. The interviews were then qualitatively analyzed.
The results revealed the following themes regarding the expanding roles of CNSs: “practice centered on direct patient care in the ward”, “securing and establishing cross-organizational activities”, “practice as a CNS in the organization”, and “activities and dissemination as a CNS to outside the organization”. The following themes regarding self-directed learning were also revealed: “case analysis and evidence update for advanced practice”, “reflecting on and learning advanced practice through case studies and academic activities”, “acquisition of skills for strengthening a subspecialty”, and “exchanges with inter-professionals through training programs in Japan and overseas”. The expanding roles of CNSs up to the fifth year after certification were based on advanced direct patient care supported by self-directed learning and were accepted in both nursing and organizational culture.
The role of CNSs expanded through a combination of intentional practice based on theoretical and evidence-based knowledge, the dissemination of advanced patient care to members of the nursing staff, changes in position with the support of nursing managers, and the increased recognition among the multidisciplinary professionals of the roles of CNSs in the organization.

Purpose
To investigate the health perspectives regarding to self-rated health and health experiences of elderly Chinese migrants who were involved in Chinese attracted community activities in Japan.
Method
Participants were 13 elderly Chinese residents who were recruited in the Tokyo Area; individual semi-structured interviews and qualitative and inductive analyses were performed.
Results
From the results of the overall analysis, eight health perspectives were identified: (1) subjectively examining health according to physical and mental faculties; (2) feeling secure by living in a safe and amenity social environment; (3) feeling peaceful by accepting support from others to solve daily life issues; (4) keeping a positive frame of mind by accepting the realities of aging; (5) communicating and engaging with other Chinese residents, so that daily life is not restricted by the language barriers; (6) preferring to reside with family members and support each other; (7) feeling relieved to be able to access Japanese healthcare services successfully by themselves; and (8) independently using traditional Chinese medicine to manage health and keep fit.
Conclusion
We confirmed that late adulthood developmental tasks, Chinese culture, and language barriers affected the health perspectives of elderly Chinese migrants in Japan. Because the language barriers and continuity of the native culture influenced their security, health promotion, and expectation of later life, it is important to create an accommodating environment to resolve language barriers and provide care based on the cultural and health promotion standards that are familiar to elderly Chinese migrants.

To clarify the folk religious experiences of elderly mothers during the course of their children’s schizophrenia, and to obtain suggestions for community nursing activities rooted in local culture.
Method
Semi-structured interviews were conducted with 10 mothers aged 70 or over who had children with schizophrenia living in Okinawa. The mothers’ experiences of folk beliefs were surveyed and analyzed qualitatively and inductively in terms of their perceptions of and hopes for folk beliefs, as well as their self-evaluations.
Results
As reasons for using local shamans (Yuta), eight mothers cited “the child’s illness”, and one cited “the husband’s illness”. One stated “did not use”. Of the nine mothers using Yuta, seven were “recommended by others” and two were by “self-intention”. The perceptions of folk beliefs were “ingrained in own lives”, “creating a connection with our ancestors” and “not completely accepted”. The Hopes for folk beliefs for their children’s illness were “expectation of the power of spirits” and “manifestation of parents’ love for their children”. The self-evaluations of the use (or non-use) of folk beliefs were “emotional support that cannot be supplemented by medical treatment”, “consultation with half doctor and half Yuta (a combination of the two)”, “power of worship that grows with support”, and “acceptance of diverse values”.
Discussion
This study suggested that community nursing activities should be based on the understanding of the perception of illness from the perspective of local culture, and on the concrete response to consultations with patients’ families.

Uncertainty about the decision-making capacity of patients with terminal illness in intensive care units (ICUs) is common, and family members often make decisions on their behalf. Health care professionals rarely engage patients in advance care planning; moreover, the decision-making support needs of patients with terminal illness in ICUs have not been adequately explored.
Purpose
Through a literature review, this study aimed to understand the status of decision-making for patients with terminal illnesses in ICUs in Taiwan, where patients’ self-determined decision making has been legislated, and to clarify the characteristics of nursing practice supporting decision-making.
Methods
The Chinese electronic periodical service and Taiwan periodical literature databases were searched from inception to May 2021. ‘ICU’, ‘decision-making’, and ‘end-of-life’ were used as search terms. Inclusion and exclusion criteria were employed to screen for eligibility. The findings were analysed and synthesised into major categories regarding nursing practices facilitating decision-making.
Results
Thirteen articles were selected for the final review. Seven major categories emerged: 1) consideration of patients’ best interests; 2) advocacy of self-determination for terminally ill patients with decision-making capacity; 3) emotional sharing and stability through coordinated family visits; 4) attitudes towards family surrogate decision-makers; 5) establishing a system for providing information according to family situation; 6) multi-interdisciplinary collaboration in family meetings; and 7) sharing the concept of hospice palliative care among healthcare professionals.
Discussion
It is crucial to develop a system to share hospice palliative care concepts by proposing treatment options focusing on patients’ best interests during decision-making.

As the establishment of community-based integrated care systems increases, many older people wish to live at home for various reasons, even when they become frail. Therefore, nurses need a comprehensive understanding of older people’s desire to remain in their homes. The concept of home is critical for explaining this desire; therefore, this study integrated qualitative findings on the meaning of home for older people living at home.
We conducted a thematic analysis of 14 studies. We selected the studies using Japanese and foreign literature searches. We extracted 71 codes, identified 16 sub-themes and integrated them into nine themes: “Home supports one’s own identity,” “Home supports one’s health,” “Home creates social connection,” “Home has functionality,” “Home has a special and personal atmosphere,” “A role exists at home,” “Independence and autonomy to be maintained at home,” “Impact of receiving home care,” and “Changes at home over time.”
The results of our study highlight older people’s strength in being able to accept undesirable changes and make efforts for the purpose of keeping their meaning of home. We concluded that nurses should understand older people’s desire to live at home based on the concepts of home, and they should collaborate with older people in implementing home care. In this way, they will provide necessary support for older people with health problems who wish to remain at home.