Purpose: This study aimed at examining the association between job-related stress, type of coping profiles, and social support with the quality of life (QOL) affected by gastrointestinal symptoms among Japanese nurses working at acute care hospitals.
Methods: We measured job-related stress factors, type of coping profiles, social support, and the affected QOL by gastrointestinal symptoms in 366 female nurses working at two acute care hospitals by logistic regression analysis.
Results: The results showed that job-related stress factors, such as high "quantitative overload," high "qualitative overload," high "physical load," low "skill discretion," and low "job fitness," and the type of coping profile factors such as "escape/avoidance coping" were related. These six factors increased the risk of gastrointestinal symptoms. The other factors such as "age" and "support from family and/ or friends" were also related; however, these factors decreased the risk of gastrointestinal symptoms.
Conclusion: Job-related stress and the type of coping profiles affected the QOL by gastrointestinal symptoms among Japanese nurses working at acute care hospitals.

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The purpose of this study was to clarify how critical care nursing specialist (CCNS) coordinates ethical issues for terminally ill patients in the intensive care unit. A semi-structured interview was conducted with 10 CCNSs and the results were analyzed by both qualitative and inductive methods.
The analysis revealed 13 categories such as "to predict the path to the terminal phase and assess the limit of active treatment", "to try to understand the patient's will even when it is difficult to confirm it", "to share a burden of sole decision making with a family member", "to minimize the regret of a family member who acts as a surrogate decision-maker", "to ease suffering of family members who cannot give up recovery", "to make facing death as desirable as possible as an extension of intensive care", "to understand the heavy responsibility of doctors who are required to make a difficult decision and avoid confrontation with them", and "to take care of disconsolate feelings of medical professional who lose patients".
CCNSs are considered to have played a role in patient advocacy, surrogate decision-making support and grief care for families of patients, help to patients and their families to realize their desire to have a "good death", and building a foundation among medical team members to work as a team for end-of-life care.

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[in Japanese]

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[in Japanese]

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[in Japanese]

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