The objective of this study was to clarify the factors affecting the decision making of patients undergoing cardiac surgery. We interviewed 19 patients who had undergone cardiac surgery in an outpatient department or a ward of a cardiovascular hospital, and analyzed their data. Eight categories for factors affecting the decision making of patients were extracted, including the following:
"Understanding of the necessity of the cardiac surgery associated with the experience of daily-life restrictions due to symptoms of heart failure and angina and pain the repeated catheterization," "Expectation that the cardiac surgery will improve the symptoms and daily life," "Thoughts on cardiac surgery based on a previous surgical experience," "Recognition of life risks and judgment of the appropriate timing of cardiac surgery based on the physician's recommendations." "Trust and optimism for medical facilities and the healthcare providers feeling from treatment and the nursing that patients received so far"
The results suggested the importance of continuous nursing-care assistance from the time of outpatient department visit to the surgery, to support the patients' decision making. Furthermore, the results also indicated the necessity of providing support based on treatment experience and the psychosocial background of each patient, and of promoting a seamless support system by multi-disciplinary team.

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This study examines what significance bedside photographs have for ICU nurses in order to obtain suggestive findings concerning using such photographs more effectively in nursing intervention. Nurses with experience caring for critically ill patients who have photographs at their bedsides were interviewed with semi-structured interviews. For analyzing their responses, the modified Grounded Theory Approach was used as a reference.
From the results, five aspects of significance that such photographs have for nurses were extracted. The aspects were views about photographs affected by individual backgrounds and hospital ward culture, views shifting towards paying more attention to the experience itself of patients whose lives are being threatened, thoughts for considering and respecting complicated effects, photographs acting as a catalyst for nursing actions that respect patients as living persons, and mixed feelings caused by photographs. For ICU nurses, bedside photographs change their views on patients, helping them to achieve patient-centered care through establishing partnerships with patient families. Bedside photographs can be double-edged swords; they have both benefits and disadvantages. The results suggest that being aware that photograph significance differs depending on family crisis levels and family systems and that using photographs carefully are important.

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[in Japanese]

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[in Japanese]

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[in Japanese]

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Although ICUs are an unusual and stressful environment for patients, the use of background music (BGM) may reduce their stress. However, there is not a sufficient number of studies that have clarified how nurses who hear the same BGM as patients do at the same time and same space feel BGM has impacts on patients and themselves. The present study aimed to examine nurses' views of the effects of BGM played in ICUs on patients and themselves. The subjects were ten ICU nurses, and semi-structured interviews with them were conducted. The effects on patients as viewed by the nurses were categorized into [Returning to daily life, and recovery of mind and body that BGM brings to the patients] and [Doubt or denial of effects on BGM on the patients]. The effects on nurses as viewed by themselves were classified into the following four categories: [Application of BGM to nursing care of the patients], [not feeling uneasy while BGM is played], [not feeling annoyed by BGM], and [expectations for the effects of BGM arising from patients' responses]. Relationships between patients and nurses facilitated by BGM were categorized into [interactions between patients and nurses promoted by BGM].

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This study investigated the difficulties intensive care unit (ICU) nurses faced in nursing practice and clarified the relationship between difficulties in nursing practice and willingness to continue working.
A self-administered questionnaire survey was distributed to 199 ICU nurses; the average age was 31.8 years and average ICU work experience was 56 months. The questionnaire was created based on semi-structured interviews of 33 ICU nurses with an average ICU work experience of 55 months, and included 25 items on difficulties in nursing practice and 5 items on willingness to continue working. Factor analysis showed that difficulties in nursing practice comprised 5 factors and willingness to continue working comprised 1 factor. Cronbach's α for each factor was over 0.8. Multiple regression analysis was also performed to determine the factors associated with willingness to continue working.
Results showed that 74.9% of the nurses feared that their actions would affect patients in a critical condition, and 71.3% of them faced difficulties making clinical judgments instantaneously. In addition, two factors had a negative effect on the willingness to continue working: (1) a difficulty in nursing practice, which was termed "The difficulties in nursing practice in tense situations" and (2) the length of ICU work experience.

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[in Japanese]

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[in Japanese]

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[in Japanese]

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