This study aimed to identify difficulties of nurses who are involved in families performing surrogate decision-making for an emergency patient and their reasons. Semi-structured interviews were conducted involving 8 subjects. The obtained data were categorized based on Berelson, B content analysis, and an agreement rate of more than 70%, which was calculated based on the formula of Scott W.A., was used as criteria to ensure the reliability of the categories.
As a result, 302 descriptions and expressions were extracted and classified into 13 categories, including [Nurses become suffer, being unable to accept decision-making by family members in a positive manner] and [Nurses become suffer because physicians often make decisions regarding treatment], and 698 were extracted regarding the reasons and grouped into 14 categories, such as [Due to their sense of ethics, views on nursing, and values, some nurses cannot positively accept decisions made by family members] and [Nurses have no means of evaluating their own approaches].
The agreement rate was 82.9% for difficulties and 93.2% for reasons, showing that the reliability was confirmed in both difficulties and reasons. The results suggest the need to conduct regular emergency case conferences among different professions to help nurses to reconfirm their individual responsibility and involvement with families, and provide an environment for nurses to review their practices to reduce their nursing ethical conflict.

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The aim of this study was to clarify the experiences of patients who developed acute aortic dissection and received the treatment of antihypertensive-complete bed rest, to consider the necessary nursing support. Data were collected using semi-structured interviews with 20 patients and were analyzed using a Grounded Theory Approach.
The results suggested that the patients took the same course from the onset to the hearing of the disease accounts from the doctor. In analyzing the patients' experiences of the treatment of antihypertensive-complete bed rest at the CCU,four patterns of experiences were identified. First pattern was in which patients "could keep the complete bed rest" because they tried to understand the disease and the treatment and eventually came to understanding. Second pattern was in which patients "could keep the complete bed rest by coming to terms with this situation" even though they were puzzled and anxious about the uncertainty of the future. They remembered the disease accounts by the doctor only in fragments and could not see the need for the hospital care. Third pattern was in which patients "could not keep the complete bed rest." They were confused because they had little memory of the disease accounts by the doctor and could not understand their situation. Fourth pattern was in which patients "were placed on a ventilator" for they became severely ill.
The results of this study indicate that acknowledgment of disease and treatment and self-efficacy may influence the patients' adherence on keeping the complete bed rest. Therefore, patients need the support that would enhance their understanding of the disease and treatment and promote their self-efficacy.

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This study aimed to identify the memories and experiences of patients admitted to an ICU, and examine nursing support for ICU patients.
A questionnaire survey was performed using the ICU memory tool and Hospital Anxiety and Depression Scale (HADS) involving patients who stayed in the ICU for more than 3 days, and semi-structured interviews were conducted involving 40 patients (32 males and 8 females) who experienced memory loss and had imaginary experiences in the ICU. Of the 25 subjects who experienced memory problems, 18 had imaginary experiences, and 14 had memory loss. Of the 25 subjects, 7 had both imaginary experiences and memory loss. The subjects who were emergently admitted to the ICU experienced marked memory loss compared to those with scheduled admission. The subjects with imaginary experiences strived to give meaning to their experience by telling their families, while having anxiety over suffering during the admission and disease recurrence. Most subjects attempted to organize and understand all the events that occurred during the ICU stay. The findings suggest the need to develop a support program that can be initiated during an ICU stay to help patients organize their memories and experiences.

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[in Japanese]

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[in Japanese]

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