The purpose of this study was to clarify nursing practices characteristic of the perioperative period for promoting recovery after gastrointestinal surgery. A survey was performed by semi-structured interviews about nursing practice in five nurses based on the five aspects of comfort, emotion, physical independence, support for patients, and pain.

As a result, five categories, including “Perioperative anxiety relief” and “Education for proactive postoperative behavior of patients,” were obtained as preoperative nursing practices. Seven categories, including “Understanding postoperative discomfort and providing comfort,” “Reducing postoperative pain,” and “Help getting out of bed early and identifying activity expansion,” were obtained as nursing practices immediately after surgery to postoperative day 1. Six categories, including “Help getting out of bed for ADL independence” and “Continuous postoperative pain management,” were obtained as the nursing practices for postoperative days 2-3. Five categories, including “Continuous psychological support” and “Patient-centered discharge support for self-care,” were obtained as the nursing practices for postoperative days 5-6. Nursing practices that promote postoperative recovery can be expected to improve further by accumulating practical knowledge, respecting patients’ individuality, managing safety, and strengthening cooperation.

　The purpose of this study was to elucidate nursing practices that support the autonomy of ventilated patients under light sedation in the intensive care unit. Data were collected in semi-structured interviews of four nurses with nursing experience caring for ventilated patients in an intensive care unit, and analyzed qualitatively and inductively.

　The analysis revealed six themes for such nursing practices: “Mitigating the patient’s loss of strength and assisting with the maintenance of the patient’s physical abilities” and “Getting close to the patient and understanding his or her feelings” while “Creating a sense of security where the patient can communicate even if he or she cannot speak” due to intubation, “Respecting the patient’s desire to know and helping him or her understand the situation,” “Providing support so that the patient can move safely, while taking that movement as part of daily life ” and “Reclaiming Daily Life with Patients”

　From these results, it is inferred that nurses make mental and physical preparations so that patients can display their autonomy, implement nursing practices that help the patient recover a sense of daily life, and work together with patients toward their goals. The results suggest that these practices will be helpful in nursing that supports the autonomy of ventilated patients under light sedation.

Purpose: This study aimed to develop an autonomy scale for emergency nurses and verify its reliability and validity.

Method: Upon confirming the face and content validity of the initial draft of the autonomy scale for emergency nurses, an anonymous self-report questionnaire of the 77-item draft scale was administered to 3408 emergency nurses. The scale’s reliability and validity were examined thereafter.

Results: A total of 434 valid responses were obtained. Following an exploratory factor analysis of these responses, 33 items were extracted across three factors within the draft scale. For reliability, internal consistency was confirmed by Cronbach’s alpha coefficient, and stability was confirmed by the test-retest method. For validity, criterion-related validity was confirmed using the Professional Autonomy Scale, Dempster Practice Behavior Scale, and Job Satisfaction Scale.

Discussion: The autonomy scale for emergency nurses encompasses items that evaluate independent thinking and actions aimed at advocating for, treatment of, and support for the recovery of emergency patients and their families.

Conclusion: The reliability and validity of the autonomy scale for emergency nurses is confirmed in this study.

Aim: To clarify the process by which intensive care unit (ICU) nurses acquire a sense of self-growth in the 3 years after starting to work and understand the support required to acquire and enhance the sense of self-growth. Methods: A semi-structured interview was conducted with general ICU nurses who had 4 years of experience. The responses were analyzed using the revised grounded theory approach.

Results: The process by which ICU nurses acquire a sense of self-growth comprises the five periods of “doing their best to accomplish daily nursing tasks at the ICU,” “noticing lacks in their own abilities when accomplishing nursing tasks,” “reflecting on themselves and determining directions of change,” “continuing to work hard while encouraging themselves at times,” and “objectively evaluating their own changes resulting from their hard work and perceiving them as positive changes.”

Conclusion: The study showed that ICU nurses became aware of the need for change and growth in terms of their own nursing abilities through their daily nursing duties. Such situations encourage nurses to seek self-improvement through learning-oriented reflection. We expect that support in consideration of this process is necessary while minimizing a psychological burden to promote acquisition of sensory experience of self-growth. Furthermore, the study suggests the importance of providing support that encourages ICU nurses to improve their nursing capabilities, and to recognize a change of nursing capability as my own growth.

Objective: To clarify nurses’ dilemma regarding the use of physical restraints for elderly patients in critical care units (ND-PRECC), and identify its related factors.

Method: In this cross-sectional study, a questionnaire was administered to 264 critical care nurses.

Results: An exploratory factor analysis of ND-PRECC was performed using the data of 190 valid responses. The following three factors were extracted: “Ethical dilemma due to difficulty in getting closer to patients’ feelings,” “Ethical dilemma based on experience and values,” and “Ethical dilemma due to disagreement among nurses.” On comparing item average, the first factor scored the highest, and the third factor scored the lowest. ND-PRECC was found to be related to seven items, such as ʻfree communication flow’ on the patient safety climate scale.

Conclusions: It is necessary to establish a patient safety climate to reduce ND-PRECC.

This study aimed to identify the care that brings Anraku (“comfort” or “ease”) to patients by proficient nurses in critical care units. Semi-structured interviews were conducted with eight nurses who had at least seven years of clinical experience in critical care units. Data were analyzed by qualitative description. The proficient nurses judged patient Anraku based on “indicators directly obtained through observation of the patient's body,” “indicators emitted by the patient,” and “indicators obtained from equipment,” and connected them to care. Anraku care comprised four categories: “minimizing pain through proactive measures,” “preparing the patient to overcome unavoidable pain by minimizing it,” “reassuring the patient and helping them be at peace and a calm state of mind in an unusual situation,” and “acknowledging true feelings.” Based on the premise of inevitable physical and psychological suffering caused by critical care, minimizing suffering and adjusting it to the best of one's ability was presented as a characteristic of Anraku care in critical care units.

【Purpose】The purpose of this research is to clarify the experience of familyʼs witness to the resuscitation (FWR) of the patients who were transported to emergency care facilities in order to obtain suggestions for supporting the families of such patients.

【Methods】A qualitative, inductive, and descriptive study using medical record survey and a semi-structured interview was conducted on five families who selected FWR.

【Result】7 core categories were derived. [Decision of resuscitation entrusted to the emergency servicesʼ care], [Desire to be with the patient till their death], [Deep thought for the patient occurred by FWR], [Determination for discontinuing the resuscitation], [Appreciation to the medical staff from the transportation to death], [Realization that the best work was done], and [Desire for living in the way the patient wishes till the death].

【Conclusions】The seven core categories showed that the family is spending time with the patient, has deep feelings and gratitude for the patient lead to FWR. The FWR also made the decision to continue or discontinue resuscitation. As family support for CPA patients (1) Since the family makes decisions in a short time, provide information that the family can understand. (2) Since the grief reaction varies from family to family, we will respond to each family member regarding FWR. (3) It was suggested that it is necessary to individually adjust personnel and family specialized nurses to realize FWR by utilizing protocols.

Purpose: To identify constructs related to nursing practice that promotes recovery in acute and critical care patients and to examine nursing practice structures for this purpose.

Methods: Focus group interviews were conducted with 23 nurses trained to become critical care nurse specialists, and data were analyzed qualitatively and descriptively with a focus on “nursing practices that promote recovery”.

Results: Nursing practices that promote recovery in acute and critical care patients were broadly categorized into the following elements: thoughts that promote recovery, practices that promote recovery, assessment of recovery status, and factors that influence recovery.

Discussion: It was considered necessary to practice nursing practices that promote recovery while giving consideration to the patient and reflecting on the patient's recovery according to the patient's degree of recovery. It was also considered that thoughts and practices that promote recovery could be related to and characterized by the assessment of recovery status, positive and negative factors for recovery, and systems that influence the patient's level of health and degree of recovery.

This study aims to investigate the psychological stress experienced by emergency nurses during the early COVID-19 pandemic. Semi-structured interviews were conducted with five nurses working in the emergency department at a secondary emergency medical institution, and a qualitative descriptive analysis was conducted. The results revealed four categories of psychological stress experienced by emergency nurses. The first category was [increased fear and anxiety of being infected], such as “immediate fear of getting infected.” The second was [burdens due to ad hoc measures taken by the institution], such as “concerns about a lack of reliable and safe infection control measures.” The third was [distress about rising challenges in emergency nursing practices], such as “feeling sadness about the lack of a support system.” The fourth was [feelings of being mistreated by others], such as “concerns about discrimination.” To reduce psychological stress among emergency nurses, organizations should provide evidence-based policies and procedures that allow healthcare professionals to respond safely and positively to COVID-19.

Objective: The purpose of this study was to describe the ICU nurses’ perception of patients’ death while caring for the dying patients.

Methods: Semi-structured interviews were conducted on 11 nurses working in the ICU who had experienced patients’ death in the ICU. Data were analyzed using a qualitative approach based on the grounded theory approach.

Results: Nine categories were extracted from the ICU nurses’ narratives, and 5 of the 9 categories formed a storyline created by the ICU nurses when caring for the dying patients. The storyline centered around the following main category: “conflicts of the relationship with the dying patients as an ICU nurse”.

Conclusions: ICU nurses perceived a patient’s death from how the patient’s general condition changed. ICU nurses realized what their role is, and therefore they were in a dilemma about the presence of patients’ death in the ICU. For ICU nurses, their perception of death is the root of the dilemma. Also, our results suggested that the ICU nurses’ perception of death is related to the fact that ICU nurses provide care to patients while being aware that their patients may die. Our findings also suggested that “ICU nurses” as a professional identity provide care to patients while being aware that their patients may die.

The purpose of this study was to gain an understanding of the intensive care unit (ICU) nurses’ perception of post intensive care syndrome (PICS) and their perception of care for the onset of PICS. We conducted a semi-structured interview with seven experienced ICU nurses. Their responses were analyzed qualitatively and descriptively. As a result, their perception of PICS was classified into seven categories, including “PICS includes physical, mental, and economic problems,” “PICS develops due to the special environment of the ICU,” and “PICS develops due to long-term admission (two weeks or longer) at the ICU. The awareness of the ICU nurses regarding care for the onset of PICS was classified into the following three categories: “lack of progress in PICS care,” “development of care for the onset of PICS,” and “there is a lack of interest in care for the onset of PICS.” It is necessary to share knowledge with ICU nurses about PICS for changing their perception regarding PICS. Such trainings should provide opportunities for nurses to learn the outcomes of nursing in the ICU and review and consider their nursing practices, while also providing them with spontaneous and extrinsic motivation by showing what is expected of the ICU nurses.

The purpose of this study was to clarify the learning status and needs of nurses who were placed in critical care nursing during the spread of new coronavirus infections. A web-based survey was conducted on the basic attributes, learning status, and learning needs for nurses placed in the critical care area in the fiscal years 2020~2021. A total of 336 participants were analyzed. Face-to-face in-service continuing education was often conducted. More than 80% of the subjects intended to continue in their profession, and the mean total learning need score was 146.2±14.3. The learning need tended to be higher among nurses who were willing to continue in their profession. In the critical care area, the learning need was higher for physical aspects such as airway, respiratory, and circulatory. Even in coronavirus period of employment, the need for learning in the critical care area was recognized.