A clinical system for pregnant women is named as “hospital outpatients' clinic by nurse-midwife” in Japan. In this system, nurse-midwives independently conduct health examination, education and consultation for pregnant women without medical problems.

The purpose of this study is to suggest the safety and efficiency of this system and to think use of nurse-midwife at hospital in Japan.

We discussed above using 22 reports which were written concerning this system by obstetricians and nurse-midwives. And we analyzed the 282 pregnant women at a university hospital. The results were follows.

(1) Nurse-midwives executed health examination and health education in 13 reports. In another 9 reports, executed only health education.

(2) The former 13 reported that there were no troubles, the pregnant women have positive assessments and the nurse-midwives were constructive.

(3) A obstetrician reported to get half reduction of medical examination frequency.

(4) From analysis of 282 samples, we obtained significance (p<0.01) between obesity index (BMI) and weight, though the correlation coefficient was low (r=-0.30).

(5) Obesity index, age and health education starting time were selected as effective factors for weight addition by selection of predictor variables with multiple regression analysis (ratio of contribution 0.12). It was suggested that when health education starting time was late, her weight was increase.

The purpose of this study was to describe nurses' consciousness and needs in high-risk neonatal nursing. A questionnaire was distributed 550 nurses in October 1996, and received 236 available replies (42.9%). Of those replies 229 ones excluded teachers and students were analyzed.

The findings of result were following. ①198 nurses (86.5%) thought that specialization was necessary to neonatal nursing because of improving the quality of nursing care. ②184 nurses (80.3%) wanted to get a qualification of certified expertized nurse because of improving their nursing skills or competence. ③90 nurses (39.3%) intended independently to get the qualification and the group of head nurses showed the highest percentage. ④It is time that nursing administrators should make a policy for application of certified expertized nurse to clinical nursing, as responding those nurses' positive consciousness and needs.

In order to provide systematic individual nursing care for outpatients with problems in life under medical regimen, an appropriate system which provides nursing care is needed. In the present study, we chose a university hospital and a clinic utilizing systems in which nurses judged which patient needed supports and executed systematic individual nursing. This study in investigated the practice and history of their systems to clarify constituting factors in their systems.

The systematic individual nursing care system for outpatients can solve or reduce outpatient's problems associated with medical regimen. On the other hand, the system is financially beneficial to medical institutions since it can increase both the number of patients requiring individual nursing care and reimbursement for medical fees.

Constituting factors common in the systems of the clinic and the university hospital were: 1) adequate opportunity to collect diverse information; 2) information exchange between nurses; 3) sufficient opportunity to collect information prior to examination by doctors; 4) change nurse system playing crucial rolls in support; 5) arrangement of places for consultation and interview; and 6) introduction of computers for patient management or the intent to introduce computers for that purpose. Conversely, the difference in the system constituting factors between them were: 1) the method and opportunity to recognize patients requiring supports; 2) the method and practice of providing supports; and 3) the duty assignment between nurses and other professions. These differences were most likely due to a difference in function between these two medical institutions.

In summary, the systematic individual nursing care in beneficial in supporting outpatient's live under medical regimen. It is required to establish systems in accord with the purpose and function of medical institutions.

Purpose of this study is to inquire 1) how the aged living alone in the community face their daily life, and 2) what sorts of expectation they have for the social services. In this study, a model of health support system for the elderly is proposed.

Method: After getting consent, 70 cases of 65 years and older living alone in S city were interviewed. This survey used a questionnaire composed of physical, psychological, life satisfaction and social aspects.

Results and discussion: 1) 37% of the males sampled had no relationship with their neighbors and 87% of them were not involved in any community activities. 2) 44% of the males sampled felt loneliness. 3) 38% of the males sampled scored low in life satisfaction. 4) 70% of the total sampled (both males and females) had feeling of insecurity toward the future. “Health and sickness” factor ranked first, and “solitary life” ranked second. 5) The males sampled stated they wanted more health related nursing facilities, and they strongly desired to participate male only gatherings.

Considering the results of the survey, we will propose a model of a health support system for the aged living alone in the community. 1) Establish “a day for men” in a community center. 2) Promote a neighborhood based NGO activity which provide day care for the aged in the local community. 3) Introduce a registration system of health care professionals in addition to the existing visiting nurse service agencies including a function that can provide health care consultation service, home maker service and volunteer service.

The purpose of this study was to analyze the effects of baccalaureate nursing education in Japan. 2,671 nurses were surveyed at nine hospitals which had successively employed new nurses graduated from baccalaureate programs.

A questionnaire was given to nurses working at those hospitals.

The results are follows.

(1) Direct effects were found in working continuity and ability of expected role achievement.

(2) Indirect effects were found in their capacity of scientific problem solving in addition to those of doing required daily work.

(3) The importance of keeping high rate of nurses graduated from university and making special consideration for nurses graduated from junior college were suggested for the future.

In a hospital environment where many different kinds of specialists have to work together, the head nurse function as an arbiter of complex human interactions and as a liaison with other departments. On many occasions the head nurse also has to motivate the nursing staff and serve in a managing capacity as well. The present work used a quantitative survey for exploratory descriptive research on the daily work quality of head nurses in their role as central managers. A questionnaire was presented to head nurses in charge of nursing units where they had to supervise both patients and nursing staff, with the following results.

1. The quality of their work was rated from high to low in the following order: management of the nursing staff; patient management; running the unit; management of the environment; participation in the general management of the hospital; actual nursing.

2. There was no significant difference in quality of work between those who had attended courses of more than 3 months on management and those who had not, but there was significant difference in patient management and staff management between those who had taken seminars of a few hours or a few days on management and leadership, and those who had not.

3. The quality of work tended to be better in order persons and in persons with longer experience, so that the principal factors affecting quality of work were “age” and “experience”.

This study intended to explore the needs of MRSA-infected children, who are or were hospitalized and isolated, and their families. Ten mothers and one grandmother of hospitalized one month to 5-year old children in two hospitals in Osaka prefecture were interviewed. Several open-ended questions were used to guide the interview with all families. These were: (a) What were you informed about your child's MRSA-positive condition and isolation by doctors and nurses?; (b) how did you feel when you received that information?; (c) how do/did you feel during your child's isolation?; (d)what assistance do you require from hospital staff? Need of MRSA-positive children and their families wre discussed, and correlated with their status as assessed by each child's primary nurses, and by medical and nursing records. The results revealed that families have complex feelings and emotions about the medical care services, the hospital staff, their own child, other children and other children's families. Major needs indicated by families were; (1) To be well informed about the child's MRSA-positive condition (what are the features of MRSA, what are the influences on the primary disease, child's prognosis and why is the child infected?); (2) to be well informed about the child's isolation; (3) concerns about children's psychological, growth and developmental problems caused by isolation; (4) support for the family appropriate to their social and economic problems, especially if they live with their children at the hospital. Whereas, relevant to the needs 1 and 2, MRSA-positive children and their families' demands of hospital staff were: (A) The unification on infection control policy and measures among hospitals and wards; (B) unified information about infection control policy and measures; (C) well-educated hospital staff compliance to the infection control measures.