This study sought to identify the time management practices of nurses working in hospitals employing the Partnership Nursing System (PNS) as a nursing care delivery system, and to examine the support that nurse managers might provide for effective collaboration among nurses. A hardcopy questionnaire was completed by mail by 767 nurses working in 26 hospitals nationwide. The questionnaire consisted of questions on the characteristics of the participants and open-ended questions on time management. The results were analyzed using a content analysis of the 412 valid responses. The results revealed 39 categories that represented the content of time management, including: a) Shared the patient's condition, schedule, the content of the doctor's orders, and the content of necessary nursing care with their partners at the start of work, and discussed the methods of assistance and precautions in providing assistance, and b) Had a discussion with their partners at the start of the shift, determined the priority and time allocation of work based on patient information, and made a daily action plan. Of the 27 categories specific to PNS, six categories corresponded to the PNS complementary system, suggesting that they are the core of time management. The results also suggested that reliable and frequent information sharing and appropriate and flexible work assignment are important elements of time management in PNS. Nurse managers need to inspect the system and educate their staff from the perspective of time management so that the PNS complementary system can function.
The purpose of this study was to elucidate the factors affecting the collaboration consciousness of full-time nurses when working with part-time nurses. A survey was conducted of 1,352 full-time nurses working together with part-time nurses at national university hospitals nationwide, using the scale for measuring full-time nurses' consciousness of collaboration with part-time nurses developed by Nanya et al. and an original questionnaire on nurses' attributes. The data were analyzed using Pearson's correlation coefficient, t-test, and multiple regression analysis. Of the 639 questionnaires returned (47.3% response rate), 590 valid responses were analyzed. In the relationships between the collaboration consciousness total score and subject attributes, there were significant differences in age, number of years of clinical experience, number of years of working experience in the subject's current department, and job title. In the relationship between the collaboration consciousness total score and consciousness with respect to work, there were significant differences in 15 of the questions that asked about consciousness with respect to work. The results of multiple regression analysis revealed that with regard to the consciousness of full-time nurses toward work, six items affected their collaboration consciousness total scores: burden of job responsibility, goodness of one's relationships with colleagues, workplace environment in which people can freely express their thoughts, feeling of reward in work, burden of work duties, and ease of using employee benefits.
Aim: To investigate the presence or absence of discrepancies between the role awareness and role performance of the nursing staff educating mid-career nurses, determine the factors related to these discrepancies, and further to discuss the creation of an appropriate environment for those in charge of the education of mid-career nurses in performing their roles.
Method: A total of 431 nurses in charge of mid-career nurse education in all facilities with palliative care inpatient admissions (431) were included in the study. A quantitative cross-sectional study was conducted using unmarked self-administered questionnaire. Questionnaire items included organizational education system, individual attributes, role awareness and role performance, and organizational climate. Discrepancy scores were calculated as role awareness scores minus role performance scores, targeting those with role awareness scores exceeding role performance scores. Relationship analyses, and multiple regression analysis were done.
Results: Out of 180 responses (response rate/41.8%), 72 (16.7%) were analyzed. Discrepancies, observed in 69 responses, were identified in all sub-scale factors of role awareness and role performance. Neither organizational education system nor individual attributes were significantly related to the discrepancies. Multiple regression analysiswas done with organizational climate as explanatory variable, in consideration of the assumed relationship with the discrepancy, which revealed that the discrepancy-related variable was "good communication" (β=-0.33, p<0.05).
Discussion: The organizational climate characterized by "good communication" bridges the discrepancy between role awareness and role performance of those in charge of mid-career nurse education and enhances their role performance.
The specific medical practices training system, established by the Ministry of Health, Labor and Welfare, Japan (MHLW) in October 2015, provides nurses with advanced and specialized knowledge and skills training based on the clinical procedure manuals prepared by physicians and dentists. As of March 2022, 4,832 nurses had completed the training, a number that is much lower than the MHLW's target. This study used an online questionnaire survey to investigate the factors related to the introduction and placement in hospitals of nurses trained in specific medical practices. The survey was sent to a total of 1,436 nursing directors nationwide across all hospitals with 300 or more beds; 412 responses were received (28.7% response rate). Among these, 252 (61.4%) hospitals had nurses who had completed the training. The introduction and placement of trained nurses into these hospitals was related to the following factors. Facility factors included having a large number of beds and being designated as training institutions. Factors related to the nursing managers' characteristics included the presence of a nursing manager who was a Certified Nurse Manager, who expected the training to promote collaborative practice, and who perceived that the training system could have a positive impact on patient care and nursing.
Specific procedures to minimize physical restraint in intensive care units have not been well described in the literature. This study aimed to develop and verify the content validity of a standard procedure that promotes appropriate physical restraint practice in intensive care units to guarantee patient safety and human rights. A Delphi survey was implemented with 157 certified nurse specialists in critical care nursing, of whom 68 completed the second survey. A total of 46 statements were extracted from the literature for the questionnaire, and their consistency with published guidelines was confirmed. Participants were asked to rate the degree of agreement with and/or feasibility of each statement, for instance, "Is the statement essential knowledge that individual nurses should know?" "Is the statement effective for appropriate physical restraint practice?" and "Is the statement feasible?" An agreement rate of 70% was assumed to judge the consensus formation regarding each statement. In total, 43 statements were considered to be endowed with content validity. Although agreement regarding effectiveness of staffing measures (e.g., one-on-one without physical restraint) reached around 90%, its feasibility remained low, and thus respondents suggested that innovative staffing measures would be needed. Agreement regarding the recognition, behavior, and attitude of nurse administrators (e.g., avoid blaming if extubation occurred in a restraint-free patient) were high as all reached around 90%, uncovering the nurses' high expectations for support from nurse administrators.
Objective: This study aimed to clarify the skills of home healthcare nurses to create services not covered by public insurance for medicine or long-term care.
Method: We conducted semi-structured interviews with seven nurse administrators, with more than 16 years of clinical experience, who belonged to home healthcare nursing agencies that created services not covered by public insurance for medicine or long-term care. Data were analyzed qualitatively and descriptively.
Results: Nine categories were identified as the skills of home healthcare nurses to create services: "pursuing and realizing the essential needs with the possibility of home-based services," "establishing and advertising that home healthcare nursing agencies where required in their communities," "creating a basis for home healthcare nursing agency to connect professionals in their communities," "assessing insufficiencies in usual nursing services," "assessing the community the home healthcare nursing agency are located in via multiple perspectives," "having flexible thinking and ideas to create services," "creating preventive interventions and places for all community-dwelling people," "promoting and providing voluntary activities for community dwelling people," and "developing the sustainably of the services."
Conclusion: It was clarified that nurse administrators in home healthcare nursing agencies established their position as a resource to connect with community resources with consideration for where people lived, improved the insufficiency in their community, and used flexible thinking to communicate with community dwelling people. It is considered that home healthcare nurses with these perspectives may help realize the ideal community-based integrated care system.
The purpose of this study was to identify organizational and personal factors related to discharge support among ward nurses. A self-administered questionnaire survey was conducted of 1,256 nurses at 19 institutions in Z prefecture working in ward settings. Survey items consisted of organizational factors (e.g., "information provision from the in-house post-hospital discharge coordination service," "information provision from in-house multidisciplinary sources," and "conferences with the in-house post-hospital discharge coordination service"), and personal factors (e.g., "successful experience of discharge support" and "approach to relevant professionals towards hospital discharge"). We performed multiple regression analysis using a self-evaluation scale on the ward nurses' home care-oriented nursing practice as an objective variable. The analysis identified "information collection from the in-house post-hospital discharge support service" (β = 0.211), "positive external multidisciplinary approach" (β = 0.157), and "successful experience of discharge support" by the nurses themselves (β = 0.107) as important factors promoting home care-oriented practice. The organizational factors identified included "conferences with the in-house post-hospital discharge coordination service" (β = 0.139), "support from seniors and colleagues" (β = 0.138), "holding a discharge conference with external home care staff" (β = 0.111) and "information dissemination from physicians" (β = 0.101). These findings suggest that, to improve home care-oriented nursing practices among ward nurses, it is important for the nurses themselves to actively collect information from in-house multidisciplinary sources towards hospital discharge, and to undertake a positive multidisciplinary approach of relevant external professionals. These activities are considered to improve home care-oriented practices. Such orientation will be further reinforced by support from seniors and colleagues, through conferences, information dissemination from physicians, etc.
Purpose: This study aimed to clarify the relationship between work motivation and social support in the workplace for nursing assistants working on general wards in hospitals.
Method: Self-administered questionnaire was distributed to 409 nursing assistants. The questionnaire consisted of personal background information, the multifaceted work motivation scale, and the workplace social support scale. Data were analyzed by the t-test, one-way analysis of variance, and multiple regression analysis using SPSS ver.27 for Windows.
Results: A total of 325 valid responses were received from the nursing assistants (valid response rate = 79.5%). Competition motivation was found to be affected by nurses' informational support (β = .329, p < .001) and nursing assistants' informational support (β = -.176, p = .005). Cooperation motivation was found to be affected by nurses' appraisal support (β = .180, p = .021) and, nurses' emotional support (β = .203, p = .006) and nursing assistants' appraisal support (β = .155, p = .016). Learning-oriented motivation was found to be affected by nurses' informational support (β = .353, p < .001). Accomplishment motivation was found to be affected by nurses' appraisal support (β = .245, p = .001).
Conclusion: The work motivation of nursing assistants working on general wards in hospitals was influenced by positive evaluations and information from nurses or other nursing assistants and, empathy by nurses. These results suggest that in order for nursing assistants to work enthusiastically, nursing management that is aware of these workplace supports is necessary.
Under the drastic changes that we see in nursing practice recently, nurse managers are required to be equipped with highly sophisticated nurse management skills in order to maintain and improve the quality of nursing practice. Especially, it is important role of nurse managers to secure capable human resources for mid-career nurses. The purpose of this study is to clarify the support process for mid-career nurses by focusing on the specific attitudes, methods, and ideas of nursing managers in their practice of supporting mid-career nurses to remain employed. Qualitative deduction method by semi-structured interview was used for analysis 11 nurses recommended by senior nurse managers, working at medical institutions located in Chiba or Tokyo Prefecture, were studied. They were asked what were specific attempts made in their support and what was impressive in their mind. M-GTA method was used for analysis. Verbatim record was also created for analysis. The resut of analysis presented 17 concepts, 7 sub-categories and 4 categories. It was indicated that continuous employment support given by nurse managers can be divided into two kinds. Direct support such as"stay close as a supporter " and "give him own place." give him chance to stop"which were combined effectively with indirect support such as "give the person his own place, Through unwrenchinng attitudes towards nurse management and process of support, the significance of nursing practice was recognized.
Purpose: This study aimed to investigate how mid-career nurses evolve as trainers of junior nurses.
Method: We conducted semi-structured interviews with 16 nurses who had worked for 8 to 19 years. The interviews were conducted with one nurse at a time, ensuring privacy. A modified grounded theory approach was used for data collection and analysis.
Results: We extracted 16 concepts and generated 6 categories from these concepts. Throughout the process of nurturing junior nurses, nurses were "seeking out their own course of action." When the nurses began training junior nurses, they "instruct[ed] junior nurses while continuing to learn themselves." Occasionally, while "sharing their feelings," the nurses sometimes would show "considering the feelings of junior nurses" and "supporting the subjectivity of junior nurses." Finally, in training junior nurses, they were transformed by "being extremely generous."
Conclusion: Nurses' practice regarding training junior nurses was based on nurses "seeking out their own course of action" from the initial to final stages of the process. This practice eventually transformed into nurses being generous and adopting more forgiving behaviors. It was suggested that the transformation in nurses' practice regarding guiding junior nurses involved and was influenced by persistent reflection and the influence of the chief nurse and other colleagues.
This study aimed to show the chronological changes in the activities of daily living (ADL) status of patients with hip fracture postoperatively until upon discharge and investigate its relationship to the institutional factors, such as hospital size, to identify the environmental factors that affect early ADL recovery. We analyzed 20,025 patients aged ≧65 years with hip fracture who were discharged from an acute care hospital postoperatively and recovered their mobility status between post-operation and pre-discharge. We collected data on the subject attributes, facility attributes, and mobility status from the diagnosis procedure combination (DPC) data to investigate the correlation between facility attributes and recovery speed of transfer ability. The Mann-Whitney U test was utilized for each group with significance level of 5%. Then, logistic regression analysis was performed in the early and late groups. The mean age was 84.2 years and mean duration of hospital stay was 25.3 days. In the logistic regression analysis (early recovery = 1), the odds ratio of "200–399 beds," "400–599 beds," and "university hospital" compared to "0–199 beds" were 1.23, 1.29, and 1.38, respectively (p <.001). There were no statistically significant differences in the amount and frequency of rehabilitation. In this study, which focused on femur fracture and a typical acute phase disease in the elderly, the recovery rate differed depending on the hospital size. Even with the present implementation of functional differentiation of hospitals, it was clear that there were differences in the outcomes depending on the hospital size.
The purpose of this study was to clarify the characteristics of nursing management practices in hospitals by certified nurse administrators (CNAs). A web-based survey regarding nurse administrator practice reports submitted at the time of the CNA certification renewal examination was conducted with 850 members of the Certified Nurse Administrator Association who possessed such reports as of August 2021. KH Coder 3 was used to analyze the contents of "practice progress and results" in the nurse administrator practice reports. A co-occurrence network diagram for 84 reports showed that CNAs in hospitals focused on the quality of nursing services and worked to improve the work environment. Specifically, they sought to provide consistent support to outpatient, inpatient, and discharged patients and promote regional cooperation. Furthermore, six of the 14 clusters classified by a hierarchical cluster analysis revealed the following practices undertaken by CNAs: establishing a project team; clarifying issues based on survey results; developing, implementing, and evaluating plans; setting and managing goals for each department through chief nurses; and deepening an understanding through participation in training and meetings. Furthermore, a correspondence analysis showed that nursing directors, who had received updates multiple times, broadened their perspectives outside the facilities to which they belonged and were more active in their administrative practices. This finding indicates that the development of nurse administrator practice was in line with management objectives and improvement in the quality of experiential learning through the formulation of an action plan for the renewal of certification in five years.
Objective: Fourth-year undergraduate nursing students whose practical training hours were reduced pre-graduation received training based on nursing-collaborative unification. In cooperation with an affiliated hospital's clinical instructors this study's purpose is to clarify the intervention's effect in terms of changes in risk sensitivity and deliberateness.
Methods: Twelve participants received simulated education on tube feeding; they were assessed on the Risk Sensitivity Scale and the Cognitive Deliberativeness-Impulsivity Scale, pre-and-post training and one month later (Recovery rate 100%). One-way ANOVA with repeated measures and the Bonferroni method were used for analysis and multiple comparisons, respectively.
Results: The results were compared before and after the training, and one month later. The mean total risk sensitivity score and standard deviation were 109.67 ± 7.06 before the training; 119.00 ± 13.98 immediately after the training; and 119.08 ± 8.87 before and immediately after the training as well as before the training and one month after the end of the training; indicating a significant difference in mean scores at the three-time points (F(2, 33) = 4.58, p<.05).
Discussion: The collaboration between the clinical instructors and the basic nursing educator to devise teaching materials and educational interventions using simulation education reminded the students of clinical situations and promoted their motivation to learn, leading to improved risk sensitivity.
Conclusion: Pre-graduation training for fourth-year nursing students, based on collaborative nursing unification, improved risk sensitivity.
This study aimed to clarify the elements of management practices of facility and nurse managers for supporting the effective activities of nurses who completed Tokutei Acts training at acute care hospitals. Interviews were conducted with eight facility managers and 11 nurse managers from acute care hospitals where the trained nurses of the Tokutei Acts worked in Japan. Semi-structured interviews were conducted online for approximately 20 minutes and recorded. This study was conducted in March 2021. The management practices of managers who supported the activities of trained nurses included: "expect the activities of the trained nurses in the organization," "understand the trained nurses in the organization," "gain understanding of the Tokutei Acts training system and trained nurses," "plan the allocation of the trained nurses according to the functions of the organization," "send nurses to Tokutei Acts training and supported their learning" "place the trained nurses according to the organization's vision," "create an environment for the trained nurses to continue their activities in the organization," "find the effect of utilizing the trained nurses," "adjust their activities according to the organization's vision," and "inform various subjects regarding their activities." These subcategories can be interpreted as the elements of the management practice for introducing and utilizing several trained nurses in an organization: conception, training, placement, utilization, optimization, and publicity.
Aim: To understand the experiences of nurse managers when they support nurses suffering from an illness.
Methods: Semi-structured interviews were conducted with 10 nurse managers who had experience supporting nurses with an illness. We asked them to speak freely about what happened when they provided support to nurses and the thoughts that occurred to them at the time. We categorized their narratives using a qualitative induction method.
Results and consideration: The experiences of nurse managers providing support to nurses with an illness were divided into eight categories: "I valued the nurses who worked hard despite being ill," "I performed services beyond my capacity as a nurse manager and was closely involved in the nurse's care," "Illness experience makes sense for nurses," "I had to try different strategies to keep an appropriate distance from the staff," "I faced inadequate responsiveness as a nurse manager," "Aware of the difficulty of individual intervention according to the condition of a disease," "I strived to build an organizational culture that manages illness along with work," and "I continued to manage the ward smoothly while consulting with around." The nurse managers were grateful to nurses who were able to work despite being ill. However, they struggled to build relationships and maintain a reasonably professional distance with their staff. Additionally, to manage human resources who could provide nursing care with guaranteed safety and quality, we worked in cooperation with related departments to create an organizational culture that would allow nurses to work while being ill.
This study aimed to confirm the reliability and validity of the Revised Self-Help Strategies Scale (R-SHS). A self-administered questionnaire was distributed to 826 nurses working in hospitals, visiting nurse stations, and health checkup organizations in A prefecture. The survey items included basic attributes, the draft R-SHS, and the Kessler Psychological Distress Scale K6 (K6). From the 466 questionnaires returned (56.4% response rate), 462 valid responses (55.9% valid response rate) were analyzed. The results of factor analysis indicated the two-factor structure with 15 items was the same as before the revision. Cronbach's alpha coefficients were .88 overall and .88 to .89 for both factors. The hypothetical model met the criteria for a good fit (CFI = .898, RMSEA = .084). The model included two subscales of the R-SHS, "Ingenuity to care for oneself" and "Examination and application of knowledge and information", which indicated a reduction in psychological stress as calculated from the K6 score. Therefore, the reliability and validity of the R-SHS were approximately confirmed.
This study aimed to obtain ideas for career development support by identifying the relationship between the career development and life career resilience of nurses.
Participants were nurses in their 20s to 50s at facilities with more than 200 beds categorized as general hospitals 2 and 3 by the Japan Council for Quality Health Care. Survey items included personal factors, the Life-Career Resilience Scale for Adults (LCRS), and the Adult Career Maturity Scales (ACMS). Distributing to 706 questionnaires, 335 (47.5%) responses were collected, and 309 valid responses were analyzed. Using the ACMS as the dependent variable and personal factors and the LCRS as independent variables a multiple regression analysis was performed.
The factor that most strongly influence d life career was continuous coping (β = 0.452), followed by multi-dimensional life, long-term vision, being able to recharge, age, and professional qualifications or further education. Overtime was a negative factor influencing occupational career (adjusted R2 = 0.486). The factor that most strongly influenced occupational career was continuous coping (β = 0.474), followed by long-term vision, having a position, intention to continue nursing, and professional qualifications or further education. (β = 0.118). Overtime was a negative factor influencing occupational career (adjusted R2 = 0.491). The factor that most strongly influenced leisure career was multi-dimensional life (β = 0.413), followed by continuous coping, and being able to recharge. Intention to continue nursing and using childcare support programs were negative factors influencing leisure career (adjusted R2 = 0.383). Life career resilience may influence career development.
Objective: To clarify workplace social support that influences affective commitment of mid-career nurses working in advanced treatment hospitals by demographic characteristics.
Subjects and Methods: A questionnaire survey was conducted for mid-career nurses with over 10 years of experience in advanced treatment hospitals. The questionnaires were distributed to 1,277 nurses, and responses were obtained from 614 nurses (response rate: 48.1%). Of 473 nurses who met the inclusion criteria, 428 without missing data were analyzed (valid response rate: 90.5%). After classifying the subjects by sex, years of experience, marital status, and with/without children, multiple regression analysis was performed using the forced entry method with affective commitment as the dependent variable and workplace social support measures as the independent variable.
Results: In women, the factors that had a statistically significant (p < 0.05) effect on affective commitment were emotional support and instrumental support from the boss (β = 0.193, β = 0.206, respectively). On the other hand, in men, emotional support from the senior had a positive effect (β = 0.506), while instrumental support from senior nurses had a negative influence on affective commitment (β = -0.568). Among women with 10-20 years of experience or unmarried status, only instrumental support from the boss had positive effects (β = 0.248, β = 0.341, respectively). Also, in married nurses or nurses with children, instrumental support from colleagues showed positive effects (β = 0.281, β = 0.244, respectively).
Discussion and Conclusion: The study has revealed the importance of support according to the individual demographic characteristics for mid-career nurses in advanced treatment hospitals.
Purpose: To clarify the years of nurses' experience in surgical nursing, their wish to be assigned to an operating theater, and the actual conditions of their continued work.
Methods: An anonymous, self-administered questionnaire survey was conducted among operating room nurses nationwide. The survey comprised 35 items related to the attributes and experiences of their continued work; responses were given on a four-level ordinal scale. Respondents were classified into five groups according to their years of experience and two groups according to their wish to be assigned to an operating theater. Analyses were performed via Kruskal–Wallis and Mann–Whitney U tests. The significance level was set at 5%.
Results: Among the 560 (58.0%) respondents, 56.3% wished to be assigned to an operating theater and 42.3% did not. There was no difference in the mean of 2.9 (±1.1) years of experience for "ever wanted to quit working." Conversely, the mean of 2.1 (±1.1) years of experience for "quit working" was higher than the overall mean of ≤1, 2–3, and 4–5 years of experience. The nurses' wish to be assigned to an operating theater revealed no differences.
Conclusion: The reasons for quitting the operating room were mostly the desire to transfer to a ward or another department. Nurses with 6–7 and 8 years or longer experience had lower values for many items than the overall average, suggesting that their sense of self-worth and satisfaction with the current situation led them to continue working in the operating room.
【Objective】This study sought to clarify the relationship between support that certified nurses (CNs) receive from their workplaces and supervisors, and work engagement (WE).
【Methods】We used stratified sampling to select 1,000 CNs in Japan. Participants worked in six nursing fields: emergency, skin excretion, intensive, palliative, cancer chemotherapy, and dementia. Questionnaire items included the "scale of workplace support for nurses," which indicated supervisors' support. This item was created based on previous studies that indicated support for CNs' activities. Additionally, an item excerpted from the "New Occupational Stress Simple Questionnaire" that indicated support for CNs outside of their CN activities was included. We used the Utrecht Work Engagement Scale to measure WE.
【Results】After eliminating invalid addresses, 971 CNs received our research request forms. We analyzed 323 out of 334 CNs who responded (response rate, 33.3%). The mean nursing and CN experiences were 21.5±6.4 and 7.6±4.4 years, respectively. The mean WE score was 3.4±1.1 points. Hierarchical multiple regression analysis with total WE scores and support from workplaces and supervisors revealed significant relationships for "percentage of self-identified activities" (β = 0.236, p < .01), "alignment of organization and CN intentions" (β = 0.186, p < .01), and "evaluative support" (β = 0.349, p < .01).
【Discussion】These data indicate that WE was higher when there was a greater proportion of CN activities, intentions between CNs and their workplace were aligned, and evaluative support was available.
The implicit rationing of nursing care refers to the withholding or failure to conduct the necessary nursing tasks because of inadequate time, staffing level, and/or skill mix, and is measured using the Revised- Basel Extent of Rationing of Nursing Care (BERNCA-R) scale. This study aimed to translate the BERNCA-R scale into Japanese and then assess the translated version's reliability and validity. Standard methodological requirements were followed during the translation and cultural adaptation. This study, conducted in November 2018, recruited 545 nurses working at two acute-care hospitals in Japan. Data from 317 nurses were included in the final analysis. The Cronbach's alpha coefficient of the translated scale's total score was 0.94. According to the principal component analysis, the Japanese version had a one-factor structure, similar to the original version. Meanwhile, the verification of convergent validity revealed a weak correlation between the composite score of the Japanese version of the Practice Environment Scale of the Nursing Work Index and each subscale score (r = -0.14 to -0.22, p <.01). Therefore, the validity of the Japanese version of the BERNCA-R scale remains an issue. Further verification of the reliability and validity using this scale is necessary to increase its value as a quality indicator of nursing care.
The purpose of this study was to clarify the learning contents of 53 hospital nurses who participated in the transitional care training program based on dialogue with patients and families, as well as changes in the implementation status of transitional care before and after the training program. Following completion of the training program, the learning contents were investigated through free description, and the contents of the description were qualitatively and descriptively analyzed. As a result, the learning contents were "power of dialogue," "means of dialogue that are not just words," "elements that establish a dialogue," "creating an environment where faces can be seen," and "creating an environment for mutual learning." The implementation status of transitional care was surveyed before and after the training program using an anonymous self-administered questionnaire and transitional care quality indicators. The paired t-test was used to examine the mean scores for each item. As a result, after the training program, the average score for "approve the patient's self-care behavior at home" increased significantly in transitional care for outpatients. The average score for 6 items in transitional care for inpatients, including "approve the patient's self-care behavior at home before hospitalization" increased significantly after the training program. A training program that reconstructed dialogue scenes with patients and their families using case studies resulted in learning about the effects of dialogue and elements that encourage dialogue. Furthermore, the findings suggested that the implementation status of support items that require dialogue between patients/families and nurses will increase.
This study aimed to clarify the association of the intention to stay of mid-level nurses with teamwork on the nursing team and job satisfaction. An anonymous questionnaire was distributed to nurses, with 4 to 15 years of clinical experience and employed at 30 mid-sized hospitals in urban areas. The survey included questions on their attributes, intention to stay, a teamwork scale, and a job satisfaction scale. Three models were created, with the intention to stay as the dependent variable, the sub-factors of the two scales as independent variables, and attributes as moderators. Logistic regression analysis was performed. Questionnaires were distributed to 1,183 mid-level nurses, and 263 of them were included in the analysis (valid response rate: 22.2%). The "team orientation" sub-factor of orientation for interpersonal relations (OR 1.20, 95% CI 1.00–1.43) was associated with having an intention to stay on the teamwork scale. Positive feelings about work (OR 1.20, 95% CI 1.09–1.31) and appropriate support from superiors (OR 1.09, 95% CI 1.00–1.20) were associated with having an intention to stay on the job satisfaction scale. Furthermore, a positive correlation between the teamwork and the job satisfaction scales was observed. The results of this study suggest that mid-level nurses stay at their current workplace as long as they are working toward the same team goal, fostering positive interpersonal relationships, viewing their jobs positively, and receiving appropriate support from superiors.