The purpose of this study was to analyze discharge-decision making process of family members and to clarify the strategies to facilitate discharge planning. The case-study method was employed on two families who were referred to discharge planning nurses in hospitals. The results were as follows: (1) When the client hoped to live at home with home-care services, it was an indispensable necessity that the caregiver to make discharge-decision in order to meet the client's request. (2) The family members who needed support from discharge planning nurses the principle caregiver at home. (3) The support for the family members in discharge-decision making consisted of the assessment of the enabling condition of home care and offering information regarding the condition. (4) In order all the family members to agree support for home-care, the discharge-planning nurse had listened to the requests from each family member. Then the nurse informed several services that were available for the client. With this support process, the family members made decision to accept a new life-style, and the final decision became an united view of all family members for actualizing home-care of their loved one.

The purpose of this survey is to clarify the present condition and problems of primary nursing and modular primary nursing. This survey was conducted in October 1996. The questionnaires were sent to 255 head nurses of various wards using these nursing modalities as were found in our previous survey.

We received valid replies from 37 wards who use primary nursing and 61 wards who use modular primary nursing. A variety of wards used both nursing modalities. Primary nursing was first used in most wards from 1986 and modular primary nursing began in 1995.

Eighty-one % of wards using primary nursing also combined other nursing modalities. Forty-six point seven % of these wards utilizing team nursing and 46.7 % of these wards utilizing modular primary nursing. These rates cimbined and come to be 93.4 % of wards using primary nurisng. Seventy-seven % of wards using modular primary nursing didn't use any other nursing modalities. Judging from head nurses' responses, 70~80 % of wards using both modalities had favorable feedback from patients, their families and nurses. Fifty % of head nurses received favorable reactions from doctors. In primary nursing, the problem was "the abilities and quality of nurse". In modular primary nursing, there were also "problems pertaining to abilities and quality" plus "problem carrying out function".

These two nursing modalities have some problems, but they will continue using them.

The essential problems of career development are on matching between the individual needs and organizations' needs. But individuals are different each other and organizations also differ. Furthermore both individuals and organizations constantly changes interacting with it's environment. Thus these matching processes are very complex. This study is conducted on the individual career anchor that will provide important approaches to set a effective Career Development Program (CDP), putting consideration on that the career development includes complex and ambiguous problems. What types are included in the career anchor of nurse and when is it formed? The survey was performed in cooperation with a nursing department of a hospital.

Consequently, five patterns of the career anchor of nurse are found: "Security & Stability", "Service/Dedication to a Cause", "Technical/Functional Competence", "Autonomy & Independence", "Entrepreneurial Creativity". The formation of the career anchor requires the actual working experience for ten years in almost all cases.