The purpose of this study was to identify factors related to adaptation to combining maternal and occupational roles in working mothers. In this study, adaptation was measured by fatigue, role conflict, role satisfaction, and anxiety about child care. The independent variables were background and work-related factors, individual perceptions, and coping with two roles. These variables were guided by the stress and coping framework of Lazarus and Folkman.Our survey was answered by 218 working mothers of preschool children.
The results were as follows:
1. The scores for fatigue, role conflict, and anxiety about child care had significantly positive associations with each other. Moreover, they had significantly inverse associations with the score for role satisfaction.
2. 1) Background and Work-Related Factors: Working hours had significantly positive associations with the score for role conflict.
2) Individual Perceptions and Coping:
Highly career-oriented mothers reported significantly lower scores for role conflict and anxiety about child care. However, they had a significantly higher score for role satisfaction than less career-oriented mothers. The score for social support had significantly inverse associations with the scores for fatigue and anxiety about child care. The score for passive problem-focused coping had a significantly positive association with the scores for fatigue, role conflict, and anxiety about child care. However, the association was negative in regard to role satisfaction.
These findings suggest that it is important to assess the various ways in which working mothers perceive and cope with their dual roles.

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The purpose of this study was to identify what preschoolers expressed and the meaning of those expressions when they are going through minor surgery. Leininger's ethnonursing method was used. Nine children were selected as the key informants. Eighteen general informants were selected ; fourteen nurses and four mothers of some of the children. From the data analysis, five themes were discovered.
Theme 1: Children do their best when they understand the explanation of the operation before it is performed.
Theme 2: When children are faced with a situation they do not get an explanation before or after the operation and no explanation is added alone the way, it is difficult for them to accept the situation and they feel irritated.
Theme 3: When children awake from anesthesia and returned to their rooms, nurses and mothers consider the operation to be finished. However, for children, the operation is not over since they must continue to do their best to deal with pain and intravenous injection drips.
Theme 4: Children cannot receive consistent support from their mother and nurses because mothers and nurses have had difficulty to understand the meaning of the childrens' behavior before and after operations.
Theme 5: If children were told that the beds were theirs when they were hospitalized, the beds become their base during hospitalization.

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We investigated experimentally the effects of bleomycin hydrochloride (BLM), an antineoplastic agent, on the development of pressure ulcers in rabbits. The animals were divided into two groups. Group 1 comprised 5 treated rabbits that were administered a dose of 2.5mg/kg BLM intramuscularly once a week for 5 weeks. Group 2 comprised 5 control rabbits that were administered saline intramuscularly once a week for 5 weeks. Both macroscopic and histologic studies of the ulcers were performed. We produced pressure ulcers in the rabbits by exposing their skin over the trochanter to a pressure of 138kPa (1.4kg/cm²) for 4 h. The ulcers were studied macroscopically for 5 days after the application of pressure. A histologic study was also performed on the ulcers at 5 days, as well as on the lungs of all rabbits.
Macroscopic observation revealed severe edema at the compression site in the rabbits treated with BLM one day after release of pressure, and the healing of the pressure ulcers was also retarded in these rabbits in comparison with the ulcers in the control group. There were no histologic lesions in the lungs of any rabbits. Histologic study of the pressure ulcers revealed formation of multiple thromboses and a low level of epidermal cell proliferation in the animals treated with BLM.

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The purpose of this study was to identify a process of“Search for the Meaning of the Illness”in patients with Amyotrophic Lateral Sclerosis.
Based on Frankl's theory, the will to meaning was attention to the search for meaning in one's life. A Grounded Theory approach was chosen for this research design and analysis. Six patients who had lived with ALS at home were the subjects for this study. The study was performed using participant observation and semi-structured interviews.
The results indicated that patients searched for meaning in their lives in the face of a life-threatening illness. Three phases were discovered in the process of“Search for the meaning of the Illness”.
These three phases were named“strategic supplement (phase 1)”,“ mirror-imaging (phase 2)”, and“transcendence to the new life (phase 3). Four subcategories were found in each phase. In phase 1, ALS patients tried to show themselves and others that they could maintain a normal life if this situation was supplemented. In phase 2, they tried to recognize reality. And in phase 3, they tried to reinterpret their situation and find new meaning in their life. Also this prosess includes searching for a higher order in one's life, changing one's values.
The result shows patients not only accept their illness but try to establish a positive attitude toward life. Thus, it is assumed that nurses need to enhance the patient's ability to search for the meaning of a chronic illness such as ALS.

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Breast-feeding mothers' evaluation of their nursing care can help nurse-midwives to improve this care. A questionnaire was constructed to measure the care process from the perception and evaluation of mothers during their breast-feeding. This questionnaire developed from breast-feeding care categories found in a preliminary study in which I observed nurse-midwives' care. First, 542 mothers who had delivered and were still in the hospital or midwifery center and who had begun breast-feeding (Time 1), and then 384 of the same mothers at one month postpartum (Time 2), were asked to complete the questionnaire and return it by mail. The response rate was 418 (77.1%) for Time 1 and 336 (87.5%) for Time 2. Factor analysis yielded three factors from the mothers' perception of their breast-feeding care:(1) relaxation and tender encouragement (20.6% of the variance); (2) suitable attention (12.2%) and (3) direct support or literally, a helping hand (8.2%). Most items with the highest factor loading belonged to the single category: reliving and encouraging the mother. These results indicate the importance of emotional aspects of breast-feeding care. This study shows that if nurse-midwives include an emphasis on the emotional aspects of breast-feeding care and combine that with giving mothers knowledge and technical training in this care, such an approach will greatly improve this care and also enhance the mothers' experiences of that care.

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The purpose of this study was to investigate the relationships between professional autonomy in nursing and consciousness as role models and experience as a practical guide for nursing students. Two hundred and eight-three professional nurses in a public hospital participated in a questionnaire survey conducted by Kikuchi & Harada (1996), which included items related to the scaling of the professional autonomy in nursing and their consciousness as role models as well as their years of experience as a practical guide for nursing students. The main results were as follows:(1) Professional autonomy in nursing was classified into five categories:“concrete judgment”,“abstract judgment”,“cognition”,“performance”and“independent judgment”, as in a previous survey.(2) It was indicated that the years of experience associated with increasing the score of consciousness as role model for nursing students in clinical instructors. Particularly significant mean differences was observed five or less years of experience group and more than five years group.(3) Clinical instructors had significantly higher scores of“cognition”than nurses who had no experience being a clinical instructor. To realize“cognition”and“performance”, three to five years of experience as clinical instructor was necessary.(4)“Concrete judgment”and“performance”in clinical instructors had a significant and positive correlations with their consciousness as role models for nursing students.

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The purpose of this study was try for develop the instrument that measures cognitive appraisal for the preoperative Surgical patients in the adulthood.
First, a draft of the cognitive appraisal scale was used of a conceptual framework of the Stress, Appraisal, and Coping theory by Lazarus and Folkman (1984/1991) and was based on the qualitative data of preoperative patients in adulthood by interview. The draft of the scale was composed of 70 items classified 3 subscales.
Second, this draft of the scale was examined about content validity, face validity, construct validity, and reliability. Content validity was examined by 6 surgical expert nurses and 21 nursing researchers who are adult health care nursing. Face validity was examined by 17 preoperative cancer patient. As a result, this scale was consisted of 55 items classified 4 subscales. Construct validity and reliability were examined by 70 cancer patients who are taking operation within 1 week. Seven factors were extracted from the factor analysis.
Finally, the scale was composed of 47 items classified 7 subscales: depression appraisal, the appraisal of choosing negative coping, good chance appraisal, defense appraisal, challenge appraisal, avoidance appraisal, and the appraisal of choosing optimistic coping in the encounter with the operation. And, the Cronbach's α coefficient showed 0.83 in the whole reliability of the scale. The α coefficient showed 0.86 from 0.62 in every subscale. Therefore, the construct validity and reliability of the scale was established in some degree.

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We undertook a study of the effect of peer-group education on the level of sexual knowledge and awareness in a group of high school students. The subjects were from Okinawa prefecture, and assessment was by completion of a questionnaire concerning both basic knowledge of sexually transmitted diseases (STD) and methods of contraception, and general sexual awareness. This was administered before and after a period of three peer-education sessions, in which university students taught the topics and discussed them with the students.
Levels of factual knowledge before the education sessions were unsatisfactorily low. However male students significantly increased their mean scores on questions relating to sexual responsibility, although female students showed no change. The number of students in both groups who responded that men and women should talk more openly about sexuality, when asked about means of avoiding unwanted pregnancies, were also significantly higher.
Student impressions of peer education were that 1) it was a good opportunity to think about sexuality, 2) they could talk more frankly with their university student teachers because they were close in age, and 3) they would like further such opportunities.
We concluded that discussion within the same generation is an effective means of conveying correct sexual information, and thus helps them to view sexuality in positive and constructive ways.

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The purposes of this study were: 1) to investigate the lifestyle of parents with diabetic children, and 2) to explore the relationships between diabetic children's health habits, self-care behaviors, and the lifestyle of their parents.
The subjects were 46 pairs of diabetic children aged 6 to 18 and their parents (42 mothers and 4 fathers) in three pediatric diabetic clinics. Diabetic children completed two questionnaires regarding health habits and self-care behaviors. Their parents completed a questionnaire regarding lifestyle which consisted of 8 categories of health habits, health responsibilities, self-actualization, daily hassles, stress management, positive and negative parenting attitudes, and disease-related stresses.
Significant correlations were found between parent's health responsibilities and self-actualization, health responsibilities and stress management, positive parenting attitudes and self-actualization, and positive parenting attitudes and stress management. Those parents who“wake up bright and fresh”correlated with several categories of parents' lifestyles. A total score of health habits of diabetic children was correlated with parents' bedtime and tooth brushing. Good self-care behaviors of diabetic children were related to parents' high self-actualization, low disease-related stresses, positive parenting attitudes, waking up bright and fresh, bedtime and hand washing after coming home.
The findings of this study suggested that nursing interventions for parents of diabetic children would be: 1) to increase attention to their own health and positive parenting attitudes to diabetic children, 2) to decrease daily hassles and disease related stresses, 3) to improve bedtime and hygienic behaviors which could be a life model for their children.

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The purpose of this study was to clarify preoperative coping behaviors and related factors of mothers whose children were awaiting radical day surgery for inguinal hernia, as well as the effects the coping behaviors have on mothers' acclimatization during and after surgery. A concept frame-work was prepared based Lazarus' stress and coping model.
Fifty-four mothers were asked to fill out a questionnaire before, during, and after surgery.“Preparing the child psychologically for the surgery”,“arranging extra-family resources and the home environment”,“obtaining medical information and environmental support for outpatients”,“facing the surgery and working at control of emotions”, and“avoiding overly optimistic emotional direction”were abstracted as mothers' preoperative coping behaviors. The factors affecting mothers' preoperative coping behaviors were“social support”,“the age of the child”,“the number of supporters”,“preoperative anxiety”, and“characteristic anxiety”.“Preparing the child psychologically for the surgery”,“facing the surgery and working at control of emotions”, and“obtaining medical information and environmental support for outpatients”positively affected the“postoperative sense of achievement in filing the role of mother”.“Preparing the child psychologically for the surgery”, had a positive influence on her“state of anxiety during the surgery”, while“facing the surgery and working at control of emotions”, had a negative affect. It was suggested that mothers need care assistance in“preparing the child psychologically for the surgery”, and in“obtaining medical information and environmental support for outpatients”.

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