The purpose of this study was to explore the meaning of managing both caring and farming among family caregivers of impaired elders in a small village. Ethnography was employed in data collection and analysis. Three modes of data collection were used: interviews of family caregivers (n=27) and also community members and health and welfare professionals; participant observation; and survey of community documents. The data were analyzed focusing on the managing strategies of caregivers and their motivations.
The findings were as follows:
(1) Caregivers used'incorporating strategies'to integrate both caregiving activities and farm work into their daily life.
(2) Two kinds of motivations influence caregivers' continuing engagement in both caregiving and farming. One set of significant motivations (negative motivations) reflected the context of life in a rural area;'internalizing of traditional values and norms'such as family caregiving,'following the principle of group in a rural communal society'to avoid social sanction and'accepting the difficult situation not to be able to continue farming'because of younger generation working outside the village and decreasing the supports from neighbors. The second set of positive and reinforcing motivations, were'affection for the elder','valuing farming as work worth doing'and'valuing caregivers'own acts' as evidence of their ability to continue caring and farming.
(3)'Rural family caregivers find the meaning of their reason for living in their own acts in managing to both care for impaired elders and farm'emerged as the major theme of this study. Underlying this theme is the value that caregivers placed in their independent acts. The theme refers not only to their adaptation to the actual situation, but also to seeking meaning for their life.
From these results, it was suggested that continuing to farm and providing care for family members are deeply embedded values. Caregivers accept traditional values and norms without an awareness of the social conditions which impose both caring and farming on them. And farming is very important in the lives of rural caregivers. Taking into account these perspectives, community health nursing activities to support rural family caregiving were discussed.

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This study focused on the physiological responses to stress experienced by elderly people (over 65 years old) during the middle-of-the-night hours due to acts of caregiving, through 2 kinds of ambulatory physiological measurements. This study also looked at the ramifications of this stress.
The results were as follows: middle-of-the-night caregiving at home by the aged is categorized as a low degree load of exercise. The patterns of change of HR could be classified into 3 types, one of which involved great change and severe stress on the cardiovascular system. An increase in frequency and progression in degree of SVPCs and PVCs due to caregiving was found in 27.3% and 18.2% of the caregivers, respectively. The patterns of change of BP were classified into 3 patterns, one of which involved an elevation of BP that was initiated by caregiving and continued to the time of rising. This pattern is called a morning surge.
This study indicated that some of the elderly caregivers were obliged to take on a high degree of cardiovascular load due to caregiving, and that middle-of-the-night caregiving confused the physiological rhythm of caregivers and caused health problems.

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“TOJIKOMORI”in English means shutting oneself in a room, or house, something akin to withdrawal in general. It is pointed out that“TOJIKOMORI”syndrome among home elderly results in mobility decline. The purpose of this study is to examine the structure of the“TOJIKOMORI”and extract factors that affect that the“TOJIKOMORI”phenomenon from the perspective of nurses.
Twenty-three home health nurses and public health nurses were conducted the semi-structured interview about home elderly who declined or improved in ADL. Transcripts were analyzed using the qualitative methods.
Results showed as follows. The“TOJIKOMORI”phenomenon was defined as disabled elderly who were bound to house or bed. Also mobility and the variety of daily activities contributed to the structure of the“TOJIKOMORI”phenomenon.
Two kinds of“TOJIKOMORI”were suggested by the data:“TOJIKOMORI”in a narrow sense was defined as housebound- inactive elderly, though their mobility level was high.“TOJIKOMERARE”(It means the passive of“TOJIKOMORI”) was identified as limitation of daily life within house due to disability. But in some cases, elderly were confined their home, they engaged in various activities. That is not classified as the“TOJIKOMORI”phenomenon.
Factors related to the“TOJIKOMORI”phenomenon among elderly were disability acceptance, autonomy, depression, housing environment, social networks, utilization of formal services, approaches for encouraging elderly to sit or taking them out, and family caregiving function.

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The purpose of this research is to evaluate the effect of the“foot bath”for pregnant women experiencing low back pain. This research was based on the Roy adaptation model, and the effect of the foot bath was assessed from four adaptive modes. The independent variable was the foot bath intervention for the experimental group. The foot bath was self-implemented under the researcher's guidance for two weeks.
The experimental group (30 subjects aged 25-42 with a mean age of 30.9) and the control group (31 subjects aged 20-37 with a mean age of 29.6) were recruited through convenience sampling.
The findings are as follows. The foot bath was noted to reduce the strength of pain and effected a smaller decline in the self-care function. After intervention, subjects in the experimental group showed significant reduction in the strength of pain (p<0.001). And,“a degree of reduction of the strength of pain”in the experimental group was greater than that in the control group (p<0.05). The self-care function in both groups was noted to decline with the age of gestation. Within the period of intervention,“a degree of decline of self-care function”in the experimental group was smaller than that of the control group (p<0.05).
The above results indicated that the foot bath was effective for pregnant women experiencing low back pain.

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Professionalism has been studied from many perspectives. However, only Styles (1982) has focused on the individual nurse and professionalism. She states professionhood is the reflection of individual nurses and that collective professionhood becomes professionalism. Styles identified three factors associated with professionhood, social significance, ultimacy of performance, and collegiality and collectivity.
The purpose of the study reported here was to determine if professionhood could be applied to Japanese nurses and the factors of their professionhood are the same as the factors described by Styles. A semi structured interview guideline was developed and conducted with a convenience sample of 21 nurses. Age, work experience and work Place for the nurses varied.
Data were analyzed using content analysis. Data revealed five factors associate with professionhood of Japanese nurses. Each factor also had two to six subfactors. The five main factors were social significance, ultimacy of performance, collegiality and collectivity, self-realization and protection of moral and ethical norms. The major focus of the five factors is as follows. Social significance describes wanting to be useful to the patients and the families and to be recognized by them as being useful. Ultimacy of performance describes providing the best care possible by integrating all the knowledge, skill and experience of the nurses. Collegiality and collectivity describes mutual support and sense of cohesion with colleagues that strengthen the power of nursing. Self-realization describes nursing as self-development. Protection of moral and ethical norms describes a sense of respect for human beings.
Data from this study are currently being analyzed to determine what if any is the relationship among the five factors.

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This study was conducted to clarify how of nurses working in a Japanese hospice responded to dying patients and their imminent deaths, and to characterize the perception of death which gave form to these responses and their nursing practices. The subjects included 14 nurses working in a Japanese hospice. The data was collected through participant observation and semi-structured interviews, broken into a series of stages or meaningful units, and then classified into categories. Based on the categories thus determined, the following characteristics of the nurses' behavior and attitudes, their psychological reactions, and their way of conceptualizing death.
Yoi-mitori represents a shared ideal among the nurses on how the death of a patient should be handled. The nurses viewed yoi-mitori as a pattern of death they should work to attain, consisting of four points:(1) control of physical symptoms such as pain and vomiting until death and peace at the time of death;(2) maintenance of meaningful life until the point of death;(3) acceptance of death by the family; and (4) the presence of the family in the final hours. Yoi-mitori was the most prominent factor in guiding the actual practices of the nurses and the nurses' involvement in the approaches of the patients toward their own death. The nurses' emotional responses were also affected by whether yoi-mitori could be achieved or not: If yoi-mitori could not be achieved, the were overcome with negative feelings, and when they felt it could be achieved, their responses were positive. The nurses also demonstrated an unconscious hope that the patients achieve yoi-mitori.

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The purpose of this study was to develop the Scale for Biography Recasting in Middle-aged Working Men on Chronic Dialysis. Biography recasting of chronic dialysis patients refers to redirection of future plans following the major life change. The chronic dialysis patients need to deal with chronic nature of their illness and its treatment as well as to cope with social and psychological effects of these. Biography recasting is necessary, therefore, for them to reconstruct fulfilling life.
Corbin & Strauss's concept of illness trajectory was drawn upon in the scale construction. In Study 1, twelve dialysis patients were interviewed in order to select items to be included in the scale. The content validity of the scale was then examined by using another group of subjects. In Study 2, the reliability and the face validity of the scale were tested. Study 3 tested the reliability and the construct validity. Five factors of the scale emerged in the factor analysis with varimax rotation. Cronbach's alpha coefficient obtained for the five subscales and the scale as a whole ranged from.73 to.83, indicating a good reliability of the scale. The factor structure of the scale seems generally to agree with Corbin and Strauss's conceptualization of illness trajectory, and hence the scale appears to have a good construct validity.
The scale provides a useful tool for men undergoing chronic dialysis to understand how they are going about in readjusting their lives after the major life change.
The further refinement of the scale is, however, necessary.

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Nursing sensitibility is essential for improvement in quality of nursing care, yet little research has been focused on ability and development of nursing sensibility. The purpose of this qualitive study was to analyze the responses of the student nurses and the registered nurses who appreciated six photographs of nursing scene (called “the pictures of nursing scene”) and to make visible how the nursing sensibility had work. The four patterns of the responses to the pictures, included the way to understand the nursing scene, were revealed as follows;(1) intuitive response,(2) one-sided understanding,(3) manysided understanding,(4) expanded interpretation.
The theoretical and practical knowledge on nursing powerfully influenced to the sharp sense and deep emotionality to the nursing phenomena. Accordingly, it was suggested that nursing sensibility was not inborn temperament and was able to enrich by learning and/or training. And to develop nursing sensibility, it was supposed that the nurses needed not only to memorize the theoretical and practical knowledge but also to learn internally to gain the meaning and the worth of these knowledge.

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