The purpose of this research was to explore the practice of expert public health nurses in routine health examinations for children by using the Grounded Theory Approach. This study focused on the process through which public health nurses comprehend and identify their clients.
Data were collected using semi-structural interviews and observation of 17 public health nurses with over 5 years of experience who work in 11 cities of 5 prefectures. The results were analyzed by the continual comparative analysis method.
Findings in this research can be identified as follows: “Identifying the necessity to support clients” was clarified as being an essential first step in providing support for clients. This process was explained by 4 categories: Inspection with sensitivity, Attempting to draw out mothers' true feelings, Clarifying their problems, and Predicting their states of mind. These were simultaneous, repetitious and composite steps when the public health nurses were communicating with the mothers.
These results showed the nursing competencies which public health nurses utilize in routine health examinations for the support of clients. The findings suggest that these can contribute to the improvement of the quality of public health nurses' practice in future.

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The purpose of this study was to survey experienced genetic health care provider's perceptions of the level of practice competency required for Basic Level and Advanced Level Genetic Nursing. Basic level refers to the general nurse and the advanced level refers to the genetic nurse. The respondents who agreed to participate in the study were 491 nurses and physicians who were involved in genetic care in 113 institutions of 40 prefectures. The questionnaire we developed was comprised of 89 items in seven areas of competency for genetic nursing. The respondents were asked to assign the competency items to one of the following nursing levels: (a) General Nurse; (b) nurse who specializes in Genetic Nursing; or (c) not appropriate for the nurse. Data were collected from January to March 2001. The Delphi Method was used to explore areas of agreement regarding competency fit among the respondents. Three iterations of the survey, resulting in a response rate of 60%(295 respondents), provided sufficient clarity for assigning levels of competence.
Respondents selected the following areas of competence for the General Nurse: living support, psychological support and identifying client's needs. For the Genetic Nurse they selected: provision and exchange of appropriate genetic information among health care providers, reference and collaboration with other institutions and helping clients to understand their conditions and characteristics. As a result, competency of the Basic Level and the Advanced Level were clarified in Genetic Nursing. The results help provide directions for the furtherance of genetic education in nursing in Japan.

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Purpose: The purpose of this study was to conduct and evaluate a trail run for a preadmission education program that prepares patients undergoing primary total hip arthroplasty (THA)surgery.
Design: An evaluation research design was used. The experimental group received preadmission education from the researcher, and the control group received routine preoperative education from the nursing staff.
Setting: This study was conducted at two university hospitals in the Osaka metropolitan district.
Methods: Patients scheduled to undergo THA were introduced to the preadmission education program by their doctors, 1-4 weeks before hospitalization. During preadmission, patients were assessed on the Profile of Mood States (POMS), the 36-item Short-Form Health Survey (SF-36), and an information satisfaction scale. After the baseline data was established, the experimental group was given an information videotape and a pamphlet about THA. Both groups were investigated at the preadmission stage, 1-3 days after hospitalization, and 1-3 days before discharge.
Results: All subjects were female. The experimental group consisted of 17 patients and the control group had 18 patients. A repeated measures analysis of variance (ANOVA) was used to analyze the effects of the program. Information satisfaction showed a significant group×time interaction (p<0.001). On the SF-36, role physical and role emotional showed a significant group×time interaction (p<0.10). On the POMS, there was no significant interaction between group and time.
Discussion: Recent efforts to shorten the length of stay in the hospital by providing education prior to the stay may promote the acceptance of shorter hospital stays by THA patients.

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The purpose of this study is to examine psychological complexities that affect restructuring of the life history of patients who are going to initiate dialysis and have a given life history leading up to the over-middle-aged that includes living with diabetes mellitus. Five patients were studied using a semi-structured interview, and the following three conflicting complexities were found.
(1) “Life with dialysis reduces fun and challenge” vs. “Need for the discovery of new pleasures,” (2) “Life with dialysis brought about a sense of stagnation of self-development” vs. “Acceptance of dialysis as a result of new roles” and (3) “Resignation as a result of sense of helplessness and guilt” vs. “Accepting reality and preserving self-consistency.” It is important for patients restructuring their life history to discover their own feeling toward how they represent their past experiences and their current status and how they focus on their future. Therefore, from the viewpoint of life restructuring, care that identifies the complexities of the patient's experiences during their past life history and psychological features targeting the patient's future outlook is required. The need for such care was suggested.

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Although integrated schooling has been recommended, there have been few researches on social interaction of preschool children, a core subject of such schooling. Thus, we attempted a pioneering research on social interaction of young children with and without disabilities in integrated preschools and observed remarkable differences in the social behavioral characteristics involving physical contact. Then further analyses were made aiming at exploring into the meanings of physical contact in integrated preschool; 200 nursery schoolers including 23 children with disabilities were videotaped and then 29 scenes involving physical contacts were selected and qualitatively analyzed.
Consequently it was confirmed that physical contact between healthy children helped them realize their peer relationship, arouse interest in their bodies and confirm their roles, or it has significant meanings as “establishment of peer relationship and invitation to play” and“interest in, attention to peers and recognition of their role” while the physical contact between children with and without disabilities has such meanings as “recognizing peers as real existence and invitation to play” as they confirm each other's existence through physical contact while playing, “ruling and controlling of behaviors through physical communication” as healthy children control the behaviors of disabled children by touching them and “acceptance of physical bodies as they are” as children didn't consider interaction with disabled bodies as negative experience.
To encourage disabled children to participate in social activities and feel happiness in their childhood, nurses should adovocate the importance of PEER that has been paid little attention to as a potential social resource.

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The aim of the present study was to clarify the effects of intervention by foot massage and abdominal breathing on insomnia and accessory symptoms. Eleven outpatients with insomnia and accessory symptoms, the subjects of the present study, were massaged on the foot for 15 minutes in the supine position on a bed. They were instructed to breathe abdominally for the first 5 minutes during the massage. Those massages were conducted three times at intervals of one week. Throughout the study period, I asked the patients to breathe abdominally before going to bed. The difficulty in falling asleep and in getting sound sleep among the patients was reduced in all and 8 subjects, respectively. Headaches, tenseness, and inactivity among the patients with accessory symptoms were alleviated in 7, 7 and all subjects, respectively. The results of the present study suggested the effectiveness of the intervention by foot massage and abdominal breathing for patients with insomnia and accessory symptoms.

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The purpose of this study was to identify the difficulties for the nurses who take care of children and adults in the same ward. Ethnonursing was applied to this study. The main participants of this study were 7 nurses. The study was conducted by careful observation and interview for the main participants, and additional interview for 14 general participants.
The following findings were drawn from five sub themes and one main theme.
First, nurses cared children at nurse's own pace, in contrast they cared adult patients at patient's own pace.
Second, nurses recognized their ward was specialized for children, however they also paid significant attention for adult patients who might feel uncomfortable with the inconvenience with the children.
The last, nurses felt the adult and child mixed condition did not allow sufficient application of their professional skills and knowledge, also nurses were exploring their specialties.
In consequence, those findings suggested the following: nursing team should divided to one for children and another for adults for certain period of time, both child care specialists and nurses with adult care expertise are required in this particular ward, and nurses should be given the opportunity to examine their future career development.

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The purpose of this study was to explore the spiritual needs through narratives by elderly inpatients. Spiritual needs are closely connected with the individual's life, so this research takes a form of a case study. Participants were five elderly inpatients. This paper focuses on a narrative of Mrs. A who is a 93 years old woman. The researcher kept in contact with her for five months, and unstructured interviews were held sixteen times. The researcher read the narrative texts repeatedly and from them extracted of the context of the interviewed woman's spiritual needs.
As a result, the following spiritual needs emerged: “I want to find the meaning of my life.” ; “I want to taste my actual feeling of living.” ; “I want to ask others' pardon to meet them again in the next world after my death.” From the findings of this research, the importance of listening to the narratives of elderly people including recollections of their lives, and the importance of their daily care were found. The elderly are losing many things as they grow older. Therefore, their “actual feelings of living” experienced in their lives such as eating and excretion, which seem to us very natural, have supported their lives vividly.

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