The purpose of the study was to clarify the current status of the quality of occupational experience of hospital nurses, and to identify the relationships between it and attributes of nurses for developing a predictive theory of occupational experience of hospital nurses. The Quality of Occupational Experience Scale and the Questionnaire for Nurses' Attributes were used as instruments of the study. The instrument packets were distributed 1,060 nurses worked at general hospitals in Japan. The data were analyzed statistically (descriptive statistics, correlation coefficient, t-test, ANOVA). Seven hundreds and three (66.3%) nurses returned answers by mail, and 618 valid responses were analyzed. The results showed that nurses evaluated their quality of occupational experience highly, though it might be possible for them to improve it more highly. Furthermore, the quality of occupational experience of nurses related to 21 attributes of them, those were, “years of working as a nurse”, “position”, “income”, “satisfaction of working conditions”, and so on. Three hypothesis that had to be tested empirically for developing a predictive theory of occupational experience of nurses were generated from the results.

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The aim of this study was to identify the optimum care for seriously handicapped children who were unable to breathe for themselves and did not respond to anything. This study used an ethnonursing research method, under which seven nurses were chosen as key informants and fourteen were chosen as general informants. Dates were recorded from interviews and from participating in observation. As the results of the analysis, five sub themes and one main theme were extracted. The main theme was that the nurses regarded any minute change in the children and the sound of the monitor's alarm as'the child's voice,'and built up each child's personality not as'a child that once lived'but as'a living child.'
As the result, caring for totally nonresponsive seriously handicapped children on respiratory support had two elements that were based on observations of minute changes in the children and the monitor alarm, bringing together emotion and intention, which is how the nurses build up these children's personality.
The findings suggest the importance to nurses working with such children of sharing information on their patients and of expressing their nursing experience in words.

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Self-massage on the perineum given by the pregnant woman in late gestation has been a focus of constant attention as a measure of preventing the perineal injury at delivery.
In view of the current circumstances, a randomized controlled trial was conducted to evaluate the effectiveness of self-massage in primiparous women.
Among 90 women who met the conditions of this trial, 63 women participated in the study and they were assigned to an intervention group (30 women) and a contrast group (33 women). The intervention group was given an instruction of how to give self-massage. The massage was given at least four times a week until at the time of delivery (more than three weeks).
There were two primary factors to be evaluated: reduction of episiotomy rates and comparison of the degree of perineal injury. The episiotomy rates in the intervention group were reduced by 21%, which cannot be said as a statistically significant decrease. As for the comparison of the degree of perineal injury, those who continued the massage in the intervention group had slighter injury than those in the contrast group.
It was suggested that perineal massage during late gestation could not reduce episiotomy rates and make the perineal injury slighter.
The results were thought to have been affected by insufficient power of test. More examination on the effectiveness of self-massage should be conducted, securing the number of required subjects.

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A lot of psychiatric nurses in Japan are working in private hospitals. It is safely to say that every kind of problems related to psychiatric nursing can be observed there. In such a situation they necessarily encounter various problematic events to be seriously considered and dealt with, making up their character as psychiatric nurses. Finally, their commitments to the organizations are settled. In this study, we attempted to classify the types of commitment to organizations by psychiatric nurses and investigate how each of them affects their professional care behaviors.
The subjects were 1,313 nurses working in 13 Japanese psychiatric hospitals located in Kanto and westward, and required to answer a questionnaire. The items surveyed include four measurement scales and questions concerning their attributes, ranging from age, academic career to relationship to the people they work with. The total number of questions was 95. The collected data was analyzed under covariant structure analysis and the following results were obtained:
1) Affective commitment and continuous commitment are both related to the quality of professional care behavior in a reversal way. Those who have strong affective commitment have a friendly and positive feeling to their organizations, and those who have strong continuous commitment tend to work just for making a living. The former provided professional care behavior to their patients better than the latter.
2) The level of job satisfaction, which is a prior factor of affective commitment, is strongly related to the degree of relationship to colleagues and patients' families, and how long they have spent working as psychiatric nurses.

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Purpose: The purpose of this study were to develop and validate the Discharge Planning-Process Evaluation Measurement (DCP-PEM).
Methods: The subjects were 69 nurses in “A” hospital wards and 174 nurses in “B” hospital wards. We used a self-report questionnaire including subject characteristics, DCP-PEM, Visual Analogue Scale (VAS) and Nursing Autonomy Scale (NAS). We examined the reliability and validity of the DCP-PEM by item analysis technique, corrected item-total correlation, Cronbach's α coefficient, G-P analysis, Pearson's correlation coefficients in the DCP-PEM with VAS and NAS, and known-groups technique. For validation of the DCP-PEM, we comparatively studied the change in the DCP-PEM score before and after an intervention using a quality improvement tool with a control group, and also examined the sensitivity.
Results: The following results were obtained: 1) Skewness and kurtosis in item, factor and total scores of the DCP-PEM were within ±1.0, and correlation coefficient of CITC in all items was very high over 0.471. Cronbach's α coefficient in item, factor and total scores ranged from 0.76 to 0.96. There were significant differences in all items by G-P analysis. Since factor and total scores of DCP-PEM, VAS and NAS were significantly correlated each other in “A” hospital, the concurrent validity was established. By the known-groups technique, factor and total scores in “A” hospital were significantly higher than those in “B” hospital, suggesting that the construct validity was established. 2) The DCP-PEM scores in some items of the intervention group were higher than those in the control group. The DCP-PEM was validated due to a high sensitivity.
Conclusion: The results suggest that development of the quantified DCP-PEM enables a comprehensive evaluation of the DCP and contributes to greater impacts of the DCP practice.

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The aim of this study is to define quality of life in cancer patients after gastrectomy by evaluating correlation between eating habits and postoperative symptoms, and psychological health. Eighty-nine patients without any symptoms of recurrence for at least 12 months after gastrectomy for cancer, in a university hospital, were interviewed using questionnaires, at the out-patient clinic. The original questionnaire, including evaluation of postoperative eating habits and symptoms associated with gastrectomy, as well as the Japanese version of General Health Questionnaire 28 (GHQ 28) were used. The correlation between the results of GHQ 28 and the results of the original questionnaire were evaluated. The results revealed that average point of GHQ 28 was 4.3. This was less than 5, which is considered healthy, in 59 patients (66.3%). The patients loss of appetite, amount of single meal intake being less than 80% of preoperative intake, dissatisfaction with eating habits, postprandial discomfort, and bitter reflux, or diarrhea were significantly higher in the GHQ 28, than that of other patients. In conclusion, the quality of psychological health deteriorated in the patients associated with loss of appetite and oral up-take, dumping symptoms, or reflux.

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To clarify the concept of “intimacy of couples undergoing fertility treatment”, I reviewed the literature on the general view of intimacy, intimacy in psychology, and intimacy in nursing using concept analysis based on Walker and Avant's model, and also evaluated studies on couples undergoing fertility treatment.
Concept analysis showed 9 characteristics of intimacy. Differences between intimacy and related concepts (“love”, “attachment”, “trust”, “dependence”, “amae”, and “loneliness”) were evaluated. However, studies on couples undergoing fertility treatment were analyzed in terms of the wife's understanding of the partner, what has been told or not told to the partner, the relationship of the couple, and sexual intimacy, and 12 elements of intimacy were extracted.
Comprehensive evaluation of the results suggested the following 8 constructs of the intimacy of couples undergoing fertility treatment:“close relationship”, “self-expression”, “sharing”, “dealing with matters together”, “feeling of being valued”, “security”, “trust”, and “sexual satisfaction”.
Intimacy is an important phenomenon for the physical and mental health of couples undergoing fertility treatment, and it is useful to develop during care for couples. The accumulation of research that inclusively comprehends the phenomenon of intimacy between couples and the development of a measurement scale are needed for improve care in clinical practice.

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Progress in medical technology and treatment has led to individuals with progressive neuromuscular illnesses surviving for longer periods of time. These patients may experience various distresses. In order to facilitate palliative care for them, the purpose of this study was to identify the experiences of in-home care patients living with progressive neuromuscular illnesses during long course. Data were obtained from semi-structured interviews with nine sets of patients and their families. A qualitative induction analysis was applied to extract domains and categories of their illness experiences.
Six domains with twelve categories of psychological distress of the patients were identified. The domain«somatic symptoms and difficulties in their daily lives»seemed to lead to the other categories of psychological distresses. The following ten categories were extracted as reflecting the mental support of the patients: [symptoms management], [gratefulness toward being able to perform some physical functions], [renewed spirits in facing up to their illness], [achieving their roles within their families], [hope], [sense of relief derived from medical services], [gratitude for the thoughtfulness of their families], [gratitude for the consideration of others], [religious beliefs] and [unconquerable personality]. It became evident that the psychological state of the patients fluctuates between the weight of distress and the mental support that they feel. This study suggests that nurses should precede direct approaches towards resolving somatic symptoms and difficulties in their daily lives. Then we should work together with patients and their family to find mental support, and to transform psychological distress into mental support as means of palliative care.

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This study aims to clarify the self-concept of patients who have undergone total laryngectomy in order to improve the nursing provided to such patients. Data were collected from 5 hospitalized patients through participant-observer study and semi-structured interviews before and after operations. As a result of categorization and analysis, the self-concept of patients was classified into five categories: “negative volition and interruption of mutual understanding”; “alteration of body”; “basis for self-orientation”; “approaches to self-sustainment”; and “expectations for a return to normality”.
“Negative volition and interruption of mutual understanding” and “alteration of body” indicate complicated and multifaceted changes in patients after the recognition of aphonia and other changes. Self-concept of the patient is supported by “basis for self-orientation” including original self-images. Such support gives motivation to the patient to initiate “approaches to self-sustainment” as a means of adapting to society with an altered body and provides a foundation for “expectations for a return to normality”. The findings suggest a need for nursing that sustains the patients' confidence in themselves.

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The purpose of this study is to develop and evaluate the daily life difficulties among right brain-damaged (RBD) stroke patients with neglect and related disorders (NRD) using the Catherine Bergego Scale Japanese version (CBS-J) for the first time in Japan.
Twenty RBD first-ever stroke patients with NRD were classified into 3 groups, mild (6), moderate (10), severe (4), according to the National Institutes of Health Stroke Scale score at 1 month after discharge. Subjects were measured by their function and observation, interviewed using CBS-J. Three groups were compared by one-way ANOVA in CBS-J-Observation score (CBS-J-0), CBS-J-Self-evaluation score (CBS-J-SE), and CBS-J-Anosognosia score (CBS-J-A). Among 3 groups, no difference was observed in neither attribution nor CBS-J-SE. On the other hand, significant difference higher was observed in both CBS-J-0 and CBS-J-A. The severer the stroke was, the higher the score of CBS-J-0 and CBS-J-A were observed. The discrepancy between CBS-J-SE and CBS-J-A suggests that RBD patients with NRD can not recognize their neglect behavior of their daily life when their stroke is moderate or sever.
In conclusion, CBS-J is considered to be an available and useful scale for evaluating neglect behavior and unawareness of daily life difficulties.

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