The purpose of this study was to refine the items contained in the cancer pain assessment scale and to develop a “Suffering Questionnaire” The survey was conducted among 167 subjects between September and December 2000. There were two subject groups: one consisted of 100 healthy individuals and the other of 67 cancer patients. Valid responses were obtained from 90 of the healthy subjects (31 males, 59 females) and 59 of the cancer patients (6 males, 53 females). To evaluate the internal consistency and construct validity, we analyzed 301 individuals (107 males, 194 females) who met part one (N=242) of the data after the cancer pain assessment scale was developed. The average age of the 301 individuals was 57 years. We conducted a factor analysis of the cancer patient subject group (principal component analysis, varimax rotation), examined items with a factor loading of less than 0.4, and ultimately created a Suffering Questionnaire comprising 32 items. Stability was confirmed by the test-retest results of r=0.80 (p<0.01, n=28). The Cronbach's alpha coefficient was 0.92, indicating higher internal consistency than the cancer pain assessment scale. The correlation coefficient with the SDS was r=0.33 (p<0.05, n=57). The correlation coefficient with the MAC of Fighting Spirits was r=−0.33 (p<0.05) and Helpless/Hopeless was r=0.67 (p<0.01).

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The purpose of this study is to develop the Japanese Health-Related Hardiness Scale (JHRHS). Hardiness is defined as “a constellation of personality characteristics that function as a resistance resource in the encounter with stressful life events”, which consists of 3 dimensions:commitment, control and challenge. Based on this concept, Pollock developed the Health-Related Hardiness Scale (HRHS), which has been widely used by health researchers.
The research team translated the HRHS into Japanese (JHRHS), and the JHRHS was administered to 655 participants after completing the back-translation process. As a result of the factor analysis, two factors with 14 items were obtained for the JHRHS. The factorial validity of the JHRHS was confirmed by having the same two-factor structure as the HRHS. In regard to the relationship between the JHRHS and the three other psychological scales, significant positive correlations with self-efficacy, internal locus of control, family and professional locus of control, as well as emotion-oriented coping were found, which indicate the construct validity of the JHRHS. The internal consistency of the JHRHS was verified using Cronbach's alpha coefficients (0.71~0.87 for the total of the JHRHS and subscales). Finally, we added 3 dummy items and completed the JHRHS with 17 items.
In conclusion, the JHRHS which consisted of 17 items and indicated a two-factor structure was developed, and its validity and reliability were confirmed.

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A novel Nursing Lymph-Drainage Program (NLDP) based on the Complete Decongestive Therapy (CDT) was developed using the concept of Integrated Approach to Symptom Management (IASM). According to this program, five patients with breast cancer suffering from lymphedema were provided education, skills, and nursing support regarding lymphedema management. After a trial of three weeks, the volume of the affected upper extremity and the QOL/ADL score of all patients were improved. In addition, the patients' self-management abilities regarding lymphedema were also enhanced, indicating that IASM was effective for them. This result indicates that the NLDP is a powerful way for patients to enhance their self-management abilities and reduce the suffering from lymphedema.

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This study examined direct and indirect effects of perceived social support at work on psychological well-being of nurses. Data were collected from seven hundred ninety female nurses who work in special functioning hospitals. Using covariance structure analysis, a structural model consisting of psychological well-being of nurses and its determinants was tested. Results indicated that a higher level of perceived support from supervisors and colleagues was associated with increased opportunities to utilize one's capabilities, which in turn was associated with greater psychological well-being. In addition, perceived social support at work had direct and indirect effects on psychological well-being, especially positive relationships with others. Support for nurses to utilize their full capabilities was discussed from the perspective of nursing administration.

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The purpose of this review was to examine the usefulness of the concept, “Collaboration in Community Health” for the Japanese community health nursing. Concept analysis, guided by Rodgers' approach, focused on definitions, attributes, antecedents, consequences, and related concepts drawing on literature from nursing, public health, sociology, and psychology. As a result, while no complete definition was found, two attributes, four antecedents, four consequences, and one related concept were extracted from the data. The proposed definition of the concept, “collaboration in community health” was “strategies and processes that people or organizations in different points of view participate in, have common projects or activities, build and develop mutual relationships, work together and coordinate with each other, in order to promote health for high risk groups, improve professional practice, education and research, and empower participants and communities.” The concept, “collaboration in community health” may be used as strategies and processes in the Japanese community health nursing if the unique situational background of Japan is considered.

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The purpose of this study was to clarify the structure and insufficiencies of conventional nursing care plans for patients with functional incontinence of urine due to brain damage in order to develop rehabilitation programs for them.
We investigated 783 nursing care plans for 146 patients, who were 18 to 59 years old, and had functional incontinent of urine after brain damage. The structure of the nursing care plans was examined using Mayring's method including explicative content analysis, summarizing content analysis and structuring content analysis. Insufficiencies of the care plans were classified according to reasons of failure.
We found that the structure of conventional the nursing care plans consisted of 3 domains and 9 categories. The first domain was formed from interventions to manage psychological and physical environments, and was classified into 4 categories such as stabilization of the circadian rhythm. The second domain consisted of interventions to help patients to obtain new behavioral skills. The third domain consisted of interventions to prepare alternative or compensatory techniques for dealing with urinary problem specific among patients with brain damage, and was divided into 4 categories such as introduction of an alternative communication method. Insufficiencies of the care plans were classified into 5 categories.
These findings suggest that nursing care plans for patients with functional incontinence could be more effective if they were restructured according to 3 domains and 9 categories and checked for 5 categories of insufficiencies which had been clarified in this study.

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In this study, the mindset of care-giving spouse was investigated via a qualitative approach to determine supportive and hindering factors affecting their will to continue home care in order to throw light on situations where care of one elderly spouse by another is carried out at home. Eight factors supporting this will to continue were established, being a “feeling that the care is worthwhile”, “attachment to the cared for spouse”, a “feeling of affection”, a “feeling of devotion”, “obligation to the cared for spouse”, “peace of mind”, a “means of diversion”, and “lack of a feeling of burden”. “Attachment to the cared for spouse” and the “feeling of affection” were both considered to support the feeling of self-sacrifice, or the “feeling of devotion”. The “feeling that the care is worthwhile” was considered to directly support the will to continue home care of the spouse.
On the other hand, six factors that hindered the will to continue home care were established, being a “feeling of irritation”, a “sense of despair”, a “sense of hopelessness”, “anxiety”, “loneliness”, and a “hemmed-in feeling”. The “feeling of irritation” was considered to be a factor directly hindering the will to continue spousal home care. It was conjectured that caregivers conduct home care with conflicting feelings of obligation born of a reaction to the “sense of hopelessness”, and the “feeling of devotion”. This study indicated the necessity of having nursing staff involved in the home care in such a manner that the care-giving spouse him/herself can confirm the effects of his/her care, thus reducing the burden on that spouse caused by feelings of self-sacrifice.

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The present study aims to describe Visiting Nurse Service Station (VNSS) managers' recognition of difficulties experienced by staff nurses who provide psychiatric home visiting care and the factors that affect the VNSS managers' recognition. Semi-structured interviews were conducted on 10 VNSS managers. Data were collected and analyzed in a constant comparative analysis according to the Grounded Theory Approach. Managers recognized the following four significant factors as difficulties experienced by staff nurses: ‹issues related to building client-nurse relationships›, ‹emotional issues related to clinical skills›, ‹issues related to the providing follow-up care in the community›, and ‹crises related to the interruption of home visiting care›. Moreover, the managers' recognition of difficulties experienced by staff nurses was influenced by client-nurse relationships and the duration of care from the beginning of psychiatric home visiting care. The present findings suggest that managers' support for staff nurses facilitates the provision of high quality care for people with mental illness.

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