The research objective of this second report is to describe, according to each of the four patterns of the [intersubjective parent-child relationship] derived from the first report, the effects that the nursing intervention, which was designed and implemented in the first report, had on the preschool child's autonomy and parental self-efficacy in preparation for day surgery as well as the collaboration that parents and nurses engaged in during the course of the nursing intervention, and to propose a nursing intervention program through a reexamination, using those patterns as a basis, of the methods and composition of the nursing intervention reported in the first report. The results describe the affirmative effects of nursing intervention on the preschool child's autonomy in preparation for day surgery as well as on parental self-efficacy coincident with the preschool child's autonomy approaching the medical experience. In addition, the collaboration that the parents and nurses engaged in to support the preschool child's autonomy in preparation for day surgery was demonstrated in the continuing mutual influence that the parents and nurses had on each other in regard to the manner of support and the relationship formed with the preschool child who was facing the medical experience, and both intended to apply such experience to future activities. Accordingly, a nursing intervention program to support preschool child autonomy leading up to day surgery in collaboration with the parents is proposed that consists of the nurse, prior to the operation, suggesting a method of supporting the preschool child to the parent, and the parent, after the operation, sharing with the nurse the support implemented in regard to the child to prepare for the day surgery.

View full abstract

Objectives: This study was designed to examine longitudinally the relationship between social interaction, health habits and care requirements in the elderly in a three year period.
Methods: The participants were all 65 years or older who lived in a farming community near major urban centers in Japan. The 657 participants answered the questionnaire in 2002 and 2005. The analysis was based on the 601 participants who completed the data in both years. The contents of the questionnaire were social interaction (using the “Index of Social Interaction”), health habits, physical function, health status, age and gender.
Results: 1) For social interaction and health habits, “Having an active role,” “Having a hobby,” “Life style motivation,” “Active approach,” “Feeling of importance,” “A well-balanced diet,” and “Physical exercise” were significantly related to physical deterioration. 2) Multiple logistic regression analysis adjusted for baseline age, gender, physical function, and health status indicated that “Having an active role” and “Feeling of importance” were related to reduced physical deterioration.
Conclusion: These findings show that the promotion of relationships within society for the elderly leads to the maintenance and improvement in the functioning of the mind and body. It is hoped that this research will be used for care prevention management in the future.

View full abstract

This study describes the current status of peer support among patients and examines the relationship between peer support and patients' mental health. Self-reported questionnaires were distributed to 862 patients who were members of the Japan Ostomy Association. Responses from 499 of these patients were analyzed.
Analysis of the questionnaire responses indicated that peer support among patients was categorized according to the following 3 factors: “giving support,” “receiving emotional support,” and “receiving informational support.” Many patients' responses identified the following contents of peer support: ‘recognition of the role of peer supporter,’ ‘encouragement to fight against the disease,’ ‘maintenance of an objective perception of their medical condition,’ and ‘empathy.’ Multiple regression analysis revealed that patients with high peer support were less depressed, more satisfied, perceived that their existence has meaning, and felt motivated.

View full abstract

Purpose: The purpose of the present study was to elucidate the effects of the educational infrastructure on the metacognitive clinical learning environment of students in baccalaureate nursing programs.
Method: The subjects were 205 fourth-year students in baccalaureate nursing programs of two colleges in Japan. Causal relationships between educational infrastructure and clinical learning environment were analyzed using structural equation modeling. The clinical learning environment was assessed using the Clinical Learning Environment Diagnostic Inventory (CLEDI), which measures the affective, perceptual, symbolic, behavioral, and reflective aspects of clinical learning environments.
Results: The standardized coefficient between educational infrastructure and the clinical learning environment was 0.97. “Academic-clinical collaboration” had the highest correlation among observed variables for educational infrastructure. In addition, educational infrastructure was strongly correlated with “affective clinical learning environment” and moderately correlated with other subscales of the CLEDI.
Conclusion: The above findings suggest that enhanced systems for academic-clinical collaboration may lead to improvements in the clinical learning environment of students, and that effects on the affective clinical learning environment must be considered.

View full abstract

The objective of the present study is to investigate the factors related to nurses' assessment of the necessity of continued support in 3-month and 3-year health check-ups. In the present cross-sectional survey, a self-administered questionnaire dealing with the importance of various assessment items (58 items for 3-month health check-up and 65 items for 3-year health check-up) was mailed to 239 full-time nurses working at all public welfare and health centers in two government-designated cities. An explanatory factor analysis (principal factor method, oblique rotation) was used to examine the factors related to assessment. As a result of the analysis, the following eight factors were identified for the 3-month health check-up:first factor, “Family background,” second factor, “Family support capability,” third factor, “Interpersonal relationships,” fourth factor, “Mother's physical condition,” fifth factor, “Behaviors toward the child,” sixth factor, “Child characteristic,” seventh factor, “Childrearing measures,” and eighth factor, “Child growth and development.” The following eight factors were identified for the 3-year health check-up:first factor, “Family background,” second factor, “Interpersonal relationships,” third factor, “Family support capability,” fourth factor, “Child's living environment,” fifth factor, “Child development,” sixth factor, “Childrearing measures,” seventh factor, “Behaviors toward the child,” and eighth factor, “Child growth.” The relationship of each factor to attributes was analyzed, and the results showed that, for the 3-month health check-up, the first factor “Family background” correlated to regionality and educational background, and the second factor “Family support capability” correlated to regionality. For the 3-year health check-up, the third factor “Family support capability” and the seventh factor “Behaviors toward the child” correlated to regionality, and the fifth factor “Child development” and the eighth factor “Child growth” correlated to the number of years of nursing experience.

View full abstract

Objective: The purpose of this study was to clarify coping behavior regarding risk of further fall for elderly patients who had been discharged home after undergoing open reduction of hip fracture sustained in a fall.
Methods: An ethnographic approach was used throughout this study. Data were obtained from semi-structured interview with eighteen elderly patients aged 65 years and older who were discharged from hospital 3 months to one year previously.
Results: Six categories of coping behavior related to risk of repeat fall were identified. “If I fall again, I will be bed-ridden” was characterized as the factor underlying coping behavior related to risk of falling again and this had a major influence on other coping behaviors. Coping behaviors aimed at eliminating the cause of falls “I stabilize my body when it is unstable” and “I avoid going to places where I might fall,” and coping behaviors related to daily activities “I do not act when I do not have confidence in my movements” and “I try to devise some method so that I do not fall” were identified. “I ask for help from others” influenced the four abovementioned behaviors.
Conclusions: It was concluded that the positive attitude of these patients towards prevention of a further fall could be utilized in prevention of falls and in reducing the number of elderly who might be in need of care.

View full abstract

A semi-structured interview was conducted targeting 9 mothers of children with schizophrenia, regarding their coping process, and the results were analyzed using a modified grounded theory approach (M-GTA). Consequently, it was demonstrated that the mothers continued to be engaged in child care while feeling pressure due to their children's abnormal behavior. In this respect, getting acquainted with other mothers of schizophrenic children, the feeling of sympathy shared with them, and self-confidence nurtured by their support helped support their child-care efforts. Mothers have difficulty accepting the reality of schizophrenia in their children;while rejoiced at the signs of recovery, they felt depressed with each flare-up of symptoms. Generally, when mothers became determined to continue their child-care efforts, they became able to accept the reality. Moreover, they remembered clearly the states of confusion and fear they experienced about schizophrenia. It was therefore suggested that some support including early psychological care should be provided for mothers having the experience of fear.

View full abstract

Purpose: The purpose of this study was to explore and delineate the Japanese nurses' ethical values residing in their end-of-life care practice.
Method: Thirty-two nurses with end-of-life care experiences were interviewed. The transcripts from the interviews were analyzed using hermeneutics approach developed by Benner et al.
Findings: Seven ethical concerns were emerged as Japanese nurses' ethical values in end-of-life care: 1) not hurting the patient; 2) honesty; 3) concerns for isolation/loneliness; 4) regard for the patient's personhood; 5) respect for the patient's wishes; 6) comfort/relief from suffering; and 7) meaningful and pleasant time for the patient.
Conclusion: These concerns embody the ethical values among Japanese nurses and are partly different from Western ethical principles in its meanings and reasoning.

View full abstract