This study aimed to obtain guidelines for patient education by clarifying characteristics of dislocation aversion movements (DAM) in daily life for patients after total hip arthroplasty (THA). Two movements, “wearing pants” and “picking up objects from the floor” were chosen as representative examples of movements to prevent dislocation, and these movements were analyzed for 6 THA patients and 5 healthy volunteers using 3-dimensional movement analysis and 3-dimensional acceleration instrumentation to extract differences.
Movement analysis demonstrated that adduction with hyperflexion of hip joints and forward tilting of trunk were usually seen in normal individuals, whereas restriction of flexion, abduction with hyperflexion of the implanted hip joint and backward tilting of trunk were commonly seen as DAM in THA patients. Furthermore, accelerated velocity of each movement was controlled at a low level for THA patients using some devices expanding their DAM as compared to that for normal individuals. In conclusion, characteristics of dislocation aversion movements do exist in THA patients and differ between patients, suggesting a necessity for learning systems for each patient by understanding living habits and activities of daily living.

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Based on Lazarus's theory, this study focused on positive emotions that mothers feel during childcare and termed those emotions “child-care happiness.” The aims of the study were to develop a multidimensional scale of childcare happiness and to investigate the validity of it. Mothers with children aged six or under completed Childcare Happiness Scale (CHS). A total of 872 valid responses were collected. Construct validity was examined using factor analysis and correlation with the Subjective Well-Being Scale (SWBS), and the Childcare-Related Stress Scale (CRSS). A factor analysis of the CHS yielded eight factors: (1) children's growth and development; (2) hopes and purpose in life; (3) growth as a parent; (4) being needed by children; (5) gratitude to their husbands; (6) new interpersonal relationship; (7) gratitude or comfort from their children; and (8) meaningfulness of childbirth and parenting. Cronbach's alphas were adequate for each sub-scale (α=.768–.867). The results showed that there significantly were positive correlations between SWBS and sub-scales of CHS. On one hand, the correlations between CRSS and CHS were significantly negative and weak on the whole, except “gratitude to their husbands” with “their husbands' support” of CRSS. It was concluded that this CHS should be examined in the next study;however, CHS has good enough validity.

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This research was conducted with the goals of: determining the physiological characteristics of lymphedema patients following breast cancer surgery based on the difference between the blood flow in the right and left fingertips in order to determine whether or not this simple measurement could serve as a predictive index for the occurrence of lymphedema. A total of 95 female breast cancer patients and 80 healthy females were investigated. The fingertip blood flows in all subjects were measured using a blood flowmeter, and the existence of lymphedema was taken into consideration. The results were as follows: (1) the left blood flow was greater than right blood flow in all controls, (2) there was no disparity seen in either the blood flow or the blood flow difference, for both normal women and non-edematous patients, (3) the edematous patients showed significantly higher values than the non-edematous patients in the blood flow difference percentage value. Furthermore, (4) when the blood flow difference percentage was greater than 30.0, the lymphedema occurrence ratio became 100%, while in non-edematous patients, the mean+3SD value was observed to be 29.61. In addition, when the blood flow difference was more than 7 ml/min/100 g, the lymphedema occurrence ratio increased approximately by 9 times.
From the above results, the increase in the blood flow difference suggested that it could be regarded as a physiological characteristic of edematous patients, in addition to which the possibility arose that the blood flow difference could be a predictive index of lymphedema occurrence, with a cutoff value represented by a blood flow difference percentage value of 29.61 and a blood flow difference of 7 ml/min/100 g.

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The aim of this study was to describe a nursing philosophy based on visiting nurses' reflections on their practice experience supporting family caregivers who lived with their elder until the elders' death at home. The semi-structured interviews with eight visiting nurses provided data for analysis.
The nurses' intentions were to [work with each family to support the elder until the end of the elder's long life] and to [help the family find its purpose for life after the elder's death]. The nurses believed three types of care were essential: [perceive family's unexpressed needs and desires in their daily lives]; [provide guidance for the family so the family can continue to care for the elder and also meet its desires]; [help the family to become more comfortable and confident living with a dying elder at home]. In providing this care, the nurses expressed the need to [build relationships with the family by being with the family as a person] and to [balance their affinity for a family with their awareness of their professional roles].
This analysis suggests that nurses' intentional support is important to prevent families from suffering regret associated with the care they provided for their elders and keeping the balance between affinity for the family and one's professional role is a critical dynamic in the nurses' ability to provide nursing care. Maintaining this balance facilitated the family's autonomy.

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The purpose of this study was to propose a viewpoint of care promoting elder's self-reliant corresponding to improving and maintaining the level of health, and to improving care burden and prevention of excessive care burden, and appropriate correspondence.
The sample included 282 elderly over age 65 in Japan who required home care and use in-home services to support living at home by the long-term care insurance service. The questionnaire data consisted of background, physical and mental status, ability of caregiver, use of in-home services and extracted contents of the service plan sheet. The dada were divided into two groups of those who continue living at home and those who were hospitalized or moved into facilities. Analysis extracted factors about continuation at home for each degree of long-term care required. Levels of care in the Japanese long-term care insurance plan were also considered.
Based on analysis of the factors influencing elders to continue living at home, the following recommendation is suggested: The most influencing factors are housework, judgment, bedsores, belongs to care needs category. For elderly at support required and care level 1, support should be offered to improve and maintain abilities for housework. For persons in care levels 2 and 3, caregivers should support their judgment and activity in their life that needs their judgment. In care levels 4 and 5, caregivers should pay attention to preventing aggravation of the condition of the elder's whole body such as prevention of bedsores.

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Purpose: The purpose of this study is to assess the reliability and validity of the Japanese version of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) for Japanese total hip arthroplasty (THA) patients.
Methods: The WOMAC is a health related quality of life scale, comprised of three subscales, pain, stiffness, and physical function. Higher scores indicate stronger pain and higher degree of difficulty in functioning day to day activities. The questionnaire was mailed to 319 patients who underwent primary THA. Two scales were used including the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) Japanese Edition and the WOMAC. Thirty patients were randomly chosen for a test-retest reliability study 3 weeks after the initial survey.
Results: Two-hundred and twenty questionnaires were analyzed. Although WOMAC pain had a floor effect, WOMAC subscale items showed good internal consistency (α=0.74~0.95), with intraclass correlations ranging from 0.45 to 0.71. Agreement rates between the two tests were high, and so were Spearman's rank correlations. Factor compositions were slightly different from the original study, which seems to reflect the influence of Japanese lifestyle and the specific physical function of the THA patients.
Conclusion: These findings suggest that WOMAC is a reliable and valid measure for THA patients in Japan. Further research is needed to conduct a prospective study to follow up patients with OA from the pre-operative to the post-operative period using WOMAC to determine the validity of our findings.

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The purpose of this study was to systematize nursing terminology in scientific terms, by describing how nurses expressed and described their own practice in child nursing.
The subjects comprised 28 nurses who work in the hospital pediatric ward. Each nurse was asked to choose a patient of the day, and to describe the items of her nursing activities. She was then asked to report her activities during the workday. The items covered were divided by the researchers into “label of the activity,” “reason for performing the activity,” “aim of the activity,” “actual nursing procedure for the activity,” “label of simultaneous activity,” “aim of simultaneous activity” and “actual procedure for simultaneous activity.” The data gained through this process were analyzed to determine the nature of each of the items and the relationships between them.
Results were as follows: 1) There were 34 labels of the activity and 184 activity items in child nursing intervention, of which 77 items had accompanying labels of simultaneous activity. 2) In the relationship between “label of the activity” and “actual nursing procedure for the activity,” approximately a quarter of the former did not accord with the latter, most of the labels of activity expressing only a portion of the “actual nursing procedure for the activity.” 3) The labels of activity relating to support of the mother-child relationship, support of child development and family support comprised 21% of the characteristics of total child nursing intervention terms.

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The purpose of this study was to describe family's experiences while attending to their terminal cancer relatives who were dying in the hospital and to clarify the meaning of these experiences. Further, we considered the nursing approach. The study conducted with a phenomenological approach. Thirteen family members participated in unstructured interviews and all data were analyzed. The following results were obtained.
Family members attending to terminal cancer patients dying in the hospital tended to be confused by the gap between reality and their expectations. Despite this confusion, the family members attempted to understand the situation and prepare themselves to accept whatever occurred. They thus faced the reality of the relative's approaching death. Family members sometimes attached greater importance to the patient's well-being than to the patient's death. At the same time, the family members longed for the patients to survive, even though they knew that this was in fact impossible. The result was that the family members became exhausted by the cognitive dissonance produced by the two contradicting simultaneous desires. Although the family members felt quite helpless, primarily because they could not do anything to conquer the cancer, they found their own roles they could play. They recognized that they felt ceaseless anxiety about the patient, and they sought periods of time when they could stop thinking about the patient for a while so that their attention to the patient might be refreshed. As the period attending to the dying patients became long, they began to wish that they could get out of the current situation, which seemed to wear on endlessly. When the end actually came into sight, the family members felt relieved and appeared to accept the end in a somewhat relaxed manner.
These results suggest it is important to understand the meaning of family's experience with fragility and strength.

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This study is aimed at exploring the nursing purposes and skills in effective home visit nursing for clients with schizophrenia. Subjects were seven home visit nurses and their nine clients, the latter having no experience of hospitalization for two years or more while they were assisted by the nurse. The interviews with the nurses and the field notes on the observation of their practice were analyzed qualitatively.
In effective home visit nursing, the nursing purpose changed from that before establishing the stage of having a common understanding between the client and the nurse regarding how the client wanted to live to new nursing purpose afterwards. Before establishing this ‘common understanding’ stage, the purpose of nursing was ‘letting out the client's oppressed will.’ The nurses used the skills such as ‘observing the client's situation using all of the nurse's perceptive powers,’ ‘understanding the client's experiences living with mental disorder,’ ‘understanding the client's individuality,’ and ‘intentionally utilizing one's non-professional self.’ After establishing the stage of having the common understanding between the client and the nurse, the purpose changed to ‘cultivating the client's living ability.’ Although most nursing skills were changed based on the change in the purpose, the use of some skills were seen both before and after establishing the stage of having the common understanding between the client and the nurse. Following the ‘common understanding’ stage, the nurses used the skills such as ‘knowing the client's ability of daily living,’ and ‘using both professional and non-professional self.’

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Aiming at increasing the number of inpatients with terminally ill cancer to move home and receive home care, a nationwide survey was conducted to clarify factors for nurses in charge to consider of receiving home care on the inpatients with incurable cancer. Data were obtained using a questionnaire, which investigates the demographic and situational characteristics on the patient and family caregiver, in addition to the characteristics of the nurse in charge, the care unit, and the hospital. The correlated factors on the nurse's consideration of her patient's transfer to a home care setting were examined by a logistic regression analysis. Analyzed on the data of 464 cancer patients in 82 care units from 53 hospitals, seven factors were clarified, that is, patients and/or family caregivers having desire to transfer a home care setting, patients receiving longer terminal care on the unit, not receiving an oxygen therapy, being controlled pain by using morphine by mouth, nurses in charge consulting her superiors on receiving home care of her patients, and nurses vigorous submission of information to obtain the informed consent of patients. Our results may help healthcare professionals to plan the appropriate nursing support for more terminally ill cancer inpatients to receive home care.

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The purpose of this study was to clarify the present status of the physical fitness, health status and situation of their farm work in elderly agricultural laborers. The subjects of this study were 99 elderly agriculturists more than 65 years old living in an agriculture area. The subjects were classified into three groups:a non-agricultural group (group C-controls), an agriculturist's group who had been engaged in work more than 150 days/year (group A), and those who worked less than 150 days/year (group B), respectively. As a result, for males, there was no significant difference in physical fitness between groups A and B. For females, group A had significantly higher ability than those of group C in terms of functional fitness, such as locomotive movements, standing and sitting movements, and self-care movements. On the other hand, there were no statistical differences in ability for housework movements between group A and C. The results suggest that a higher level of functional fitness in elderly females should be encouraged and the necessity for maintaining it. In addition, it is important that elderly agricultural females should be trained to improve their housework movements.

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Retinal detachment patients face the possibility of suddenly losing an important sensory function. The purpose of this study was to understand the significance of these patients' experiences, and to clarify the structure and salient characteristics of their experiences. Nine retinal detachment patients participated in unstructured interviews, and the data was analyzed by a qualitative method based on a phenomenological approach. The following are the results obtained by Giorgi's analysis.
The retinal detachment patients assumed the abnormalities in their sight would heal quickly but the abnormalities only became worse. As a result, the patients were convinced by friends and family to go to the hospital. The patients were surprised and dismayed when they were told that they must enter the hospital and undergo emergency surgery to avoid becoming blind. After the patients understood that they would not become blind if they received surgery, they were relieved and readily agreed to the surgery. However, as the patients were waiting for their surgery, they began to worry about the possibility of becoming blind and became uneasy again. After surgery, when the patients realized that their sight would be preserved, they were relieved. The patients constantly checked their own vision to confirm that it continued to progress well after the surgery. After discharge from the hospital, the patients were able to return to their former lifestyles and maintain their roles in society, but they continued to worry about relapsing. Consequently, the patients displayed coping behavior and attended all regular ophthalmological examinations.
In summary, this study found that retinal detachment patients experience alternating anxiety and relief as they undergo diagnosis, treatment and recovery.

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