Objective: In Japan 100 new cases of multi-drug resistant tuberculosis (MDRTB) are diagnosed each year. During treatment patients must be hospitalized under isolation conditions. To describe their experience and feelings was the purpose of this study.
Method: Five patients in two hospitals responded to semi-structured interviews in 2006. Interviews were audio-taped, transcribed verbatim and analyzed by qualitative description.
Results: Participants were four men and a woman ranging in age from 45 to 76 years. Two were experiencing the initial onset of disease; the others were re-admissions. Their current admissions extended from 50 to 3036 days.
All patients knew they had a disease that was “difficult to cure”; some believed they would “be cured,” but others were afraid that they “cannot be cured”; “whether they would survive to return home or not” was a concern. Most felt much stress because they “could not see future,” due to their disease and also the long-term hospitalization and isolation... “almost nothing about hospitalization is enjoyable.” Visits from family and friends, letters and emails, and conversations with nurses linked patients to others and the outside world.
Conclusion: MDRTB patients sense the possibility of death. As patients respond to laboratory tests and treatments nurses help them “envision their possible futures.” Nurses are key connectors to outside worlds. Recognition of and support for such communications functions might help nurses sustain their burden of caring and thus patients' endurance of the difficult conditions of their enforced hospitalization.

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Purpose: This study examines stress-buffering effects of coping strategies (“active coping,” “one's own control,” and “meaning of illness”) in the relationship between stress cognition and mental health in chronic obstructive pulmonary disease (COPD) patients.
Methods: Hierarchical multiple regression analysis using mental health as the dependent variable was conducted on 95 COPD patients. Post hoc probing was performed on variables showing significance in order to test for interaction effects.
Results: Interaction effect of “meaning of illness” on mental health were observed (β=−.439, p<0.01). According to the post hoc probing, when “meaning of illness” was low, stress cognition caused a decrease in mental health. However, when “meaning of illness”
was high, no differences in the effect of stress cognition levels on mental health were observed.
Conclusion: Thus, when meaning of illness was frequently used as a coping strategy, mental health was maintained, even if levels of stress cognition were high. This suggests the necessity of nursing intervention to help patients attach positive meaning to illness in order to maintain mental health.

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As cancer treatments transit from inpatient to outpatient, there is more demand for patients to learn to adjust to their own physical and mental condition which changes in accordance with the treatment and progress of the disease.
The purpose of this research is to clarify and conceptualize the characteristics of self-care as a pre-stage to create index to assess self-care ability of cancer patients.
This research is guided by Rodgers' approach. In order to focus on self-care of cancer patients based on nursing in practice up to now, qualitative analysis is done by searching and collecting original articles from Igaku Chuo Zasshi and PubMed. Among 76 articles which have met the requirements, there were no articles which clearly defined self-care of cancer patients. From the analysis, 4 antecedents, 4 attributes, 3 consequences and 2 related concepts are extracted from the concept of self-care in cancer patients. The self-care of cancer patient can be defined as a decision making to maintain their own life by searching and collecting information on cancer. And it is composed of coping with adverse effects of cancer therapy and change of their condition, and carrying out health behaviour to prevent from advancement of cancer.

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Purpose: This research examined the reliability and validity of the Nursing Management Minimum Data Set in Japan, version1 (NMMDS1), which was developed for nurse managers as a practical self evaluation index.
Method: The NMMDS1 questionnaire mail survey was conducted from July to October, 2006. Analyzed were data based on 1762 responses (43% response rate) obtained from nurse managers of 579 Japanese hospitals. To examine the internal consistency of NMMDS1, alpha coefficients were computed. Principal component analysis was also performed for the 7 items in each of 6 categories. Messick's unified concept of validity was used as a basis to examine the validity aspects of contents, structure, and constructs of the NMMDS1.
Results: Alpha coefficients of reliability for the categories ranged from 0.37–0.82. When the items with low principal component loadings were deleted, alpha coefficient of reliability rose to 0.4–0.82. Evidence for construct validity were obtained from the three above-mentioned aspects. The proof of content aspect was accomplished by a pool of experts; structural aspect was examined by computing correlation coefficients between categories and they ranged from 0.39–0.71. The external aspect of construct validity gained proof by calculating the relationships between the NMMDS1 score and the years of experience as nurse managers, the size of hospitals, and the experience of taking examination by JCQHC.
Conclusion: NMMDS1 was developed as an index for nurse managers' self evaluation index. There were items with low factor loading and the categories with low internal consistency. We will continue further examination to raise the accuracy, and it will be considered to be a useful index for nurse managers' professional practice.

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Objective: With regard to childcare for challenged children, it appears reasonable to expect elevated desire to actively partake in childcare and child rearing in mothers with positive attitudes toward convalescence, given the nature of childcare involved. This study was designed to concept analysis of empowerment in mothers of concern in parenting, to determine its utility in the practice and study of support to such mothers of children with chronic disorders or disabilities.
Method: Forty-seven literature in the fields of nursing and psychology published between 1983 and 2005 were selected expediential and subjected to concept analysis referring to methods outlined by Rodgers.
Results: Six categories were extracted as the attributes of “empowerment for mothers of concern in parenting”: “acquisition of knowledge,” “construction of partnerships,”
“awareness,” “sense of positivity,” “acquisition of problem-solving skills,” and “self-directed action.”
Conclusion: The concept of “empowerment in mothers of concern in parenting” was deemed to have practical utility in the practice and study of support for mothers of children with chronic disorders or disabilities.

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This study explores characteristics of the life-experiences of people with schizophrenia (2 first episode patients and 2 relapsed patients) who were given nursing counselling after they were discharged from psychiatric hospital. Their life-experiences were described from their point of view, and classified into “variable life-experiences” and “non-variable life-experiences.” It was found out that thoughts about self with an illness had changed over time among first episode patients. On the other hands, two variable life-experiences were altered among relapsed patients, which were [their unique understanding about their illness] and [considering their way to deal with problems]. The non-variable life-experiences found among first episode patients were [the uncertain self] and [the anxiety about their future]. In contrast, [a difficulty in improvement of their insights], [a wide-range of uncertainty], [stereotyped way of taking action], [obsession] and [the gap between reason and emotion] were found among relapsed patients.
The results indicate that there is a possibility of increasing the gap between reason and emotion, stereotyping the way of taking action, making patients stick to certain tasks and creating meanings in their own way for their perceived body condition in a process of relapsing. Therefore, the characteristics such as uncertainty caused by establishing their ego boundary and converting the level of social involvement and understanding about their illnesses, were considered from the aspect of a journey from self area to social area.

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Objective: To elucidate the characteristics of psychological stress reaction among fire fighting staff as well as the occupational stressors and stress-related factors affecting the psychological stress reaction.
Methods: An anonymous self-report questionnaire survey was conducted in September 2006 on 443 fire fighting staff belonging to a fire headquarters.
Results: Fire fighting staff had a high level of psychological stress reaction, particularly those who were full-time staff. The mental health of fire fighting staff was greatly influenced by stress-related factors that strengthen or weaken the relationship between stressors and stress reaction, such as “self-esteem,” “non-work activities,” and “support from coworkers.”
Conclusion: In order to improve the mental health of fire fighting staff, it is necessary to provide stress management education for improving the staff's own coping ability and to enhance social support systems. In addition, it is important to implement measures that consider the particular nature of the profession.

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[Objective] Self-monitoring is an important concept in order for support of patients to self-observe the condition of their heart failure and grasp the actuality of its progression, but its meaning in the context of care for heart failure patients has not been sufficiently clarified. Thus, we have now clarified the concept of self-monitoring in heart failure patients.
[Methods] The concept is identified with reference to the concept analysis method of Rodgers et al. (2000).
[Results] In the results from analysis of 31 cases from the literature, self-monitoring in heart failure patients involved staying aware of the changes in physical symptoms, changes in physical activity and the status of health management, and conceptual attributes were composed of three aspects: “awareness,” “measurement,” and “interpretation.” “Knowledge,” “skills,” and “concern” exist as antecedents of the concepts, and “adequate self-management” and “QOL improvements” were the consequences observed.
[Conclusions] It is suggested that novel concepts extracted from the present work be applied as the basis for nursing care support to strengthen self-monitoring by heart failure patients.

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