Objectives: The present study aimed to explore the daily experiences of patients with unruptured intracranial aneurysms through a wait-and-see approach and examining nursing support.
Methods: We employed a phenomenological approach and conducted a survey using unstructured interviews of patients with unruptured intracranial aneurysms who had been monitored for more than a year. Data were analysed using Giorgi's method of phenomenological analysis.
Results: The qualitative analysis of data gained from the 17 subjects revealed 20 essential factors. We divided these into 3 aspects: (1) diagnosis and treatment experiences, (2) coping and life restructuring, and (3) living with aneurysm. Subjects, though burdened with “anxiety that cannot be wiped away,” had coped with it in various ways including “gradually increasing the range of daily activities” or “minimizing the risk of rupture,” and ultimately gained “confidence and assurance that built up over time.” With respect to the particular aspect of ‘living with aneurysm,’ we found that patients followed three phases, including “reinterpreting aneurysm in one's own way,” “looking at the positive aspects of the condition,” and “learning to keep an appropriate distance from aneurysm.”
Conclusions: We demonstrate the need for follow-up that incorporates nursing support. This support should maintain a balance between preventative action and anxiety, reinterpret and acknowledge the positive aspects of this condition, and help to define and understand an appropriate distance from aneurysm.

View full abstract

Purpose: The purpose of this study is to investigate the mechanics and processes by which gastrointestinal cancer (GIC) patients utilized their health literacy awareness, starting from initial detection of symptoms to cancer diagnosis.
Method: Participant observation and semi-structured interview data from 10 pre-operative GIC patients were analyzed using the grounded theory approach.
Result: Core category is “self-examination.” Results indicated that GIC patients detected the symptoms and hypothesized the cause of disease by managing the prior medical experiential knowledge and new medical information they collected. The patients were diagnosed with GIC after they consulted with a gastrointestinal (GI) doctor, a non-GI doctor or follow-up without further consultation. However, patients with no symptoms were diagnosed with GIC after they had access to a family doctor or had a regular medical examination.
Conclusion: Pre-operative GIC patients examined themselves based on prior medical experiential knowledge, new medical information, and opinions of other people from the initial onset of symptoms. These observations explained the need for patients to be able to obtain new medical information. The observations suggested that providing appropriate medical information was essential for health literacy in pre-operative GIC patients. Furthermore, patients predicted the cause of symptoms and then decided to consult a doctor. Therefore, recognizing the symptoms might be a trigger for pre-operative GIC patients to search for and handle new medical information, prior medical experience and knowledge. GIC patients' health literacy might be initiated by symptoms.

View full abstract

Purpose: To reveal psychological distress and feelings of guilt of probands and unaffected relatives at 1 and 12 months after the disclosure of genetic test results regarding hereditary nonpolyposis colorectal cancer (HNPCC).
Methods: Participants of the research were probands who fulfilled HNPCC criteria and their unaffected relatives. The participants consisted of those who visited the outpatient clinic for cancer genetics, and those who were underwent a genetic test for HNPCC. The structured clinical interview was used in order to investigate psychological distress of probands and unaffected relatives at 1 and 12 months after the disclosure of genetic test results regarding HNPCC. The feelings of guilt were also investigated using semistructured interviews. This is a descriptive prospective cohort study.
Results: The object of analysis was 30 who completed the final interview conducted 12 months after the disclosure of genetic test results for HNPCC. The disclosure of genetic test results related to HNPCC did not have a significant psychological impact, as none of the probands or relatives met the criteria at the time of the 1-month or 12-months follow-up interview. It was revealed that predictive factor for long-term psychological distress was the participants' innate psychological weakness. Feelings of guilt were observed regardless of genetic test results.
Conclusion: This suggests that nurses who are in charge of genetic counseling should assess whether or not psychological weakness is observed within probands or their relatives as soon as possible, and set up a system to provide long-term support.

View full abstract

Purpose: This study aims to qualitatively examine the characteristics of benefit-finding in people with mental illness living in community and being hospitalized in Japan.
Method: A cross-sectional questionnaire survey of people with mental illness aged 20 years and above was conducted from June to September 2008 in Japan. The questionnaire included an open-ended question about benefit-finding. Of 193 participants who gave informed consent, valid data from 107 participants were analyzed through content analyses by Berelson.
Results: The seven benefit-finding categories derived from content analyses were as follows: “growth in relationships/awareness about relationships,” “personal growth/change of values in life,” “health-related behavioral changes/self management,” “growing interest or understanding of mental illness,” “finding a new role in society,” “religious growth,” and “others.”
Conclusion: The results of this study demonstrated that there are various benefit-finding themes for people with mental illness in Japan, and the features were rather common to those observed in previous studies of people with various chronic physical conditions.

View full abstract

The purpose of this study was to examine how nursing practice in Japan can be described with the International Classification for Nursing Practice (ICNP^®) and to review the problem of introduction of the ICNP^® to Japanese nursing.
Ninety-four terms for nursing activity were described according to the guidelines for creating ICNP^® statements. They consisted of three domains; “Observation and/or Monitoring,” “Support for activities of daily living,” and “Approach to the physical function” in the Classification of Nursing Practice by Japan Academy of Nursing Science.
Results were as follows: 1) about 70% of the terms were successfully expressed with ICNP^®. This shows the feasibility of introducing ICNP^® to describe nursing activity in Japan. On the other hand, 2) about 20% of those terms could express things only very abstractly; for example, “assist (action) and elimination (focus)” could not be used to narrow down the tools or means of assistance. 3) About 10% could express only a part of nursing activities. For example, “cleaning (action) and denture (means)” could not express “denture” itself but only so as to indicate cleaning with a denture; and 4) a certain important nursing activity like “bed bath” could not be described directly.
These results indicate the necessity of further investigation of additional important terms and a review of the definition and how to use the axes of ICNP^®.

View full abstract

Purpose: The purpose of this study is to clarify the factors relating to affective commitment to organization (AC) depending on the years of nursing experience. High scores for affective commitment to the organization are indicative of a low turnover and high quality organizational performance.
Methods: The subjects were 1,302 non-managerial nurses working in three public hospitals located in Kanto area. The items surveyed include affective organizational commitment scales, superior and coworker support scales, and 21 items made by the authors.
Results: Five hundred and fourteen nurses responded (39.5% response rate), 510 questionnaires were analyzed. Multiple regression analysis shows that each category of nursing experience (less than one year, one to five years, more than five years), AC correlated with different predictors. Less than one year of nursing experience, AC correlated with [job contentment] and [organizational justice]. One to five years of nursing experience, AC correlated with [evaluation of the hospital], [opportunities for skill development] and [evaluation of workload and allowance]. Nurses with more than five years experience, AC correlated positively with [superior support], [evaluation of the hospital], [marital status] and [age].
Conclusion: These findings show the importance of taking care of nurses at differing years of nursing experience in order to enhance nurses' affective commitment to the organization.

View full abstract

Objectives: To elucidate the characteristics of skill in placing with a peripheral-short catheter by new, mid-career, and experienced nurses.
Method: This study targeted 20 new nurses, 25 mid-career nurses, and 45 experienced nurses, wherein their skill in placing a catheter was observed by video recording. The time required to perform the procedure, the success rate of the catheter placement, and the failure factors were compared among these 3 groups.
Results: Significant differences were observed in the procedure time for the following instances: the time required to select an insertion site, wherein new nurses took 59.4 seconds and experienced nurses took 44.1 seconds; and the time required to insert a catheter, wherein new nurses took 109.4 seconds and experienced nurses took 66.6 seconds. The success rate for a single insertion was 35.0% for new nurses, 44.0% for mid-career nurses, and 75.6% for experienced nurses, and the success rate for twice insertion was 65.0% for new nurses, 68.0% for mid-career nurses, and 93.4% for experienced nurses. The failure factors were mostly as follows: for new nurses, “no reflow of blood after insertion”; and for mid-career nurses, “no reflow of blood after removal of the stylet.”

View full abstract