This study aimed to clarify the lived experiences of pregnant women diagnosed with a fetal abnormality by examining their everyday lives. Taking Merleau-Ponty's Phenomenology as the study's philosophical base, data was analyzed according to Pollio's Phenomenological Approach, the framework previously used by Thomas. The results showed four themes in women's experience: “a feeling of safety derived from carrying a child,” “a sense of burden in meeting public expectations,” “a sense of connection/disconnection with other people,” and “feeling a separate sense of time with a child.” Pregnant women experienced a sense of safety by feeling a child's existence within, and a sense of comfort in being with other children. Also, through daily interactions, mothers learned about differences between their own and other people's values: this gave them a dual sense of loneliness and belonging. Their everyday experience while pregnant taught them about the society norms to which they have to adapt after going through the positive and negative aspects of their pregnancy.

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Purpose: This research aimed to clarify the factors related to the self-rated health of elderly persons requiring support (persons who were certified as “requiring support 1-2” by the long-term care insurance law in Japan), and verifies these factors according to age group.
Methods: Subjects comprised 1,732 elderly persons requiring support individuals who were sent self-administered questionnaires by postal mail.
Result: Data from 1,046 valid responses were subjected to logistic regression analysis. The following factors were found to be related to the self-rated health of elderly persons requiring support: “young age group,” “worry about the household finances,” “high degree of cognition,” “have many diseases,” “have many objective symptoms,” “dissatisfied with sleep,” “require preventive support for depression,” and “going out less than once per week.”
In the young-old, risk factors were “have many diseases,” “require preventive support for depression,” and “reduced activities of daily living.” In the old-old, risk factors were “worry about the household finances,” “high degree of cognition,” “have many diseases,” and “require preventive support for depression.” In the oldest-old, risk factors were “have many diseases,” “dissatisfied with sleep,” and “require preventive support for depression.”
Conclusion: The present findings suggest that it is important to improve the self-rerated health of elderly persons requiring support, reduce the pressure of household finances, prevent lifestyle-related diseases and depression, appropriately manage symptoms, improve satisfaction with sleep, and facilitate going out more frequently. In addition, it is necessary to develop support strategies that are suited to the characteristics of each age group.

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Purpose: Using a randomized controlled trial, we aimed to determine the effects of a home monitoring-based telenursing (TN) practice considering two endpoints: preventing acute respiratory exacerbation (primary outcome) and readmission (secondary outcome) among chronic obstructive pulmonary disease (COPD) patients with home oxygen therapy (HOT).
Methods: Thirty-seven COPD HOT patients were randomly assigned to TN experimental group (n=20, mean age 76.0 years) and control group (n=17, mean age 77.7). Experimental group was given usual treatment (UT) by the primary care physician plus daily TN for three months. Controls received only UT for three months.
Results: Experimental group showed significantly higher number of hospitalization bed days before the immediate implementation period. Experimental group acute exacerbations were significantly decreased by TN 32.9%. The onset of acute exacerbation was significantly delayed compared to control group. The frequency of acute exacerbation during the three months was significantly decreased for the experimental group. TN insignificantly decreased readmissions 3.5%. Readmissions during the three months were significantly decreased for the experimental group compared to controls. Acute respiratory exacerbation ratios and readmission rates compared by Kaplan–Meier analysis showed that acute exacerbations were prevented in experimental group.
Conclusions: Home monitoring-based TN has the potential to prevent and decrease the frequency of acute respiratory exacerbations in COPD HOT patients.

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Purpose: To compare oral hygiene of the homebound elderly receiving oral feeding with those receiving tube feeding.
Methods: In 56 homebound elderly over 65 years, the oral mucous membrane was rubbed with a disinfected cotton swab and oral microbes were obtained. Staphylococcus aureus, Pseudomonas aeruginosa and Candida albicans were measured quantitatively.
Results: P. aeruginosa was not detected in the oral feeding group. The rate of detection (64.7%) and colony forming units (median; 2.0×10 CFUs/ml, range; 0~1.5×10⁴ CFUs/ml) of P. aeruginosa were significantly higher in the tube feeding group (p<.001). No significant differences were found in the rate of detection and colony forming units of S. aureus and C. albicans between the two groups.
Conclusions: In the homebound elderly, the oral hygiene of those receiving tube feeding was inferior to those receiving oral feeding, which indicates a higher risk of aspiration pneumonia in tube feeding than in oral feeding.

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Purpose: The purpose of this study was to clarify the coping strategies and factors affecting psychological adaptation among breast cancer patients with recurrence/metastasis in order to support their coping with cancer.
Methods: 64 women with breast cancer who were informed of a recurrence or metastasis completed a questionnaire comprised of the Japanese edition of the Mental Adjustment to Cancer (MAC) Scale, the 24-item version of the Tri-axial Coping Scale (TAC-24), and information pertaining to demographic variables. The patients' recognition of six supportive factors were obtained using a specially designed questionnaire. Data were subjected to univariate analysis, correlation analysis, multiple regression analysis, and covariance structure analysis in order to assess the above-mentioned factors.
Results and Conclusions: Significantly more patients with higher “Fighting Spirit” were found to use the “Affirmative interpretation” strategy, while significantly more patients with higher scores in “Helplessness/Hopelessness” used the “Abandonment/Resignation” strategy. “Peripheral neuropathy” and a “family relationship without an effective support function” were found to have negative effects on the patients' psychological adjustment. “Satisfaction with information” and “Consent for primary care” were support factors that strengthened “Affirmative interpretation.” Furthermore, these factors were both associated with “Trusting the nurse” and “Trusting the doctor” and had positive effects on the patients' psychological adjustment. Cancer patients have high stress levels and require systematized psychosocial intervention as a component of their long-term care following their initial diagnosis.

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Kanter argued that employees come to express their situations through their behaviors, and opportunity and power may explain a large number of discrete individual responses to organizations. Based on Kanter's theory, Laschinger et al. developed the Nursing Work Empowerment Scale, which includes the Conditions of Work Effectiveness Questionnaire (CWEQ) I.
Objectives: The purpose of this study is to develop a Japanese version of the Nursing Work Empowerment Scale and to test its utility.
Methods: After obtaining permission, we developed the Japanese version of the Nursing Work Empowerment Scale by translating and back-translating the CWEQ I. We invited nursing staff from five hospitals (N=1,511) to submit answers to the questionnaire.
Results: We received responses from a total of 1,145 nursing staff (response rate: 76%). The Chronbach α values for Opportunity, Support, Resource, and Information were 0.81, 0.90, 0.75, and 0.86, respectively. Nursing staff who had worked less than three years obtained low Support scores, and those who had a long tenure obtained higher Information scores. Japanese nursing staff had lower Opportunity and Resource scores and higher Support scores than Canadian nurses.
Conclusions: The Japanese version of Nurses Work Empowerment Scale is sufficiently valid, and work empowerment in Japanese hospitals is comparable to that of North American hospitals, according to this scale.

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Purpose: The purpose of this study was to clarify the emotional experiences of nurses caring for patients with serious spinal cord injury.
Method: Participants were six nurses caring for patients, most of whom had serious spinal cord injury. Data were collected by semi-structured interview and analyzed by using qualitative inductive methods.
Results and Conclusion: Nurses caring for patients with spinal cord injury experienced negative emotions of “aggression,” “detachment,” and “exhaustion.” Although nurses suffered waves of these negative emotions, they kept their emotions in balance and performed their nursing duties by using coping behaviors, including “adjustment of physical distance” and “adjustment of mental distance.” They felt “sympathy” toward patients and experienced a “sense of fulfillment” in learning from patients and feeling their own personal growth.
The gap between nurses' expectations of the patients' ability to achieve independent living and the patients' situations influenced the nurses' negative emotions. Nurses mainly tended to use emotion-focused coping to deal with the consequences of spinal cord injury. It is important that nursing staff not only share their experiences, but also think about the meaning of the emotions that they experience and attempt to make the best use of their nursing practice.

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Purpose: This study intends to clarify the practical knowledge of outpatient nurses by the verbal expression of expert nurses to reveal latent experiences—a process of that can measure nurses' job satisfaction.
Method: Data were collected using interviews conducted with six outpatient nurses who each had five years experience and worked in a polyclinic hospital. They talked about their “job satisfaction” experienced while practicing. The results were analyzed using the modified grounded theory approach, suggested by Dr. Y Kinoshita.
Results: Expert outpatient nurses manage the entire space with [practical knowledge to view, understand, and control the entire outpatient space]. They are always sensitive to the needs of their patients, and [use practical knowledge related to the event at hand] to care for patients appropriately. Such effort provide a connection with future examinations, allowing the [use of practical knowledge over a series of events] to provide continuous and effective nursing care. Nurses experience actual feelings based on patient's reactions during such individual events and series of events, providing support for patients during their normal lives in society, and thereby [attaining a sense of job satisfaction]. Moreover, nurses who feel satisfied with their jobs do not remain content with current circumstances, and instead work hard to achieve self-growth [and the path to nurse autonomy].
Conclusion: The following became clear by this study. Practical knowledge of outpatient nursing is practiced based on the general ideas of “time” and “space,” and it is refined through actions that require a great deal of skill.

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