The purpose of this study is to develop a universal uncertainty in illness scale (UUIS) which can apply to both inpatients and outpatients. The research was conducted in 2 studies.
The first study developed a draft questionnaire of UUIS which consisted of 53 items selected from published patients' notes and interview transcripts of patients who suffer from various diseases.
The second study consisted of two surveys. The first survey tested the reliability and the validity of UUIS. Data was obtained from 535 inpatients and outpatients suffering from various diseases. Construct validity was tested with exploratory factor analysis and resulted in a 6-factor solution with 26 items ((1) Unpredictability of Daily Life; (2) Complexity of Interpretation of Information; (3) Lack of Cues Finding Meaning in Illness; (4) Ambiguity of Characteristics of Illness; (5) Unpredictability Recovery from Illness; (6) Instability of Self-confidence in Carrying on a Struggle against Illness). The total score and subscale score of UUIS showed excellent internal consistency. Sufficient concurrent validity was confirmed by the State-Trait Anxiety Inventory, POMS–SF Depression/Dejection subscale, and the Mastery scale with a 1% level of significance. In addition, confirmatory factor analyses indicated that a 6-factor model for the 26-item UUIS was valid.
The second survey tested test–retest reliability for 36 patients with type 2 diabetes mellitus. The results of Spearman's correlation coefficients resulted in a total score that was generally good (ρ=0.74) but three subscale scores were under the level of 0.7.
The results of this study suggest this scale is in need of further refinement, but is considered an efficient tool for clinical use.

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Maternal and Child Health Volunteers (MCHVs) are collaborators with Public Health Nurses (PHNs) in the community. The objective of this study was to clarify the skills of PHNs for building partnerships with MCHVs through community activities with which PHNs find persons needing support and access to care.
The study was conducted in City A with a population scale of sixty thousand, consisting of a city area and agricultural/fishery area where community health activities for mothers and children were conducted. Data were collected from April 2009 to March 2010 through interviews MCHVs and PHNs in the community, as well as by participating observation by one of the authors as a PHN of the city. We used a qualitative study method to analyze the result.
The skills of PHNs for building partnerships with MCHVs were categorized into five skills. The skills of a PHN who is in charge of supporting an MCHV's activities are the creating significance in an MCHV's activities together with them and the promoting confidence between MCHVs and PHNs. The skills of PHN who is in charge of a district are the assessing the efficacy of MCHV's support, the relying on for cooperation of MCHVs and the helping to maintain high morale among MCHVs.

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Purpose: We performed intervention using the EASE program in a non-blind randomized controlled trial in patients with chronic kidney disease (CKD), and evaluated its effects on mean blood pressure and blood pressure measurement rate, self-management behavior and perceived self-efficacy.
Methods: In the intervention group (n=19), intervention using the EASE program was performed for 12 weeks. The control group (n=12) received conventional education. The parameters of intervention effects were the mean blood pressure and blood pressure measurement rate during every 4-week period and self-management behavior, perceived self-efficacy.
Results: No significant difference was observed in the effect parameters between the two groups. However, in the intervention group, self-management behavior significantly improved after intervention. The median value of perceived self-efficacy increased in the intervention group but decreased in the control group. The blood pressure measurement rate significantly decreased during the period after 9–12 weeks compared with the period after 1–4 weeks in both groups, and the decrease was marked in the control group.
Conclusion: A randomized controlled trial showed no significant difference in the effect parameters. However, in the intervention group, self-management behavior significantly improved after intervention. EASE program has therefore been shown to be effective self-management behavior.

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Objective: The objectives of this study were to generate the factor structure of mothers' “attachment” and “caregiving” toward their children, and to examine the reliability and validity of measurement items created.
Methods: A three-factor structure, “adaptability,” “sensitivity,” and “intimacy,” was selected, and each was further defined by two categories based on “attachment” and “caregiving” factors, which generated six factors in total. Then, 244 items were developed to measure these factors based on the relevant literature along with the author's original items. These were narrowed down to 60 items according to the definitions of each factor as defined by “motherhood” and “midwifery” experts. Based on the results of a self-administered questionnaire survey involving 344 mothers with a 1-month-old or 18-month-old child, the validity and reliability of each item was examined to further narrow the selection.
Results: Results from item analysis and comparisons of Cronbach's alpha coefficient of various 30-item combinations yielded a selection with a Cronbach's alpha of 0.882. The exploratory factor analysis yielded a six-factor solution.
Conclusion: While the six factors found in this analysis did not perfectly match the anticipated ones, the items were divided into the attachment and caregiving factors as expected, which demonstrated good reliability and validity of the items.

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The purpose of this study was to investigate factors related to the attitudes of nurses attending terminally ill patients. A self-report questionnaire was administered to nurses with three or more years of clinical experience employed at medical institutions providing cancer care in the Kanto region. Answers were obtained from 697 nurses, and 586 (response rate: 50.3%) excluding invalid answers were analyzed to examine the relationships between the attitudes of nurses (as measured using the “Frommelt's Attitudes Toward Care of the Dying Scale”) and “personal attributes,” “characteristics of the nurse in terminal care,” and “characteristics of environment around the nurse.” Analysis of the data revealed that there were significant relationships between the attitudes of nurses and both age and clinical experience, as well as with “characteristics of environment around the nurse” in terms of the strength of the nursing organization as a team, the sharing of opinions with physicians, the condition of care given at the facility to support terminally ill patients and families, and the attendance and involvement of nurses in the process of informed consent. These results suggest the importance of the environment around nurses, including organizational approaches, in promoting positive attitudes of nurses.

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Purpose: This study examined the reliability and validity of the Japanese version FFS (Family Functioning Scale) for family on child fostering phase.
Methods: FFS was developed in South Korea by Korean researcher. It consists of 24 items with a 4-point Likert scale ranging from strongly disagree to strongly agree. We developed a Japanese version of FFS in cooperation with Korean investigators. Then, 501 subjects were recruited randomly at nursery schools and during routine health examination for infant at community centers. Mothers with a child less than 3 years of age completed the questionnaire that consisted of FFS and data on family characteristics.
Results: All of the data were analyzed statistically. In pretest, the Japanese version FFS has obtained positive correlation coefficient of 0.63 (Spearman's ρ, p<0.001) with family APGAR score in pretest which was conducted among 250 adult men and women. In order to clarify the structure of FFS, factor analysis was performed. The result showed that the structure of FFS contained 6 factors (Affective bonding and unity, External relationship, Family norm, Role and responsibility, Financial resources, Communication) as same as Korean original version. Cronbach's alpha coefficient reliability score for all 24 items was 0.90, and also each factors reliability score were 0.70–0.86, confirming highly internal consistency.
Conclusion: The Japanese version FFS was thought to be useful for assessing family function in Japanese families on child fostering phase.

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Purpose: The purpose of this study was to investigate the psychological mechanism of nurse's turnover action from “organizational commitment” (OC) and “organizational citizenship behavior” (OCB) in Japan and China as a comparative study between the two countries.
Method: We conducted a questionnaire survey among 180 nurses at 5 facilities in Japan and 257 nurses at 8 facilities in China, with a total of 368 effective data obtained. We set up a framework based on the Allen & Meyer model, and tested our hypotheses based on this framework.
Results: Our results revealed significant differences in the average score and all lower dimension scores of OC and OCB. In OC, there was no significant interaction of country and years of experience; however, individually each had significant main effect. In Japan/China/total both, the OC mean of nurses in “no turnover intention” group was significantly higher than the “turnover intention” group. OC was observed to have significant influence on OCB.
Conclusion: These findings suggest that OC differs according to country and years of experience. OC level of the nurse with no turnover intention was higher than with turnover intention. The tendency that the higher level of OC, the more OCB is performed by nurse was confirmed.

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