Purpose: The aim of this study was to investigate the relationships among insight, perception of people with mental illness, self-esteem, and reality testing in patients with schizophrenia.
Method: We examined the responses of 63 patients to the Schedule for Assessment of Insight-Japanese version (SAI-J), Insight Scale (IS), Rosenberg Self Esteem Scale, Japanese version of the Beck Cognitive Insight Scale (BCIS-J), and perception of people with mental illness.
Results: We found significant relationships among insight (SAI-J and IS), perception of people with mental illness, and self-esteem when we divided the participants according to degree of awareness of mental illness. We also found a significant correlation between insight (SAI-J and IS) and self-reflectiveness as well as a good model for predictive factors of “awareness of illness” by multiply regression analysis. The predictive factors were negative symptoms, self-reflectiveness, self-certainty, self-esteem, and one of the factors of perception of people with mental illness.
Discussion: The findings of this study suggest that insight, perception of people with mental illness, and self-esteem are complexly related and that self-reflectiveness is an important cognitive ability for insight in people with schizophrenia. Although further study is needed, these results suggest that improving self-esteem, perception of people with mental illness, and ability of realistic cognition is important for improving insight in patients with schizophrenia.

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Purpose: To clearly identify the process by which students can learn how to provide nursing care from the children's point of view during their pediatric nursing practice.
Method: Semi-structured interviews were conducted with 14 nursing students and the data were interpreted and analyzed based on the Modified Grounded Theory Approach (M-GTA).
Result: The results indicated that there were 29 different concepts generated in the students' learning process. These fall into 7 categories: “anxiety and expectations,” “anxiety over the future,” “adjusting the approach distance with patients,” “promoted understanding of children,” “enhanced desire to assist patients,” “taking action to respond to patients' needs,” and “realizing one's personal growth.” In addition, it was found that “adjusting the approach distance with patients,” “promoted understanding of children,” and “enhanced desire to assist patients” are the core categories in the learning process, and that these are pivotal factors in enabling the students to shift their views to provide care from the children's point of view. Accordingly, we have constructed a diagram that clearly explains the structure of the learning process. In this process, the students experienced a “sense of connection with the children,” which ultimately allowed the students to provide pediatric care from the children's point of view.
Conclusion: The concepts and categories inherent in the learning process that the constructed diagram explains can be used to understand the status of a student's stage in the learning process, and can also be used as a key to provide students with more efficient support for their learning.

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Objective: In accordance with the enforcement of the ethics guidelines for clinical research, the research ethics review systems and exiting problems in the nursing science research/education institutes were investigated, and the ethics review systems to promote future research were studied.
Method: The survey subjects were taken from each type of research education institute using convenience sampling, and the respondents were the persons in charge of the ethical review systems at the institutes. The survey method was a semi-structured interview which consisted in part of constitutive questionnaires, and a simple descriptive summary with qualitative and inductive data analyses that were conducted.
Result: The cooperating organizations were four universities and two colleges. The survey showed that one college and one university had an established ethical review board specializing in nursing science. The other four universities implemented follow-up reviews, etc. by nursing researchers after completing the university-wide ethics review. There was need for improvement and fulfillment in both the contents and hours of instruction of nursing research ethics. It was also learned that a tremendous burden had been imposed on the research ethics review committees.
Conclusion: It was suggested that nursing science researchers are required to facilitate ethical review systems and to enhance research ethics education.

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Purpose: To clarify the lifeworld-rooted experience of the elderly with depression and to provide suggestions to alleviate their depression in nursing care.
Method: An unstructured interview of 11 elderly patients aged 65 or above diagnosed with depression and undergoing psychiatric treatment was carried out and analysis performed using the Giorgi scientific phenomenological method.
Results: Six themes were derived. Elderly people with depression were living with “the weight of past negative memories” and their depression had further deepened as a result of their experience of pain such as “the weight of loss due to old age,” “the threat of physical symptoms occurring with depression,” and “a decline in self-worth and loneliness caused from interaction with others” they had experienced stemming from old age. These experiences were all linked with a feeling of “becoming strongly conscious of death.” It was caused more vicious cycle of depression. On the other hand, the elderly subjects could revive their “zest for living” by being able to feel a connection with others and the world and their depression could be alleviated.
Conclusion: Anguish at having their dignity as a person easily threatened and living with the touch of death is thought to be at the foundation of the experience of elderly with depression. It is important for nurses to encourage a “zest for living” in elderly people living with depression in spite of their depression.

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Purpose: The purpose of this study was to examine the effects of a family support program for staff supporting family members of persons with dementia receiving day service.
Methods: Subjects included staff and families who were randomly assigned to an experimental group or a control group (experimental group; staff n=41, families n=48, control group; staff n=22, families n=45).
The program was composed of a 45-minute lecture and 45 minutes of exercises regarding dementia approaches and how to support families. The data were collected at baseline and after three months for both groups, and the experimental group's data was also collected immediately after the program.
Conclusion: In the experimental group, the staff's dementia knowledge increased immediately after the program, but these effects diminished over time, suggesting a need for adding periodic “boosters” to the program design.
The Staff Empathy Scale asked families the degree to which they perceive staff as being understanding. This item increased after participation in the program, demonstrating the effectiveness of the program in increasing the empathy of the staff.

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Purpose: To develop a dietary education program for patients with Crohn's disease (CD) aiming to maintain remission and improve their satisfaction with meals, and to examine the effectiveness of the program.
Method: The core of the program consisted of self-monitoring by patients and feedback of evaluation by healthcare providers. The developed program comprised three periods such as baseline, intervention, and follow-up; each period lasted for 8 weeks (total, 24 weeks). Participants were randomly assigned to the experimental group who entered the education program (n=10) or control group (n=11). Both groups filled out questionnaires to measure outcomes every 4 weeks, in total 7 times.
Results: In the experimental group the frequency with which patients tried food increased significantly during the intervention period but decreased significantly during follow-up (p<0.01). The health condition of the experimental group did not become worse. There were no significant differences in participants' satisfaction with meals between the two groups and for each period.
Conclusion: This program helped CD patients to increase the frequency with which they tried food maintaining health condition. The results suggest that the program should incorporate devices to maintain these effects.

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Purpose: The purpose of this study was to develop a self-control ability assessment scale associated with health behavior (SCAAS) for older adults in a community.
Methods: The SCAAS contained 24 items, namely, present behavior (a) and future goal (b) for each of 12 health behaviors. A questionnaire survey about the SCAAS was conducted among 1,883 older adults. Then thirty-eight older adults were asked to participate in a program to maintain oral health for a month. The questionnaire survey about the SCAAS was conducted before the program start and after one and a half months.
Results: 1. Eight-hundred and three responses to the SCAAS were analyzed. The subjects had an average age of 75.7±6.3 years, and 42.0% were men. 2. Twenty-two items were selected for the SCAAS from the results of frequency distribution, mean and factor analysis. Five factors were obtained by exploratory factor analysis. The degree of self-control ability was determined as the sum of 11 health behavior scores calculated using a formula; b/(4−a)+1. The sum of the scores significantly correlated with the total scores of the health locus of control scale (r=0.24) and the reformative self-control scale (r=0.27). Cronbach's α was 0.83 for overall scores. 3. The sum of the scores of 27 older adults that had practiced the program were significantly higher than those of the 11 elderly that had not practiced. The test–retest correlation was 0.577 overall scores.
Conclusion: These results suggest that the developed SCAAS has construct validity, criterion-related validity and reliability.

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Objectives: To clarify the actual status of SOC in patients on hemodialysis.
Methods: We conducted a postal questionnaire survey of 800 patients undergoing hemodialysis, and the 424 valid responses retrieved (valid response rate: 53.0%) were used for this analysis.
Results: The characteristics of the patients with high SOC were: higher age; affluent living standard; presence of hobbies; cooperative family members; presence of good relations with nurses and attending doctors; subjective perception of good health; high self-control.
Conclusion: The results suggested that support is necessary for hemodialysis patients to improve their SOC through taste of success and high-quality life experiences.

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