Aim: The purpose of this study was to clarify recovery of self for individuals undergoing cancer treatment during the downward phase of the illness trajectory.
Methods: The study sample comprised 5 patients undergoing cancer treatment with stage III or IV digestive tract cancer. Data were collected through the records of nursing care offered to the patients by the researcher who was the primary nurse. The qualitative synthesis method (KJ method) was used to analyze the structure of recovery of self within and across cases.
Results: The structure of recovery of self consists of 6 characteristics: [awareness of physical deterioration], [recognizing that one is struggling with the surrounding environment], [searching for strategies to ease suffering], [responsive to people with whom one feels a connection], [confirming meaningful experiences], and [expressing how one wants to be in the present moment]. It was based on awareness of physical deterioration and was affected by interpersonal relationships.
Conclusion: Recovery of self for individuals undergoing cancer treatment during the downward phase of the illness trajectory was an expression of how to want to be as individuals living with other people. And it was related to the possibility that they would be able to live meaningfully in the moment. The results of this study confirmed the care viewpoint of supporting how individuals are themselves regardless of the circumstances of their sufferings.

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Purpose: To develop and validate a self-evaluation scale on research utilization competency for clinical nurses.
Methods: There were four stages in developing the scale: (a) Extracting important performances related to research utilization based on qualitative and inductive research findings. (b) Making items for the scale based on the important performances related to research utilization. (c) Examining the content validity with a panel of experts and a pilot study. (d) Conducting a survey and performing item analysis, factor analysis for arranging subscales, and testing the reliability and validity of the scale.
Results: Self-Evaluation Scale on Research Utilization Competency for Clinical Nurses (SRUC), which had 6 subscales and 35 items with a 5-point Likert scale, were constructed through the four stages. In all, the data of 548 nurses, who worked at hospitals all over Japan, were collected and analyzed. The results supported that the scale has high internal consistency and stability, and construct validity.
Conclusion: The SRUC has good reliability and validity, and nurses can use the scale for self-evaluating research utilization competency.

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Objective: This study evaluated the reliability and validity of the Attachment–Caregiving Balance Scale which measures mothers' “attachment” and “caregiving” toward their children.
Methods: A self-administered questionnaire was completed by 630 mothers who had children aged 1 month old, 6–11 months old, and/or 18 months old. The survey was conducted to assess the reliability and validity of the Scale using six factors (the factors of “adaptability,” “sensitivity,” and “intimacy” for each of the “attachment” and “caregiving” categories) and other external indices.
Results: Cronbach's α was 0.882, and exploratory factor analysis found a factor structure quite similar to what was expected. The results of confirmatory factor analysis were a goodness of fit index value of 0.842, an adjusted goodness of fit index value of 0.812, and a root mean square error of approximation value of 0.074. Significant differences were found by known groups analysis, and there was also a significant correlation, albeit below 0.7, with the external indices.
Conclusion: While criterion-related validity should be further examined, reliability and construct-related validity were supported, indicating that the scale can be used to measure the development of mothers as caregivers.

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Purpose: The purpose of this study was to describe the process of change in the nurses' perception of their care and their nursing practice.
Method: The research was conducted based upon the action research. Participants were fifteen nurses in the child and adult ward. The researcher facilitated the “Kobanashi”(study sessions) where the data from the observations and interviews with patients and their families and the results of the various nursing researches were presented to the nurses.
Results: At the beginning of this study, the nurses' attitudes appeared as though they had acquired a work style in which they focused only on performing at a minimum and ceased concerning themselves with other issues in the care of the patients. They constantly experienced feelings of frustration and helplessness. Until starting those sessions, they were not entirely open-minded about the remarks from the patients because they took them as criticism. Through the collaborative work, the nurses found a different point of view when considering patients' opinions and reviewing their work. They started to integrate their professional knowledge and nursing practice by participating in the Kobanashi. They discussed the issues among themselves, conceived ideas of actions for improvement.
Conclusion: The study findings suggest that support and an environment for open discussion among nurses are necessary to improve the care of both children and adults.

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Purpose: To develop an Anticipatory Grief Scale for Family Caregivers (AGSFC) of a person dying at home and analyze its reliability and validity.
Methods: Based on a review of the literature and our previous study, a temporary scale consisting of 51 items was prepared. The scale was conducted on 99 families who were caring for a family member dying at home. As a control group, the scale was also conducted on 68 families who were providing care for a family member with a non-terminal disease.
Results: As a result of factor analysis, 4 factors (spiritual pain in preparing for a loss, physical and mental fatigability in daily life, precedent anxiety regarding bereavement, and exhaustion) comprised of 19 items were extracted. The reliability of the scale was confirmed by a Cronbach's alpha internal consistency reliability coefficient of 0.87 (0.70–0.85 for subscales). The criterion-related validity was confirmed by comparison with the 28-item General Health Questionnaire (GHQ28) scores. Construct validity was confirmed by comparison between families caring for a family member in the terminal stage and families providing care for a family member with a non-terminal disease.
Conclusion: The reliability and validity of the AGSFC were confirmed. Therefore, this scale may be suitable for use with family caregivers of a person dying at home. Further, it is necessary to refine this scale.

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Objective: To describe the difficulties faced by immigrant Chinese mothers caring for their children in Japan and their process of coping with cross-cultural experiences.
Methods: We conducted semi-structured interviews of 8 Chinese–Japanese mothers living in the Tokyo metropolitan area who had given birth to and were caring for their children in Japan. A qualitative descriptive research method was used.
Results: We found 3 categories of difficulties that these women faced repeatedly: 1) Could not imagine how to be a Japanese mother; 2) Were confronted by a wall of a different culture; 3) Lost their sense of self in cross-cultural experiences. We found 1 common category of coping: We found 1 category of outcomes from coping with difficulties: They found new identities as mothers with both Japanese and Chinese cultural characteristics.
Conclusion: We found that they coped with their difficulties by observational learning and imitation, and that this result resembles the stage theory of culture shock proposed by Pedersen; that is, Chinese–Japanese mothers experienced intercultural adjustment and mothering together over time, because caring for their children forced them to acclimate to their new culture.

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Purpose: To review international and domestic literature on the process of family experiences in caring for a person with a serious mental illness and identifiy common stages of the process.
Methods: Through a database search, I identified international and Japanese research articles published since 1980 that examined the process of family experiences in caring for a family member with schizophrenia, depression, or bipolar disorder.
Results: Seventeen qualitative research articles, including fourteen international and three Japanese articles, were identified. From nine international articles on general family experiences, the following twelve common stages of the process were identified: awareness of the problem, ineffective effort and being consumed, crisis, diagnosis or recognition of illness, dissatisfaction with professionals and care systems, negative emotions, feeling of loss and grief, difficulties because of stigma, unstable condition of patient, learning to cope and using care systems, stability and chronicity of patient's condition, and realistic hope.
Conclusion: Although the identified common stages could be applied to Japanese families, further research on the process of general family experiences in Japan is recommended.

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Objectives: Work engagement is an important aspect of organizational efforts that are made to retain nurses and to improve the quality of care. This literature review aims to clarify the research methodology with regard to the work engagement of nurses and to consider the research challenges.
Methods: Electronic databases for the Health Sciences and Health Administration (CINAHL, MEDLINE, PubMed, Japanese Central Review of Medicine) and Psychology (PsycINFO) were systematically explored with the following key words: nurse, engagement, and work engagement. Twenty English articles published from 2004 to November 2011 were reviewed.
Results: Most studies focused on nurses in hospital settings. The findings revealed that methodological issue was to juggle various hospitals and units at once. There were four scales measured work engagement. Recently, researchers used Utrecht Work Engagement Scale with the conceptual framework of Job Demands–Resources model. Improving nurses' work engagement made a contribution not only to nurses' physical and mental health outcomes but also to a quality of care and organizational efficiency.
Conclusion: The following are future challenges: need for further research regarding variables considered features of settings and units, application of further analytical methods. Thereafter, the causal association between antecedents, work engagement, and outcomes should be clarified by studying longitudinal and interventional designs.

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Objective: To demonstrate specific examples and the assignment of ethics review systems for nursing research in hospital where clinical nursing research is implemented, and to study the future direction of ethical review systems.
Methods: An inquiring survey of the persons in charge of research on ethics reviews, or who are versed in ethics reviews, was conducted by convenience sampling, selecting one cooperating hospital from each type of organization (national/public universities, corporation, university-affiliated school, technical school, etc.).
Results: The analysis of the data from the six hospitals showed problems such as: 1) the review systems depend on the hospital, some hospitals review every nursing research result with the research ethics board, some review the research in the nursing department separately from the ethics board, and there are hospitals without a review system, 2) they also have differences in the establishment and the contents of the review criteria, 3) some institutions do not have a nursing or ethics specialist on the research ethics board, 4) the standards of ordinary or basic reviews are undefined, the reviews are time-consuming, or the knowledge of research ethics are deficient.
Discussion: There is an urgent need to work on the cultivation of human resources to properly conduct nursing research ethics reviews, and academic societies and nursing associations are required to present educational/training programs, and to offer the information on the research ethics.

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