Purpose: We conducted a meta-evaluation of item characteristics such as percentage of correct answers, item discrimination degree and item difficulty using classical test theory (CTT) and item response theory (IRT) for 90 items in a gerontological nursing that created a computer based nationwide common achievement test (CBT) at nursing universities.
Subjects and Methods: We conducted a written monitoring survey by convenience sampling 730 college juniors prior to starting their on-site training at 23 public and private nursing universities. We analysed the percentage of correct answers by CTT, biserial correlations of Item Total (IT), item difficulty by IRT(2PL model), item discrimination degree and factor loading. From these results, we constructed item characteristic curves to evaluate each item's characteristics.
Results: The average percentage of correct answers for gerontological nursing was 65.8–69.3%. The correlation coefficients were r = 0.30–0.41 for pharmacology and r=0.28–0.38 for anatomy and pathology (p<0.01). There were large gaps for both item difficulty (-5.851–4.068) and item discrimination degree (0.292–2.218). As a result, the information content curves exhibited each item's characteristics. The item discrimination degrees for 3 out of 90 items were low, which presents a subject for future study.
Conclusion: This study suggests that the remaining 87 items were considered to be usable in CBT however, 71.1% of the items had negative item difficulty, which indicated that they were easy items to answer. There remain some challenges in discriminating highly capable examinees in this CBT items.

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Purpose: This study aimed to clarify the difficulties experienced by mothers of children with pervasive developmental disorders (PDD), their psychological support needs and the support apparatus available to them.
Methods: Ten mothers raising a child with PDD responded to semi-structured interviews. Interview data were analyzed qualitatively.
Results: The results of the analysis were as follows: 1) Five categories of difficulties were identified: [Burden due to a lack of adequate medical services and special education at home], [Daily tension due to the pressure of keeping house, raising children, providing special training for children and supporting the child's educational needs], [Struggle to find the optimal way to raise the child], [Long-lasting emotional instability due to continuous worries about the child's future], and [Worries and stress about the child's school life]. 2)Six categories of psychological support they are receiving and they need were identified: [Support through the understanding and advice of family members, friends and the community], [Inadequate support from family members and friends], [Need for more psychological support], [Spending time away from providing care for the child], [Hopes by recognizing the child's strengths], and [Need for support for the child that focuses on his or her strengths].
Conclusion: The present findings suggest the necessity of psychological support for mothers of children with PDD from professionals who have knowledge and skills related to PDD and providing psychological support, and offering support for the child that aims to reinforce his or her strengths together with psychological support for the mother.

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Purpose: The relationship between cognitive distortions in interpersonal situations and the stress responses of nursing students was investigated.
Methods: Nursing students(n=307)completed the Cognitive Distortion Scale and the Stress Response Scale. They were divided into four groups based on the results of cluster analyzing Cognitive Distortion Scale scores: “Low distortion,” “High distortion,” “Refusing friends,” and “Modest.”
Results: The total stress score of the Low distortion group was significantly lower in comparison to the other groups, whereas, the High distortion group had the highest stress responses. Moreover, the Refusing friends group showed more negative emotional responses than the Modest group.
Conclusion: Nursing students with tendencies for Cognitive distortions and Cognitive avoidance in interpersonal relationships are under higher stress. Therefore, the important including cognitive—behavioral methods such as cognitive restructuring in the stress management programs for nursing students are suggested.

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Purpose: We used the life-line methodology to elucidate the illness experience studying psychological changes and related factors in ALS patients under TPPV.
Methods: Fifty ALS patients under TPPV participated through questionnaires followed by semi-structured interviews.
Results: The psychological state of all participants deteriorated after onset, but this state persisted in some while others experienced subsequent improvements. Of these, some participants experienced a second deterioration of their psychological state. Positive and negative factors influencing psychological state were grouped into seventeen categories in eight areas, some of which were in opposition to each other. These consisted of the primary area of “physical symptoms and disabilities,” as well as “use of TPPV and associated decisions,” “illness and medical care,” “life prospects,” “personal relationships,” “role performance,” “economic issues,” and “lifestyle issues.” Participants who were able to eliminate or mitigate negative factors while increasing positive factors experienced improvements in their psychological state, while those with significantly increasing negative factors were unable to make improvements even in the presence of new positive factors.
Conclusion: All participants experienced major life breakdowns according to multiple factors following onset. However, some exhibited the process of life-reconstruction as they navigated physical, medical, and social environments. These results suggest concrete measures toward improving quality of life for ALS patients.

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【Purpose】The aim of this study was to elucidate the thoughts and feelings of presymptomatic FAP family members who underwent the genetic testing for FAP and obtained the positive result of abnormal transthyretin gene, and to utilize the results for better nursing to such subjects in the future.
【Methods】Data from five presymptomatic family members of FAP patients were collected by using a half structured interview method. The data were analyzed by content analysis.
【Results and Discussion】They experienced the death of a parent or a relative who had fought against illness since the respondents were children. And they were informed that they were at risk of appearing FAP themselves. They made up their mind to inspect presymptomatic genetic testing to be responsible to their possible future family. In examination for the genetic test they were found to be positive. They, of course, felt aggrieved by this, but it reaffirmed their desire to live. The brothers were different in their thinking for presymptomatic genetic testing. They felt a debt for the husband and wife, and they felt guilt for the children.
【Conclusion】It was suggested that it was important that I would show various choices in the design in the future as to how they could best live with the disease. It was suggested that it was important that I undertook psychology research on how to build richer social support.

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Aim: This study aimed to clarify the body image of patients with Parkinson's disease (PD).
Method: Data were collected from 6 PD patients under nursing care in hospital. All data were analyzed using the Qualitative Synthesis Method (KJ method). After analyzing the data individually for each case, analysis as for which each result united all was conducted.
Results: According to the results of analysis for which each result united all, the following body images were observed: “the body which a coping method established,” “the body which is hopeless by myself,” “the body which expected to improve,” and “the body which perceives life and death by the moment.” The results also indicated that PD patients are continuously influenced by body condition, and they keep transitioning between different body images. In addition, they were affected by “the body which continue trial and error” and “the body which has a relation with the others.”
Conclusion: Particular body images of patients with PD are formed by transitioning between various body images. Therefore, nurses caring for patients with PD should understand the mechanism underlying the formation of body images in these patients.

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Purpose: This study aimed to examine the experience of patients with progressive muscular dystrophy, and clarify the status and process of achieving independent living.
Methods: A qualitative descriptive study using a modified grounded theory approach was conducted involving 18 patients.
Results: The subjects simultaneously experienced the process of [accepting the progression of the disease] in order to spend the rest of their lives with the disease, and that of [creating a balance between dependence on care and taking initiatives in activities of daily living] in order to be self-reliant as much as possible. In the process of achieving independent living, the subjects tried to [take initiatives in activities of daily living], suggesting that these processes were to 《explore ways to take initiatives in their lives》.
Conclusion: In 《exploring ways to take initiatives in their lives》, the subjects tried to maintain an attitude to take initiatives in their lives, even in a situation where they have to be physically dependent. The results suggested the need to provide appropriate support.

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Purpose: The purpose of this study was to develop an operational definition of sexuality for use in assessments by professionals in Japan's health and medical areas.
Method: After reviewing the definitions in textbooks and dictionaries and operational definitions in original articles, analysis was conducted on 32 original articles collected by searches of the ICHUSHI Web from 1995 to 2010, with reference to the Walker & Avant conceptual analysis method.
Results: In considering sexuality in health and medical care domains in Japan, it was clarified that sexuality relates to the personal sexual characteristics and interaction with a sexual partner. Personal sexual characteristics included “degree of concern for sex,” “the importance of sex,” and “male- and female-related evaluations.” Interaction with a sexual partner included “spending time together,” “verbal communication,” “physical contact (‘skinship’),” “mutual consideration,” and “condition of sexual intercourse.”
Conclusion: Because our developed operational definition verifies the existence of sexuality, it is available for assessment by Japan's health and medical professionals.

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