Purpose: To develop a self-evaluation scale available for stable business management by the home-visiting care station manager.
Method: Development of the scale involved a) clarifying the framework of the principle, b) preparing the draft based on the experiences from prior researches and/or of researchers, c) validating the draft in a pilot study and/or an experts’ meeting, d) performing a survey targeting home-visiting care station managers, constructing the subordinate scales based on item and factor analyses, and examining the reliability and validity of the scales.
Results: Twenty-five items and seven subordinate scales were configured. The Cronbach’s coefficient alpha was 0.897, therefore, internal consistency was ensured. The seven factors were “1st factor: establishment of pleasant work environment characterized by effective communication,” “2nd factor: fund management,” “3rd factor: expansion of service,” “4th factor: monitoring of balance,” “5th factor: productivity improvement,” “6th factor: guarantee of nursing quality,” and “7th factor: market research.”
Conclusion: This scale can be used for promoting self-evaluation of business management by a manager and for establishing stable business management.

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Purpose: To assess the effectiveness of a daily 10-minute self-care program, which involves exercising and skin moisturizing with aromatherapy using a self-lymphatic drainage technique over 3 months for patients with breast cancer treatment-related lymphoedema (BCRL).
Methods: Twenty-seven patients with unilateral BCRL participated in this study. The primary endpoint was based on arm volume, whereas the secondary endpoints were based on oedema volume, relative volume change, skin tissue resistance, BMI, self-reported BCRL-related symptoms, skin condition, and time, score, adherence, effectiveness and burden in self-care. Measurements were taken at baseline, after 1 and 3 months of the program.
Results: Twenty-five participating patients completed the program. The significant difference between baseline and 3 months with Bonferroni multiple comparison procedure was shown in the volume of the upper arm and whole arm on the affected side, whereas the unaffected side showed no notable change. Skin tissue resistance significantly declined in the both forearms. BMI was also reduced significantly. There was a significant decrease in severity of arm discomfort regarding BCRL-related symptoms. Self-reported self-care time and self-care score, as well as patients’ perception regarding self-care adherence, significantly increased.
Conclusion: Our 3-month self-care program may significantly lessen the severity of unilateral BCRL.

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Purpose: We aimed to evaluate a family peer-education program on mental disorders qualitatively through an analysis of free-response descriptions.
Methods: The study used qualitative descriptive methods. The free-response descriptions were collected by a questionnaire survey that was conducted to family participants and family facilitators of the program course that ended between November 2013 and March 2014. We performed qualitative and descriptive analyses on the free-response questionnaire item in terms of what you thought and what changed for you as a result of participating or facilitating the program. We also grasped the demographics of family participants and family facilitators.
Results: The questionnaires were sent back from 163 family participants and 133 family facilitators. Ten categories and 41 subcategories were extracted from the free-response descriptions. Compared to family facilitators, family participants had shorter durations of membership in family groups, less education about mental disorders, a wider range of disease history, and more housebound family members with illness.
Conclusions: From the free-response descriptions, we identified group processes of therapeutic factors, the spread of experiential knowledge, and a growing desire to change society. We also identified that some family facilitators reported acquiring new identities. The demographics of family participants were different from those of a prior survey in that the present participants had a higher number of ill members with a longer history of disease.

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Purpose: This study aimed to clarify the integration of care and cure and the internal structure of nursing practice in our country.
Methods: The sample comprised 12 certified nursing specialists with expanded nursing roles. Data were collected through semi-structured interviews and analyzed using the modified grounded theory approach, a qualitative synthesis method.
Results: Ten categories were extracted, and were characterized by the following 4 features of the integration of care and cure. “Drive” is the trigger to start integrating care and cure. “Prop” refers to support for nursing practice that integrates care and cure. “Core elements” are what push care and cure to integrate. “Effect” is the result of the nursing practice that integrates care and cure.
Conclusion: As nurses expand their roles, they can review cure from the nursing perspective and integrate it with care, consequently establishing a new medical treatment. The above results revealed the internal structure of integrating care and cure.

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Purpose: This study aimed to clarify the skills required by nurses for the physical assessment of the cranial nerve in stroke patients to conduct this test and whether any item can be practiced at any level of the acute and recovery phases, which is regarded as essential by Certified Nurse in Stroke Rehabilitation Nursing (SRN).
Method: The Delphi method was used for this quantitative descriptive study. A newly developed self-administered questionnaire was distributed by mail to 126 certified nurses in stroke rehabilitation nursing, with whom, the expert panel was organized. The questionnaire comprised 40 items regarding cranial nerve examination during the acute phase and recovery phase. An established consensus was defined by 51% agreement on the third survey results.
Result: The nurses reached a practice-level consensus on the 30 acute phase items and the 23 recovery phase items. Furthermore, an assessment-level consensus was reached for 8 acute phase items and 7 recovery phase items.
Discussion: The selected practice-level items suggested the necessity for nurses to make a clinical determination of normal or abnormal status. The selected assessment-level items suggested greater applicability for determining an appropriate nursing intervention and evaluating using multidisciplinary support.

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Aim: With the aim of obtaining suggestions for management that prevents turnover in facilities covered by public aid providing long-term care to the elderly, or intensive care homes for the elderly, we evaluated a model of care workers and nurses in these facilities to identify factors that affect their organizational commitment, their coping strategies for intergroup conflict and their intention to continue working.
Methods: Anonymous, self-administered questionnaires consisting of 90 items were sent by mail to three care workers and three nurses at 400 facilities covered by public aid providing long-term care to the elderly nationwide. Returned questionnaires from 316 care workers and 250 nurses (25.3% response rate) were processed by a covariance structure analysis for the causal model study.
Results: The fit indices of the model for care workers were GFI=0.925, AGFI=0.893, CFI=0.940, RMSEA=0.044. For nurses, the fit indices were GFI=0.932, AGFI=0.901, CFI=0.945, RMSEA=0.039. The intergroup conflict coping strategies identified from the causal model were “compassionate coping style” for care workers and “passive compassionate coping style” for nurses. As latent variables that affect organizational commitment, “workplace career” and “communication between employees and management” were identified for care workers, and “life career” and “career advancement opportunities” were identified for nurses.
Conclusion: These findings suggest that enhancing information exchange between employees and management and the development of career advancement and support systems are necessary to prevent turnover of care workers and nurses.

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Purpose: This study aims to describe phenomenon that has arisen in the stagnation of career development of mid-career nurses, and reveal the process after the stagnation.
Method: We performed semi-structured interviews with eight nurses of more than 10 years working in a university hospital. A Grounded Theory approach was used for date collection and analysis.
Results: Experienced a stagnation from “lack of sense of accomplishment at work” nurses, had led to “taking steps towards a new goal” or “acceptance of the current situation.” There seemed to be two processes resulting from nurses’ attitudes to new opportunities. Some nurses expressed a “taking steps towards a new goal” aim to explore and utilize opportunities, and to move on from stagnation by “deciding on a new direction” to find a goal. On the other hand, some nurses seek to compromise with this sense of stagnation and report a “hesitation of direction”: a tendency not to seek and utilize opportunities, leading to an “acceptance of the current situation” and an attempt to find meaning in the work situation.
Discussion: Stagnation in the career development process is not uniform. Organizational support should match nurses’ individual needs and be suited to their specific stage and process of stagnation.

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Aim: The aims of this study were 1) to understand the perceived barriers to conducting research experienced by young Japanese nursing researchers, 2) to understand the support expected from the Japan Academy of Nursing Science, and 3) to examine factors associated with the barriers and support.
Method: We conducted a web-based survey targeting members of the Japan Academy of Nursing Science younger than 40 years old. We conducted multiple regression analyses predicting scores on subscales of questionnaires assessing perceived barriers and expected support.
Results: 648 young nursing researchers were analyzed. Regarding analyses on perceived barriers, “Difficulty in work–life balance” was related to positively raising children (β=0.36). “Workload of education and management” was negatively related to being assistant professor or research/education associate (β=0.31). Regarding expected support, “Improvement of environment/system for research activity” was negatively related to some subscales of perceived barriers including “Lack of research competency,” “Lack of research resources,” “Non-establishment of identity as researcher,” and “Workload of education and management” (β=0.15–0.20).
Conclusion: Young Japanese researcher had various perceived barriers and expected supports according to their own situation. Japan Academy of Nursing Science should develop strategies 1) to encourage networking among researcher, 2) to nurture young nursing scholars’ growth in research competency, 3) to improve the research environment.

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Purpose: The purpose of this study was to identify the meaning of peer support experiences among people with psychiatric disabilities upon recovery.
Research methods: A qualitative research design based on the theoretical premise of Denzin’s interpretive interactionism theory was employed. The study was comprised of twenty participants diagnosed with mental disorders who provided peer support by telephone. They were interviewed in a semi-structured manner about their peer support experiences.
Results: Peer support upon recovery among people with psychiatric disabilities meant the following: 1. Being able to live a unique life through interactions with other people, and 2. Being able to make use of themselves for the happiness of others. “Being able to live a unique life through interactions with other people” is as being comprised of the following aspects: 1) a release from the uniformity caused by psychosis and 2) seeking a unique life. “Being able to make use of themselves for the happiness of others” is as being comprised of the following aspects: 1) pain and concern, 2) experiences in which they were accepted as themselves, 3) connections and solidarity, 4) feeling responsibility toward other people, 5) making use of themselves to support other people, and 6) work that makes meaningful human relationships essential.
Consideration: From Lévinas’ theory of “others,” these results were interpreted as a regaining of uniqueness through the interaction with “others,” whom it is impossible to fully comprehend, and an establishment of subjectivity as an ethical response to others with pain.

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Support is indispensable for families providing home care for cancer patients. This study investigated factors supporting decisions made by families that provided end-of-life care for cancer patients at home. Semi-structured interviews were conducted with members of such families (N=15) about why they could provide such care. The responses were analyzed using the Grounded Theory Approach. The results indicated 115 codes, 32 ideas, eight subcategories, and three categories. The categories were: (1) the feelings of accepting end-of-life care at home, i.e. the family’s view of life and death, (2) support from people around the family, i.e. human relationships with surrounding people, and (3) the courage to continue home care, i.e. the family members’ recognition of the condition in which the family and the patients are placed. It is suggested that interventions for these factors are necessary to support the decisions made by families providing end-of-life care for patients at home.

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Objective: The purpose of this study was to verify reliability and validity of the Natural Disaster Preparedness Scale for Nursing Department of Hospital that we had prepared.
Method: The items for the scale were extracted from materials including literatures, and corrected and pretested by specialists. The scale consisted of the following 114 items: 49 in “Plan,” 11 in “Organize,” 14 in “Equip,” 22 in “Train,” 9 in “Exercise” and 9 in “Evaluate and Improve.” The subjects included nursing departments of 4,298 hospitals in Japan. The survey was made via postal mails, and analyses were made using correlation coefficient and reliability coefficient. The survey was conducted from May to June 2013.
Results: Responses were obtained from 723 hospitals. Of these, 555 facilities (12.9%) had sent valid answers. For reliability, alpha-coefficient for the entire scale score was 0.987, and that for each subscale was 0.843–0.971. The criterion-referenced validity and construct validity were also verified.
Conclusion: Although the number of items is still too large, this scale is useful to measure preparedness against natural disasters in hospital nursing departments.

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Purpose: This study was conducted to confirm the effects of a nursing shared-structured decision-making model (NSSDM) for cancer patients who need to make care-related decisions.
Methods: While the control group mainly received information about their condition, the intervention group received decision-making support based on the nursing shared-structured decision-making model. Anxiety and conflict were measured using the Japanese version of the State-Trait Anxiety Inventory-Form (STAI) and the Decisional Conflict Scale (DCS), respectively.
Results: This trial consisted of 28 control and 26 intervention group patients. STAI subscale scores was no significant difference between before and after the interview. DCS subscale scores, “information” was significantly worse (p=0.02), and “Clarity of value” was significantly improved (p=0.031), however, “Clarity of value” was significantly higher in the intervention group score before interview.
Conclusions: Decision-making support based on the nursing shared-structured decision-making model was possibility of effective in clarifying personal values, but it is necessary to further promote research in the future. On the other hand, when increasing the new information into the patient, it was suggested that there is a possibility of conflict occurs for the information in the patient.

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Aim: The purpose of this research is to determine the optimal depth of water in a foot-bath by analyzing adult women’s physiological and psychological responses to foot bath.
Method: 19 adult women from 21 to 37 years-old were asked to put their legs in a bathtub containing water at 41 degrees Celsius in a sitting position for 15 minutes. We set up three types of foot-bathes with different depths—8 cm, which was below the Sanyinjiao point, 15 cm, which was above the Sanyinjiao point and below the gastrocnemius muscle, and 20 cm, which was at the gastrocnemius muscle, and conducted each type of footh-bath every other day. Low frequency (LF) and high frequency (HF) was calculated from heart rate variability. Physiological indicators were measured by autonomic nerve activity (HF as parasympathetic nerve activity and LF/HF as sympathetic nerve activity) , surface temperature, deep temperature, and blood pressure. Psychological indicators were measured by the Japanese version of the Profile of Mood States (POMS)-Brief Form and the new version of State-Trait Anxiety Inventory Form (STAI) JYZ.
Results: The POMS assessment showed that subjects were more relaxed when they took a foot-bath with 15 cm depth of water than the ones with 8 cm or 20 cm depth of water at a statistically significant level. Yet, no statistically significant difference was found between three groups regarding sympathetic nerve, parasympathetic nerve, heart rate, surface temperature, and blood pressure. Deep temperature was more stable in 15 cm depth of water than in 8 cm and 20 cm depth of water at a statistically significant level.
Conclusion: These results suggest that the optimal depth of water for adult women in a foot-bath is not 8 cm/20 cm but 15 cm.

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Purpose: The purpose of this study is to translate the Occupational Commitment Scale into Japanese, and examine its reliability and validity.
Methods: We developed a Japanese version of the Occupational Commitment Scale consisting of 18 items. We then tested its reliability and validity in a pilot study among nurses. As predicted, the results indicate that the three-factor structure of the scale (affective occupational commitment, continuance occupational commitment, and normative occupational commitment) is sufficiently reliable. Subsequent to testing, we mailed self-administered questionnaires to 4046 nurses in Japan, and analyzed 1331 (32.9%) of the responses we received.
Results: As with the original scale, three factors were extracted by factor analysis, but one item was excluded from the scale due to insufficient factor load. Confirmatory factor analysis indicated a 3-factor model was valid for the 17-item scale (GFI=0.946, AGFI=0.925, CFI=0.929, RMSEA=0.060). Cronbach’s alpha coefficients of the scale and its three subscales were 0.690–0.837. Internal consistencies were confirmed by item–total correlation, resulting in one item’s exclusion. Concurrent validity was supported by positive correlations of the three subscales with job satisfaction, and negative correlations with intention to leave nursing.
Conclusion: While further studies are needed to confirm the reliability and validity of one item, this study’s results indicate that the Japanese version of the Occupational Commitment Scale has acceptable reliability and construct validity.

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Aim: This study aimed to investigate the effects of family support, motivation factors (satisfaction, self-efficacy) and patient’s subjective general evaluations in diabetes self-management behavior on motivation to manage diabetes on one’s own in outpatients with diabetes who have received support from their family.
Methods: A self-administered questionnaire was distributed to two hundred and eight outpatients with diabetes.
Results: Fifty-five outpatients with diabetes (26.4%) have received support from their family. Their average age was 59.8 years old, the median HbA1c% (JDS) was 6.4. Results of path analysis showed a significant path coefficient for links between family support and patient’s satisfaction with family support and diabetes self-efficacy (p<.05). The path coefficients for the links from patient’s satisfaction with family support to motivations for self-management were significant (p<.01). The path coefficients for motivations for self-management were significant (p<.05) from subjective general evaluations of patients where self-management behaviors showed significant path coefficients while feeling a sense of self-efficacy with diabetes.
Conclusion: The results of this investigation indicated that patient’s satisfaction with family support and patients’ own subjective general evaluation in diabetes self-management behavior associated with diabetes self-efficacy positively influenced motivation in diabetes self-management in diabetic outpatients.

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Objectives: This study aimed to clarify the experiences and subjective attainment level (attainment level) of nursing skills among nursing students during clinical practice, as well as the factors influencing attainment levels to identify strategies to improve these levels.
Methods: A self-administered questionnaire survey was conducted among nursing students before their graduation. The survey collected data on attributes, whether they had clinical experience of 29 fundamental nursing skills in clinical practice, the number of such experiences, and their attainment levels of these skills. Descriptive statistics were used to analyze participant attributes and the number of experiences. The Mann–Whitney U-test was used to compare the attainment level and the number of experiences. Factors influencing attainment level were analyzed by discriminant analysis.
Results: The study included 300 nursing students. The experience rate and attainment level for vital signs measurement were 100%; however, the experience rates for seven other nursing skills, including assistance with toileting, were 50% or less. The factors most influencing the attainment levels were as follows: prior experience for 23 nursing skills, presence of a hospital affiliated to the nursing education institutions for two skills, and the nurse’s gender for one skill. The attainment levels for all nursing skills markedly improved when the skills were experienced three or more times.
Conclusion: The factors that most influenced the attainment levels of nursing students differed between the skills being assessed. The results suggest that the attainment level could be improved by ensuring that the student nurses experience fundamental nursing skills at least three times during clinical practice.

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Aim: The purpose of this study was to develop a Parental Perception of Toddler and Preschooler Feeding Assessment Index (PPTPFAI) and analyze the index’s reliability and validity for confirming its characteristic.
Methods: Based on a literature review, we prepared a preliminary index consisting of 27 items. These self-report questionnaires were administered to 571 parents of 1–6-year-old children at public health centers and schools. Internal consistency and test–retest reliability and factor analysis were performed.
Results: Valid responses were obtained from 213 parents. Four factors with 18 items were extracted: (1) Assisting children to eat on their own initiative, (2) taking care of children’s health and regulating their eating lifestyles, (3) demanding good manners, and (4) understanding children’s wants. The Cronbach’s alpha coefficient for the overall scale was 0.83, and for the subscales ranged from 0.62 to 0.79. The test–retest reliability was 0.78 or more. The scores on PPTPFAI were negatively correlated with scores on the Parenting Stress Index Short Form.
Conclusion: This study found that the PPTPFAI constructed 18 items and four factors was developed, and had moderate reliability and validity.

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Aim: The purpose of the present study is to develop and verify a model to examine the relevance of relationships, which was recognized to be useful for the socialization by new graduate nurses and the resulting reality shock and their work commitment.
Methods: A paper-based survey of 2,350 new graduate nurses was conducted using a questionnaire. The model of the “relationships,” which may be related to the socialization of new graduate nurses and its influencing factor was examined by the structural equation modeling method.
Results: The date from 456 participants was analyzed in this study and it was found that recognition of “relationships” gave the greatest effect on the socialization of new graduate nurses. The indirect negative effect from the “relationships” toward “intention to quit their jobs” in the process of “socialization” was 1.5 times higher than the direct effect. The results suggested that “relationships” developed through “socialization” may reduce the “intention to quit their jobs” which is expressed in the form of reality shock and their sense of work commitment.
Conclusion: The present study revealed that the promoting of the socialization may be important for new graduate nurses, and the tentative model developed in this study is acceptable for examination of relevance between the conditions of socialization recognized by the new graduate nurses and relationships promoting their socialization.

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Purpose: We clarified the process of the acquisition of foot care skills by elderly people so they could perform them by themselves, and aimed to derive a concrete intervention method for self care.
Method: We taught foot care methods to 7 elderly persons living at home, using a day-care service. Instruction continued for a total of 12 weeks, once per week, and content analysis of the conversations during instruction was conducted.
Results: The contents of each instructional day and the implementation situation of care continued to change. These contents were classified into five groups according to the number of the apparent conversation during instruction. Elderly people acquired foot care skills in the middle stage, and in the second half, instruction, testing, and device usage were performed by elderly people. In intervention contents: The introduction of the intervention explained the meaning of care and the execution method, the first half of the intervention promoted the understanding of the method and the resolution of any doubts about the observation and judgment, the middle-stage of intervention supported a caring, appropriate confirmation and caring method. In the second half of each intervention, the frequency of observation and encouragement increased. The confirmation of understanding was solidified by and the troubles of the body were prevented by the total process of intervention.
Conclusion: In the process of foot care skill acquisition which a group of elderly people performed, the intervention’s contents of supporting care activities were acquired successfully.

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Self-directed learning is a process in which learners take initiative in determining their own learning needs and in choosing and evaluating appropriate methods of learning. Self-directed learning readiness describes the degree to which individuals, for instance adult learners in nursing, possess the necessary attitude and capabilities for self-directed learning, and can be measured by the Self-Directed Learning Readiness Scale for Nursing Education (SDLRSNE) developed by Fisher et al. The aim of this study was to develop a Japanese version of the SDLRSNE. After translation permission from the original developers was secured, development of the Japanese version of the SDLRSNE was conducted in the following three steps: translation from English to Japanese, back-translation, and pilot testing. We were able to establish the face validity of the Japanese version of the SDLRSNE. A Japanese version of the SDLRSNE may be useful to consider and evaluate the learner’s learning methods and to conduct international comparisons. We will examine and report on the validity and reliability of the Japanese SDLRSNE in the future.

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Objectives: The objective of this study was to identify child fall prevention measures that were implemented on which consensus was reached by the pediatric nurses.
Methods: Three steps of the Delphi technique were carried out and applied to the creation of a questionnaire and two questionnaire evaluations. Participants included 110 pediatric nurses and 44 items were included in the questionnaire as measures to be implemented for child fall prevention. Responses were given as five scores ranging from 5 (strongly agree) to 1 (strongly disagree) for each of the measures.
Results: Answers were obtained from 90 participants in the 2nd questionnaire evaluation. Thirty-five items had measures with an agreement rate of 80% or more, consisting of 8 items of measures for children, 16 items of measures for parents, 5 items of measures for the environments, and 6 items of measures for activities in the ward. These items served as the measures to be implemented for child fall prevention on which a consensus was reached.
Conclusion: The measures for parents were the highest in number and this shows the importance of parents’ cooperation in child fall prevention.

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Objectives: The aim of this study was to clarify the organizational citizenship behaviors of nurses working at hospitals.
Methods: A self-administered questionnaire survey was conducted among 1,003 nurses at 4 public hospitals in neighboring districts. The questionnaire devoted 28 items to organizational citizenship behavior and demographic details.
Results: A total of 763 valid responses were analyzed. More than 90% of participants reported “sometimes performed” or “frequently performed” in two questionnaire items out of four regarding “Staff Support,” whereas more than 50% reported “not performed at all” or “not much performed” regarding “Royalty.” Five factors were obtained by exploratory factor analysis: “Quality Improvement,” “Environmental Improvement,” “Coaching,” “Cooperation,” “Caring,” and “Quality Improvement.” “Cooperation” was the most frequent factor and “Quality Improvement” was the least frequent one.
Conclusion: In conclusion, we clarified the organizational citizenship behaviors of nurses working at hospitals. It was found that organizational citizenship behaviors toward individuals such as colleagues were frequently performed by nurses, on the other hand, those toward organizations were not performed so much. Furthermore, we found not only general organizational citizenship behaviors, such as “Staff Support,” but also the typical behaviors of nurses, such as “Quality Improvement” and “Coaching.”

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Objectives: This study aims to explore related factors for expanding number of nursing staff (“the present number of nursing staff” and “the number of employed nursing staff minus the nursing staff who quit in the period of 16 months”) in the home-visit nursing offices in Chiba prefecture.
Methods: The participants, who answered the questionnaire, were 78 out of 213 managers in all home-visit nursing offices in Chiba prefecture (the answer rate was 36.6%). The questionnaire investigated the home-visit nursing offices’ characteristics, the managers’ discretional claim to administer their offices, working environment, managers’ and the corporate bodies’ expanding views regarding the number of staff, and nurses’ salary. After analyzing relationships in each variable, multiple regression analysis was used to clarify the relationships between dependent variables “the present number of nursing staff” and “the number of employed nursing staff minus the nursing staff who quit in the period of 16 months” and the related variables.
Results: The factors that increased “present number of nursing staff” were: the amount of work the managers perform on their overtime, seasonal bonuses in annual income, and the managers’ discretional right on personnel matters, while the factor that decreased it was the discretional right on personnel matters by the corporate bodies. The factor that increased numbers of “the number of employed nursing staff minus the nursing staff who quit in the period of 16 months” was seasonal bonuses in annual income, while the factors that decreased it were a medical corporation within the corporate bodies, and a lack of the consultation system dealing with the staff’s difficulties to provide home-visit care for their clients.

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In this study, we performed hand massage on individuals with mental disorder, based on a soft-touch skin contact method developed by us. In addition, we elucidated the changes before and after the intervention using autonomic activity indices, such as heart rate variability and amylase, and psychological indices, such as anxiety, the degree of relaxation, the level of fatigue, desire for conversation and the sense of intimacy. The subjects were 10 individuals with mental disorder living in a community (mean age 56.7±14.9 years) who underwent 15 min of face-to-face hand massage in a sitting position following loading with the Uchida–Kraepelin test. A comparative analysis conducted for each index before and after the intervention revealed a significant decrease in the heart rate and a significant increase in pNN50 after the intervention. The State-Trait Anxiety Inventory (STAI) score showed significant decreases in both state and trait anxieties after the intervention, and a subjective evaluation using the Visual Analog Scale (VAS) showed a significant reduction in the level of fatigue alone. Desire to converse with and the sense of intimacy toward the practitioner was increased by ≥50% following the intervention. No significant difference in salivary α-amylase was observed between the state at rest and before and after the intervention. In addition to enhancing the parasympathetic activity and causing a reduction in anxiety and subjective fatigue, our study indicates that hand massage has a favourable effect on psychological distance from the practitioner and has nurse–patient relationships forming of possible applications.

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Purpose: This study was to identify NICU nurses’ benefits, promotion and barriers for family centered care (FCC) implementation in Japan.
Methods: This qualitative descriptive study used a convenience sampling of NICUs from the greater Tokyo area Japan yielding 12 NICU nurses from six of the ten perinatal medical centers approached. Three focus-group interviews with four nurses each were conducted.
Results: Seven categories were extracted as actual nurses’ practices of FCC. Four categories were extracted as benefits for to implement FCC: 1) greater psychological health of parents and improvement in parental competencies; 2) strengthening family bonding and function; 3) enhancing communication and information sharing about child’s care and 4) nurses’ greater job satisfaction. Five categories were extracted as promoting factors for nurses’ to implement FCC: 1) strength of staff education about FCC; 2) opportunities of decision-making about care policies of the unit; 3) team activities to improve care for families; 4) understanding and support from pediatricians about FCC and 5) positive responses from families to implement FCC. Five categories were extracted as barriers to implement FCC: 1) lack of knowledge and skills about FCC; 2) limited opportunities of decision-making about care policies; 3) concerns about families’ abilities to perform child’s care; 4) negative attitude for shifting to family-centered care policies from staff centered/task oriented care; 5) burden to implement FCC with limited staff and 6) different views on FCC among staff.
Conclusion: This study provides direction for promoting nurses’ to implement FCC by strengthening staff education about FCC and providing organizational support from managers and other healthcare professionals.

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This research investigated the various effects of nursing care on a patient’s life in hospital. During the research, which employed the grounded-theory method, the 57 patients and 35 staff of a general hospital underwent participant observation and interviews. As a result, a core category whose central theme was “feelings of being well cared for and at home in the hospital” was obtained. This core category embraced 4 categories: “The role of the inpatient”, “Nurse’s duties”, “Nurse’s preconceptions and attitudes”, and “Nurse’s focus of attention”. Of these, it is the nurse’s focus of attention that determines whether or not the patient feels well cared for and at home in the hospital. It was found that when a nurse’s main focus was directed beyond merely her preconceptions and attitudes, a patient would feel well cared for and at home in the hospital environment, and so could more readily “play the role” of inpatient.

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Purpose: This study aimed to elucidate the characteristics of conscious and unconscious empathy that psychiatric nurses experience through their patient–nurse relationships in daily nursing practice.
Methods: Unstructured interviews were conducted with 30 psychiatric nurses who had ≥5 years of work experience. Nurses described relationships with patients that had deepened and left an impression on them. The data were analyzed within the framework of Benner’s interpretive phenomenology.
Results: Analysis on empathetic experiences of psychiatric nurses within their patient–nurse relationships interpreted 4 themes. The first 2 themes, concern about their relationship with patients and instinctual drive for understanding the patients and mutual effect between personality characteristics and life histories of patients and nurses, demonstrate nurses’ commitment and desire to relieve patients’ pain and negative feelings. The second 2 themes, feeling of a genuine connection with patients as confirmed through therapeutic effect and a lifelong bond surpassing time and space, demonstrate mutual understanding, sharing of joyous, tender, and unexpected moments, and feelings of security and satisfaction between nurses and patients.
Conclusion: These findings suggest that empathy experienced by psychiatric nurses through the patient–nurse relationship is a phenomenon that cannot be explained by only one particular scenario of nursing care, and is rather an experience acquired through the association between everyday nursing care and the time that nurses and patients are living in.

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Purpose: Construction of a support system is a crucial issue for women and their partners who receive a diagnosis for fetal abnormality. We sought to identify the current issues and the direction of future studies by reviewing the Japanese and international literature.
Methods: PubMed, Web of Science, and Ichushi Web were searched using the key terms “fetal abnormality,”“women,”“partner,” and “nursing,” to find Japanese and international articles from January, 2003 to December, 2013. We performed a systematic literature review. After title and abstract screening, study quality was assessed.
Results: Most studies addressed women’s issues that occur during pregnancy. Twenty-six articles in domestic and international journals were reviewed for this study. Women and their partners experienced the psychological conditions of sadness, anxiety, and shock after receiving a diagnosis of fetal abnormality. No gender differences were found, and intra-couple congruence was frequent. Moreover, not only negative feelings but also positive feelings, such as hope, were experienced. In addition, health professionals need to provide accurate information and empathic support from the time of disclosure for fetal abnormality.
Conclusion: Based on the results of this literature review, future studies should examine the care needs of women and their partners as well as assess the quality of care they receive in order to construct care systems. There is a smaller body of knowledge about women and their partners who received a diagnosis for fetal abnormality in Japan than in other countries. Therefore, education programs for nurses who provide support to women and their partners should be developed.

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The purpose of this study was to clarify changes that occurred among nurses who participated in a learning relationship with researchers, while the nurses were performing patient education. The nurses learned to use the “nursing practice model for patient education (TK Model)” and the study was conducted on their learning experience.
This action research study was conducted between February 2008 and April 2010. There were four nurses who participated. Fourteen case study sessions and teaching sessions were held and 7 to 15 nurses attended each study session.
During the process of learning to use the TK Model, the nurses increased their practical skills. The phases of Introduction, Emergence, Stagnation, Breakthrough, Adoption, and Propagation were observed. Also during the process, changes occurred. There was a period of conflict between colleagues and doubt about the utility of the model had to be eliminated. Finally the nurses achieved understanding about the relationship between nursing practice and the model. Furthermore, the experience generated changes among nurses in other wards and at the outpatient clinics.
These positive changes demonstrate the usefulness of the TK Model.

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Purpose: The purpose of this study was to clarify the relationship between the ambivalent state of simultaneous cognition of “worthwhileness” and “burden” and mental health or work motivation among senior clinical nurses.
Method: Self-administered questionnaires were completed by 325 non-managerial senior clinical nurses with three or more years of clinical experience. The questionnaire consisted of personal background information, the role stress perception scale, work motivation measurement scale for nurses, and the Japanese version of the Kessler Psychological Distress Scale (K6). Data analyses were conducted using chi-square test, Kruskal–Wallis test, one-way analysis of variance and multiple regression analysis.
Results: Among senior clinical nurses in a state of cognitive ambivalence, 73.4% scored ≧5 on the K6 that means mental health is poor, and work motivation was significantly higher compared to those having a low “worthwhileness” score. In addition, their K6 scores were associated with score of “making the workplace more humane,” and work motivation scores were associated with score of “self-development and working positively for nursing practice.”
Conclusion: Results in this study indicate that, although work motivation is high, mental health is poor among senior clinical nurses who are in a state of cognitive ambivalence. Also, mental health was associated with “making the workplace more humane,” and work motivation was associated with “self-development and working positively for nursing practice.”

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