Objective: To determine the characteristics of nursing research considered by the IRBs and how to improve IRBs reviewing nursing research in Japan in comparison with IRBs in the USA with respect to types of reviews, the IRB reviewing systems.

Methods: We classified nursing research based on the research characteristics through a literature review, and obtained information about the types of reviews and review systems of IRBs from two universities with nursing departments in the USA.

Results: (1) Nursing research is classified into four types (research, quality improvement, evidence-based practice, and program evaluation). (2) Depending on the anticipated risks of research subjects, protocol reviews are classified as follows: exemption, expedited, and full board. (3) In the USA, research proposals are generally reviewed by a full IRB, but there is a sub-committee for expedited review. The reviewing system is very well-organized with sufficient staffing, which allows distribution of staff to various sections, including a consulting section for inquiries of researchers. (4) The objectives of nursing research are largely associated with improvement in nursing care, evaluation of programs, and evidence-based practice, and these types of research are categorized as exempted or expedited reviews.

Conclusion: There are significant needs for improvement in the IRB system in Japan regarding reviewing procedures, which should be modified depending on the methods of nursing research, subjects, and content. In addition, there is a need for staff development so staff can provide advice or consultation with researchers who want to apply to the IRB.

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Objectives: This study examines the trajectory of patient education from the two perspectives of basic nursing education and clinical practice, to shed light on the development of nursing in the 70 years since the end of World War II. Methods: This literature review employed historical methods following Ranke’s positivism-based history. The materials analyzed were categorized as primary, secondary, and tertiary. By conducting a source criticism of the categorized materials, this paper examined the relationship between the stages of patient education development by checking them with each piece of source material. Results: Since the 1960s and 1970s, as the prevalence of lifestyle-related diseases increased and an aging society emerged, the regulations for educational institutions for public health nurses, midwives, and registered nurses were revised. Additionally, the learning foundations for patient education in basic nursing education were prepared. Learning has come to be conducted from an analytical perspective that aims to understand patients as individuals. Since the 1980s, awareness regarding patients’ human rights has increased. In clinical practice, patient decision-making is now encouraged. Furthermore, the introduction of neoliberal policies necessitates that clinicians engage with patients. Conclusions: Patient education has revolutionized basic nursing education and clinical practice while changing with political and economic developments.

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Purpose: This study aimed to elucidate relationships between work-family organizational culture, job satisfaction, organizational commitment, and intention to stay among Japanese female registered nurses who are wives or mothers.

Method: A self-administered questionnaire was distributed to registered nurses (n = 869) working in 4 hospitals of eastern Japan. The focus of the analysis was limited to female registered nurses who were wives or mothers (n = 335). Our questionnaire measured work-family organizational culture using the Work-Family Culture Scale for Nurses, as well as nurses’ job satisfaction, organizational commitment, intention to stay at their current workplace, and individual attributes.

Findings: A total of 766 (88%) registered nurses filled in and returned their questionnaires; 335 of them were wives or mothers and thus were included in the present study. The results of hierarchical multiple regression analyses conducted on their survey responses revealed the following: (1) job satisfaction completely mediated the positive effects of work-family organizational culture on nurses’ intention to stay and (2) organizational commitment partially mediated the positive effects of work-family organizational culture on intention to stay.

Conclusion: The results indicated that work-family organizational culture enhanced job satisfaction, organizational commitment, and intentions to stay in female registered nurses who were wives or mothers. Therefore, fostering work-family organizational culture would help promote the retention of these nurses.

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Aims: This research aims to clarify how a mother’s experience of parental bonding (PBI) and internal working model (IWM) impact the development of the mother’s caregiving system, and obtain basic data to provide support that promotes development as a caregiver.

Method: A self-administered questionnaire was given to mothers who consented to participate in continuous research starting at 1-month postpartum. This paper discusses analysis of 150 mothers from whom valid responses were received at 12 months, 18 months, and 2–3 years postpartum. Research content covers attributes, development of the caregiving system (attachment-caregiving balance), PBI, and IWM.

Results: Correlations with the attachment-caregiving balance were seen in the 3 postpartum periods. A correlation between the attachment-caregiving balance and PBI was seen at 12 months postpartum, and between the attachment-caregiving balance and IWM at 18 months postpartum. Structural equation modeling shows PBI impacted IWM and development of the caregiving system at 2–3 years postpartum. PBI had no direct impact on development of the caregiving system.

Conclusion: A mother’s PBI impacts the development of the caregiving system at 2–3 years postpartum through IWM. This suggests that changing a mother’s awareness of PBI may lead to support that promotes development as a caregiver.

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Purpose: The purpose of this study was to reveal what new nurses had recently learned and discovered through multiple reflections about their clinical experiences with their mentors as well as to reveal ways for them to recognize effective reflective support.

Method: A total of seven nurses, having experienced reflective support when they were new nurses, were interviewed at two facilities that practiced multiple reflections on clinical experience. The data was content analyzed qualitatively.

Results: These new nurses gained “awareness of their own previously unrecognized weaknesses,” “awareness of what they value most,” and “recognition of concrete actions through dialogue,” etc. Effective reflections that participants recognized included “respecting the uniqueness of new nurses” and “supporting new nurses’ actions.” On the other hand, ineffective reflections included giving “unilateral suggestions” and “authoritative guidance with a lack of understanding concerning the situations of new nurses.”

Conclusion: The results of this study revealed that the new nurses did receive effective support, such as being respected for their uniqueness, through a deepening understanding between them and their mentors. As a result, more than a single reflection method, a multiple reflection method facilitated within them a greater awareness of self-understanding and practices.

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Objectives: To interpret elements of resilience in patients with senile depression were interpreted from stories of their illness and recovery.

Methods: Participant observation and unstructured interviews were conducted among 5 elderly patients who were receiving psychiatric treatment after being diagnosed with depression. The data were analyzed using Riessman’s narrative analysis.

Results: Six themes of resilience in patients with senile depression were interpreted from subjects’ stories of illness and recovery: “strength that emerged from re-recognition of abilities acquired throughout their lives, and from everyday lives”; “strength to perceive bonds with family members from day-to-day kindnesses and consideration”; “strength to re-recognize a sense of belonging to a familiar community”; “strength to accommodate feelings of guilt, thereby creating an integrated view about their own lives”; “strength to find value in loneliness”; “strength to love and entrust one’s hopes to the next generation through the connections of life”.

Conclusions: The six themes of resilience found in this study seemed to be closely associated with the lives and the worlds inhabited by elderly patients over a long period of time. It is important that nurses have their own views about aging, death, and human beings, and that they stay beside elderly patients and talk with them, thereby noticing the patients’ strength that has emerged from the experience that the patients gained throughout their lives.

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Purpose: The aim of this study is to verify the validity of a novel wellness checklist for maintaining the health of elderly persons living at home in the communities by care managers.

Method: The proposed “wellness checklist for maintaining the health of the elderly” was iteratively reviewed three times using the Delphi method with 19 licensed nurse instructors as the participants. The response items were rated on a nine-point Likert scale from 1 (not suitable at all) to 9 (highly appropriate) and examined by researchers. Furthermore, the researchers discussed the categories and the way in which the information is presented.

Results: The content validity of 66 items divided into nine categories was iteratively reviewed three times using the Delphi method with the agreement of all participants. Ultimately, the number of items was reduced to 55 in nine categories. The mean range were 6.7–7.9, each of these items was judged “appropriate” the third time around. The response rate of the participants was 94.7% throughout the process.

Conclusion: This study clarifies the content validity of the wellness checklist for maintaining the health of elderly people who live at home in the communities, which has been confirmed by experts. The elderly can maintain self-reliant and healthy lives by monitoring daily life using the wellness checklist. It can be expected that the checklist will help them recognize when professional support is necessary to prolong their independence in maintaining their overall health.

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Purpose: To elucidate the process by which community-dwelling individuals with mental disabilities achieve favorable daily living conditions.

Methods: Semi-structured interviews were conducted with 12 individuals with mental disabilities who visited a community activity support center. Data were analyzed using a modified grounded theory approach.

Results: Subjects indicated that they forged a “my guide” from a state of “loss and troubles” by making use of repetitive experiences of “trial-and-error” and by “selecting only what is necessary”. They maintained favorable daily living conditions by engaging in “self-care” and creating a “stable lifestyle”. This process constituted “re-acquisition of initiative”, in other words the process of managing their disease and regaining the ability to live independently.

Conclusion: Our results suggest that in health care professionals must consider the cognitive impairment associated with mental disorders. Our results also highlight the need for more detailed research into the techniques used by health care professionals who provide support.

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Purpose: This study aimed to explore the decision-making process in patients with inflammatory bowel disease who were considering biologic therapy.

Methods: This descriptive study used a grounded theory approach, involving semistructured interviews and continuous comparative analysis, to study decision making. The study subjects were 20 adult patients with inflammatory bowel disease that was in remission.

Results: During the data analysis, one core theme (“should I take the risk to reduce my symptoms?”) emerged as the central problem in patients considering biologic therapy. This was resolved through a process consisting of five stages: 1) experiencing disruption of daily life by symptoms, 2) selecting who decides treatment to receive, 3) searching for information, 4) weighing the risks against the benefits, and 5) making the decision. When weighing the risks against benefits, common considerations were “seriousness of the symptoms,” “desire for a normal life,” “fear of the side effects,” “cannot go back to a condition before receiving the treatment,” and “treatment as the last remaining option.” The decision is based on this evaluation.

Conclusions: The results suggest that when making decisions regarding biologic therapy, patients are influenced by their evaluation of the risks and benefits of the treatment.

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Objectives: The aim of this study was to reveal the incidence of low back pain in ward nurses who assist patients with mobility, how often these nurses engage in mobility assistance movements, and whether mobility aids are used properly. We investigated the correlation between low back pain during mobility assistance and the frequency of mobility assistance or the proper use of mobility aids.

Methods: A self-administered questionnaire survey was conducted among nurses working in hospital wards where patients frequently require mobility assistance.

Results: Survey responses were obtained from 534 nurses working at 18 facilities. Low back pain occurred always or 50% of the time in 43.9% of nurses when changing patients’ position in bed and in 33.4% of nurses when moving patients horizontally in bed. The most frequently performed mobility assistance movement was changing patients’ position in bed, followed by moving patients horizontally in bed. There was a weak positive correlation between the frequency of all mobility assistance movements and the incidence of low back pain during mobility assistance. The most frequently used mobility aids were sliders, followed by sliding boards and sliding sheets. The incidence of low back pain did not correlate with the use of mobility aids, when used properly, except for the use of sliders between bed and stretcher.

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Purpose: We investigated whether matrix metalloprotease-9 (MMP-9) and bone morphogenetic protein-6 (BMP-6) of biopolymers can be used to assess pressure ulcers. We examined whether the quantity of both proteins in the ulcer exudate was associated with the DESIGN-R scores for the pressure ulcers.

Methods: The concentrations of MMP-9 and BMP-6 in the exudate from pressure ulcers were measured. DESIGN-R scores were determined for the pressure ulcers. The associations between the biological markers (MMP-9 and BMP-6) and the DESIGN-R scores were calculated. Based on the DESIGN-R scores, the differences in the concentration of both proteins measured were also evaluated.

Results: The concentration of MMP-9 was greater in the exudates from pressure ulcers with higher scores for D (depth), E (exudate), and G (granulation tissue) in the wound bed. BMP-6 in the pressure ulcer exudate correlated with higher scores for P (pocket, undermining formation) in the wound edge. Furthermore, it was suggested that by estimating concentrations of MMP-9 and BMP-6, a judgment of severity was possible individually based on the exudate from the depth (D) of the wound bed and pocket (P) of the wound edge.

Conclusion: The amounts of MMP-9 and BMP-6 in the wound exudates could be utilized as biological markers for the assessment of pressure ulcers.

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Purpose: The purpose of this study was to determine the effect of intervention by certified nurse specialist in psychiatric mental health nursing (PMHCNS) on depressive cancer patients.

Method: The randomized controlled trial design was used. Inpatients from three hospitals were randomly allocated into the intervention (n = 34) or control group (n = 37). Participants in the former group received PMHCNS intervention while control participants were given a booklet about self-management of depressive symptoms. The primary outcome was scores of depression evaluated on the Patient Health Questionnaire (PHQ)-9 scale before and after intervention.

Results: PHQ-9 scores improved in both groups. As a result of 2-way ANOVA, there were significant interaction effects between the intervention and time in the scores.

Conclusion: The result of the study provided evidence to support that PMHCNS intervention improves depression.

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Objective: To develop a self-evaluation questionnaire to measure the self-image of nurses in the early stages of their mid-careers.

Subjects and Methods: Nurses in their twenties with more than three years of clinical experience were selected as subjects of this study. A self-evaluation questionnaire to evaluate their self-image was developed, and its adequacy was reviewed by use of article analysis, exploratory factor analysis, and its reliability and criterion-related validity.

Results: The number of subjects was 569. As a result of the analysis, a model with 5 items containing and 16 factors was developed and called “Self-evaluation questionnaire of self-image of nurses in the early stages of their mid-careers.” The 5 items included “My tired self,” “My isolated self,” “My lost or worried self,” “My unskilled self,” and “My striving self.” The trust factor obtained for the entire measure was .872, and the subscale for internal consistency was .544 to .816. Concurrent validity, significant positive correlation with the self-esteem scale, CES-D and significant negative correlation were then observed.

Conclusion: The self-evaluation questionnaire of the self-image of nurses in the early stages of their mid-careers, reliability and validity has been confirmed.

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Purpose: The research aim was to clarify how nurses develop their nursing philosophy from their nursing practices.

Methods: Semi-structured interviews were conducted with nurses who had at least five years of practical nursing experience and who the Director of Nursing determined had an established nursing philosophy. The obtained data were analyzed using the modified grounded theory approach.

Results: Eight categories emerged from the analyzed interview data of 17 nurses. These were divided into two processes: [Formative Nursing Philosophy] and [Establishment of Nursing Philosophy]. The former process relates to when a nurse who has <experienced fluctuating nursing philosophy> attempts a <confronting his or her experienced fluctuating nursing philosophy>, <expanding his or her nursing ideas> and then <deciding his or her nursing philosophy>. The latter process relates to when a nurse <establishes nursing philosophy through nursing practical experience> by <searching for nursing care methods that suit his or her nursing philosophy>, <experimenting with nursing practices while conscious of his or her nursing philosophy>, and repeatedly obtains <recognition for nursing care>.

Conclusion: These results indicated that the nursing philosophy develops by internal reflection from experience, and by performing nursing practice that is conscious of the formed nursing philosophy.

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Objective: This study was designed to identify the factors that affect the proper use of the insulin self-injection procedure by elderly outpatients with diabetes.

Methods: The current study included patients with diabetes aged 65 years or older who self-injected insulin at home. A logistic regression analysis was carried out to examine the 15 factors that could affect the proper use of the self-injection procedure as independent variables and the ability to self-inject insulin properly as a dependent variable.

Results: A total of 105 subjects with a mean age of 74.0 ± 5.4 years were included in the study. Based on the logistic regression analysis, high cognitive function as measured by Hasegawa’s Dementia Scale-Revised (odds ratio: 1.16, 95% confidence interval: 1.01 to 1.33) and the presence of support from medical staff, mainly nurses (odds ratio: 6.35, 95% confidence interval: 1.43 to 28.28), were considered the factors associated with the proper use of the self-injection procedure.

Conclusion: Impaired cognitive function increases the likelihood of difficulty in self-injecting insulin. However, this study suggested that support from medical staff increased the likelihood of the proper use of the self-injection procedure.

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Purpose: The present study aimed to develop a scale measuring full-time nurses’ collaboration consciousness with part-time nurses (CCSFN-PN).

Method: The participants consisted of full-time nurses in working with part-time nurses. Scale development involved several phases, including item development, reliability testing, criterion-related validity testing, and construct validity testing.

Result: Data from 390 nurses who responded to all 48 items of the CCSFN-PN were analyzed (response rate: 50.5%, valid response rate: 87.8%). Exploratory factor analysis revealed four factors with 26 items. They were “differentiation,sense of appreciation,sense of covering-up the mess,and sense of mutual help”. The model showed approximately good fit to the data by confirmatory factor analysis (GFI = 0.846, AGFI = 0.816, RMSEA = 0.074) A significant correlation was observed between the CCSFN-PN and Job Satisfaction Scale (r_s = 0.314) as well as “Agreement to Collaborate with Part-time Nurses” (r_s = 0.365),thus confirming construct validity and criterion-related validity. Cronbach’s α coefficient was 0.895 for the overall scale and 0.678–0.915 for subscales, confirming general internal consistency.

Conclusion: The results prove the reliability and validity of the CCSFN-PN. The CCSFN-PN can be used to assess full-time nurses’ collaboration consciousness with part-time nurses.

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Objective: This study aimed to identify the difficulties experienced by spouses caring their partners with Parkinson’s disease (PD), focusing on the period before they became bedridden.

Methods: We conducted semi-structured interviews with 10 spouses caring for their partners with PD. Data were analyzed qualitatively and subjected to descriptive analysis.

Results: The spouses were “facing an intractable and perplexing disease”, however they were “challenged to care for fluctuating symptoms”. Furthermore, they “wished to cherish their present life supported by the couple’s history together”. At the same time, the spouses were “deeply suffering from the elusive symptom”, and they were “distressed by the great disparity in aging due to spouses’ disease.” Therefore, they “desired someone who could support them with deep understanding of the elusive symptoms”.

Conclusion: Spouses in this study were affected by fluctuating motor symptoms, and non-motor symptoms emerging in the early stages. Therefore, it is highly recommended that care is offered to a) emphasize the professionals support in the early stages, b) evaluate patients and spouses ideas and efforts at understanding the symptoms, and c) consider that fluctuating symptoms cause miscommunication between the couple.

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Purpose: The object of this study was to describe public health nurses (PHNs) intention for supporting mothers with low birth weight infants.

Methods: Data were collected using semi-structured interview from nine PHNs. Interview data were analyzed qualitatively and subjected to descriptive analysis.

Result: Intention of support by PHNs was classified into three major categories: (1) “preventing mothers from getting caught-up in thoughts and feelings that her child is vulnerable and enabling mothers to value their child’s individuality”, (2) “enabling mothers to spontaneously incorporate child-care into their life and not devote all of their resources to child-care”, and (3) “enabling mothers to child-care continuously in their living area in a relaxed manner”. PHNs supports were mutually associated to assist mothers in attaining easeful child-care.

Discussion: PHNs were mindful to be aware of mother’s thoughts and feelings about having a vulnerable child so they could provide support from a multidimensional perspective. Therefore PHNs provided support with these intentions: (1) to support mothers in broadening their perspective about their child, (2) to create child-care that fit in with their life, and (3) to adjust or modify their environment to become easeful for child-care.These results described the features of supporting mothers with low birth weight infants and can be used as indicators for supporting mothers with low birth weight infants.

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Purpose: The purpose of this study was to clarify the factors related to the competency of the interprofessional collaborative practices of nurses working in convalescence rehabilitation wards.

Methods: Questionnaires using «Chiba Interprofessional Competency Scale (CICS29)» were administered to 539 nurses working in convalescence rehabilitation wards. Categorical regression analysis was performed on variables that were found to significantly correlate or differ using univariate analysis.

Results: The seven variables that significantly correlated with total «CICS29» scores were “years of clinical experience,” “position,” “Continuing interprofessional education (IPE),” “superiors support,” “coworkers support,” “regular information sharing,” and “communication outside the hospital.” These factors explained 40.3% of the total variance.

Conclusion: Continuing IPE was considered to be an effective means for improving the competency of the interprofessional collaborative practices of nurses. Moreover, it is necessary to have an environment in which it is easy for people in the same profession to share support and in which there are opportunities for timely and informal interprofessional discussions.

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This study aimed to clarify experiences of Japanese patients with idiopathic pulmonary fibrosis (IPF) who were coping with dyspnea. We conducted semi-structured interviews with a total of 14 subjects who had developed dyspnea (Borg Scale I or higher) on walking. The data obtained were subjected to qualitative and inductive analyses, which led to the extraction of 36 subcategories. These subcategories were divided into 7 categories, each of which represented the following 7 experiences of IPF patients coping with dyspnea: 1) distress due to physical changes, 2) a growing sense of helplessness, 3) making adjustments to one’s lifestyle in order to cope with their sensation of dyspnea, 4) feeling conflicted between dyspnea that occurs during work hours and its alleviation by taking oxygen, 5) being estranged from other people due to an inability to cooperate with them, 6) one’s life in which they require assistance from their family and friends, and 7) searching for the significance of experiencing dyspnea. IPF patients restricted their own daily activities due to the stigma of suffering from dyspnea and needing to receive at-home oxygen therapy. In addition, to cope with such a sensation, while feeling conflicted, they changed their perspective on life, and searched for the significance of experiencing illness.

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Objective: This study aimed to construct a new theoretical framework of providing care to diabetic patients so that they can make use of their embodied intelligence. This new construct is based on Benner’s nursing theory, in which the concept of care is a theoretical assumption.

Method: Meta-synthesis and interpretative phenomenology approaches were used in this study. We conducted a group discussion with nursing exemplars to extract the commonality in the meaning of care.

Results: The meta-synthesis of seven papers revealed four continuous nursing care categories: describing ambiguous experiences, deepening the understanding of the body, recovering trust in the body, and utilizing new coping methods. We integrated these categories and named them as “embodiment care for diabetic patients.”

Conclusion: Our new theoretical framework of nursing practice is based on the conclusion that embodiment care for diabetic patients enables them to have a sense of well-being, regain their everyday life by comforting their body, and become independent.

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Aim: This study aimed to determine the reliability and validity of the Self-Harm Antipathy Scale-Japanese Version (SHAS-J).

Methods: A self-administered questionnaire was distributed to 764 nurses working in 32 emergency departments across Japan, and 302 (39.5%) of them responded effectively. The questionnaires collected demographic data about the nurses, the SHAS-J, the Emotional Labor Inventory for Nurses (ELIN) and the Empathic Coping Scale. Data were evaluated with Cronbach’s alpha along with exploratory factor, confirmatory factor, and correlation analyses.

Results: Factor analysis of the SHAS-J resulted in extraction of four factors. The four factors comprised “low empathic practice competence”, “care futility”, “lack of active understanding” and “ignorance about rights and responsibilities”. Cronbach’s alpha for the four factors were 0.83–0.54. The SHAS-J score correlated with ELIN and Empathic Coping Scale scores.

Conclusion: The reliability of the SHAS-J was approximately verified using Cronbach’s alpha. Validity of the SHAS-J was approximately confirmed based on its relationships with the ELIN and the Empathic Coping Scale.

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Purpose: To conduct a concept analysis and clarify the definition of medical professionals’ ethical sensitivity.

Method: Rodger’s concept analysis method was used. Five databases were searched: MEDLINE, CINAHL Plus with Full Text, PsycINFO, Ichushi Web, and CiNii Articles. Search terms included: “ethical sensitivity”, “moral sensitivity”, and “rinriteki-kanjusei”. A total of 47 published articles were analyzed.

Results: The following five attributes were identified: 1) exhibition of an emotional response to an ethical situation, 2) responsibility for one’s role in person-centered medicine, 3) capacity for awareness of ethical issues, 4) capacity for understanding ethical issues, and 5) capacity to take a positive stance towards solving ethical problems. Furthermore, two antecedent factors and three consequences were identified.

Conclusion: Medical professionals’ ethical sensitivity was significant contributor to solving ethical problems. This synthetic capacity included not only explaining ethical problems but also taking a positive stance to facing up to these problems.

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Purpose: The purpose is to clarify the concept “delay of help seeking behavior” for breast cancer patients with the concept analysis strategy proposed by Rogers (2000).

Method: Four databases (PubMed, MEDLINE, CINAHL, Ichushi Web) were used. Search terms were“breast cancer”, “help seeking behavior”, “delay”. DIPEX Japan was added to our data analysis. As a result of the research, thirty resources were chosen and used for this analysis.

Results: Two attributes of the concept “delay of help seeking behavior” were identified; 1) time, 2) decision making process. Three antecedents were identified; 1) individual factor, 2) medical environment, 3) social culture. Two consequences were identified; 1) reduction of the survival rate, 2) load of medical staffs and patients in medical treatment. From the study, the delay of help seeking behavior of breast cancer patient is defined as the phenomena which have negative influences on the load of medical staffs and patients in medical treatment and survival due to the extension of the objective time during the decision-making process for help-seeking include subjective time.

Conclusion: The definition of “delay of help seeking behavior in breast cancer patients” is useful for construction of effective nursing care which compresences medical professionals and patients point of view.

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Purpose: There have been increasing numbers of working pregnant women and it is important to accumulate knowledge about their feelings and features specific to them. The study purpose was to clarify the concept of “working pregnant women’s guilt feelings”.

Method: We reviewed the literature on the general view of guilt feelings as well as guilt feelings in psychology, psychiatry, and nursing using concept analysis based on Walker and Avant’s model. Nine characteristics of guilt feelings were found and the differences between those feelings and related concepts (“shame,” “debt,” “qualm,” “being sorry”) were evaluated.

Results: The concept of guilt feelings were integrated with a review of the experience, situation, and negative feelings of working pregnant women, as well as working mothers’ guilt feelings. The results suggested the following three constructs of working pregnant women’s guilt feelings: “negative feeling when behaving the opposite to own norm,” which included the worker’s role and pregnant women’s role; “emotion of controlling own behavior,” such as troublesome behavior in the workplace and dangerous behavior to the baby; and “feeling because of extra favors,” such as taking leave and receiving concern from coworkers.

Conclusions: Working pregnant women’s guilt feelings are important to help understand working pregnant women’s situation more deeply and the potential impacts on their mental health. An accumulation of research and development of a measurement scale will assist with this.

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Background: Long-term survival has been made possible with the development of novel treatments for cancer. However, there are many patients with repeat hospitalizations and discharges depending on the changes in their conditions while continuing treatment and gradually shifting to the terminal stage. Therefore, there has been an increasing demand for discussions about end-of-life in terms of the choice or cessation of treatment and how to spend the end-of-life.

Purpose: This research aimed to clarify and conceptualize the characteristics of end-of-life discussions (EOLd) with cancer patients.

Method: The study involved data analysis using Rodger’s approach. Forty-five reports in the literature in the fields of nursing and medicine published between 2000 and 2015 were selected.

Results: From the analysis of these reports, the following nine categories were extracted as attributes: “Judge the timing of end-of-life discussions”, “The contents of a discussion are made a document”, “Discussion about treatment and care in the end of life and dying process“, “Discussion about recuperation place”, “Discussion about patient’s hope and preference”, “Knowledge provision to the family and discussions about family’s values and preferences”, “Respect of valuation and individuality”, “Shared by a team of the medical staff, patient, and their family”, “Build the relationship and support the decision making”.

Conclusion: The EOLd with cancer patients can be defined as follows: “Discussion about treatment, palliative care, and recuperation for advanced cancer, which is based on a team approach and the relationship between patients and their families and healthcare providers, while respecting the patient’s values and individuality.” Improvement of the QOL of patients who are in their end-of-life stage was realized through the process of own decision making involving the interplay of attributes and antecedents arriving at consequences.

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Objective: To analyze evaluation of use of the web application developed as a self-care tool by pregnant women who used the program for relieving “hiesho” (sensitivity to cold) (“hiesho,” hereafter).

Method: Participants were 60 pregnant women using the program for relieving hiesho. The web application includes the items wearing leg warmers, performing exercises, and pressing acupuncture points, and participants continued self-assessment for four weeks. Data was collected at the end of the four weeks by means of a paper questionnaire, measured on the 5-point Likert scale ranging from 1: very much disagree to 5: very much agree.

Results: The web application was useful for continuing the program: median score of 4.0 (“somewhat agree”) (interquartile range 0.7); participants’ own awareness of sensitivity to cold: median score 4.0 (1.0); and able to continue the program with enthusiasm: median score 4.0 (1.0).

Conclusion: Many pregnant women believed that using the web application helped them continue the program and was useful for self-care.

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Aim: The purpose of this study was to evaluate the effects of an educational program (a total of four sessions) aimed to improve partnership-building ability, focusing on family caregivers of persons with dementia. Method: A non-randomized controlled trial was conducted in 43 caregivers who completed the survey, and the subjects were assigned to an intervention group (n = 22) and a comparison group (n = 21). The intervention group was asked to attend the educational program, whereas the comparison group was provided with a booklet of key elements excerpted from the educational program. As indicators of effectiveness, ability of caregivers to build partnerships, a sense of burden and positive feeling toward caregiving, and use of social support were measured before, immediately after, and 2 months after the intervention. Results: The ability to build partnerships with persons with dementia and positive feelings toward caregiving were significantly improved in the intervention group compared with the comparison group. However, there was no significant difference between both groups in the ability to build partnerships with health professionals, other family members or neighbors, use of social support, and sense of burden toward caregiving. Conclusion: This study demonstrated the effectiveness of the educational program in improving the ability of family caregivers to build partnerships with persons with dementia and in enhancing positive feeling toward caregiving.

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Purpose: The purpose of this study was to identify the change in nurse’s cognitions of nursing practice through learning and case study meetings with faculty members using the Nursing Practice Model for Patient Education (TK model).

Methods: Participatory action research techniques were used. Eleven meetings were held and participants’ statements of each meeting were analyzed and organized qualitatively and inductively by comparative analysis.

Results: The number of participants was 3–8. Nurse who participated in all meetings was one. The changes of nurse’s cognition to practice were identified as following themes: 1) noticing the characteristics and meanings of the educational involvement through the nurse’s own practice processes, 2) associating personal portrait with the views of ordinary citizens through patient’s behavior, and 3) exploring the grassroots movement for advancing team nursing practice.

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Purpose: The purpose of this study was to clarify the characteristics of psychosocial burden and coping among nurses with clinical experience in a general hospital assigned to the palliative care ward for the first time within 2 years.

Methods: A qualitative, descriptive study method using semi-structured interviews was adopted. The obtained data ware analyzed qualitatively and inductively.

Results: Individual analysis results of seven nurses in the palliative care ward were integrated, and the psychosocial burden was consolidated into eight categories through a four-stage analysis process. Coping with psychosocial burden was also consolidated into nine categories.

Conclusion: Core characteristics of psychosocial burden reported by nurses assigned to the palliative care ward were 1) “Feelings of confusion and helplessness as if one had zero experience.” This and similar experiences were then structured into three layers. While psychosocial burden changed with years of nursing experience, it was revealed that nurses experienced psychosocial burden that continued even after gaining more experience. 2) The coping process of nurses changed from negative coping with their psychosocial burden to positive coping on gaining more experience. The resilience of nurses in the palliative care ward is thought to be related to this change in process.

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Purpose: This study aimed to clarify influence factors involved in midwives’ behavior providing sexual education for pregnant woman and its intention to enhance one’s intention and influence factors on activity.

Method: The study conducted a questionnaire survey with use of TPB for 184 midwives. The survey items were “Intention”, “Behavior”, “Recognition of necessity”, “Negative emotion”, “Expectation from midwives”, “Expectation from patients”, “Confidence on ability”, and “Environment as an obstacle” regarding attribute and individual/group sexual education.

Result: In the individual sexual education, “Intention” could be explained approximately 60% by “Recognition of necessity” and “Expectation from midwives”, and “Behavior” could be explained approximately 51% by “Expectation from midwives” and “Confidence on ability”. In the group sexual education, “Intention” could be explained approximately 75% only by “Recognition of necessity”, and “Behavior” could be explained approximately 42% by “Intention” and “Confidence on ability”.

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Purpose: We implemented a class that planned aid toward the case and that allowed students to provide an explanation and perform a practical demonstration in front of other students (hereafter “demonstration”) to identify the effect that this form of learning had on nursing students’ acquisition of tracheal suction techniques.

Method: We had second-year nursing school students perform demonstrations after a technical exercise of tracheal suction that used a simulator. They then performed a self-evaluation by following the attainment goal after each learning session. We set up 27 items of customized attainment goals that were composed of cognitive, psychomotor, and affective areas.

Results: Of the 50 students who consented to the experiment, we analyzed the responses of 37 students. We compared the scores after the technical exercise with those after the demonstration. These scores and attainment goal scores significantly increased after the demonstration (P < 0.01).

Conclusion: We speculated that a demonstration after the technical exercise led to the integration of knowledge, technique, and attitude. This contributed to the existing knowledge and linked that knowledge to the actual practice through individual learning and group work, explanation and practice, and Q&A between students. We also believe that through the establishment of a specific case and simulated patient, the students learned the necessity of nursing care of consideration for patients, individuality and patient-centered care.

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Purpose: The purpose of the present study was to investigate empathy of nursing students.

Methods: The Empathic Experience Scale Revised was conducted among nursing college students, and the result was compared with those of previous studies from 1995 to 2005, which had not identified the decreasing discourse of empathy of young people over time.

Results: The result of the Empathy Experience Scale was similar to the results of the previous studies. There was no significant difference in the score of the Empathic Experience Scale or the typology of empathy by academic year, similar to the results of the previous studies.

Conclusion: The results of the present study suggest that the empathy of nursing students is similar to that shown in the previous studies.

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