Objective: To analyze and clarify aspects of the boundary between discipline and abuse by mothers raising preschool age children based on analysis of narratives regarding parenting behaviors.

Methods: Semi-structured interviews were conducted on 26 mothers raising preschool-age children focusing on the experiences they considered to reflect the boundary between discipline and abuse. Interview transcripts were qualitatively analyzed using a modified grounded theory approach.

Results: Categories reflecting aspects relating to the boundary between discipline and abuse were extracted as follows: “power to overwhelm the child unconsciously when their mother becomes emotional” and “differences in discipline depending on the attributes of the child”. Additional categories included “superiority of other people’s appraisal of discipline”; “accumulated fatigue from idealized images and responsibilities as a mother”; and “peace of mind to change according to surrounding support and mother’s capabilities”.

Conclusion: The present findings suggest that subconscious power possessed by the mother over the child and the child’s attributes comprise aspects of the boundary between discipline and abuse by mothers raising preschool-age children. Mother were deeply exhausted from how they are perceived by others as important. Mother’s allowance were influenced by social support and mother’s own power. Emotional control method, provide knowledge due to child’s attributes, evaluative support for mothers, support for mothers’ community expansion, and provide effective social resources were found to be important forms of parenting support for mothers.

Purpose: Diabetes patients who develop acute coronary syndrome (ACS) tend to waste much time before the first visit to hospitals. The purpose of this study was to clarify the process of getting the First Medical Contact (FMC) for patients with diabetes who developed ACS.

Method: A semi-structured interview was conducted for 6 patients with diabetes who developed ACS. An individual analysis and comprehensive analysis were carried out. Data was analyzed by using the qualitative synthesis method (KJ method). This study was conducted with the consent of the Ethics Committee of the author’s affiliated institution and the targeted one.

Result: Our study has specified 8 symbolic marks of the process of getting the FMC for patients with diabetes who developed ACS. These included the followings: [how to deal with diabetes: making their efforts even in inescapable circumstances], [interests in myocardial infarction: the experience of learning about diabetes cannot lead to the understanding of the relationship between diabetes and myocardial infarction], [interpretation of prodromal symptoms: assuming the relationship between the symptoms and other causes], [decision that leads to hospital visit: sensing myocardial infarction is perceived as “dangerous”], and four others.

Conclusion: [how to deal with diabetes] and [interests in myocardial infarction] was the basis for getting the FMC. A need of the education for individual patient including the process to FMC was suggested.

Objective: Health and Ikigai need to be encouraged. Ikigai is Japanese original well-being. This study posited that a sense of coherence (SOC) and social support were factors affecting local residents’ Ikigai, and this study then verified that conjecture.

Methods: Subjects were 532 adults over the age of 18 (275 males 44.2 ± 13.7 y, 257 females 41.4 ± 12.7 y). The items studied included Ikigai, SOC, social support.

Results: SOC (β = 0.285–0.398) and social support from significant others (β = 0.184–0.331) were found to affect individual’s Ikigai.

Conclusion: SOC and social support from significant others affected individual’s Ikigai. Thus, focusing on enhancement of individual’s SOC and social support (and particularly his or her social support from significant others) may help to enhance individual’s Ikigai.

Objective: To illustrate the diverse decision-making pathways followed by women who decide to discontinue fertility treatment and the factors affecting their decision, in order to find ways to support such women at the time of treatment termination.

Method: Fifteen women who had discontinued fertility treatment after unsuccessful attempts were interviewed, and the results were analyzed using the Trajectory Equifinality Model.

Results: The decision-making process was found to involve the following divergences before leading to the discontinuation of fertility treatment: a decision on whether to tell people that they are undergoing a treatment, conflict over whether to continue with the treatment, a decision on whether to seek counseling, and conflict over whether they are certain about discontinuing the treatment. Factors such as the anticipation of other people, the sense of urgency because of their age, and the difficulty to let go of their desire prompted the women to continue with the treatment. In contrast, factors such as acceptance by their husband and parents; care given by health professionals; and realization of their limits, the possible risk to their future child, and the finite nature of life persuaded the women to discontinue with the treatment.

Conclusion: Understanding the patients’ feelings toward continuation or discontinuation of treatment as well as the factors affecting their decision, providing appropriate information, and ensuring opportunities for counseling are required in order for patients and their significant others to make a wholehearted decision.

Objective: To clarify aspects of cross-cultural experience perceived by foreigners living in Japan when using its healthcare services.

Methods: Four focus group interviews were conducted with a total of 22 foreigners living in Japan.

Results: When using <Japan’s medical service systems that are difficult to understand> with <difficulty in accurately expressing their own pathological conditions and needs>, foreign patients faced <insufficient communication with doctors> and <barriers to communication>, and realized that <individual patients’ cultural backgrounds are not sufficiently considered>. They also found it <difficult to exercise their right to refuse>. As they could not understand <rules or their reasons> in Japan’s systems, they adopted adaptive behaviors, such as <Bewilderment to tacit agreements>. While <developing a sense of security with nurses creating a family atmosphere>, they recognized that they could <not rely on nurses for the treatment of their diseases>.

Conclusion: The foreigners living in Japan faced barriers related to language, preconceptions due to differences in physical appearance, and insufficient understanding of different cultures, indicating that medical professionals should become aware of such a lack of attention to the cultural aspects of foreign patients.

Purpose: This study identified how outpatient nurses determine the aim of educational support for the elderly with type 2 diabetes mellitus.

Methods: The participants in this study were six outpatient nurses who provided educational support to the elderly with type 2 diabetes mellitus. We conducted semi-structured interviews and analyzed the interview data using the grounded theory approach.

Results: The phenomenon of [Evaluation of the Potentiality to Change Self-Care Patterns] which consisted of 12 categories, was identified. The aim of educational support varied according to nurses’ [Evaluation of the Potentiality to Change Self-Care Patterns]. This phenomenon consisted of several processes that led to three different consequences: «Education Aimed at Change», «Directionality of Maintaining the Status Quo», and «Reconsidering the Treatment Plan».

Conclusion: [Evaluation of the Potentiality to Change Self-Care Patterns] is necessary to guide the delivery of individual educational support and to ensure safety for elderly people. It cannot be necessarily said that «Education Aimed at Change» is appropriate for all patients. Therefore, it is necessary that nurses consider switching to «Directionality of Maintaining the Status Quo» by considering the goal of self-care, goal sharing, and evaluating the motivation of each patient.

Aim: The present study aimed to clarify the current status of emergency nurses who provide care to suicidal patients who might have suicidal ideation.

Methods: A self-reported questionnaire was distributed to 764 nurses in 32 emergency departments across Japan.

Results: Responses from 302 (39.5%) nurses were valid. Among them, 206 (68.2%) reported an experience that confirmed suicidal ideation among patients. Responses to the open-ended questions were obtained from 197 nurses. These responses underwent qualitative descriptive analysis and categories were extracted. The categories, “Lack of ability/knowledge about how to care for suicidal patients”, “Worry and concern about repeated suicide attempts and self-harm”, “Confirming that the environment is difficult” and, “Physical and mental problems of patients”, were associated with hindrances or barriers to confirming the presence of suicidal ideation among patients.

Conclusion: Three strategies were identified to help emergency nurses effectively care for patients who self-harm: improving their knowledge, adjusting the care environment and enhancing support systems for nurses.

Objective: This study aimed to clarify the structure of family attitudes towards social withdrawal among the elderly.

Methods: In the present study, we conducted a semi-structured interview of 10 family members participating in a project to prevent nursing care dependence among the elderly in 8 municipalities in Prefecture A. The interview consisted of questions on four points relating to the attitudes of family members towards social withdrawal by the elderly. We then used the KJ Method to qualitatively analyze the study data in the form of the interview content.

Results: The results of the interview demonstrated that family attitudes to social withdrawal in their elderly relatives were composed of three elements. The first was that family members perceived themselves to be “I am ‘shouldering the weight of family bonds’,” the second was that they perceived their elderly relatives as “it’s a worry and ‘slightly heavy’ existence,” and the third was that they recognized “ideal for the elderly to ‘create by themselves’ life.” In terms of the relationship between these three elements, the first element formed the core of their attitudes, while the second and third elements formed interactive components of their mindset.

Conclusion: The results of this study showed that the structure of family attitudes towards social withdrawal among elderly relatives were based on the family (family conception) of family bonds, while their confusion about how to communicate had interrelated components with their ideal of elderly relatives being self reliant hand being automomous.

Aim: The aim of this study was to examine the relationship between hope and positive aging cognition, health conditions, social roles, life style, social network, and support for the frail elderly living at home alone.

Methods: The participants were senior citizens in Japan who aged 65 and above. Data were collected via anonymous questionnaire. The 463 study subjects were matched for care-need requirement from nothing to level 1 according to long-term care insurance in Japan. The Herth Hope Index (HHI) was used to assess the level of hope. Data were analyzed using multiple regression analysis.

Results: The mean age of the subjects was 83.4 ± 6.6 years. The mean HHI score was 33.1 ± 6.7. On regression analysis, HHI score significantly correlated with positive aging cognition (β = 0.244), mental health (β = 0.241), roles in the community (β = 0.175), social network (β = 0.027), and home-help services (β = 0.124).

Conclusion: The findings suggest the importance of caregiver and local resident support for the frail elderly living at home alone in order to improve hope by positive living in old age through their own life histories, maintaining social networking by exchange with the neighborhood and community, and remaining in good mental health.

Purpose: The purpose of this study was to clarify the barriers to behavioral change in young male workers with obesity, and to identify the skills pertaining to providing individual and group health guidance for them.

Methods: Two group interviews took place with 8 health nurses and 2 dieticians who had experience in providing health guidance for young workers for more than five years.

Results: The following barriers to behavioral change in young male workers with obesity were identified: negative mental state to behavioral change, lack of knowledge of one’s health problems, and difficulty in changing one’s lifestyle. The following skills for providing individual health guidance were identified: maintaining a continued supportive relationship with the young male workers, building a relationship of trust with them by becoming a person who is close to them, and motivating young workers to lose weight.

Conclusions: It is important that health care providers support young male workers with obesity to develop the intention to lose weight and to motivate behavioral change, and provide them knowledge regarding diet control and stress coping strategies.

Objective: To uncover the experiences of Marfan syndrome patients with a history of cardiovascular surgery as they go about their lives.

Method: Six Marfan syndrome patients with a history of cardiovascular surgery participated in a semi-structured interview, and their responses were analyzed using the qualitative synthesis method (i.e. the KJ Method).

Results: Eight major symbolmarks were extracted from the interview data: “Withstanding feelings of dread about sudden death by ignoring them”, “Bottling up the inferiority complex-like thought pattern that I am different from others”, “Trying to avoid thinking about the disease, because it cannot be changed even with great effort”, “Cherishing life as a result of experiencing surgery, as well as the death of someone close to me”, “Feeling pangs of conscience towards my drive to marry/have kids and to a family who will not leave my side”, “After overcoming various hardships, being now able to believe that I can manage living with the disease”, “Hoping for society’s understanding and the robust provision of medical care and social security”, “Interacting with other Marfan syndrome patients acts as support for me, even though the information I get can sometimes make me anxious”.

Conclusion: While considering the innermost emotion and thought of the patient, the importance of genetic nursing, assistance to enhance the self-care abilities, and the need for the development of a medical care environment were suggested.

Objective: The purpose of this study was to explore the difficulty of life related to health experienced by elderly Korean residents of Japan who are living without or with a low pension.

Method: Elderly Korean residents aged 65 or above living in a regional area participated in the study. One-to-one semi-structured interviews were conducted with 8 participants, using Spradley’s (1979) ethnographic interview method.

Results: From the data collected through the interviews, Analysis of the interview data extracted 70 sub-categories and 8 categories. These 8 categories described the following issues: everyday struggles due to lack of money; inability to read and write as first generation immigrants; difficulties with integration into regional areas; both subjects and Japanese locals avoiding contact with each other; being unable to form human connections while realizing the importance of these connections; feeling that they have no support from their surroundings; having more than one identity; and the feeling of resignation towards society that slowly affects local activities.

Conclusions: It is important for nurses to understand and support difficulties in living due to diverse cultural backgrounds and customs of older foreign residents in Japan.

Aim: The aim of this study is to determine public health nurses’ support process for specified expectant mothers (Tokutei-ninpu), as pregnant, postpartum, and child-rearing women with special needs.

Methods: Participants were 11 public health nurses with more than five years’ experience with maternal and child health,and experience concerned with the same specified expectant mothers more than two times during the pregnancy and delivery period. Support process for pregnant women with special needs were examined through semi-structured interviews. The data were analyzed using the grounded theory approach.

Results: We found that public health nurses’ support process for pregnant women with special needs focused on [identifying maternal attachment capacities]. This process was explained by five categories: building relationships between pregnant women and public health nurses, finding locations to depend on neighborhood people (pregnant women’s indulgent dependency or amae), identifying capacities for pregnant life, providing continual support for pregnancy, and providing a support net for pregnancy and infant security.

Conclusions: The social vulnerability of pregnant women with special needs shifted to independence through the power of neighborhood support; public health nurses assessed the internal psychological function of pregnant and enlisted community resources for infant security.

Purpose: To examine the association between advance care planning (ACP) by a visiting nurse and achieving the desired place of death for patients with end-stage cancer.

Methods: A cross-sectional nationwide questionnaire survey was conducted for visiting nurses at 1,000 randomly selected home care agencies. Items included the actual place of death, patients’ preferences for place for death, ACP (support for understanding of life expectancy and confirmation and adjustment of the chosen place of death) by nurses at each home visit, and factors related to ACP in nurses’ practice. Logistic regression was conducted with achieving the desired place of death as the dependent variable.

Results: A total of 374 responses were analyzed. Regarding the place of death, 65.0% of patients died at home and 73.8% died at their chosen place. The rate of an explanation of the prognosis, including problems likely to occur in daily life was low (27.8–31.8%). Factors related to death at the desired place included confirmation of the chosen place of death during the whole period (adjusted odds ratio: 19.92, 95% confidence interval: 9.48–41.87; 21.10, 9.53–46.71; 187.35, 51.79–677.64) and the explanation of the prognosis (2.44, 1.05–5.66) at the progression stage.

Conclusions: These results suggest that patients are more likely to die in their desired place if visiting nurses confirm the chosen place of death repeatedly until close to the end of life and explain the influence of the disease prognosis on daily life, with updates of this information based on changes in symptoms.

The purpose of this study is to reveal descriptively how a numb body is experienced, proceeding from the fact that it is expressed as “like living in someone else’s body.” I employed phenomenological methodology conceptually grounded in Maurice Merleau-Ponty’s body theory to analyze and describe participatory observation records obtained from four participants experiencing numbness due to disorders of the central nervous system. The results showed that experiences involving the dysphoric sense of living in someone else’s body comprised: changed bodily responses caused by the numbness; a sense of instability due to the capacity to act not being guaranteed from one day to the next; and living daily life in a body that was no longer their own spontaneously moving body, but instead a body that was instructed to move, requiring them to issue instructions to his or her own body. This study concludes that, whereas the participants had previously felt a physical certainty that they existed as an embodied self, body numbness was an experience that caused that certainty to waver. It suggests that through assisting patients with daily routines one can take an interest in their physical experiences and think together with them about the body. In this way it is possible to bring the numbness that was previously thought to be known only to the patient closer to a level at which it can be disclosed to others.

Purpose: It is crucial that nurses in Japan exert autonomy as professionals. One of the ways in which they exert autonomy in nursing practice is through autonomous clinical judgment. The aim of this study was to describe the process of how to enhance autonomous clinical judgment among Japanese nurses.

Method: We conducted semi-structured interviews of 14 nurses who had more than 8 years of clinical experience. The modified grounded theory approach was used for data collection and analysis.

Results: Five categories were extracted from 15 concepts. First, the process of autonomous clinical judgment of the nurses started from [building foundation to deepen their knowledge]. Nurse’s autonomous clinical judgment was enhanced constant repetition of the four categories of [using acquired knowledge and skills], [understanding knowledge and skills of others], [reviewing contents of judgment], and [increasing their knowledge and skills].

Conclusion: Autonomous clinical judgment of nurses was enhanced by accumulating knowledge and by reflecting on their nursing practices.

Purpose: To elucidate discharge planning nuring (DPN) practices, we conducted nationwide surveys in 2010 and 2014.

Methods: We administered nationwide questionnaire surveys to DPNs working at hospitals of 100 beds or more—819 nurses in 2010, and 948 nurses in 2014. The survey items were primary attributes of DPNs, practice ability as DPNs (Nurses’ Discharge Planning Ability Scale (NDPAS) score), etc.

Results: Subjects were 461 DPNs in 2010 (response rate 56.3%), and 479 in 2014 (response rate 50.5%). The mean age during both years was approximately 47. The mean years of experience for DPNs was 2.5 in 2010 and 3.1 in 2014. In addition, the scores for “A. Ability to Estimate Post-discharge Care Balance” in the NDPAS were higher in 2014, but the scores of the other three abilities were not significantly different between the two years.

Conclusions: Results suggest the necessity of systematic and continuous human resource development to ensure quality support by DPNs.

Purpose: To develop and evaluate an educational program based on Orem’s self-care theory and aimed at controlling menstrual pain by having young women deliberately employ effective coping methods tailored to their level of pain and palliative needs.

Methods: Eight universities were non-randomly assigned to the intervention group (in which the educational program was implemented) or the control group (in which it was not implemented), and outcomes were quantitatively measured before and after the educational program. Outcomes were seven items: thoughts on coping with menstrual pain, knowledge of menstrual pain, level of menstrual pain, menstrual symptoms, hindrances to activities of daily living, impact on social activities, and control of menstrual pain.

Results: Forty-nine women (45.4%) in the intervention group who took part in sessions and responded to all questionnaires and 58 women (57.4%) in the control group who responded to all questionnaires were subject to analysis. Compared with the control group, women in the intervention group were able to significantly change their way of thinking to one in which they sought to cope with menstrual pain, increase their accurate knowledge of menstrual pain, reduce their level of menstrual pain and menstrual symptoms, and control their menstrual pain.

Conclusions: The results of this study suggested that this program could be effective in teaching young women to deliberately control their menstrual pain.

Objectives: The purpose of this study was to reveal the meaning of discharge planning for nurses working in a Palliative Care Unit (PCU).

Methods: Using an ethnographic design, data collection included participant observation, field notes, and semi-structured interviews with PCU nurses in an urban hospital in Japan. Spradley’s Developmental Research Sequence method was used for data analysis.

Results: The following was the general theme: “Discharge planning presented a challenge for nurses as they supported the patient’s and family’s transition to home and facilitated the patient’s return to his/her genuine self.” Discharge planning was a challenge for nurses because they had to try to help the patient’s transition to home and support the patient to be his/her genuine self despite the risk that the transition may disturb the patient’s and the family’s well-being. Additionally, the nurses faced a dilemma, along with discharge planning, when the patient chose to be discharged and while preparing for discharge. Therefore, nurses saw off the patient to his/her home with a guarantee that he/she would come back to the PCU.

Conclusion: Discharge planning from the PCU presented a challenge for nurses. This study suggests ways nurses experience and should help improve the discharge planning process in the future.

Aim: This study aims to develop a novice nurse assertiveness scale to enable the provision of support of assertiveness.

Methods: We created a draft novice nurse assertiveness scale based on qualitative, previous studies and literature review, and examined the validity and reliability by administering a questionnaire survey to 1,285 novice nurses working in seventeen hospitals.

Results: Because there was a difference in the mean total scores of the draft NNAS between male and female, we determined to analyze 701 female novice nurses. Sixteen items and three factors were extracted using factor analysis that uses the maximum likelihood technique with promax rotation.

Further, we performed a confirmatory factor analysis to test the fitness of the hypothetical model obtained from an explanatory factor analysis, and obtained the following confidence coefficients: a Cronbach’s alpha of .81, a correlation coefficient of .60 from a test-retest, and a correlation coefficient of –.49 with the J-RAS (Japanese version of the Rathus assertiveness schedule).

Conclusion: The validity and reliability of the scale developed in this study was on the whole excellent.

Purpose: The aims of this study were to evaluate the outcomes achieved through terminal-phase inter-professional team care for residents of special nursing homes for the elderly and clarify the structure of such outcomes. This study also aimed to discuss the future outcome that the team would aim for.

Methods: A nationwide questionnaire survey of the health professional staff and focus group interviews (FGIs) with each type of professionals were conducted. The data obtained from FGIs with inter-professional team care members were qualitatively and inductively analyzed to investigate the relationship between the categories extracted by analysis.

Results: The following seven categories were identified: 1) maintaining lifestyles that residents desire and desirable death for him/herself, 2) good relationships between the residents and their families, 3) family participation in care practice and relief of residents’ anxiety, 4) positive acceptance of death by other residents, 5) improvement of the quality of team care, 6) staff development and satisfaction, and 7) improvement of the facility’s overall quality of care. The first five categories were direct outcomes of inter-professional team care. The last two categories were indirect outcomes.

Conclusion: The results of this study suggested that developing inter-professional team care with direct outcomes as indicators could improve the quality of terminal care.

Purpose: This study aimed to clarify the process in which people with intellectual disabilities feel it difficult to consult medical institutions on the basis of the parents’ opinions.

Methods: Focus group interviews were conducted with three groups of parents (n = 14) of people with intellectual disabilities. For analysis, the Modified Grounded Theory Approach was used.

Results: On the basis of the parents’ opinions, the process in which people with intellectual disabilities feel it difficult to consult medical institution included “concerns that it may not proceed smoothly and the burden of relieving the disabilities” and an “increase in the burden of receiving the consultation because of a negative experience at medical institution”. In addition, due to a “sense of helplessness about reducing the burden of consulting medical institution”, as well as a “loss of confidence in receiving it successfully”, people with intellectual disabilities felt [hesitation to visit medical institution]. Parents thought that [actions that each of parents and medical institution and society enables] influenced [hesitation to visit medical institution].

Conclusion: The process in which people with intellectual disabilities feel it difficult to consult medical institutions were [hesitation to visit medical institution].

A possibility that those can be reduced was suggested by the respective each efforts of parents, medical institution and society.

Purpose: The aim of this study was to clarify the examination skills required for whole-body physical assessment except cranial nerves of stroke patients, and the item-assessment level in the acute and recovery phases of stroke that is regarded as being essential by Certified Nurses 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 stroke-rehabilitation certified nurses, from whom an expert panel was organized. The questionnaire consisted of 98 items regarding physical examination except for cranial nerves during the acute and recovery phases of stroke. An established consensus was defined based on 51% agreement on the results of the third survey.

Results: Participants included consented candidates that totaled 126, with responses from 105 for the first round, 86 for the second round, and 87 for the third round. The nurses reached a practice-level consensus on 62 acute- and 56 recovery-phase items. Furthermore, an assessment-level consensus was reached for 32 acute- and 34 recovery-phase items.

Discussion: The selected skills of practice-level items suggested the physical assessment of stroke patients, and degree and presence or absence of dysfunction associated with stroke onset as fields of exploration to determine self-care ability.

Purpose: To identify the processes by which parents and nurses can support siblings visiting children hospitalized in the pediatric intensive care unit (PICU), and what kind of change occurred in the siblings through the visits.

Method: We observed nine siblings visiting children hospitalized in the PICU, and performed semi-structured interviews with four mothers and one pair of parents, who accompanied them. The observation and interview data were analyzed using a grounded theory approach.

Results: Parents and nurses supported siblings visiting children hospitalized in the PICU by «prompting them to approach the hospitalized child» «providing explanations to get siblings interested in the hospitalized child» «prompting them to touch the hospitalized child», and [bringing siblings to the center]. Through continued steps of related support, a change occurred in the siblings, specifically that they had a «feeling the hospitalized child was closer».

Conclusion: It is important to cause changes in siblings toward the «feeling the hospitalized children was closer». Nurses should support the siblings, in cooperation with parents, and provide the support that assists in [bringing siblings to the center].

Purpose: The aim of the survey was to identify the characteristic of employment and turnover of experienced nurses at Japanese Hospitals.

Method: Stratified sampling by hospital size identified 1,200 Japanese hospitals invited to participate in the survey. Nurse executives from each hospital provided the number of experienced nurses who were hired and left within 2013. The same data about newly graduated nurses were also collected for comparison.

Results: Returned were 246 valid responses. Experienced nurses tended to be hired by smaller, long-term care and psychiatric hospitals; by contrast newly graduated nurses were hired by larger and advanced treatment hospitals. While 75.7% of experienced nurses were hired full-time compared to 99.2% new graduates, 24.3% of experienced nurses were hired part-time compared to 0.8% of new graduates. The turnover rate of experienced nurses was 17.9%, and was higher than 7.9% for new graduates. Smaller hospitals with under 100 beds had difficulty in retaining experienced nurses.

Conclusion: The retention of experienced nurses was much lower compared to new graduates. It is proposed that each hospital develop tactics tailored to support experienced nurses continuing with their employment.

The purpose of this study was to clarify the structure and processes of nurse manager support for their staff nurses after adverse patient events. Participants were 26 nurse managers. Semi-structured interviews were conducted and data were analyzed by a grounded theory approach. The core category that emerged from this study was “working on patient safety tasks as a team.” The other categories that emerged from the data included “sharing information and discussing the events with staff nurse,” “perceiving the reactions of all team members,” “assuring a sense of security,” “directing nurses on how to address difficulties,” “threatening patients safety,” and “supporting nurses involved in overcoming their experience.” These findings suggested the psychological impact of adverse patients events on staff nurses, and the necessity not only to work on a task-oriented approach to assure patients safety, but also to assure a sense of security for all staff nurses.

Objectives: We aimed to develop a scale to measure the outcomes of inter-professional team care for terminal-stage residents in special nursing homes for the elderly.

Methods: We conducted an anonymous, self-administered questionnaire survey by mail on nursing staff, caregiver staff, care managers, and life consultant social workers in special nursing homes for the elderly. We conducted exploratory and confirmatory factor analyses on 243 variables with no missing scale items. We examined the stability of the scale by the retest method.

Results: The results of exploratory factor analysis demonstrated a 25-item, 3-factor structure comprising “teamwork,” “support for residents ‘daily life and death’,” and “support for family members and close friends.” The model showed approximately good fit to the data by confirmatory factor analysis (GFI = .839, AGFI = .807, CFI = .897, RMSEA = .067). The reliability coefficient in the retest method was 0.80 for the scale.

Conclusion: We confirmed the validity and reliability of our developed scale.

Objectives: This study aimed to investigate associations between thinking errors and depression, and between thinking errors and attitudes toward parenting, in mothers of school-age children with developmental disorders.

Methods: A self administered questionnaire survey with scales to measure thinking errors, depression, and attitudes toward parenting was conducted with 473 mothers of school-age children with developmental disorders.

Results: A total of 179 valid responses were collected (response rate: 37.8%). Among the items for mothers’ thinking errors, scores were highest for “Selective attention”. Mothers who had no one to consult were more likely to have thinking errors than mothers who did have someone to consult. Thinking errors such as “Arbitrary inferences,” “Excessive generalization,” “Perfectionistic thinking,” and “Selective attention” were associated with greater levels of negative attitudes toward parenting and greater levels of depression. Mothers with a tendency to depression and a propensity for making these four thinking errors therefore exhibited negative attitudes towards parenting.

Conclusion: Nurses need to assess thinking errors of mothers, understand the feeling of mothers raising school-age children with difficulties achieving developmental tasks and provide cognitive therapeutic support, so that mothers can recognize both their children’s development and their own attitude towards parenting.

Objective: To clarify the actual situation of discharge support for cancer patients from ward nurses in acute care hospitals, and collaboration with the ward nurse and discharge coordinators relation.

Methods: A self-administered questionnaire survey was conducted, involving 645 nurses working on wards of designated hospitals for acute cancer care. The study items included: basic attributes, discharge support and training systems, and scores using an original 5-point scale, consisting of 52 subscales to evaluate discharge support for cancer patients. Basic statistical processing for each item and factor analysis of scores using the discharge support scale were performed. Subsequently, the associations of each factor with collaboration with discharge coordinators and professional backgrounds were examined.

Results: Through factor analysis, 43 items of 7 factors related to discharge support were created. On analyzing the associations among the 9 items of <collaboration with discharge coordinators> and the other 6 factors, a correlation was observed in all cases. Interest in discharge support, participation in training seminars, and the organization of conferences showed associations with all of the 7 factors.

Conclusion: Ward nurses in acute care hospitals for these shows and the discharge coordinators collaboration and related, realities of discharge support for cancer patients became clear, cancer patients discharge support for an active collaboration should be.

Aim: This study aimed to reveal nurses’ and patients’ perceptions of nursing care provision during the initial phase of involuntary admission to an emergency psychiatric hospital.

Methods: Nursing staff and patients were interviewed based on the authors’ observation at the time of involuntary admission. Data were qualitatively analyzed according to the qualitative synthesis method (KJ method).

Results: Five nurses and five patients were interviewed. The nurses’ perceptions were divided into nine categories, and had a conflicted logical structure; for example “trying to remove the risk of violence,” and the other hand “making efforts to care according to patients’ wishes in cases of involuntary admission.” Patients’ perceptions were divided into six categories, had a conflicted logical structure; for example “anger and resignation to the irrational way of compulsory admissions” and the other hand “involvement from patient position that lead to treatment acceptance.”

Conclusions: These results indicate that both nurses’ and patients’ perceptions were conflicted with regard to two aspects of implementing compulsory treatment and supporting patients’ autonomy. Involuntary treatment might make patients perceive coercion even when the treatment is required. However, this study suggests that supporting patients’ autonomy may allow treatment to be performed safely and may also reduce patients’ perceived coercion. Therefore, patient autonomy needs to be considered from the initial phase of involuntary admission.

Objectives: This study determines factors related to self-esteem, including experience of developing negative feelings toward patients, as reported by psychiatric nurses and examines ways to assist the nurses.

Method: A self-administered questionnaire survey was distributed to 737 nurses working in nine non-public psychiatric hospitals. We received 365 valid responses (49.5%). The questionnaire included questions about “demographics”, “working environment factors”, “mental health” and Japanese edition (Yamamoto et al, 1982) of “Self-Esteem Scale” by Rosenberg (1965). Using the total score of a self-esteem scale as the dependent variable, a multiple regression analysis was conducted.

Results: The multiple regression analysis showed that the adjusted coefficient of determination was 0.44. Factors that showed statistically significant correlations are “high environmental mastery”, “dislike for the experience of negative feelings toward patients”, “respondent being married”, “presently assistant head nurse”, “coping behavior by discussing with relevant persons when having concerns at the workplace”, and “respondents who had been working longest in surgery wards”.

Conclusions: The findings suggest the importance of providing the following support: (a) to prevent developing excessive feeling of dislike when experiencing negative feelings toward patients, (b) to help acquire skills and understanding to know how to assist patients as a means to control the human and physical environments including psychiatric nurses themselves, and (c) to develop coping strategies for communication with those involved when encountering negative events at the workplace.

Purpose: The aim of this study was to clarify the actual situation and characteristics of visiting nursing agencies providing visiting nursing outside of the insurance benefits.

Methods: A self-administered questionnaire survey was distributed by mail to 145 visiting nursing agencies in five municipal districts working to participate in multidisciplinary collaboration situation regarding the actual situation they were providing nursing services outside of the insurance benefits as well as the characteristics of their visiting nursing agency. The visiting nursing agencies were then divided into two groups according to whether they practiced visiting nursing outside of the insurance benefits and compared.

Results: Responses were received from 58 of the 145 visiting nursing agencies, among which 20 practiced visiting nursing of the insurance benefits. The reason they were providing visiting nursing outside of the insurance benefits was because of the following aspects: the users require professional nursing care, the families wish to fulfill their roles. These 20 agencies had high numbers of users and staff members, performed a significantly higher frequency of home visits, and had set up a payment system outside of the insurance benefits for visiting nursing. No significant differences were seen between groups regarding participation in multidisciplinary collaboration.

Conclusions: Large visiting nursing agencies understood the needs of users and families rearranged their schedules to accommodate visiting nursing outside of the insurance benefits.

Purpose: To clarify the experiences of nurses with illness in their work environment.

Methods: Semi-structured interviews were conducted involving 8 nurses with experience of working for more than 6 months with an illness, and the obtained data were analyzed using a qualitative and inductive approach.

Results: Twelve sub-categories and the following 5 categories were extracted: [Understand the reaction of surrounding people], [explore the balance between work and health], [make effective use of disease experience in nursing practice], [maintain commitment towards nursing as a job], and [accept one’s life with illness that sometimes takes an unexpected turn].

Conclusions: The results showed the need to explore the ways to help them continue working, while managing their health and discussing their work conditions with bosses or colleagues based on their wishes and situations. The results also indicate the need to establish a work environment where employees understand that working with illness is one of the various work styles, and can care for each other.

Aim: This study aimed to identify the challenges of Laotian nursing practice from the characteristics of nurses’ clinical judgment and through Action Research (AR) in order to improve nursing practice, identify how their nursing practices have changed from the characteristics of nurses’ clinical judgement at the end of AR and discuss the factors of changes of nursing practice.

Method: An AR group of 17 nurses (research cooperators) was created that underwent three stages in the process of AR. We conducted semi-structured interviews before and after AR with the research cooperators about the nursing practice they performed and conducted a qualitative analysis of the interview data using Tanner’s clinical judgment model. The records of meetings organized in the process of AR were analyzed qualitatively.

Results: We identified 4 challenges of nursing practice, and through the process of AR, found that research cooperators’ characteristics of clinical judgment have shifted from being fixed to focusing on individual patients, and their nursing practices have changed.

Conclusion: Through the process of AR, we found that their nursing practices have changed and there were two factors of the changes.

Purpose: Effective ways to alleviate nausea and vomiting in pregnancy (NVP) differ among pregnant women. The purpose was to evaluate the effects on self-care agency (ESCA35) and NVP (INVR) by a two-week nursing care program (NCP) aimed for pregnant women to improve self-care behavior to find their own ways to alleviate NVP using a quasi-experimental study.

Method: The conceptual framework was based on Orem’s self-care deficit nursing theory. An intervention group was given NCP based on Miwa’s reflective practice, which three meeting-style interventions, two phone calls, and a self-recorded diary were included.

Result: Data analysis was performed for 45 pregnant women in an intervention group and 67 pregnant women in a control group. The variations of total score and subscale scores of ESCA35 were larger in intervention group. Three subscale scores of INVR (retching experience, retching occurrence, and total distress) were significantly improved only in intervention group. The scores after two weeks showed no significant differences in comparison between two groups.

Conclusion: NCP may improve self-care agency of pregnant women with NVP and decrease retching and the distress of NVP, but further study is needed.

Purpose: This study aimed to clarify the contents of experiential learning among 10 nurse managers in the early years of a supervisory role who participated in an experiential learning-based program to foster competence among nurse managers and showed obvious changes in their scores on the experiential learning scale after completing the program.

Methods: Sixty-three nurse managers participated in this experiential learning-based program, during which they wrote about their experiences in a reflective journal. Furthermore, they completed an experiential learning scale before and after the program. We focused on 10 nurse managers who showed obvious changes in their scale scores after completing the program. Data from 41 reflective journal entries written by these 10 nurse managers were analyzed qualitatively and subjected to descriptive analysis.

Result: Contents of experiential learning among nurse managers were categorized as follows: (1) seven categories of challenging tasks that nurse managers struggled with; (2) six categories of reflections of nurse managers; (3) six categories of knowledge and skills that nurse managers acquired through dealing with challenging tasks; and (4) two categories of attempts to apply new knowledge and skills in different situations.

Conclusion: Our results indicated the contents of experiential learning among nurse managers who showed obvious changes in their experiential learning scale scores. We believe nurse managers can promote experiential learning by incorporating the contents of this study into their nursing management practice. Furthermore, we believe that the results of our study are applicable to the development of programs for nurse managers that utilize experiential learning.

Aims: This study aimed to clarify the characteristics and identify factors related to uncertainty in illness as perceived by idiopathic interstitial pneumonia patients to help them cope with their illness.

Methods: The subjects included outpatients aged ≥40 years diagnosed with idiopathic interstitial pneumonia more than six months ago. Uncertainty in illness was assessed using the “Universal Uncertainty in Illness Scale; UUIS” consisting of 26 items and six subscales (a high score represents a high level of recognition of uncertainty). In addition, the uncertainty in illness was compared between the idiopathic pulmonary fibrosis group and the idiopathic interstitial pneumonia group excluding idiopathic pulmonary fibrosis. We conducted the forced entry multiple regression analysis using by the modified medical research council dyspnea scale, forced vital capacities.

Results: 51 patients included, age 71.3 ± 8.7, males 40 (78%). Patients with Idiopathic pulmonary fibrosis were 13. The mean UUIS scale total score was 84.7 ± 20.0. The uncertainty in illness of idiopathic interstitial pneumonia patients was assessed using their modified medical research council dyspnea scores which showed a positive correlation (P < 0.05), and their forced vital capacities which showed a negative correlation (P < 0.05). Multivariate analysis showed that the modified medical research council dyspnea score was an independent variable related to uncertainty in illness of [Instability of Self-confidence in Carrying on a Struggle against Illness].

Conclusion: Dyspnea tended to increase the perceived uncertainty in illness in the patients, suggesting its possible effects on the self-care of patients. Healthcare providers must consider care that takes into account the relief of symptoms, physical and psychosocial distress.

Purpose: The aim of this study was to develop an terminal care simulation scenario for baccalaureate nursing students, and evaluate the effectiveness of the scenario by comparing flow-experiential and self-confidence score.

Method: Eligible students were randomly assigned to either an experimental group (n = 13) or control group (n = 12). The evaluation of terminal care scenario was conducted by randomized controlled trial using a flow-experiential checklist and five-point Likert scale to rate student self-confidence.

Results: After the terminal care simulation, the experimental group showed a statically significant increase in mean score of flow-experience checklist. The self-confidence in providing terminal care also significantly increased in the experimental group.

Conclusion: These findings suggest that terminal care simulation scenario developed is well-balanced, with a reasonable quantity of information at a suitably challenging level. Such simulations may be a useful way to help students to learn about terminal care more effectively.

Purpose: To clarify the subjective experience and coping with multiple symptoms of outpatients with metastatic and recurrent breast cancer receiving chemotherapy.

Methods: Twenty outpatients with metastatic and recurrent breast cancer receiving chemotherapy participated in semi-structured interviews. We used an inductive approach to qualitatively analyze the responses.

Results: Responses regarding subjective experience could be grouped into three categories: “I feel that daily life routine is interrupted due to overlapping of multiple symptoms,” “I feel irritated that I have no control over my symptoms,” and “I fear whether I can continue chemotherapy.” Responses regarding coping with multiple symptoms could also be grouped into three categories: “I explore skills to control multiple symptoms better,” “I am aware of the changes my body is going through and foresee the future,” and “I want to avoid further damage to my weakened body.”

Conclusion: It is necessary for nursing care to capture patients’ difficulties in daily life caused by multiple and variable symptoms. Moreover, nursing professionals should pay close attention to patients who are dealing with the uncertainties regarding metastatic recurrence in order to provide effective personalize care. Future research is warranted to identify core symptoms and to develop assessment tools to detect them.

Objectives: A scale was developed to evaluate supervision by midwives during skilled birth attendance training, and its reliability and validity were examined.

Methods: Based on the data obtained through semi-structured interviews, a draft consisting of 79 items was created. To examine this, a survey was conducted, involving 3,988 individuals who belonged to 501 medical institutions providing maternity services throughout Japan. After reliability and exploratory factor analyses of each item, the criterion-related validity was examined in relation to existing scales.

Results: Out of a total of 906 responses, valid responses were obtained from 875 participants. Consequently, 56 items of 7 factors were adopted, each of the latter was named as follows: [Leading students to develop thoughts as a basis for appropriate diagnosis during delivery] [Ensuring both safe and comfortable delivery and sufficient learning opportunities for students] [Providing guidance on birth reviews] [Leading students to consider parturient females’ emotions] [Leading students to adopt appropriate actions independently] [Put instructor’s hands on the student’s hands at birth] [Confirming important points of preparation]. The internal consistency of the developed scale was sufficient, with Cronbach’s α of .960. Its criterion-related validity was also regarded as sufficient, as it was correlated with the Professional Autonomy in Midwifery, in addition to a scale to measure occupational recognition among nurses.

Purpose: The aim of this study was to develop a valid and reliable new nursing practice scale for measuring support for surrogate decision-makers, such as family members and close relatives, of terminal care in the intensive and critical care unit.

Methods: Based on a review of the literature, a new scale was drafted and its content validity was evaluated. Next, a survey using an self-administered questionnaire was conducted at intensive and critical care units in emergency and critical care centers in Japan on 473 clinical nurses. All responses were then subjected to statistical analysis, including item analysis, item–total correlation, good–poor analysis, exploratory factor analysis，validation of criterion-related validity，known-groups method, and the test–retest method. The ethical behavior scale for nurses was used for criterion-related validity.

Results: Exploratory factor analysis using the maximum likelihood method and promax rotation was performed to extract factors, resulting in a four-factor solution with 18 items. The four extracted factors were named as follows based on their content: Factor 1, “Interprofessional Collaboration”; Factor 2, “Preparation for surrogate decision-making”; Factor 3,“Evenly unbiased attitudes and checks on Doctor’s explanation”; and Factor 4,“Facilitation of surrogate decision-maker thinking”. Cronbach’s alpha coefficient was 0.89 for the total score and varied between 0.74–0.84 for the four factors. The correlation coefficient for the retest survey was 0.71, while that for the ethical behavior scale for nurses was 0.54. Known-groups method resulted that the group of certified nurse specialists and certified nurses showed significantly higher score than nurses except them, and so did the group with learning experience.

Conclusion: The validity and reliability of the nursing practice scale developed in this study to measure support for surrogate decision-makers of terminal care in the intensive and critical care unit were confirmed.

This study aimed to describe the learning of the practicum in multi-tasking and shadowing practice for nursing students before the establishment of the clinical practices of each nursing area (the practices). Participants were 61 third-grade nursing students at one university: 7 male students and 54 female students. Data were the reports handed after the practices and were analyzed using a qualitative descriptive method from the viewpoint that “What did the nursing students learn throw the practices? ”

Research participants were 29 students (47.5%) among the 61 students. Results of the learning outcomes through the practices were 7 categories as follows: 1) requirements for independence as a nurse, 2) practical thinking to manage multi-tasking, 3) building relationships among the team-nursing staff, 4) management the team members and the system of the ward, 5) accurate information exchange among the nursing team and multi-disciplinary professional team, 6) offering patient-centered nursing approaches, 7) defining self-challenges or tasks for future nursing practices.

We could obtain these learning for 3rd grade students that the other studies obtained for 4th grade. Furthermore, we thought the outcome that each category connected “offering patient-centered nursing approaches”.

Purpose: To examine whether there are differences in pelvic circumference, the presence and severity of lower back pain, and the level of impairment of activities of daily living between women who wrapped a girdle around the pelvis during the postpartum period (intervention group) and those who did not (control group).

Methods: Participants included 82 pregnant women who were followed through the early postpartum period (n = 45 in the intervention group, n = 37 in the control group). For each participant, we measured the pelvic circumference in the third trimester and on days 1 and 4 of postpartum, conducted a questionnaire survey, and statistically analyzed participant questionnaire responses and pelvic measurements.

Results: Pelvic circumference measurements were smaller during the postpartum period than during the third trimester for both groups. Lower back pain was experienced by approximately 60% of the participants in both groups during the study period, and there was no difference in the level of pain reported. In the control group, many participants developed back pain in the first day of the postpartum period. The level of impairment of activities of daily living was reduced over time during the postpartum period for both groups.

Conclusion: In both groups, the pelvic circumference during the early postpartum period was smaller than that during the third trimester; however, we were unable to confirm if girdle-wearing further reduced pelvic circumference measurements. It was inferred that girdle-wearing during the early postpartum period contributes to the prevention of back pain.

Aim: This study was conducted to produce a constructive concept of self-care for mentally handicapped persons in a community.

Methods: We identified the concept using concept analysis methods developed by Rodgers & Knafl (2000) as a reference. Three databases were searched: Ichushi Web, MEDLINE, CINAHL Articles. Search terms included: “mental illness” or “mental disorder” or “psychiatric illness” or “psychiatric disorder” and “self care” or “self-management”.

Results: Analysis of 42 reports of the relevant literature revealed a definition of self-care for people with mental disability in a community. It includes actions to build a foundation for life, live it, and improve quality of life (QOL), with maintenance and improvement of mental and physical health, change of self-concept, participation in society, and QOL improvement by continuing community life.

Conclusion: The self-care concept extracted this time is useful as an index to assess self-care and to provide necessary and desired support to realize ways of life and living.

Objective: The purpose of this study was to reveal the research trends in the domain of Ventricular Assist Device (VAD) patients’ caregivers and to examine home care support.

Method: We examined the MEDLINE, CINAHL, and Ichushi-Web databases to find English/Japanese articles on the topic of “VAD” and “caregivers.” A literature review of 25 published articles was conducted in July 2016.

Result: The research trends were subdivided into three categories: “experience of caregivers,” “the role of caregivers in self-care and education of VAD patients,” and “challenges faced by caregivers with regard to decision making support and end of life.” Common burdens of the caregiver in all three aspects have been shown; however, the reporting of specific supporting research was not present.

Conclusion: We need to clarify the experience of VAD caregivers in the Japanese context, and improve research on home care support intended to reduce their burden.

Purpose: The purpose of this review is to explore effective yoga intervention programs for menopausal women and identify the design and construction of the programs.

Method: Based on the principle procedure of the PRISMA statement, the medical databases (Ovid MEDLINE, CINAHL plus, PubMed) from 1997 to March 2016 were searched. Search terms included: “women”, related to “menopause”, and “yoga”. A total of 16 published articles were analyzed.

Results: There were 11 kinds of yoga programs. The intervention period was 8 to 24 weeks, the duration of classes ranged from 45 to 90 minutes, and the session frequency 1 to 5 times per week. Programs were conducted in two ways: group practice only and a combination of group practice and home practice. The programs comprised three elements: postures, controlled breathing, and meditation. They were found to be effective in mitigating menopause symptoms.

Conclusion: Effective yoga programs for menopausal women were created based on postures, controlled breathing, and meditation. This study revealed that trained instructors, peer supporters, the allocation of time to practice, and easy access to yoga practice, are important considerations.

Objectives: This study reviewed the education, research methodology, and evaluations used in a simulation-based learning program for undergraduate pediatric nursing students.

Methods: A review of studies published in December 2015 was performed using the following databases: CINAHL, PubMed, and the Japanese Central Review of Medicine. The primary search terms were ‘pediatric,’ ‘child,’ ‘simulation,’ ‘manikin,’ ‘nursing,’ and ‘student.’ Additionally, reference lists from all relevant reports were searched.

Results: In total, 38 studies were included in the review. We found that studies regarding simulation-based learning for pediatric nursing students are increasing. The simulation scenario in these studies focused on assessments of child development and nursing care using common pediatric clinical situations involving manikins and high-quality human standardized patients. These studies also performed pre-briefing and debriefings for pediatric nursing courses and clinical practices, and some studies exchanged a component of a course on pediatric clinical practices for simulations. The evaluations included various learning outcomes, such as knowledge, experience, performance, critical thinking, clinical judgment, and self-confidence, as well as a measure of the satisfaction of undergraduate student nurses, particularly many learning outcomes was subjectively.

Conclusions: It is important that the scenarios of the simulations used in pediatric nursing education emphasize child developmental assessment and pediatric nursing care and be well-designed and educational; it is also important that programs include a combination of classroom learning and clinical practice. Additionally, the use of a valid research design, predefined learning outcomes, and measures of the effectiveness of simulations are important contributors to undergraduate pediatric nursing education.

Objective: To clarify the Japanese concept of “the spiritual pain of terminal cancer patients.”

Method: A total 52 references published in Japan, including 40 theses and 12 books, were analyzed using Rodgers & Knafl’s (2000) method of concept analysis.

Results: Seven attributes (namely “seeking meaning,” “anxiety about death,” “loss of dignity,” “consciousness of guilt,” “grief for real self,” “loss of relationship,” and “longing for transcendental existence”), two prerequisites and four consequences were extracted.

Conclusion: The Japanese concept of “the spiritual pain of terminal cancer patients” was defined as “terminal cancer patients’ pain of an inevitable ongoing quest regarding the meaning of life, existence and suffering, anxiety about death, loss of dignity, consciousness of guilt, grief for real self, loss of relationship, longing for transcendental existence, etc., due to helplessness arising from fear of a life threatening condition and declining bodily functions caused by progression of the disease.” This concept was similar to that of the West and seems to be a universal concept among humans. Of these, excretion behavior (which is strongly associated with the attribute of “loss of dignity”) and the method of expression (which demonstrates the consequence of “complex modality”) were thought to be the characteristics exclusively associated with the Japanese.

Purpose: This study aimed to clarify the relationship between personal background information of children with eating disorders and the difficulty of daily life by their parents. It is an important decision to consider the family support.

Method: The parents completed a self-administered questionnaire about the personal background of their children (4 items) and the Scale for Evaluating Difficulties in Daily Life (15 items). Statistical analyses were performed using the Wilcoxon signed-rank test, chi-square test (with Yates correction), and Fisher’s exact test.

Results: A total of 45 valid responses were analyzed. The age of children with eating disorders significantly correlated with “unable to go out freely” and “physical and mental fatigue” (P < .05) and “no personal time” (P < .01). The onset age significantly correlated with “always have something to worry about marriage story of other family members” (P < .05). The history of admittance to hospital significantly correlated with “unable to go out freely” (P < .05).

Conclusion: The personal background of children with eating disorders (current age is 19 or under, the onset age is 20 or older, and there is history of admittance to hospital) has an effect on the difficulty of daily life by their parents. Thus, such parents require support, considering that the personal background affects how they feel about their children.

Objective: To determine the effectiveness of nursing intervention using CGA in late-stage elderly patients admitted to acute hospitals.

Methods: A total of 39 elderly patients aged 75 years or older who were admitted to acute hospitals were assigned to the intervention group (20 subjects, mean age of 83.9 years) or the control group (19 subjects, mean age of 85.0 years) to compare ADL, cognitive function, and vitality at baseline, changes in outcomes at three weeks post-admission, length of hospital stay, and discharge destination.

Results: Total scores of ADL, cognitive function, and vitality significantly increased from baseline in the intervention group compared to the control group with interactions among the total scores. Scores on subscales of ADL (toilet use, dressing, bowel control, and bladder control), the subscale of cognitive function (names of five items), and subscales of vitality (on and off toilet) significantly increased from baseline in the intervention group compared to the control group. The length of hospital stay did not significantly differ between the intervention and control groups.

Conclusion: This study indicated that nursing intervention using CGA was effective in preventing decline in ADL, cognitive function, and vitality in late-stage elderly patients admitted to acute hospitals.