Purpose: To conduct a concept analysis and clarify the factors that to create workplace culture of nurses.

Method: Using Rodger’s concept analysis method. Five databases were searched: PubMed, ProQuest, Ovid SP, CINAHL Plus with full text and Ichushi web. A total of 27 articles were analyzed.

Results: The following four attributes were identified: 1) shared criteria for judgment among nurses, 2) administrator’s management policy, 3) shared attitudes of workplace members and 4) characteristics of the workplace. Furthermore, two antecedent factors and five consequences were identified.

Conclusion: Administrator’s management policy, shared criteria for judgment and attitudes of workplace members were important forming factors in the workplace culture of nurses.

Objective: The purpose of this concept analysis was to define patients’ adherence for complex decongestive therapy in relation to lymphedema caused by cancer treatment.

Method: With using the framework outlined by Walker and Avant, articles were searched by the databases of internet engines related to 4fields and 50 articles were analyzed.

Result: The defining attributes consisted of “Mental stability,” “understanding the lymphedema and complex decongestive therapy” “spontaneity”, “devise the management skills” “practice and assess the complex decongestive therapy” and “self-efficacy to manage by themselves”, “educational approach from medical professionals” and “Partnerships with medical professionals” were also extracted. Recognized antecedents were “suffering symptoms” associated with lymphedema and, “long-term management”. In addition, factors such as the “forced to self-management of complex decongestive therapy” was extracted. The consequences were improvement of lymphedema and the patient’s quality of life.

Conclusion: According to the concept analysis in this study, adherence for complex decongestive therapy in patients with lymphedema caused by cancer treatment was defined “As managing the symptom by using customized skills spontaneously based on understanding the lymphedema and the treatment with mental stability, patient carry out the treatment with self-efficacy. It is established by education and partnership with medical professionals.”

Purpose: Creating a scale of father identity in the transition period and verifying its reliability and validity.

Method: To develop the scale, the researchers extracted 37 items from existing literature and examined the appropriateness of their content and face validity. A questionnaire survey was conducted of husbands whose wives delivered babies at 6 designated hospitals in the Kinki Area from January to March of 2016, and these items were analyzed together with the data to examine the scale’s reliability and validity.

Results: After examining the results, the researchers completed a scale with 21 items and 3 factors. The scale’s Cronbach’s coefficient alpha was 0.908, which gives it a high credibility factor. In the re-test method, it showed a strong relationship with an interclass correlation coefficient of r = 0.846 (P < 0.01). Additionally, with the existing group method, there were significant differences between husbands with one child and those with multiple children (P = 0.00, P < 0.01) and between husbands who were attending childbirth for the first time and those who had attended multiple times (P = 0.03, P < 0.05). The 3 factors extracted by the factor analysis were “a rush of emotion coming from the existence of a child/children,” “the upwelling consciousness of being a father” and “concerns for the wife”.

Conclusion: This scale is comprised of 3 factors and the researchers confirmed its reliability and validity.

Purpose: This study aimed to identify differences in levels of resilience in nursing students by grade level and their relationships with social support.

Methods: A self-administered questionnaire was conducted on 246 first- to third-year nursing students. The questionnaire included demographics, the Bidimensional Resilience Scale (BRS), and social support. Analyses included the one-way analysis of variance and multiple regression analysis.

Results: “Control” of innate factors of the BRS was significantly higher in third-year students than in first-year students (F_2,227 = 3.2, P = 0.042). By contrast, acquired factors included significantly higher levels of “attempting to solve a problem” (F_2,227 = 6.2, P = 0.002) and “self-understanding” (F_2,227 = 7.3, P < 0.001) among second- and third-year students, in comparison with first-year students, and there was no difference in “understanding others.” Support from nursing school instructors during clinical training influenced “self-understanding” (β = 0.22). Furthermore, “understanding others” was influenced heavily from support by significant others (β = 0.21).

Conclusions: Our findings indicate that “self-understanding,” “attempting to solve a problem,” and “control” of nursing students increased. Building resilience requires support from providers in both regular and extra-curricular activities.

Objective: The purpose of this study was to examine the effectiveness of the preceptor education program to facilitate reflections about the clinical experiences of new nurses.

Methods: [Research Design] Intervention study on a single subject. [Subjects] Seventy-six preceptors of a University Hospital. [Methods of Analysis] Self-evaluations of preceptors on reflection support sessions, which were conducted four times, were compared. The types of preceptors’ questions were classified at the supporting reflection in two pairs. Additionally, the amount of remarks of new nurses in the session was quantitatively analyzed.

Results: In respect of self-evaluations by the preceptors, 14 out of 20 items concerning support skills, including “wait for remarks of the new nurse”, and three items concerning changes in attitude toward support, such as “Notice my tendency” were significantly higher in and after the third sessions (P < .05). In the two sets of support situations, with continuous support, there was an increase from “pursuing type” to “confirmation type” questions for Preceptor A and from “confirmation type” to “eliciting type” questions for Preceptor B, which demonstrated that the preceptors had changed in such a way that they could ask questions that elicited ideas and thoughts from the new nurses.

Conclusion: The changes in the preceptors’ support approaches suggest that this program is effective in developing preceptors who can support the new nurses’ reflection on their clinical experience.

Purpose: To describe common behavior patterns of nurses and associated rules while providing induced abortion care.

Methods: An ethnographic approach was used as a research method. A study was conducted for approximately one year, observing participants at a gynecological clinic, and 15 nurses were interviewed. Using the data collected from the field notes and interviews of the study, common behavior patterns of nurses and associated rules while providing abortion care during early pregnancy were analyzed and described.

Results: The nurses question a woman’s decision to have an abortion when they sense the woman’s hesitation, suspect her of being pressured from people around her, and/or doubt her ability to make a rational judgement. Otherwise, the nurses provide “non-intrusive care”. The common behavior patterns of “non-intrusive care” were carrying out the abortion procedure smoothly and making the woman comfortable. The nurses provided overall care according to schedule in a matter-of-fact manner by keeping an emotional distance, not reproaching, not hurting the women’s feelings, not intruding on her private affairs, not getting too involved, allowing her privacy, noticing her physical discomfort and pains, and providing physical care accordingly.

Purpose: To clarify the components and characteristics of subjective sexual well-being (SSWB) of patients with inflammatory bowel disease (IBD).

Method: Referring to the text-mining approach, analysis was performed on the self-descriptions for sexually pleasing and satisfying state by 88 patients to a self-administered questionnaire survey, involving categorization of dependency structure, frequency analysis, and feature analysis.

Results: SSWB consisted of seven categories. Two of seven categories, “psychological stability” and “physical health,” were particular to IBD patients. These particulars were observed: among male patients, “satisfaction of sexual needs”; among female patients, “mutual empathy”; among patients aged 20 to 39, “psychological stability”; and among male patients aged 40 to 59, “satisfaction of sexual needs.” “Satisfaction of sexual needs” was characteristic among male patients in good subjective physical condition or good subjective relationships, and “realization of skinship” (physical intimacy) among female patients with Crohn’s disease or stoma.

Conclusion: The components and characteristics of SSWB are influenced by the degree of IBD symptoms. These findings can be harnessed so as to be introduced as topics, to set intervention goals that reflect the SSWB of a subject or to evaluate achievement.

Purpose: The goal of this paper was to clarify the thought regarding the collaboration with the nurses involved in cancer rehabilitation from the perspective of the physical therapists, occupational therapists and speech-language-hearing therapists (therapists) under the present conditions of the Interprofessional Work (IPW) surrounding cancer rehabilitation.

Method: I carried out a semi-structured interview for therapists having practical experience collaborating with nurses in cancer rehabilitation. The contents of the interview were transcribed and converted to data, and the data was encoded and categorized with sequentially increasing degrees of abstraction, followed by a qualitative explorative factor analysis of the data.

Results: It became clear that the present condition was that of a [Relationship of information support and opinion suggestion for the nurse], and the thinking aimed at [Pursuing the specialty of both types of jobs] and [Hoping of quality improvement based on IPW promotion] became clear.

Discussion: When practicing nursing while respecting the identity of the cancer patient, the nurse needs to deepen his/her understanding of cancer rehabilitation. Moreover, future issues to be researched would be the improvement of practical nursing ability and the further cultivation of IPW competency.

Objective: The aim of the survey was to determine the diversified ways and influential factors of the process used by women who terminated infertility treatment without having a child to accept the rest of their childless lives, and find their own unique ways to live, in order to identify the nursing support required.

Method: We conducted an interview survey among 14 women who terminated infertility treatment without having a child. The trajectory equifinality model (TEM) was used for analysis.

Results: Childless women had ambivalent feelings that oscillated between freedom and loss immediately after terminating infertility treatment. They then struggled with thoughts about whether giving up a child would be right or wrong, which led to their decision to not have a child. They looked back on the treatment they received, sought a way of life, found a positive meaning in the treatment experience, and then began to think positively about their childless life, regardless of social standards, which made it possible for them to find their unique lifestyle. Influential factors in this process included the recovery of self-confidence, approval from and stable relationships with significant others, existence of peers, and a shift in values.

Conclusion: Results suggest that nurses need to assist childless women in undergoing and terminating fertility treatment such that they, along with their husbands, are satisfied, and to provide information and lifestyle models based on an understanding that their conflicts and attempts to find meaning in the treatment experience can continue even after terminating the treatment.

Purpose: This study was aimed to examine the impact of self-esteem and self-efficacy on resilience among female senior clinical nurses.

Method: Self-administered questionnaires were distributed among 1,551 non-managerial senior clinical nurses. The questionnaire consisted of personal background information, the Japanese version of Rosenberg’s Self-esteem Scale, the Japanese version of the Generalized Self-Efficacy Scale, and the Adolescent Resilience Scale consisting of three factors (“novelty seeking”, “emotional regulation”, and “positive future orientation”). Data analyses were conducted using path analysis.

Results: 684 valid answers were returned (valid response rate = 44.1%). The path coefficient was 0.44 for “novelty seeking” and 0.26 for “positive future orientation” from self-efficacy, and 0.34 for “positive future orientation” from self-esteem (p < 0.001). The fitness indexes of the model were good (GFI = 1.00, AGF = 0.996, CFI = 1.00, RMSEA < 0.001).

Conclusion: In female senior clinical nurses, self-esteem and self-efficacy have been verified to affect resilience.

Purpose: This study aimed to develop and assess the reliability and validity of a scale measuring life motivation in older adults living alone and requiring assistance.

Methods: We designed a scale incorporating general notions of desire and motivation, developmental tasks, and opinions of the professionals who supported older adults. A self-administered paper questionnaire consisting of 77 five-point Likert items was then distributed to older adults living alone who required assistance. From the collected surveys, 218 valid responses were used for the analysis.

Results: We conducted a factor analysis using maximum likelihood with promax rotation, from which 4 factors and 14 items were extracted. We designated the factors as follows: “Capacity to Enjoy Life,” “Capacity for Mental Adaptation,” “Vitality in Daily Activities,” and “Capacity to Accept and Relish Living Alone.” To confirm reliability and validity, we determined a Cronbach’s alpha index of .850, a test-retest reliability index of .762, criterion-related validity of .726, and model fit of GFI = .901 and AGFI = .853.

Conclusion: Our results suggest that the scale developed in this study demonstrates an acceptable level of statistical reliability and validity. The scale can be easily used by both older adults requiring assistance and caregivers who help them, serving as an index to determine fluctuation in an individual’s life motivation.

Aim: To reveal the interaction process of sustained evacuation region with mother and children from Fukushima Daiichi Nuclear Power Plant accident.

Method: Semi-structured interviews were conducted with 12 mothers who had evacuated with their children to an area not affected by the great East Japan earthquake. Data were analyzed using The Modified Grounded Theory Approach.

Results: The process of comprised 12 concepts and four categories: “Fit to evacuation region as an evacuee,” “Real feeling for avoidance of health risks,” “Relationship is comfortable,” and “Satisfied with self-selection.”

Conclusion: To support mother and child evacuees, it is important to conduct risk communication of radiation health effects that understands the mother’s anxiety. It is also important to support the construction of human relations in the evacuation region. Additionally, it was suggested that communication and built a trust relationship for respect to their make a choice are also critical.

Purpose: This research was aimed at elucidating and obtaining suggestions from nurses working in nursing home (hereafter, nurses) on how they prognosticate the death of the elderly approximately one month before the actual death.

Methods: In this study, 20 nurses working in nursing homes from 15 facilities in the Kanto and Tokai regions were interviewed using the semi-structured interview method. In addition, with the permission from the facilities, the nurses were also put under observation. The data obtained were qualitatively analyzed using the analysis method proposed by Miles, Huberman, and Saldaña.

Results: All the included nurses had foreseen the death of the elderly approximately one month before the actual death. The qualitative data analysis revealed that nurses prognosticated the death of the elderly using nine categories of symptoms and changes such as “fear of death expressed by the elderly,” “diminishing motivation,” “decline in the function of meal intake,” “changes in facial expression,” “changes in the eyes,” “changes in voice,” “appearance of objective symptoms,” “declining in activities,” and “weight loss.” These symptoms and changes were broadly classified into “changes in psychological aspects” and “changes in physical function” as major categories with higher concepts.

Conclusion: Nurses perceived the death of the elderly approximately one month before based on certain symptoms and changes. Although not all symptoms and changes necessarily appear in one elderly person, it was suggested that the nurse would perceive the death of the elderly and accordingly take end-of-life care in a sufficient time.

Objective: To clarify factors influencing home-visit nursing services for end-stage cancer patients receiving home care and their relationships.

Methods: An anonymous, self-administered questionnaire survey was conducted involving visiting nurses. Their responses were scored through factor analysis to create a path model that explains factors influencing home-visit nursing services for end-stage cancer patients receiving home care.

Results: Responses from 750 visiting nurses were analyzed. Based on their FATCOD-B-J scores, a model (X² = 3.06, p = 0.82, GFI = 0.999, AGFI = 0.994, RMSEA = 0.000) explaining the influences of [behavior based on basic principles], [opportunities to offer opinions regarding organizational management], [collaborative relationships with visiting doctors], [motivation to accomplish work-related tasks], and [the length of home-visit nursing experience] on home-visit nursing services for end-stage cancer patients was created.

Conclusion: The necessity of developing mutually supportive relationships among visiting nurses and enabling them to make commitments to their organizations, while emotionally supporting them with appropriate advice in their workplaces, was suggested to promote home-visit nursing support for end-stage cancer patients receiving home care.

Aim: The present study aimed to analyze the recognition by general ward nurses of their role in supporting transition of end-stage cancer patients to home care setting.

Method: Semi-structured interviews were conducted with nurses in designated cancer hospitals, who provided care to end-stage cancer patients, for performing a qualitative and inductive analysis of the obtained data.

Results: Participants were 6 nurses with 3 to 7 years of clinical experience in 2 designated cancer hospitals. Our analysis revealed 16 categories and 34 subcategories of recognition of the role in supporting transition of end-stage cancer patients to home care settings. 4 characteristics were suggested from 16 categories including “nursing practice focusing on patients and their family members,” “using interdisciplinary cooperation skill,” “behaviors on understanding one’s nursing role,” and “addressing the role development”.

Conclusion: Such obtained categories suggest that, in supporting the transition of end-stage cancer patients to home care setting, nurses emphasize active support while understanding their role as a nurse and interdisciplinary cooperation, and consider enhancing their role through introspection of own challenges. Our future task is to examine the relationship between such awareness of roles and specific behaviors and factors relating to support for transition.

Objective: This study aimed to describe adaptation, including the stimuli, responses, and mental health, of patients with acute coronary syndrome who are discharged after percutaneous coronary intervention.

Methods: We conducted semi-structured interviews with ten patients after one month from the onset of the disease and intervention, and data were analyzed by content analysis. Onset, intervention, and discharge were predefined as focal stimuli based on the Roy Adaptation Model. Responses that were provoked by stimuli, mental health, and contextual and residual stimuli were described.

Results: Nine categories, including “having fear for cardiac diseases,” were identified as contextual and residual stimuli, and 22 categories, including “having cardiac symptoms after discharge” and “recognizing that it is better not to overtax myself,” were identified as responses. Six categories of mental health, including “having worry about recurrence” and “having trauma for appearance of cardiac symptoms,” were identified.

Conclusions: Our results indicate that patients experienced poor mental health. The identification of patients at a high risk of depression by observing both at hospitalization and ambulatory setting, review of experience at the onset, and instruction of response for cardiac event may be effective for patients’ mental health.

Purpose: To describe part of maternal resilience of children with congenital abnormality discharged from hospital to home medical care.

Methods: Semi-structured interviews using diagrams of emotional vicissitudes were performed with seven mothers of children with congenital abnormality discharged from hospital to home medical care, and results were categorized into maternal resilience using content analysis.

Results: Ten categories of maternal resilience were extracted: “motivation for discharge,” “ability to rise above negative feelings,” “presence of the husband,” “presence of trusted medical staff,” “the child’s life force,” “presence of the family,” “positive feelings about pregnancy and childbirth,” “presence of the mother in the same situation,” “maternal pride,” and “social support.”

Conclusion: The categories of maternal resilience of children with congenital abnormality discharged from hospital to home medical care included characteristics specific to mothers, relationships of trust with and support from those around them, the child’s life force, thoughts and feelings as a mother cultivated through interaction with their child, and the desire for the child to be discharged home. Planned support before delivery and later; support focusing on the interaction between the mother and child; and systematic support for receiving home medical care are essential to promote maternal resilience.

Objectives: This study aimed to determine the reliability and validity of the Bidimensional Resilience Scale (BRS) among nursing students and nurses.

Methods: A cross-sectional study using a self-administered questionnaire was conducted on 246 students in a nursing school and 881 nurses in 4 hospitals in Japan. The questionnaire included demographics, the BRS, and the Adolescent Resilience Scale (ARS). Analyses included the Cronbach’s alpha, correlation coefficient, partial correlation coefficient, and higher-order factor analysis using a covariance structure analysis.

Results: 230 nursing students (response rate: 93.5%) and 742 nurses (84.2%) replied. The result of the higher-order factor analysis of the BRS indicated a two-dimensional structure with two scales (innate and acquired resilience scales) and seven factors. In the revised model, the factor named “control” that was earlier included in innate resilience scale was moved to the acquired resilience scale, following which, no remarkable higher goodness of fit was obtained. The Cronbach’s alpha for the two scales were 0.79–0.80, and those for the 7 factors were 0.49–0.85. The BRS score correlated with ARS score.

Conclusions: The reliability and validity of the BRS were confirmed on a sample of nursing students and nurses. However, the findings on some factors need to be interpreted with caution.

Aim: This study aimed to structure the nursing practice of Certified Nurses in Emergency Nursing in regard to patients only required outpatient treatment in primary or secondary emergency care departments in Japan.

Method: Questionnaire data and semi-structured interview data were collected from 12 Certified Nurses in Emergency Nursing in the Kinki region in Japan. All responses were analyzed using the qualitative synthesis method (KJ method).

Results: Our study extracted seven symbolic marks in relation to Certified Nurses in Emergency Nursing practice for patients only required outpatient treatment, as follows:

[Independently observing and following up on patients, with a nursing focus, after doctor examination], [Source of care for patients needing help], [Imagining life after discharge for patients when determining whether hospitalization is necessary], [Receiving confirmation that hospitalization is unnecessary and sympathizing with emergency patients’ uneasiness and tension], [Explaining methods of risk aversion when return has taken place after a short period], [Where there is danger of aggravation, cooperating with other professionals], [Educated medical staff, care staff, and local residents who are able to administer first aid].

Conclusion: This paper revealed the nursing practice of Certified Nurses in Emergency Nursing that took responsibility in returning patients to their original life as well as the patients’ restoration to health.

Further research is needed to examine the influence of the emergency nurses’ intervention on re-consultation to an emergency outpatient and regular consultation to a general outpatient.

Objective: The purpose of this study was to clarify the process of adherence to complex decongestive therapy (CDT) acquired by the patients with secondary lymphedema.

Method: Semi-structured interview was conducted with 10 female lymphedema patients who had well-established adherence to CDT. Interview transcripts were qualitatively analyzed.

Result: Five categories including “perception of lymphedema,” “motivation,” “practice,” “medical profession,” “barrier” were associated with the process of adherence to CDT acquired by the patients. These were divided into 4 aspects based on time distribution. Aspects were changed from the first aspects of getting on the CDT caused by worsening of lymphedema to final aspects of becoming a habit to CDT spontaneously.

Conclusion: In order to acquire adherence to CDT, it is important for the patients who suffer from secondary lymphedema to recognize the lightness in their arms or legs with lymphedema and additionally to motive them with customized CDT.

Purpose: To examine the individual and organizational factors that predict nurses’ family-centered care (FCC) behaviors in neonatal intensive care units (NICUs) in Japan.

Methods: A nested cross-sectional survey (nursing staff within units) was conducted using a mailed self-reported questionnaire to 43 nurse managers and 1,700 staff nurses from 43 NICUs in Japan. Nurse-managers responded to an organizational-level questionnaire including items about visiting policy, staff education and management behaviors. Staff-nurses responded to an individual-level questionnaire including items about FCC behaviors, FCC beliefs, unit’s organizational climate and demographic data. The data were analyzed with a multi-level analysis and a multiple linear regression analysis.

Results: The response rates for nurse managers and staff nurses were 40 (93.0%) and 764 (44.9%), respectively. Greater beliefs about FCC (t = 9.11), better individual-level organizational climate (t = 4.79), and clinical experience (t = 3.35) were significant individual-factor predictors of FCC behaviors. Better unit-level organizational climate (t = 3.33), and open access 24-hour parental visiting (t = 2.62) were significant organizational-factors predictors of FCC behaviors. The unit-level organizational climate mediated the relationship between the nurse-managers’ management behaviors and staff-nurses’ FCC behaviors.

Conclusion: Better NICU individual and unit-level organizational climate and open access visiting policies for families and were significant predictors of FCC behaviors. Nurse-managers’ management behaviors toward staff, enhanced organizational climate and organizational commitment to an open access visiting policy for families are key components in implementing FCC.

Purpose: To develop a nursing evaluation scale for child maltreatment prevention (NES-CMP)—maternity ward nurses version—that can be utilized by obstetric nurses.

Methods: We randomly selected half of obstetric medical institutes nationwide. As a research target of which 1568 people of obstetric nurses of the 79 facilities that were obtained consent; an anonymous self-administered questionnaire was sent by mail.

Results: Reliability and validity were examined using data from 739 respondents (valid response rate 47.1%). With the help of results from an exploratory factor analysis, a 4-factor scale comprising 30 items was completed. The 4 factors are “Coordination for an interprofessional care system,” “Building of trusting relationships,” “Assessment of necessity of child care support,” and “Team-care practices.” Cronbach’s α was 0.97.

Conclusion: The NES-CMP was confirmed the validity of construct and internal consistency of this scale. That it can be utilized for self-evaluation of nursing practices for the prevention of child maltreatment.

Purpose: This study aims to propose a telenursing intervention model for assisting the self-monitoring of elderly patients with chronic heart failure and ascertain its efficacy in lowering the risk for hospitalization and the maintenance and improvement of patients’ quality of life (QOL).

Methods: Nursing intervention was provided through video calls for one year to patients aged ≥65 years with chronic heart failure who had frequently been hospitalized. The following items were compared and investigated: patients’ number and duration of hospitalization before, during, and after the intervention along with their weight, blood pressure, brain natriuretic peptide (BNP) values, and QOL.

Results: Video call nursing intervention was provided to 11 patients. The mean length of calls was 11.5 ± 3.6 min/session. Patients were hospitalized two to five times a year before the intervention, but nine were not hospitalized even once during the intervention period; of these, five were never hospitalized during the year following the completion of the intervention. No apparent changes were observed in parameters such as the BNP value; however, the scores for the psychological questions of the SF-36® used to assess post-intervention QOL were significantly higher.

Conclusion: This study confirms the efficacy of the telenursing intervention model for giving successive sessions of rapid and intensive intervention, customized for each patient to enhance their QOL and prevent hospitalizations. The preventive impact on hospitalization continued to last after the completion of the intervention period, suggesting that it effectively contributed to strengthening the self-monitoring abilities of patients living in their homes.

Objectives: The purpose of this study is to clarify the current state of collaboration between psychiatric nurses and dentists with regard to oral health care.

Methods: This study targeted psychiatric nurses for an exploratory descriptive assessment (questionnaire survey) concerning collaboration with dentists in oral health care.

Results: Valid response data from 186 individuals was analysed. While approximately 85% of psychiatric nurses had issues collaborating with dentists in the oral health care field, it was revealed that approximately 35% did not collaborate with dentists at all. Psychiatric nurses with a long history of work in the nursing field exhibited a tendency to collaborate with dentists, while those with low Oral Health-Related Quality of Life (QOL) tended to collaborate with dentists. Psychiatric nurses who did collaborate with dentists tended to believe that functional oral health was sufficient. Highly-skilled psychiatric nurses, who were more likely to collaborate with dentists, exhibited difficulties when attempting such collaboration. Psychiatric nurses who strongly believed in the importance of oral care also experienced difficulties in collaborating with dentists.

Conclusion: In this study, it became clear that while there are problems concerning collaboration among dentists in oral health care, psychiatric nurses who are unable to collaborate also exist. These results suggested a need for measures to encourage collaboration with dentists.

Purpose: To devise and verify the effective shampoo technique to decrease bacterial contamination and causes little stress in the recumbent state.

Methods: We set up four different conditions which vary in hot water quantity (5/10 L) and the way of rinsing (cupping one’s hands to hold hot water and then gently shake hair in it/brushing hair with fingers in hot water). We then divided twenty healthy adults into four groups, so that five participants were tested under each of the four different conditions. Hair and scalp bacterial counts (Staphylococcus) and triglyceride (TG) levels were investigated before and after hair washing. The rate of change was calculated using before hair washing “1” as a reference.

Results: Bacterial counts decreased by 0.34 ± 0.05 when 10 L of hot water was used and the hair was gently shaken (p < 0.05). While the scalp bacterial counts decreased to below 1 for all methods, a greater decrease was seen when a larger quantity of hot water was used (p < 0.05). TG level decreased in both the hair and scalp when 10 L of hot water was used, regardless of how the hands were used. Although no significant differences were observed for subjective evaluation, rinsing after cupping the hands to hold the water tended to cause the participants to feel highly refreshed.

Conclusions: Using a large amount (10 L) of hot water and cupping the hands to hold the water to rinse the hair while gently shaking it is an effective method of hair washing to eliminate bacterial contamination.

Workfare programs, which have become prevalent worldwide. In Japan, governments are providing employment assistance for welfare recipients who are considered capable of working. The recipients of these services may have complex health concerns, all of which could be barriers to finding employment. However, there is a lack of research on this matter. The aim of this study is to clarify the structure of health characteristics that affect the willingness of welfare recipients to work via the workfare program. We conducted interviews with 31 welfare recipients in the workfare program and extracted [persistent agony, which is hard for others to understand], [vulnerability to stress], [difficulty of social adaptation], and [health management via their own style]as health characteristics. Additionally, we extracted [expecting to work], [worrying and mental conflict about ending welfare assistance], and [perception of social exclusion]as factors that affect their health and willingness to work. These categories relate to each other and cause «fracturing of willing of work due to work with complicated health problems versus the benefit of being a welfare recipient». The welfare recipients in this study who had physical, mental, and social health problems tended to be isolated; they have anyone to advise them regarding health problems. Health professional’s support is needed to alleviate recipients’ problems and provide more effective encouragement to strengthen their willingness to work.

Purpose: Nurses have a responsibility to improve the quality of their nursing skills. However, it was reported that this is difficult to achieve. This study was conducted to clarify how nurses who work at advanced treatment hospitals discover worthiness in their nursing practice and to understand the type of support that is needed to develop and foster growth in the nursing profession.

Methods: Data for this study was collected through semi-structured formatted interviews from eighteen nurses with five to ten years of clinical nursing experience at hospital A. The data were then analyzed using modified grounded theory approach.

Results: Early in their careers, nurses reported a struggle to understand their essential duties. However, over time and through trial and error, many said they could dutifully carry out their primary nursing responsibilities. Once nurses genuinely considered their skills and recognized the worthiness of their nursing abilities, that knowledge became a strong motivating factor for the continuation of learning and a deepening of their nursing expertise. Nurses were influenced and supported by a diverse group of patients and team members which eventually led them to reciprocate their influence and support back to the people around them in the workplace. Upon reflection on their work experience, nurses were able to see clear signs of progress in their nursing practices, motivating them to have a deeper understanding of nursing skills to accomplish better nursing practices.

Conclusions: The data suggest the importance of providing team support to assist nurses in reflecting on their work experience and recognizing the worthiness of their nursing practice.

Purpose: The aim of this study was to describe the involvement of nurses in understanding the feelings of school children and adolescents with pediatric cancer undergoing long-term hospitalization.

Methods: Leininger’s ethnonursing method was used in this study. We conducted fieldwork at the pediatric ward to gather data for analysis.

Results: The following main themes were identified: (1) putting up an “antenna” to determine the children’s daily lifestyle and understand their individual traits, (2) exploring about the difficult-to-grasp “world of the child” in school children and adolescents, (3) becoming a person that the child feels they can talk to, (4) creating opportunities for the children to think and express themselves in their way, (5) waiting for a sign from the child with preparedness, and (6) taking actions and not dismissing words uttered by the children.

Conclusion: Nurses utilized their “periods of free time” and “unnecessary conversations” to discover “world of the child”. By discovering the world of the children, in particular their peer relationships, nurses were able to understand their honest desires and values, which could not be easily shown in the hospital setting. Nurses also determined the children’s true intentions by waiting for them to express their feelings in their own time using two approaches. The first approach involved waiting while proactively taking action, such as cultivating the children’s ability for self-expression and feelings, such as building a relationship in which the children felt they could talk to the nurse. The second approach involved waiting preparedly so as not to miss any difficult-to-discern signs in the children.

Purpose: This study examined gait self-assessments and the psychosocial aspects of female patients with hip osteoarthritis pre- and post-surgery, comparing perspectives from patients with total hip arthroplasty (THA) and patients with Spherical Periacetabular Osteotomy (SPO).

Method: An anonymous self-response questionnaire survey was conducted with female THA patients and female SPO patients 6 to 12 months post-surgery and the self-assessment and psychosocial aspects of the patients’ gaits pre- and post-surgery were compared.

Results: Responses were received from 70 THA patients and 10 SPO patients. For both THA and SPO patients, gait self-assessments were significantly higher post-surgery. The pre-surgery gait self-assessments were related to feelings of claudication, a feeling about walking with the aid of a stick, and depression in THA patients. The post-surgery gait self-assessments were related to self-esteem, depression, public self-consciousness, and general health perceptions (GH) in THA patients, and overall GH in SPO patients.

Conclusion: This suggested that assessing the gait self-assessment of female patients with hip osteoarthritis would help to provide psychosocial supports. However, there were differences in the psychosocial factors that relate to gait self-assessment. This suggests that it is necessary for care to be adapted to the period of time in relation to surgery and the characteristics of each patient.

Objective: To examine prostate cancer survivors’ resilience and effective nursing practice for them.

Methods: Semi-structured interviews were conducted with 20 prostate cancer survivors at 6 to 18 months after surgery, and the obtained data were analyzed, adopting the modified grounded theory approach.

Results: The prostate cancer survivors’ resilience was summarized into a process of [reconstituting their identity as a male] to develop a new sense of self-worth, adopting a different perspective of manliness, while <recognizing their unique qualities to assert themselves>, <finding themselves still needed in society>, and <realizing that their partner’s presence is indispensable at all times>. The process was promoted by <convincing themselves that this cancer is not fatal> and <confirming the significance of life>.

Conclusion: The promotion of this process may be effective for resilience-focused nursing practice. Nurses should help them develop a new sense of self-worth by realizing that they are socially recognized as a person even if their erectile function and urinary control cannot be maintained.

Purpose: This study aimed to identify cause- and background- related 30-day revisit pattern among patients who were discharged from the emergency department (ED).

Methods: This was a chart review-based comparative case study. Data were collected from the medical charts of patients who were discharged from the ED of an university hospital in Tokyo, Japan, between February and December 2013. Patients who revisited the ED within 30 days after discharge were included. Data were analyzed using a case-code matrix for pattern classification and compared across pattern groups.

Results: We analyzed 136 patients who revisited the ED within 30 days of discharge. Patients were classified into five categories of 30-day ED revisit patterns: those who were instructed to revisit by the health care provider at the first visit (planned revisit), those who were instructed to revisit after discharge (prompted revisit), those who experienced worsening of original symptoms (revisit needed for medical treatment/examination), those who experienced new symptoms (revisit due to a new episode), and those with mild symptoms (revisit for minor problems).

Conclusion: Patients were classified into 5 ED revisit patterns. These findings indicate the necessity of assessing such patterns at the first visit and providing appropriate services to avoid unnecessary second visits.

Purpose: The association between the presence or absence of clients who are known to use violence against visiting nurses (VN) by the administrator of the visiting nursing station (VNST) and community cooperation is investigated.

Method: Anonymous self-administered questionnaire mail survey for VNST administrators. Survey questions included the personal attributes of VNST administrators, affiliation, the number of clients acting violently against VN, and the Identifiable Relation Rating Scale score in home care providers (community cooperation). Logistic regression analysis was performed using community cooperation as the independent variable and the presence of abusive clients as the dependent variable.

Result: A total of 805 responses were collected (response rate 27.3%). The numbers of ST having abusive clients were 240 for physical violence (29.8%), 296 for verbal abuse (36.8%), and 251 for sexual harassment (31.2%). Each type of violence was associated with personal attributes and affiliation. The percentage of verbally abusive or sexually harassing clients was higher in the ST group which scored low in community cooperation compared with other groups with a high cooperation score.

Conclusion: It was suggested that the lowness of community cooperation of VNST were related to the verbal aggression and occurrence of sexual harassment.

Purpose: The purpose of this study was to develop a self-evaluation scale to assess nursing faculty’ thoughts in instructional design.

Method: A questionnaire survey was conducted with 583 nursing faculty of 52 nursing education institutions. Based on previous studies, 47 items were prepared for the draft of the scale, and the validity of the contents was examined. Results of item analysis and exploratory factor analysis confirmed the reliability and validity of the scale.

Results: The questionnaire was collected from 286/583 responses (response rate: 49.1%) and there were 262 effective responses (effective response rate: 44.9%). As a result of exploratory factor analysis, 31 items and 5 factor structures were identified. These were “teaching strategy,” “students’ readiness,” “view of education,” “teachers’ expectations from students,” and “nursing faculty’s experience.” The Cronbach’s α of each five factor ranged from .806 to .905 and Goodness of fit of five factor model were GFI = .812, AGFI = .780, CFI = .892, and RMSEA = .064.

Conclusion: Reliability and validity of Self-evaluation Scale to Assess Nursing Faculty’s Thoughts found to be almost secured.

Aim: The purpose of this study is to examine the health habits, medication adherence, renal function and the relationship between quality of life (QOL) among renal transplant patients.

Methods: The participants were 238 patients who had undergone renal transplantation. Health-related QOL was measured using the self-administered Medical Outcomes Study 36-Item Short-Form Health Survey, health habits were examined using questions on six health-related habits, and medication adherence was measured using the Japanese version of Morisky Medication Adherence Scale-8. Participant characteristics and renal function data were obtained from the patients’ electronic medical record data.

Results: Among the 142 participants whose data were analyzed, those with good health habits or high level of medication adherence were more likely to have mental QOL. A mixed effect model showed that mental quality of life was significantly explained by good health habits, aging, high level of medication adherence, and high degree of obesity calculated from body mass index.

Conclusion: The results suggest that a long-term support system in outpatient care settings might facilitate good health habits and appropriate medication adherence among patients who have undergone renal transplantation, in order to improve or maintain their QOL.

Objective: This study aimed to clarify clinical nurses’ perceptions of effective teamwork.

Method: Semi-structured interviews were conducted with 13 nurses working in general wards. The contents of interviews were analyzed descriptively and qualitatively.

Results: Clinical nurses are [Making arrangements so that the team can work smoothly], [Supporting one another’s work], and [Acting in a way that allows other members to work easily]. They also learn teamwork from [Learning teamwork in team practice] and [Learning teamwork through activities by interprofessional collaboration]. When these activities become [Realizing the result of care by the team], they can feel effective teamwork.

Conclusion: To have effective teamwork, it is crucial to share among team members the goal of providing quality care, to reflect on the practice from the viewpoint of effective team work, and to learn by associating the experiences of teamwork with actions to be taken as a team member.

Purpose: The purpose of this study was to clarify the relationship between the recognition of colorectal cancer symptoms in affected patients and the knowledge of risk factors and lifestyle.

Method: Postoperative patients with colorectal cancer participated in a self-report questionnaire survey on “recognition of symptoms,” “knowledge of risk factors,” and “current lifestyle habits.” A univariate analysis was performed on “recognition of symptoms”; each question had one of three possible answers: “I didn’t know symptoms,” “I knew symptoms after onset,” and “I knew symptoms before onset.”

Result: Responses were received from ninety-five patients. Thirty-six patients (37.9%) who answered “I didn’t know symptoms” were male and Stage II/III patients with less than 3 million yen in annual income; their knowledge of risk factors was low, and they reported high alcohol and fat intake and low vegetable intake. Forty patients (42.1%) who answered “I knew symptoms after onset” were female and Stage II/III patients; they reported high intake of vegetables and low alcohol and fat intake. Nineteen patients (20.0%) who answered “I knew symptoms before onset” were Stage 0/I patients and more than 3 million yen in annual income; their knowledge of risk factors was high and their fat intake was low.

Conclusion: Differences in the knowledge of risk factors and lifestyle were observed because of differences in the recognition of symptoms, suggesting the necessity of suggesting the necessity of providing nurses’ support.

Aim: A study was conducted to clarify the effects of exercise therapy for patients with chemotherapy-induced peripheral neuropathy (CIPN) based on a review of the English literature.

Method: A literature search was conducted using the Japan Medical Abstracts Society and PubMed. To be included in the study, a paper had to meet all of the following conditions: Publication within the past five years, the original articles, and the search terms “peripheral neuropathy” and “exercise therapy.”

Results: Following the search, most of the search conditions were many studies on diabetic peripheral neuropathy, and others were few. The exercise contents were mainly aerobic exercise, muscular strength exercise, sensory exercise, and expert management that took safety into consideration. Nerve conduction velocity, muscular strength, balancing power, and walking speed were used, and in all the literature, a significant improvement was seen in the comparison between before and after the intervention. However, the significant improvement by comparison between groups was not necessarily clear.

Conclusion: This review provides evidence that neurological symptoms and balance ability can be improved by exercise therapy for CIPN through a comparison between before and after the intervention. Regarding the exercise content, it is a complex exercise program rather than alone. It is appropriate to conduct exercise intervention starting with a mild load under the management of medical staff and maintain a moderate load.

Purpose: The aim of this research is to organize knowledge of domestic literature on Interprofessional Work (IPW) competencies for nurses working in a hospital in Japan.

Method: A search was done on the literature in various databases including the Japan Medical Abstract Society (JAMAS) Web Edition (Ver. 5), National Institute of Informatics Scholarly and Academic Information Navigator (CiNii), and Google Scholar, using the following keywords: “Interprofessional human relations/Team healthcare/Doctors–Nurses professional relationships/cooperation,” “Clinical abilities/competencies” and “Hospitals.” As a result of having searched it, we finally intended for 22 original papers.

Results: The results of content analysis showed “Clinical abilities of nurses regarding their IPW ability,” “Coordination ability of nursing excellence” “Inter-disciplinary communication,” “Nursing education and IPW ability training” and only one piece of literature dealt with Competency Evaluations.

Discussion: The competency regarding the IPW of nurses in hospitals was necessary for various nursing activities and was an essential factor in the excellence of nursing. Moreover, assertive communication between the different job types was important.

It was suggested that more pragmatic investigations into such issues as conflict resolution and evaluations from the perspective of various disciplines are research problems for competency studies related to the IPW in our nation.

Purpose: To ascertain the places, postures, and napping times of elderly persons in a long-term care insurance facility during naps, and to clarify the characteristics thereof.

Method: For 20 elderly persons residing in a long-term care facility, measurements of sleep variables were taken for three days using actigraph, and the places and postures while napping were studied through behavioral observation. Thereafter, the participants were divided into short-and long-time nap groups, whose nap times were shorter than 30 minutes and 30 minutes or longer, respectively. We analyzed the characteristics of short and long nap times.

Results: There were significances between the two groups in terms of the number of time subjects stayed in a particular place during the napping period. Compared with the long-time nap group, participants in the short-time nap group were in their rooms for a fewer number of times during the napping period, and spent a greater number of times in the communal activity room.

Conclusion: For elderly facility residents, spending more time in the communal activity room during the napping period from 1 p.m. to 3 p.m. meant increased opportunity for interacting with others, with increased length of daily life spent in accordance with the facility schedule. It was suggested that these increases are two of the factors affecting nap time of elderly persons in a long-term care insurance facility.

Purpose: We conducted an active-learning program on nursing process of pediatric patients using the jigsaw classroom among nursing sophomores. We prepared a practical report on it including its evaluation by the students.

Methods: The participants included 76 students who were divided into 19 groups of 4 students. Students organized expert groups for each of the following four assessments: Disorder and treatment, life, growth and development, and family. The students discussed the each of assessments in expert groups. Students returned to jigsaw group and taught each other about the assessment. Students described concept maps, clarified nursing problems, and made nursing care plans. After students’ presentation, we distributed questionnaires.

Results: After active-learning, 65 students responded to the questionnaire. Most students answered “I was able to participate positively” and “I was able to participate responsibly.” The average of their satisfaction with jigsaw classroom was 80.5 out of 100.

Conclusion: Students were able to participate positively by clarifying their own tasks for group and responsibilities within the jigsaw classroom. There was a high degree of satisfaction about the jigsaw classroom among students. Students regarded jigsaw classroom as a favorable learning method.

Objective: The objectives of this study were to identify work environment factors that are needed for staff retention according to nursing and care staff working at facilities covered by public aid providing long-term care to the elderly, and to obtain input for organizational management.

Method: Focus group interviews were conducted with 18 participants working at three facilities that employed nursing staff and care workers. The data were then analyzed using qualitative inductive analysis.

Results: According to the nursing staff and care workers, the following work environment factors are needed for staff retention: “favorable working conditions”, “a system to improve quality of care” and “measures to develop human resources” as physical factors, and “support from superiors” and “harmonization among staff members” as personal factors.

Conclusion: Organizational management needs: i) an enhanced balance of work and rest, ii) work arrangements that value the expertise of the professionals, and iii) an educational system for capacity building catered to each individual staff member. The present study also revealed the importance of fostering a personnel environment that is based on a support system among the facility’s staff, including the Facility Director and bosses.

Objective: The aim of this study was to reveal current practices in experience-based learning concerning interprofessional work (IPW) of the students at a nursing university without a department of medical and welfare studies.

Method: A questionnaire survey on experience-based learning concerning IPW was conducted on fourth-year students in the faculty of nursing at a university without a department of medical and welfare studies. Simple tabulation for the closed-ended questions was obtained and a qualitative, inductive analysis was performed on the open-ended questions.

Results: At clinical practicums, nursing students had contact with other professionals and they observed nurses participating in IPW. Students acquired knowledge concerning IPW. While the goal of developing the “ability to collaborate and cooperate in the healthcare and welfare” by graduation was evaluated as being achieved, the evaluation of targets concerning team activities was relatively low. Acknowledging not only the different positions from other professionals but a lack of knowledge in each expertise and role, the students perceived a barrier between themselves and other professionals.

Discussion: During the four-year clinical practicums, nursing students learned about collaborative competency in the IPW competencies. Future studies will need to explore education methods that improve their ability to solve problems with a team.

Objectives: In this study, we aimed to examine the short-term effects of open college on health awareness and behavioral change for healthy lifestyles.

Methods: This was an uncontrolled before-and-after trial of adult participants invited by open recruitment. The open college were held weekly for five weeks, with questionnaire surveys provided at three points for examining the effect of the intervention. Two scales were used for measuring the outcomes: the Japanese Language Version of the Health-Promoting Lifestyle Profile (JLV-HPLP II) and the Health-Related Quality of Life Short Form (SF-8).

Results: In total, 32 out of 35 approached individuals agreed to complete the surveys. Findings of one-way repeated measure analysis of variance, using general linear modelling, indicated significant differences in several subscales. In the JLV-HPLP II, differences were present in the total score as well as in the following elements: health responsibility, spiritual growth, physical activity, and nutrition. On the contrary, we noted only a difference in the general health element of the SF-8.

Conclusion: These results suggest that open college had a positive short-term effect on health awareness and the requirement for behavioral change for achieving a healthy lifestyle among participants.

Purpose: The aim of this study was to clarify the outcomes associated with continued implementation of progressive muscle relaxation program in group homes and small multifunctional satellite home-care services.

Methods: The mutual collaborative approach was used by researchers and the facility staff. Facility staff interviews conducted by researchers and notes maintained by the facility staff pertaining to program implementation were inductively analyzed. Survey data on the behavioral and psychological symptoms of dementia (BPSD) in elderly residents were quantitatively analyzed.

Results and Conclusions: Group home and small-scale multifunctional facility staff began to conduct initiatives on their own following continuous implementation of the progressive muscle relaxation program. This program appeared to reduce BPSD among elderly residents with dementia. In addition, the program had a positive meaning and a possible synergistic effect on the facility staff and elderly residents with dementia.