Objective: This study aimed to clarify the elements of recommended practice from a literature review of interventional studies that promote advance care planning (ACP) in patients with chronic respiratory diseases.
Methods: This study performed a search of literature regarding studies on interventions that support ACP in patients with chronic respiratory diseases. The bibliographic databases PubMed, CINAHL with Full Text, and Ichushi ver. 5 were used to find related studies published until December 2017.
Results: The review of the interventional studies revealed the following recommended practice elements: targets of ACP, assessment of the potential needs of ACP intervention, number of meetings with ACP intervention practitioners, provision of information on ACP, provision of information on artificial respiration, and sharing records on ACP.
Conclusion: The results indicated way of thinking of subjects suitable for ACP as understood from the results of interventional studies, and significance of practice elements recommended for promoting ACP.
Objective: To obtain a definition of nursing judgment in home healthcare nursing practice as performed by home healthcare nurses in Japan.
Methods: A total of 33 literature references published in Japan were assessed. Rodger’s method was employed for concept analysis.
Results: The following four attributes were extracted: “understanding patients as individuals with their own lifestyles, opinions, and values”, “proactive perspective”, “discussing care for patients to meet their lifestyle needs”, and “careful patient-centered consideration”. In addition, 3 antecedents were extracted: “characteristics of nursing in daily life”, “intention to exercise professional judgment”, and “ability of each nurse”. Finally, 2 consequences were extracted: “contents of judgment” and “conduct of appropriate care for patients”.
Conclusion: Nursing judgment in home healthcare nursing practice by home healthcare nurses in Japan was defined as the process of understanding patients as individuals with their own lifestyles, opinions, and values and discussing the care required to meet their lifestyle needs with the patients as well as the people surrounding them. This process should be performed proactively and should be based on careful patient-centered consideration. Through this process, the patient’s condition, care, and involvement are determined, so that appropriate care for each patient can be provided in nursing practice.
Purpose: The present study aimed to elucidate sleep states, sleepiness, and fatigue among nurses working 12-hour double, day, full day, and night shifts using subjective and objective indicators.
Methods: Sleep states, sleepiness, and fatigue during day, full day, and night shifts were measured in seven 22-year-old female nurses using the Kwansei Gakuin Sleepiness Scale (KSS), the Subjective Fatigue Questionnaire (Jikaku Sho Shirabe), the Psychomotor Vigilance Task (PVT), and an Active Tracer (GMS Inc., Tokyo, Japan). The nurses also wore an ActiGraph for four days at the end of their shifts for a total of seven days.
Results: A full day shift required more physical activity than day or night shifts. Fatigue and sleepiness did not change during day or night shifts. Fatigue and sleepiness increased during the full day shift and arousal linearly decreased at the end of the shift. Meanwhile, nurses on night shift had less sleepiness and fatigue at the start of the shift, but drowsiness, eyestrain, and fatigue were increased at the end of the shift. The nurses slept for shorter periods before a night shift than after a day shift. Furthermore, sleep-wake rhythms temporarily changed after night shifts but recovered on the following day.
Conclusions: The nurses were more active during 12-hour double and full day shifts than any other shifts, but fatigue was increased and arousal was decreased. The nurses slept for shorter periods before night shifts than after day shifts.
Purpose: The purpose of this study was to clarify the structure of motivation for growth of clinical nurses.
Method: Thirteen nurses with more than three years of clinical experience were interviewed using a semi-structured interview.
Results: Eight categories were extracted. Laying a “foundation for working as a nurse” facilitated nurses to “tackle nursing work”, and developing “awareness of immaturity as a professional” while working helped nurses to make an “effort to overcome immaturity”. As nurses developed relationships with others, they gradually strengthened their “interest in what I should be through relationships with others”, and they “reflected on themselves with consideration for others”. “Pride in nursing and a desire to contribute” was cultivated with accumulation of experience, leading to “fusion of autonomy and cooperation at work”.
Conclusion: These results suggest that motivation for growth of clinical nurses requires establishment of both cooperative and autonomous behaviors by maintaining a balance of thoughts for others and the inner self, with the aim of becoming a fully-fledged professional.
Purpose: The purpose of this research is to conduct a educational program based on the cognitive restructuring method in order to provide nurses with training in emotional coping, and to verify changes in emotional coping tendencies.
Method: Using a web-based version of cognitive restructuring, we conducted a educational program with 26 nurses who had less than 10 year’s nursing experience. Evaluation of the intervention was carried out at three stages: pre-intervention, post-intervention, and one month post-intervention, and was performed using scales of the ECSS-N (Emotional-Coping Strategies Scale for Nurses), STAI (State-Trait Anxiety Inventory), and SOC (Sense of Coherence).
Results: The results indicated increases in a “regulating both patients’ and one’s own emotions”, which is effective to mental health (F(2, 48) = 3.61, p = .035). These changes led to increased confidence with regards to emotional coping (F(2, 48) = 5.02, p = .010). Additionally, this effect was observed one month post-intervention rather than immediately after intervention.
Conclusion: The results of the conductance of educational program indicated its ability to change nurses’ emotional coping tendencies.
Purpose: To visualize operative nursing experiences of nurses in their first to third year after graduation.
Methods: We conducted a semi-structured interview of seven nurses and analyzed the data using narrative analysis methods by Riessman.
Results: We identified the following nine themes pertaining to the operative nursing experiences of the enrolled seven nurses: [Caring for the pain and anxiety of a patient] [Careful that understanding and trusting relationships of patient’s feelings are important] [A need for assistance with ethical considerations, identified from the patient’s point of view Sex] [Awareness of being a nurse] [The pain of not being able to issue the instrument, and the awareness that it is nursing to save the patient] [Responsibilities and responsibilities to fulfill their responsibilities to protect patients’ safety] [Feeling that operative nursing was able to be done] [Attraction toward operative nursing developed while providing operative nursing care] [Sense of achievement and encouragement resulting from relationship with patients].
Conclusions: Nurses 1–3 years after graduation perceive that nursing cannot be practiced adequately. This study explored the meaning of nursing through the experience of daily operative nursing, and was aiming at the improvement of the technique in the surgical nursing while feeling the satisfaction.
Purpose: The purpose of this study was to examine the correlations between daily physical activity and objective/subjective sleep variables in schizophrenic patients.
Methods: Twenty-seven schizophrenia patients (male 17, female 10, mean age: 58.3 ± 11.6 years, no change in medicine for one month of the study) were evaluated with regard to their physical activity and objective sleep variables for one week. Total sleep time (TST), sleep latency (SL), waking after sleep onset (WASO), and sleep efficiency (SE) were determined by wrist actigraphy. Daily physical activity (steps per day) was assessed with the help of a waist pedometer. Subjective sleep quality was also assessed using the Pittsburgh Sleep Quality Index (PSQI).
Results: Physical activity showed significant correlation with SE (r = .629, p < .01), TST (r = .406, p < .05), and WASO (r = –.615, p < .01). On the other hand, there was no correlation between physical activity and PSQI score.
Conclusion: Our results suggest that objective sleep quality index in schizophrenia inpatients may be more effectively improved by increasing the amount of daily physical activity.
Purpose: This study aimed to consider the reliability and validity of the Peer Coaching Scale for Nurses during the initial career-development period.
Methods: The researchers selected 55 items from an initial scale of 64 items based on peer debriefing and their content validity index. A questionnaire survey was conducted for nurses in the second and third years after graduation from 65 institutions nationally from September 2017 to March 2018. Data obtained from 318 nurses were analyzed. The reliability and validity were examined using item analysis, exploratory factor analysis, Cronbach’s α coefficient, the confirmation of correlation with external criteria, and the test-retest method.
Results: As a result of the exploratory factor analysis, four factors and 20 items were extracted. The four factors were “the act of building a reciprocal relationship,” “the act of co-creating a care method,” “the act of compensating a care method,” and “the act of accelerating self-transformation.” The Cronbach’s α coefficient for the overall scale was .93. The Cronbach’s α coefficients for the subscales ranged from .82 to .89. The correlation coefficient of the Peer Coaching Scale with the subscale “usefulness of cooperation” of the Belief in Cooperation Scale was .33 (p < .01), and with the Teamwork Measure for Nursing Teams was .33 (p < .01). Using the test-retest method, the intraclass correlation coefficient for the subscales ranged from .65 to .79 (p < .01).
Conclusion: The reliability and validity of the Peer Coaching Scale for Nurses during the Initial Career-Development Period were verified.
Purpose: To interpret the experience of elderly people with Charles Bonnet Syndrome (CBS) due to visual impairment from the perspective of embodied perception.
Method: Participant observation and unstructured interviews were carried out with Patient A, who had visual impairment complicated by hallucinations and depression. The patient’s narratives were then interpreted based on Merleau-Ponty’s theory and Ito’s theory of embodiment.
Results: By interpreting the experience of Patient A, the following six themes were derived as processes for accepting the characteristics of hallucinations accompanying visual impairment and the distress of experiencing loss: (1) “the impact of thoughts and feelings on vision and the onset of hallucinations,” (2) “invasive hallucinations and depression due to repeated experiences of loss,” (3) “sensory compensation,” (4) “an incipient ability to live vicariously through others,” (5) “the manifestation of what has been lost,” and (6) “acceptance of fate.”
Conclusion: These results suggest that vision is subject to the thoughts and feelings of those affected by impairment, and that hallucinations and depression can be transformed as a result of sensory compensation, connections with others, and the acceptance of impairment and loss. Thus, after understanding the distress experienced by those affected, it seems important to support the process of accepting impairment and loss while aiding in the reconstruction of lifestyles and the quest to find meaning in life.
Aim: This study aimed to investigate the status and factors of implementing respite care in a visiting nursing stations and adjoining office for children requiring medical care.
Method: A survey questionnaire was distributed to 1,154 visiting nursing stations for children between August and September, 2017. Statistical analyses were performed using χ2 test and Mann-Whitney U test.
Results: There were 381 valid responses (response rate: 32.8%). The respite care implementation rate was 57.1% and there was a relationship between the adjoining of After-school day care service including child development support and respite care implementation rate (p = .004). The factors related to the implementation of respite care were the number of nursing staff, needs, standardization of the quality of nursing, recruiting personnel, staff's ability to communicate with children and family caregivers, and staff's ability to build relationships of trust with family caregivers (p = .00–.04).
Conclusion: As per this study, it was suggested that improvement of respite care implementation was necessary, based on factors such as personnel allocation, unified quality of nursing care, acquisition of basic nursing skills.
Purpose: To understand the relationship between ward nurses’ perceptions about the chief nurse’s transformational leadership at university hospitals and their sense of community
Methods: A self-administered survey was completed by 275 ward nurses at private and public university hospitals. The questionnaire items consisted of basic characteristics, a scale for sense of community among nurses, and a transformational leadership scale. Multiple regression was used to assess the relationship between these items.
Results: Multiple regression with sense of community score for nurses as the dependent variable showed a significant relationship between sense of community and transformational leadership (β = 0.515, p < 0.01). Furthermore, individual consideration, which is a subscore of the transformational leadership score, was also significantly associated with sense of community among ward nurses (β = 0.400, p < 0.01).
Conclusion: These results suggest that ward nurses’ perceptions about the chief nurse’s transformational leadership improves their sense of community.
Objective: Trial clinical interprofessional education (IPE) was introduced as part of the nursing practice for University A, involving joint clinical practice with pharmacy students at a different university. This study’s objective was to identify IPE’s effectiveness and issues as perceived by nursing students.
Method: Forty undergraduate students in University A’s School of Nursing (third year, n = 28; fourth year, n = 12) completed an anonymous, self-administered questionnaire before and after the IPE. Surveys included free-response questions, the Readiness for Interprofessional Learning Scale (RIPLS), and goal attainment items. Free responses were examined using Berelson’s protocol for content analysis. Quantitative items were compared between time points (significance: p < 0.05).
Results: Valid responses were received from 7 out of 12 fourth-year (58.3%) and 12 out of 28 (42.9%) third-year nursing students. Statistically significant changes in RIPLS scores after the practice were not observed for students in either year. However, fourth year students had gained professional attitudes for interprofessional work and cooperation. IPE relieved third year students’ awareness of barriers and tensions to other professions. Issues identified by the survey included the need to (a) ensure that goals are set according to students’ grade and (b) introduce modifications in practice methods.
Conclusion: This study showed IPE’s effectiveness to a certain degree. Further, several issues with the program’s operation and supervision were identified, requiring customization to suit nursing students’ readiness to learn.
Objectives: The purpose of this study was to explore the experiences of male workers whose wife and children voluntarily evacuated after the Fukushima nuclear power plant disaster (implementation group).
Methods: The sample was 2,209 male workers working for 32 companies of the Fukushima Prefecture. We sent an anonymous self-administered questionnaire to them.
Results: Among the 352 men (response rate: 16.0%), 80 (22.7%) were in the implementation group. Among the implementation group, more than 80% were concerned about the effect of radiation on their children. Additionally, 61.3% of the implementation group evaluated the evacuation of the wife and child as “good”. On the contrary, the evaluation of it as “not good” was significantly associated with “I could not trust the information released about radiation”, “I had to do housework by myself”, and “I could talk to nobody that my wife and children evacuating voluntarily”.
Conclusion: The results suggested that the person with low evaluation of voluntarily evacuation of their wife and children would feel that there was a problem in risk communication during disasters, and might have experienced increased household burden and social isolation.
We examined the effect and practicality of a preventive care program (including physical, psychological, and cognitive exercises) conducted to utilize the regional power of the elderly.
The participants used the “A-CYOKIN-KYOUSHITU.” The preventive care program developed to be conducted at home is called the “IKI-IKI TAISOU PROGRAM.” The participants engaged in physical exercise, song time, and tea time activities once a week in the “A-CYOKIN-KYOUSHITU.” The cognitive, physical, and psychological function of 32 participants measured using the Hasegawa Dementia Scale (HDS), handgrip strength and 30-second one-leg standing with vision, and the Geriatric Depression Scale (GDS), respectively, were appraised and compared before and after the preventive care program. The participants’ the physical functions stayed the same after the intervention.
The HDS score improved after the intervention from 27.9 ± 2.9 to 28.6 ± 2.4 (P = .02). The physical and cognitive exercises were performed by 87% of the participants. Further, the preventive care program “IKI-IKI TAISOU PROGRAM” can be conducted at home by the elderly.
We found that the “IKI-IKI TAISOU PROGRAM” can help to improve cognitive functions and maintain physical functions among the elderly. It is important to foster and use the strength that the elderly provide to their community.