Objective: We aimed to clarify how the concept of coordination was implemented by ward nurses in discharge support, and its characteristics.

Methods: Thirteen English and two Japanese research papers were reviewed using Rodgers’ concept analysis method.

Results: The following attributes were identified: [understanding patients’ intentions to provide care], [helping patients/families/professionals build good relationships], [promoting the sharing of goals/information among professionals involved], [resolving post-discharge problems], [organizing post-discharge environments], and [adopting new systems]. Based on the results, the concept of coordination may be defined as: “The discharge support teams connect information and relationships among professionals involved to provide care by understanding patients’ intentions. Furthermore, discharge support teams consider resolving problems with post-discharge support perspectives, organize environments for patients to continuously receive support after discharge, and adopt the discharge support system in accordance with the current situation”.

Objective: The purpose is to clarify the concept of advanced care planning for older adults with dementia in Japan by concept analysis.

Method: Forty-two documents were analyzed using the method of concept analysis by Rodgers.

Result: The 6 attributes are “Person, multi-professional, all related parties form a team to build a relationship”, “Selection of proxy decision makers”, “Share ethically appropriate advance directives”, “Final of life family preparation for the stage”, “Person-centered decision-making that continued from early to final”, “Efforts to think about the best way of life desired”. In addition, 4 prerequisites and 3 consequences were extracted.

Conclusion: This concept is defined as follows: “With changes, progression, and anxiety of dementia, we will prepare an environment for future decision-making, and from the early stage of dementia, while building relationships between the person and all concerned, sharing advance directives, proxy decision-makers selection, family preparation for the final stages of life, a process of personal-centered decision-making that continues to the end and efforts to think about the best way of life.”

Objective: The purpose of this study is to present a definition and conceptual diagram of the concept of “young carers in Japan”.

Method: The Rodgers method of concept analysis was used. Some Japanese text search databases were searched for relevant keywords, and 35 articles were identified and analyzed.

Results: The attributes identified were Various types of care, Excessive roles and responsibilities, Striving to maintain the family, Complex emotions, and No awareness of the situation. The antecedents identified were Family system and dynamics, Unmet care needs, A concealed existence. The consequences identified were Making sense of one’s own existence, A negative cycle within the family, Impact on one’s growth and development as a child, Impact on building a social and economic foundation, Social loss, Carers tend to be invisible.

Conclusion: Young carers in Japan “Children under the age of 18 who have excessive roles and responsibilities, providing a variety of proxy and mental health care at home. While striving to maintain their families, they grapple with complex emotions but are not aware of the situation they are in.” Information needs to be shared with individuals providing support to those carers and issues with and specific forms of support need to be discussed.

The purpose of this study is to review domestic and international literature to identify the trends and issues in decision-making support for breast cancer patients regarding fertility choices.

MEDLINE, CINAHL, and Japan Medical Abstracts Society Database (the ICHUSHI Web) were used to search for articles published between 2004 and 2021, with the keywords “breast tumor” and “fertility preservation” in both Japanese and English.

Eight papers were included in the study, and decision making support were categorized as “support by developed tools” and “consultation by healthcare professionals”. The effectiveness of support through healthcare collaboration was demonstrated, but the outcomes of decision support tools was limited, suggesting further investigation on the amount and method of information provision. Fertility choices for women with breast cancer need healthcare collaboration and continuous support because of the variety of backgrounds and have a long-term impact. It is desirable to establish a support system that is appropriate for Japan.

Purpose: This study aims to determine a definition for the Ohen, an activity which is practiced in the medical field for people with some health problems in Japan, by conducting a conceptual analysis of Ohen.

Methods: For 29 articles published in Japan, a concept analysis was conducted based on the Rodgers method.

Results: One ‘category’ was extracted from each subcategory identified: three for antecedents, four for attributes, and four for consequences. Ohen is a process based on ‘empathy towards difficulty of living in ways preferred by a person’ someone who is at a loss for how to live with health problems. In this process, health professionals ‘Mikataninaru (become a supporter for a person) so that the person can live in ways the person likes, and then try new activities’, resulting in ‘enriching the own identity as a health professional when seeing the person (patient) living as that person likes’. Mikataninaru here is defined as the activity to help the person live in ways the person likes by communicating medical information in a way that is easily understood, thinking about the wishes of the subject together with him/her, expressing the thoughts of the subject as a spokesperson, spreading empathy to people around the subject, and creating an environment of comradery.

Conclusions: It is suggested that Ohen in the medical field is a concept that helps health professionals, who think a great deal about the subject of living in the way a person likes, help create new their activities.

Objective: To comprehensively review the literature on, as well as clarify the characteristics and factors of, nurse-to-patient violence and abuse in psychiatry.

Methods: A scoping review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). PubMed, CINAHL, and Ichushi Ver.5 databases were used to search for relevant literature. The inclusion criteria for the selection of literature were papers (1) focusing on psychiatric nurse-to-patient violence and abuse in psychiatric inpatient or outpatient department, (2) written in English or Japanese.

Results: A total of 12 studies were reviewed. The content of violence and abuse was about assault, violent language, neglect, and physical restraint. The content of the causes of violence and abuse were related to assume that psychiatric care is not violence and the closed treatment environment in the psychiatric department .

Conclusion: The results suggested that the characteristics and factors of nurse-to-patient violence and abuse include structural problems in psychiatry, such as exclusive and closed environment and coerciveness.

Objective: To identify improve psychosocial outcome methods by reviewing and analyzing the foreign literature on the support of psychosocial outcomes of People Living with HIV(PLWH) by peer supporters.

Methods: A literature review was performed from articles published up to June 2022 using PubMed, MEDLINE, and CINAHL using (“PLWH” AND (“antiretroviral therapy” OR “quality of life”)) AND (“peer-led intervention” OR “peer support”).

Results: Supports that were reported to improve psychosocial outcomes in previous studies included counseling, discussions on overcoming barriers to adherence, and individualized interventions. The results showed that social interaction increased, stigma was reduced, self-efficacy improved with experience-based advice, adherence and self-management were promoted, and quality of life was improved.

Conclusoin: This review showed that experiential support from peer supporters helped PLWH to improve their social interactions, reduce their stigma, and improve their quality of life.

Purpose: To clarify family caregivers’ responses to behavioral and psychological symptoms of older people with dementia who are outpatients or hospitalized at hospitals specializing in dementia.

Methods: We conducted semi-structured interviews with 16 family caregivers of older people with dementia. The method described by Elo and Kyngäs (2008) was used for qualitative content analysis of the data obtained via the interview.

Results: The analysis identified four themes: «exploration for responses to BPSD», «developmental responses», «oppressive responses», and «responses leading to isolation». These themes were composed of 16 categories, including [uncontrollable reprimands to the caregiver] and [restraint on care recipient’ activities]. Family caregivers’ responses included both «developmental responses», such as [acquisition of tips on caregiving for the care recipient] by sharing effective responses with people around them, and «oppressive responses», such as rebuke, restraint. «responses leading to isolation» were observed in some cases in which [the care recipient was kept secret from people around the family] and caregiving involved self-sacrifice.

Conclusion: Appropriate support for family caregivers with regard to «oppressive responses», which can violate care recipients’ dignity, should prevent abuse and isolation.

Objectives: To examine benchmarks for key competencies of nursing managers and verify the relationship between nursing manager key competencies and individual attributes and facility characteristics.

Methods: A questionnaire survey was conducted on 9,010 nursing managers at 422 facilities regarding the key competency scale of nursing managers, personal attributes, and facility characteristics. In the analysis, descriptive tabulation was calculated for each key competency by individual attributes and facility characteristics, and multiple regression analysis was performed with each key competency as the dependent variable and the individual attributes and facility characteristics as the independent variables.

Results: Responses were obtained from 5,093 nursing managers, and analysis of 5,007 valid responses revealed key competency scores, situational awareness was 17.5 points, decision making 16.7, meta-cognition 19.2, career support 16.4 and self-management 17.3. As a result of multiple regression analysis, nursing manager training, position, organization scale, and establishment entity were related to all five key competencies. Excluding career support, the coefficient of determination for situational awareness, decision making, metacognition, and self-management was 5% or less.

Conclusion: We presented a benchmark of the key competencies of Japanese nursing managers. It was suggested that the relationship between individual attributes and facility characteristics to the key competencies of nursing managers was poor.

Purpose: We aimed to clarify the experiences of welfare managers in Japan in response to the COVID-19 pandemic.

Methods: We conducted semi-structured interviews with eight welfare managers as participants from seven welfare facilities in Japan. Thereafter, we performed qualitative descriptive analysis of their responses.

Results: Thirty-six categories and 109 subcategories were extracted. The participants have steadfastly coped with the COVID-19 pandemic in their own welfare facilities despite the absence of medical staff and healthcare resources. Although the participants had multilayered anxieties and distress about COVID-19, they continued to provide uninterrupted support to service users and their families depending on the disabilities, while sharing information with the facility staff, reorganizing the work system, and organizing priorities for support. In addition to the existing relationships and measures within the facility, the interaction with the general public had an impact on service provision. In particular, cooperation with local medical services was essential.

Conclusion: It appears to be important to share information, prioritize tasks, and take measures against infection and mental health within the organization in order to provide continuous support even in an emergency. Moreover, we consider it essential for welfare managers in Japan to collaborate with medical care to overcome to COVID-19 pandemic. Nursing support is crucially needed.

Aim: This study was conducted to clarify relations of work–family conflicts of working caregivers to assessment of care manager support for continued employment and to the working caregiver characteristics.

Method: Study participants were 3,000 working caregivers nationwide who administer home care services, and their 3,000 care managers. An anonymous self-administered survey conducted by mail elicited data from 696 respondents (23.2% valid response rate). Survey questions for working caregivers included inquiries related to their sociodemographic characteristics and work-family conflicts as measured by the Work-Family Conflict Scales Japanese version. Regarding care managers, their sociodemographic characteristics and judgment of support for the caregiver to continue working were obtained.

Results: The mean age of these working caregivers, 79.3% of whom were women, was 57.2 years ± 8.8 years. Logistic regression analysis results indicated that working caregivers who were having psychological care needs assessed by their care managers tended to report worse living, longer working hours, worse subjective health, and a higher degree of conflict in working interference family issues (WIF).

Conclusions: Results indicated that working caregivers have psychological care needs and employment-related conflicts associated with fulfillment of their domestic roles.

Objective: To clarify the relationship between nurses’ surrogate decision-making support and difficulties faced by and attitudes of end-of-life care in emergency or intensive care area of community medical support hospitals.

Method: A survey was conducted using a self-administered questionnaire, and nurses in emergency or intensive care units responded anonymously to the questionnaire. Nursing practice of surrogate decision-making was assessed using a nursing practice scale for measuring support for surrogate decision-makers of terminal care. Difficulties of nurses providing end-of-life-care were measured using the Scale for DFINE, and attitudes of nurses providing end-of life care were measured using The FATCOD-BJ.

Results: Of the 120 respondents, 60 nurses practicing surrogate decision-making with more support were more likely to have clinical practice in emergency or intensive care units of over 6 years as compared to the remaining 60 nurses practicing surrogate decision-making with less support . The DFINE scores of nurses practicing surrogate decision-making with more support were significantly lower than those of nurses practicing surrogate decision-making with less support under Student’s t-test as well as under analyses of covariance adjusting. The FATCOD-BJ score of nurses practicing surrogate decision-making with more support was almost the same as the score of those of nurses practicing surrogate decision-making with less support under Student’s t-test as well as under analyses of covariance adjusting.

Conclusion: The results suggested that nurses in emergency or intensive care units involved in surrogate decision-making with more support had less difficulty providing end-of-life care as compared to nurses involved in surrogate decision-making with less support.

Aim: To identify the relationship between work conditions, unequal work-assignments, lack of work-life control, and burnout or somatic complaints among shift-work nurses.

Methods: In January and February 2020, a web-based questionnaire was sent to 4,360 shift-work nurses in Japan. First, an exploratory factor analysis and Spearman correlation were conducted to confirm the construct of unequal work-assignment and lack of work-life control. Second, a hierarchical multiple regression analysis was conducted to evaluate the relationship between unequal work-assignment, lack of work-life control, and burnout or somatic complaints after adjusting work conditions.

Results: Data from 394 nurses were analyzed. An exploratory factor analysis and Spearman correlation revealed lack of work-life control on the basis of three factors: vacation requests are not approved, there is uncertainty about working days and vacations, and nurses cannot take paid vacation. Unequal work-assignment was related to emotional exhaustion and depersonalization, uncertainty about working days and vacations was related to emotional exhaustion, and unpaid vacations was related to depersonalization and somatic complaints.

Conclusion: In addition to poor working conditions, unequal work-assignments and lack of work-life control may cause psychological or physical stress reactions.

Objective: To clarify the thoughts and feelings of nurses before and after acquiring nosocomial coronavirus disease 2019 (COVID-19) in order to support hospital-acquired nurses and to suggest how to provide prior and continuous education to nurses involved in infectious disease nursing.

Methods: Semi-structured interviews were conducted with eight nurses working on the infectious disease ward at Hospital A who were able to return to work after acquiring nosocomial COVID-19, and the data were then analyzed qualitatively and inductively.

Results: The extracted thoughts and feelings of nurses before infection included a “lack of awareness of threats to unknown infectious disease” and “anxiety and dissatisfaction about working in the infectious disease ward”, immediately after infection included “shock and anxiety about being infected” and “desire to protect themselves”, and at some time after infection included a “sense of mission as a nurse and remorse for patients” and “recovery from the damage caused by the infection”.

Conclusion: Before becoming infected, the nurses worked with anxiety and frustration as confusion arose in the hospital, and immediately after the discovery of their infection, they felt a sense of mission while dealing with shock and anxiety and supporting each other. These results suggest the importance of maintaining a high level of awareness regarding the spread of infection, education on infection prevention, and the timely provision of information.

Purpose: This study aimed to examine the change in physical activities and health-related quality of life (QOL) of persons one month after they attended a health education event.

Method: We held a health education event for adults from the general public. Based on the measurements of physical parameters we developed an action plan that included the use of a tool that promotes physical activities. The Japanese version of health-related QOL (SF-12^®) of the International Physical Activity Questionnaire (IPAQ) was employed for the valuation index and the Wilcoxon signed rank test was performed.

Results: The number of valid responses was 202 (73.6%). One month later, 161 participants (79.7%) had implemented the action plan, which covered physical activities and diet. The walking and daily activities in the action plan group had increased significantly. However, the health-related QOL was within the standard values and had not changed significantly.

Conclusion: It is concluded that participatory interventions using individually devised action plans that include motivational tools can mobilize physical activities among individuals.

Objective: This study aimed to outline the findings from nursing practice narratives and action plans for nurses working in acute care hospitals, describing potential changes that may occur between participants and other nurses.

Methods: This was an action study using meetings to discuss nursing practices. The participants included five female nurses and head nurses in one ward of the acute care hospital. During the meetings, the nurses shared their practical stories and other participants were asked to put the knowledge they gained from the stories into practice. We conducted a qualitative analysis using four semi-structured interviews before and after the meetings.

Results: A nurse who heard of a story about wound cleaning applied a new method after a meeting, and successfully treated her patient. At another meeting, a story about finding the cause of symptoms was mentioned. Another nurse who heard this story noticed that she “caught the thoughts of patients who do not want to receive care” and took a new action “Caught the cause of the patient not eating”. Two years later, she found mechanisms to talk about her problems.

Conclusion: Participants gained new perspectives and ideas at the meetings, taking new actions that were different from the ones practiced so far. Participants suggested that the meetings take place in the hospital ward going forward, in order to create a culture of participation and encourage communication.

Aim: This study examines the association of work-family conflict (WFC) and job stress with back pain and neck and shoulder pain (katakori) among female nurses working in a hospital.

Method: We surveyed 118 female nurses working in the hospital considering their demographic characteristics, level of back pain and katakori, and their scores on the Japanese version of the WFC scale and the new brief job stress questionnaire. They were also asked to rate their back pain or katakori on a 0–10 point Numerical Rating Scale (NRS). For the analysis, participants were first divided into two groups: a high-level group with an NRS score of 7 or more points for back pain and katakori and a non-high-level group with an NRS score of fewer than 7 points. Next, multiple logistic regression analysis was conducted using the items that were significant in the univariate analysis as explanatory variables and the level of back pain or katakori as objective variables.

Results: Back pain was independently and significantly associated with “time-based work interference with family (WIF)” (OR: 1.26, 95% CI: 1.00–1.58, p = .047) and “role clarity” (OR: 3.94, 95% CI: 1.28–12.14, p = .017). Katakori was independently and significantly associated with “time-based WIF” (OR: 1.30, 95% CI: 1.07–1.59, p = .009).

Conclusions: The results suggest that WFC measures by both individuals and employers and the establishment of a workplace support system in which individuals are not overly responsible are important in addressing back pain and katakori among female nurses.

Purpose: The purpose of this study was to develop a “Competency checklist for Vital Signs Accurate Measurement (VSAM checklist)” that can be applied to various situations, and to verify its content validity and reliability.

Methods: For the draft of the VSAM checklist, a total of 18 items were extracted by the conceptual analysis of “accurate measurement of vital signs”, and the modified-delphi method was performed to validate these items by 8 nursing faculty members. The reliability of this checklist was verified by an Objective Structured Clinical Examination (OSCE) administered to 24 nursing students (third-year students), and a kappa coefficient of 0.61 or higher was used as a criterion of inter-rater agreement.

Results: The Content Validity Index (CVI) and inter-rater agreement rate showed the standard values, and the overall CVI (S-CVI/Ave) was 0.88. In order to improve the usability of the checklist, the expression of each item was sophisticated through the OSCE, and the total number of items was modified to 15.

Conclusion: The content validity and reliability of all 15 items VSAM checklist reached to an adequate level. This checklist can be used in nursing education as an assessment tool that can be applied to a variety of clinical situations.

Purpose: To capture the processes of nursing practices that focusing on autonomy in personal care for elderly people with dementia and who are hospitalized in the acute ward due to physical illness.

Methods: Research design: Qualitative and inductive research using a modified grounded theory approach (M-GTA). Two types of data were used in the study: (1) field notes based on participant observations and (2) verbatim records of formal interview data.

Results: Fieldwork took place at three acute wards in two hospitals. Participant observations and interviews were conducted with 21 nurses. The processes of nursing practices enable respect for the autonomy of elderly people with dementia in the acute ward leads from [A stepping stone to the respect for autonomy] to [Support for maintaining autonomy]. The process that does not lead to the respect for autonomy is a case where the nurse’s <Prejudice against dementia>leads to [Ignoring autonomy] by [Paying little attention to the will of the elderly people with dementia].

Discussion: The process of nursing practice enable respect for autonomy can be utilized in the acute ward as a nursing practice that maintaining dignity of the elderly people with dementia.

Objective: To clarify the support most expected from nurses for families of hospitalized children with cancer.

Methods: Semi-structured interviews were conducted with 12 families of children with cancer consisting of 14 parents and the results were analyzed using qualitative inductive content analysis.

Results: The analysis identified seven categories and 23 subcategories of support themes. They are “Support of care and consideration for the family”; “Support to encourage communication in order to share and discuss the family members’ problems”; “Support to help the family members feel secure and trust the health care providers”; “Support to reduce the burden they have”; “Support to offer appropriate consultation and advice”; “Support to provide them with information they currently need”; “Support for their liaison with other health care professionals.”

Conclusion: It is critical for pediatric nurses to analyze and understand clearly how, when, and why the families expect and require certain types of support depending on their situation. Enhancing these support themes with the professional medical care and providing the families with timely and effectively combined support services and care would help the nurses to relieve the psychological and socioeconomic problems, anxiety and burdens the families endure.

Purpose: The purpose of the study was to clarify the associations between emotional labour and self-efficacy in female care and nursing staff working at long-term care health facilities in Nagano prefecture and intention to continue working in order to determine the ideal approach to personnel management for sustaining and encouraging continuous employment.

Methods: Anonymous, self-administered questionnaires were sent by mail. Returned questionnaires from 554 female staff (333 care workers, 221 nurses) were processed by a covariance structure analysis for the causal model study.

Results: Among care staff, the subscales of intensity and sensitivity in the Emotional Labour Scales Japanese version (ELS-J) were associated with intention to continue working (GFI = 0.883, AGFI = 0.414). However, no associations were observed between intention to continue working and either emotional labor or self-efficacy in nursing staff, revealing a difference between the two types of professionals.

Conclusion: Consideration of the ideal approach to personnel management based on the results of this study suggests that care staff need development of a constructive work environment that allows young staff to easily seek advice and a training system, and that nursing staff need development and improvement of the caring work environment and a system for cooperation between nursing and care staff.

Purpose: This study aimed to evaluate the clinical utility of a nursing intervention program to promote cancer pain self-management for outpatients by adapting the program for clinical practice.

Methods: This study used a single-group, pre-post intervention comparative research design. In the study, a face-to-face individual intervention using the program was conducted three times for 10 outpatients with cancer pain. A self-administered questionnaire survey was conducted, and the scores of pain intensity, interference with daily life, quality of life, self-Efficacy, anxiety and depression were compared and analyzed before and after the intervention.

Results: The mean participant age was 59.9 (SD 8.3) years. The items that had a large effect size comparing those before and after the intervention were anxiety (r = .63) and depression (r = .67), which decreased significantly (p < .05). The items that were not significantly different but had a medium effect size were the most severe pain (r = .36), average pain (r = .33), and total interference with daily life (r = .31), which both decreased after the intervention. The satisfaction with the analgesic treatment (r = .36) increased after the intervention.

Conclusion: Patient anxiety and depression decreased significantly, and pain intensity, interference with daily life and satisfaction with analgesic treatment had a medium positive effect size. Overall, this program was suggested to have clinical utility.

Purpose: To clarify the actual conditions of compassion fatigue of nurses working in the general ward of a university hospital, and the association between compassion fatigue and work performance.

Methods: A self-administered questionnaire was distributed among 301 nurses in the general ward of a university hospital in Tokyo.

Results: For 192 subjects (response rate 63.8%), there was no significant association between compassion fatigue and work performance. Subgroup analysis, based on demographics and workplace characteristics, showed negative correlations between compassion fatigue and work performance. Results indicated that groups showing negative correlation consisted of participants aged 35–44 years of age, had more than 10 years of experience as a nurse, cared for patients and families with traumatic experiences, handled unreasonable complaints of patients and families, dealt with extremely upset patients and families, and cared for patients during sudden changes (p < .05).

Conclusions: Compassion fatigue is a complex phenomenon which continues and accumulates. In order to understand this condition, it is necessary to carefully analyze the situation based on individual characteristics of nurses such as age, years of experience, and conditions of care.

Purpose: This study aimed to clarify the relationship between the nursing staff’s work engagement and social support from hospital head nurses and colleagues.

Method: A questionnaire survey was conducted among 37 head nurses and 529 nursing staff working in 16 medical institutions. The survey explored work engagement and social support from the head nurse and colleagues. Multilevel correlation coefficients were calculated and statistically analyzed.

Results: At the individual level, significant positive correlations were found between nurses’ perceptions of social support from the head nurse and colleagues and their work engagement across all scales and subscales of social support. There were significant positive correlations between work engagement and the three subscales of head nurse motivation, discretionary support, and positive attitudes toward colleagues’ work at the departmental level.

Conclusion: Nursing staff with positive perceptions of social support from the head nurse and colleagues have higher work engagement.

Objective: To consider the ideal way to support community-dwelling older adults to take medicine correctly, we compared the attributes of subjects in good and bad medication adherence groups and then analyzed the characteristics of the medication self-management strategies used by these two groups.

Methods: We surveyed 55 community-dwelling older adults with a questionnaire to examine their background and medication adherence. Their medication self-management strategies were identified through observation and interviews.

Results: Of the 55 subjects examined, 19 (34.5%) had good medication adherence, while the remaining 36 (65.5%) had poor adherence. All subjects were found to have devised some form of medication self-management strategies. In the medication instructions and setup, there were 13 medication self-management strategies, such as “memorizing medication instructions”; in medication storage, there were ten strategies, such as “storing medicines scheduled for the week in the place where the person spends most of his or her time”; and in the measures against forgetting timely medicine intake, there were nine strategies, such as “going from eating to taking medicine in a series of steps.”

Conclusions: The self-management strategies were tailored to the individual’s daily life. Therefore, it is important to understand one’s daily life and medication self-management strategies before providing medication support.

Objective: To examine oral care practices for improving the oral hygiene of older adult patients requiring nursing care who use visiting nursing services, considering their cognitive functions and family burden.

Methods: A three-round questionnaire survey using the Delphi method was administered to 32 people, who were dentists (including those specialized in oral surgery), dental hygienists, and home health care nurses involved in oral health treatment and care of older adult patients requiring nursing care.

Results: Approximately all participants participated in the three rounds (response rate: 96.8%). In the final round, the agreement rate was 80% or higher for 59 items across 8 domains. Of these, one item— the risk of recurrence of aspiration pneumonia—was at the “highest” consensus level, whereas a “high” consensus level was noted for the remaining 58 items, including techniques, handling of oral symptoms, and handling of participants with cognitive decline, for example, refusal of care.

Conclusions: The results suggest the need for support related to oral care preparation and techniques, handling of symptoms such as bleeding, handling the behavior of participants with declining cognitive function, such as refusal, and prevention of aspiration pneumonia.

Purpose: This study aims to qualitatively examine work-family enrichment resources for female nurses raising preschool children (hereafter, parent nurses). Work-family enrichment is the extent to which an individual’s experiences in one role improve quality of life in another. This relationship can be bidirectional; work-to-family enrichment occurs when work experiences improve the quality of familial roles, and family-to-work enrichment occurs when family experiences improve the quality of work.

Method: Participants were 16 parent nurses working in hospitals accredited by Japan Council for Quality Health Care. Semi-structured interviews were used to collect data on participants’ work-family enrichment resources. Data were analyzed qualitatively and inductively.

Results: The work-to-family enrichment resources were classified into six categories: “care capability,” “ability to lead,” “efficiency,” “emotional fulfillment,” “cultivation of sociality,” and “economic stability.” The family-to-work resources were classified into another six categories: “empathy,” “receptiveness,” “expansion of one’s horizon,” “coordination ability,” “help-seeking behavior,” and “emotional fulfillment.”

Conclusion: All participants had gained resources from their work experiences that improved their family roles, as well as resources gained through experiences in their familial roles that improved their work quality. The findings suggest that the resources obtained from each role interacted with each other, and that the acquisition of one resource triggered the acquisition of others.

This study investigated the physical touch between nurses and patients (hereafter referred to as “touching” of patients by nurses) in critical care situations, particularly characterizing this phenomenon in the intensive care unit (ICU). A qualitative, descriptive design, coupled with data collected from fieldwork and semi-structured interviews, were used in this endeavor. Data were analyzed using with Uwe Flick’s thematic coding; data were organized and analyzed in terms of the methods by (and circumstances under) which nurses touch patients while providing healthcare. Ten ICU nurses and 13 patients were recruited as participants, and seven types of touching were identified: 1. Non-invasive touching of the patient’s body; 2. touching to prepare for possible changes in the patient’s condition; 3. touching to sense the internal state of the patient’s body; 4. touching as a stimulus to check the patient’s state of arousal; 5. touching a patient to prevent any harm to them and provide peace of mind; 6. touching to assess a patient’s reaction and avoid discomfort; and 7. touching to augment verbal communication with non-verbal communication. These characteristics were shown to have certain commonalities. Among others, touching was always performed as a means of tactile, hand-based observation of patient’s situation, and was dynamic in nature, depending on the circumstances surrounding the patient-nurse interaction.

Objective: To clarify emergency department nurses’ nursing practice for critically ill patients with acute myocardial infarction (AMI) based on Jean Watson’s Theory of Human Caring (1988/1992).

Method: This research used a qualitative descriptive study design. Semi-structured interviews were conducted with five emergency department nurses. The interviews used the Caritas process of the Human Caring Theory (Watson, 2012/2014) and the five groups of Watson’s explanatory models presented by Torres (1986/1992) as a framework.

Results: Emergency department nurses’ nursing practices based on the Human Caring Theory for critically ill patients with AMI were extracted 60 codes and classified into 21 categories. It was found that the nurses approach the patients holistically with a philosophical foundation that endorses the science of caring, protects human dignity, and practices human caring to maximize support for the patient’s greatest needs. Because of the specific characteristics of care, the practice is devised to build relationships with patients, develop nursing processes, and adopt a metaphysical approach.

Conclusion: The emergency department nurses’ nursing practice based on the Human Caring theory is provided by addressing their holistic needs, including saving the patient’s life whilst building a relationship of trust.

Aim: This study aimed to identify the learnings of students of maternal nursing from the perspective of legitimate peripheral participation.

Method: Semi-structured interviews were conducted with nine fourth-year university nursing students who had completed maternal nursing training. A descriptive, qualitative approach was used for analysis.

Results: The students of maternal nursing engaged in step-by-step practical training alongside established nurses and were thus in the process of legitimate peripheral participation. However, they found it burdensome as there were certain practices they could not perform by themselves, and they had the responsibility of taking care of the mother and child simultaneously. Moreover, they experienced challenges communicating with the postpartum mothers and nurses, resulting in growth through interaction with others. Their experiences in practical training helped them understand maternal nursing. They learned more from the experience in practical training than they could from lectures and exercises in school.

Conclusion: The nursing skills of students gradually improved as they practiced them alongside established nurses. They also reported additional self-growth and learning via these field experiences and interactions with people they could not otherwise directly interact with on campus.

Purpose: The present study aimed to clarify the cognitions, thoughts, and behavior process applied by nurses to approach depressed patients who have communication difficulties.

Methods: Data were collected through semi-structured interviews of 17 nurses with >3 years’ experience of practicing psychiatric nursing. The data were analyzed using a modified grounded theory approach.

Results: Based on the nurses’ interviews, nurses who continue to be involved with depressed patients, even if they have to confront the barriers created by the patient, they try to find a way to penetrate these barriers. In such a situation, the nurses believed in depression nursing and did not want to leave the patient alone. For this reason, they could ponder on the inexpressible true intentions of the patients and continued to act in ways that allowed the patient to open up to them emotionally.

Conclusion: Nurses tend to feel helpless toward depressed patients, but they can control their emotions and keep approaching the patient by capturing the patient’s feelings of loneliness and believing that their voice will reach the patient.

Objective: To develop a scale for measuring stressors for nurses involved in children with pediatric oncology and their families, and to examine its reliability and validity.

Method: The constructs of the scale were defined and the items were selected from the literature. The surface validity and content validity were examined. Based on the results, the items were modified to create a draft scale of 59 items, and the reliability and validity of the draft scale were verified. A total of 1,246 nurses were asked to complete the questionnaire survey and the results were analyzed using factor analysis, Cronbach’s α, correlation analysis, and confirmatory factor analysis.

Results: There were 469 valid responses. The item analysis and exploratory factor analysis created a scale of 5 subscales and 20 items. Cronbach’s α was high. The external criteria did not correlate with the job satisfaction scale of nurses working in hospitals but were positively correlated with the Japanese burnout scale. Model fits were as follows: comparative fit index (CFI) = .925, goodness of fit index (GFI) = .882, adjusted goodness of fit index (AGFI) = .844, and root mean square error of approximation (RMSEA) = .075.

Conclusion: The reliability and validity of the scale were generally good, but there remained issues regarding criteria-related validity.

Aim: The study aimed to investigate the relationship between frailty and quality of life (QOL) in older patients with gastrointestinal cancer at the time when an anticancer drug regimen is changed.

Methods: We conducted a cross-sectional observational study of gastrointestinal cancer patients aged 65 years or older at the time of anticancer drug change. Frailty and QOL were measured using G8 and EQ-5D-5L.

Results: Fifty-one patients agreed to participate in this study. Data collection and analysis were conducted. Forty (78.4%) older patients with gastrointestinal cancer were considered frail. Flail group had a lower BMI (p < .001), thinner calf (p = .023), and lower quality of life (p = .04) compared to the non-frail group.

Conclusion: This study showed the characteristics of frail patients with gastrointestinal cancer when changing anticancer drug regimen and the population that is vulnerable to falling into the frail cycle. The assessment of frailty in older cancer patients receiving anticancer drugs was an essential factor for QOL-conscious treatment decision.

Objective: This study aimed to verify the validity and reliability of a nursing practice scale for treatment and care policies for terminal-stage patients on maintenance hemodialysis.

Methods: A prototype nursing practice scale for treatment and care policies for terminal-stage patients on maintenance hemodialysis was developed based on interview surveys and literature reviews. To verify the validity and reliability of this scale, a questionnaire survey was used. Nurses working at the dialysis department of 250 different facilities that provided maintenance hemodialysis throughout Japan answered the questionnaire survey.

Results: The responses of 280 nurses were analyzed (valid response rate: 83.3%). Based on the results of the exploratory factor analysis, we developed a scale consisting of 19 items in five factors. As for the goodness-of-fit indices of the model, the root mean square error of approximation was .081 and the comparative fit index was .966. The concurrent, convergent, and discriminant validities were also sufficient. Cronbach’s α coefficients were .793–.912 for the subscale factors and .940 for the entire scale.

Conclusion: The nursing practice scale, which consisted of 19 items in five factors, for treatment and care policies for terminal-stage patients on maintenance hemodialysis was confirmed to be valid and reliable.

Objective: This study aimed to verify a self-evaluation scale for middle-aged mild stroke survivors’ self-management status and examine its reliability and validity.

Methods: A questionnaire was created using 37 items based on a previous study that comprised three domains: “acquisition of knowledge”, “actions to prevent disease progression”, and “utilization of resources”. We conducted a survey among mild stroke survivors, aged 40–65 years, who visited the clinic. Data obtained from 93 patients were then analyzed.

Results: As a result of a confirmatory factor analysis, the scale comprised 28 items. A good fit was obtained for the 1-factor with 7 items relating to “acquisition of knowledge”, 3-factor with 12 items relating to “actions to prevent disease progression”, and 1-factor with 9 items relating to “utilization of resources”. Internal consistency and criterion validity was confirmed, and the scale was evaluated by a parallel group test.

Conclusion: The reliability and validity of the scale were almost confirmed. The scale included self-management contents unique to middle-aged mild stroke survivors, and was considered to be an index that can comprehensively self-evaluate disease management and psychosocial conditions among such individuals.

Objective: This study aims to develop a scale for measuring cancer treatment acceptance and to examine its reliability and validity, which will help patient accept and complete cancer treatment.

Methods: A questionnaire survey was conducted, involving 294 cancer patients receiving treatment. The reliability and validity of the developed cancer treatment acceptance scale were confirmed by examining evidence in content, from substantive, structural, generalizability, and external aspects.

Results: Responses were obtained from 235 patients (response rate: 79.9%), and 210, who returned valid responses, were analyzed. To verify the reliability and validity of the scale, item analysis was performed. Through factor analysis for 28 items finally adopted, 2 factors, [the value of treatment] and [a positive feeling about treatment], and 18 items were identified. The goodness of fit of this model was represented by GFI = 0.901, AGFI = 0.853, CFI = 0.919, and RMSE = 0.049. The correlation coefficient with Decisional Conflict Scale was r = –0.589 to –0.667. Cronbach’s alpha for each factor ranged from 0.915 to 0.945.

Conclusions: We developed a scale consisting of 2 factors with 18 items to measure cancer treatment acceptance and confirmed its reliability and validity.

Aim: The aim of this study was to develop the Pain Management Scale for Older Patients with Cancer and Dementia (PMSOP-CAD), and to examine its reliability and validity.

Methods: We drafted a scale for elderly cancer patients with moderate to severe dementia, based on concepts derived from our past qualitative research, a literature review, and an expert panel. The questionnaires were distributed to 889 ward nurses who had at least three years of experience in clinical nursing care for older patients with cancer and dementia.

Results: The PMSOP-CAD consisted of 32 items. We conducted exploratory factor analysis and extracted 6 factors including, for example, “further understanding older patients with dementia, respecting their physical and emotionally expressive ability and their own pace to seek their comfort” and “inferring where the pain comes from while continuing to observe and collate signs and symptoms.” The Cronbach’s α for the entire scale was .95, the intraclass correlation coefficient by retests was .58, the correlation coefficient indicating concurrent validity was .64.

Conclusion: The results of this study suggest that the validity and reliability of PMSOP-CAD was confirmed to be within a statistically acceptable.

Objective: To examine the current status of the PHQ-4 and factors associated with the information needs of chronic obstructive pulmonary disease (COPD) patients regarding health care during the COVID-19 pandemic.

Methods: A web-based survey was conducted among December 2020 COPD patients. Multivariate analysis was performed on factors associated with information needs and PHQ-4.

Results: During the COVID-19 pandemic, 57.0% had information needs and 34.8% felt psychological distress. Multivariate analysis showed that factors associated with information needs were CAT (OR = 2.63), social support (OR = 4.42), and physical activity (OR = 3.48); factors associated with PHQ-4 were under 40–65 years (OR = 3.11), CAT (OR = 4.28), hand washing (OR = 1.90), loneliness (OR = 3.48).

Conclusion: COPD patients during the COVID-19 pandemic had information needs and psychological changes. Patients with related factors need symptom care, social support, and assistance focused on loneliness.

Objective: To clarify the nursing practices of home-visit nurses that improve the physical activity of patients with chronic obstructive pulmonary disease (COPD) from the viewpoint of home-visit nurses.

Methods: Semi-structured interviews were conducted with four home-visit nurses about their experience of one case in which they improved the physical activity of a COPD patient. The interview responses were qualitatively analyzed using the Steps for Coding and Theorization by applying the spiraling model of collaborative partnership to the analytical framework.

Results: A total of 62 pieces of theory writing showing interactions between COPD patients and home-visit nurses were obtained from all the case examples. Examination of the commonalities and differences between the theory writing of each case example revealed 26 nursing practices of home-visit nurses, including “gaining of trust to improve motivation” and “collaborative building of comfortable activities of daily living skills.”

Conclusions: The results suggest the importance of a nursing perspective aimed at improving the physical activity and nutritional disorders of patients even at the end of life, and that solving medical problems while building a relationship in which specific visiting nurses can encourage COPD patients to open up about their thoughts is a key element in improving the physical activity of these patients.

Objective: This study aimed to shed light on the hospitalization experience of high-risk pregnant women transferred from the MFICU to the maternity ward.

Method: Adopting qualitative and descriptive research design, we conducted semi-structured interviews with nine mothers admitted to the MFICU and then transferred to the maternity ward.

Results: The hospitalization experience of high-risk pregnant women transferred from the MFICU to the maternity ward before the transfer was described as follows: “unable to relax due to difficulty of sorting the mind out about the critical situation,” “perceiving critical pregnant women in the same room through the curtain and spending time quietly,” “feeling a sense of security with nursing staff watching over them by patient’s side,” “spending the time conscious of a transfer to maternity ward from MFICU that will come someday,” “emotional turmoil toward the transfer without feeling improvement in their condition,” and “anxiety about whether they can adapt to the new environment.” After being transferred to the maternity ward, their experience was expressed as follows: “refraining from monopolizing the nursing staff,” “confusion and anxiety due to the difference between the MFICU and the maternity ward,” “camaraderie and mutual support borne from interaction with fellow pregnant women,” and “stability of feelings due to the formation of trusting relationships with the nursing staff.”

Conclusion: High-risk pregnant women who transferred from the MFICU to the maternity ward had positive interaction experiences due to the transfer, despite increased stress.

Objective: To develop a work-life balance achievement scale for head nurses and to examine the validity and reliability of the scale.

Methods: A questionnaire survey consisting of 43 items was administered to 786 head nurses working in hospitals with 100 or more beds in Japan. We examined the validity and reliability of the scale.

Results: We received 571 responses (72.6% response rate), of which 479 valid responses (83.9% valid response rate) were included in the analysis. Six factors and 27 items were extracted from an exploratory factor analysis. Confirmatory factor analysis confirmed the goodness of fit of the hypothesized model. Criterion-related validity was confirmed by correlation with the Work-Life Balance Scale for Nurses. Cronbach’s alpha coefficient for the overall scale was .911 (range of each factor, .710 to .902). The overall reliability coefficient of the scale using the retest method was .862.

Conclusion: The validity and reliability of the Work-Life Balance Achievement Scale for Head Nurse were confirmed.

Aim: This study determined the impact on mothers careing for infants under one year old during COVID-19 infection spread.

Methods: Semi-structured interviews were conducted in November and December 2020 with five mothers who had given birth after December 2019 and six midwives who conducted home visits.

Results: Lack of support due to “Barriers to receiving support outside the home” “lack of support due to concerns about infection affecting childcare support and care choices.” This resulted “Anxiety and discouragement due to cancelation of childcare support” “effects on childcare skills and newborns” and “lack of connections among local mothers”. Additionally, “benefits and difficulties due to partner telecommuting” and “benefits and difficulties due to online support” appeared to be emerging.

Conclusion: Barriers to receiving support were caused by canceling support services, lack of space and opportunity, and anxiety about the infection. In the future, there is a need to consider support for childcare skills, support for partners who telecommute, a combination of online and in-person support for different purposes, and ways to reduce the barriers to connecting with further support.

Purpose: This study examined the emotions associated with the development of dementia among the middle-aged or older adults living in community.

Methods: A qualitative descriptive research method was adopted in this study. Data were collected through semi-structured interviews from 13 middle-aged or older adults who belonged to several clubs.

Results: The participants were six men and seven women aged 60–91 years. Twelve participants (92.3%) had contact with people with dementia. Consequently, 40 codes, 24 sub-categories, and 13 categories were formed, and the following six core categories representing the emotions associated with developing dementia among the middle-aged or older adults living in community were identified: (a) fear, (b) apprehension, (c) threat, (d) denial, (e) despair, and (f) relief.

Conclusions: The middle-aged or older adults worry about dementia due to unfavorable knowledge. Thus, there is a need to promote sufficient knowledge about dementia among the middle-aged or older adults and provide good care via professionals for people with dementia.

Purpose: The study aim was to understand difficulties experienced in daily life from the early stage of onset to the present by patients with pemphigus and pemphigoid.

Methods: We conducted semi-structured interviews with 13 patients with pemphigus or pemphigoid, and analyzed the data qualitatively and descriptively.

Results: During periods when their physical symptoms were strong, patients experienced difficulties such as “symptoms interfering with daily activities”, and “feelings of pain and burden when the affected area required treatment”, even though these difficulties were alleviated by the treatment. Patients also experienced difficulties such as “restrictions in daily activities owing to side effects of steroid therapy”. Furthermore, patients reported psychological and social difficulties experienced “anxious and lonely because of their rare disease and lack of understanding by others”, “anxious and afraid because of the disease, treatments, and relapse”, or “difficulty in socializing with others owing to symptoms and treatment side effects”, and “disturbances in schoolwork, employment, and jobs owing to the disease”.

Conclusion: Patients with pemphigus or pemphigoid experienced difficulties owing to the effects of symptoms and treatment, the rarity and intractability of the disease, the visibility of the symptoms, and the lack of understanding by others.

Purpose: The purpose of this study is to clarify the mediating effect of nurses’ perceptions of head nurse leadership on the relationship between nurses’ work engagement and head nurse’s self-efficacy.

Method: A questionnaire survey was conducted on the head nurse and nursing staff in 16 medical institutions regarding work engagement of nursing staff and self-efficacy and leadership of head nurses. A multilevel mediation analysis was conducted on 269 nursing staff members.

Results: It was found that nurses’ perceptions of the head nurse’s leadership were fully mediated by the head nurse’s self-efficacy and staff nurses’ work engagement. It was suggested that the mediating effect of the perception of leadership on the head nurse’s self-efficacy and nurses’ work engagement was an individual level effect.

Conclusion: It was found that nursing staff’s perception of the head nurse’s leadership was fully mediated by the head nurse’s self-efficacy and nursing staff’s work engagement.

Purpose: This study clarified the educational involvement of teachers for students who required special support in clinical training due to developmental disability characteristics.

Method: Semi-structured interviews were conducted with eight nursing teachers from a three-year nursing vocational school who had experience in teaching clinical training to students who required special educational support. Interview data were analyzed qualitatively and descriptively.

Results: “Teacher involvement” was classified into “educational practice toward students” and “teacher’s thoughts.” The following were classified under educational practice toward students: “avoiding a biased perspective that considers students requiring special support as troublesome and teaching them with patience,” “assessing their aptitude as a nurse and advising them on career choices,” “coordinating a special environment to support student practicum,” and “improving the educational capability of teachers themselves.” The following were clarified from the teachers’ thoughts: “worry about support methods identified through trial and error,” “dilemma of evaluating students’ grades and their aptitude as a nurse,” “controlling negative emotions,” and “high expectations regarding their educational attainment considering the quality of education they received until now.”

Conclusion: Nursing teachers took two to five times longer to teach students requiring special educational support due to developmental disabilities when compared to teaching normal students. However, considering the difficulty in evaluating the growth of such students, there was conflict between support for promoting their growth and guaranteeing quality of nursing.

Purpose: This study uses the Delphi method to reach consensus and investigate the items that can be used in nursing practices of visiting nurses for patients receiving forensic outpatient treatment under the Medical Treatment and Supervision Act.

Method: Two questionnaire surveys were conducted using the Delphi method for the proposed 42 nursing practice items in five areas of devising measures to address difficulties in support related to aspects such as repeated harmful behavior and social reintegration into community life, as identified in previous studies. The subjects were 54 visiting nurses who had been recommended by their managers as having extensive visiting nursing experience with patients receiving forensic outpatient treatment under the Medical Treatment and Supervision Act.

Results: In the first survey, 28 responses were collected, the expressions for seven items were revised, and one item was added based on free opinion. In the second survey, 24 responses were collected, one item was deleted, and the expression for one item was revised. Eventually, consensus was reached for the proposed 42 nursing practice items.

Conclusion: Utilizing the nursing practice items for which consensus was reached will likely alleviate the perceived difficulties of visiting nurses for patients receiving forensic outpatient treatment under the Medical Treatment and Supervision Act.

Purpose: To develop a scale (Scale for Elderly with Diabetic Nephropathy being initiated on dialysis: SEDNID) that measures the prospect of transition associated with the introduction of dialysis in elderly patients with diabetic nephropathy, and then verify the reliability and validity of the scale.

Methods: A draft scale consisting of 40 items was prepared after an interview-based survey. Using this scale, a questionnaire survey was conducted on patients aged 65 years old or older who were on regular hemodialysis treatment at any of 1,665 facilities nationwide for diabetic nephropathy. Analysis was conducted with data imputed for missing values.

Results: Data from 496 patients were analyzed to verify the convergence validity. For other validations, data from 502 patients were analyzed. Exploratory factor analysis led to the extraction of 6 factors and 32 items. Confirmatory factor analysis showed a comparative fit index (CFI) of .955 and a root mean square error of approximation (RMSEA) of .067. Thus, the results of convergence validity and known-group validity were statistically significant. However, the results of concurrent validity were not statistically significant. McDonald’s ω coefficient was .887 for the entire scale and .728 to .922 for the subscales.

Conclusion: Although issues of concurrent validity remain, we confirmed a certain level of reliability and validity.

Aims: The study aims were: 1) to compare empathy traits of nurses and non-nurse general public and to identify empathy traits of nurses; and 2) to compare empathy traits of nurses by age, years of clinical experience, and job title.

Methods: The study design was two-points cross-sectional study. Study A included 400 nurses working at a national university hospital in Japan. Study B included 416 members of the non-nurse general public. Basic attributes, the Interpersonal Reactivity Index, and the Clinical Interpersonal Reactivity Index were used for analysis, and uncorrelated t-tests, multiple regression analysis and correlation analysis were conducted.

Results: Nurses scored significantly higher on the Interpersonal Reactivity Index of “empathic concern” and “perspective taking” and significantly lower on “personal distress” and “fantasy scale” than did the non-nurse general public. In addition, “perspective taking in nursing” and “unconditional positive regard” on the Clinical Interpersonal Reactivity Index were significantly higher for nurse administrators.

Conclusions: This study revealed that nurses need to distinguish and recognize “personal distress” and “empathic concern,” respectively, and to enhance their “fantasy scale” in terms of imagining others.

Purpose: This study aimed to classify types of disease perceptions of patients with non-diabetic chronic kidney disease (CKD) in the conservative phase—based on the characteristics of the patient disease perceptions.

Methods: An interview survey was conducted for non-diabetic CKD patients in the conservative phase to understand the characteristics of the patient disease perceptions. The interview data were deductively analyzed by summarizing the characteristics in a case-code matrix based on the components of the Health Belief Model.

Results and Conclusions: Patient health behaviors were classified into groups with or without the patient “perceived benefits” of adherence to behavioral advice. Further, focusing on “perceived barriers” and “behaviors”, the group “perceived benefits” were classified into three types (A to C), and those without such feelings into two types (D and E). Type A patients “consistently adopt and practice self-management in their life,” type B “adopt and practice self-management in their life with unstable feelings,” type C “follow instructions despite unwillingness to self-manage,” type D “practiced self-management although they cannot accept their illness and have a sense of emptiness,” and type E “have no awareness of illness and cannot fully practice self-management.” The findings suggest the necessity to consider the contents and methods of educational support depending on the patient type.