Purpose: To develop an e-learning-based shared decision-making (SDM) education program and evaluate its impacts on the behavioral intentions of those practicing SDM.

Methods: A single-group pre–post comparison study was conducted with 49 mid-career nurses from healthcare institutions across Japan. The nurses were provided with a self-directed e-learning program and were subsequently assessed for their behavioral intentions regarding SDM practice by using a CPD-reaction questionnaire at three time points: pre-intervention (T0), immediately post-intervention (T1), and 1 month post-intervention (T2).

Results: Behavioral intention scores improved significantly immediately after the intervention (T1) (p = 0.001) but showed no significant difference from baseline at the 1-month follow-up (T2). Multiple regression analysis revealed that “belief in capabilities” (β = 0.445) and “moral norms” (β = 0.386) were positively associated with behavioral intentions immediately post-intervention (T1). However, only the moral norm scores showed sustained improvement at the 1-month follow-up (T2).

Conclusions: The e-learning SDM education program developed in this study enhanced the behavioral intentions of mid-career nurses in the short term. However, the sustainability of this impact must be addressed in future studies. This study suggests that the enhancement of both belief in capabilities and moral norms is important for promoting SDM practice among nurses.

Objective: This study aimed to examine the current status of discharge support practices for stroke patients provided by nurses in acute care hospitals and to identify the factors associated with these practices.

Methods: A questionnaire was distributed to 719 nurses working in the neurosurgery or neurology wards of hospitals certified as primary stroke centers by the Japan Stroke Society. The survey included the Discharge Planning of Ward Nurses scale. Statistical analyses were performed using the scale as the dependent variable.

Results: Data from 180 valid responses were analyzed. Multiple regression analyses revealed that the implementation of discharge support conferences (β = .260, p < .001), collaboration with physicians (β = .205, p = .005), participation in discharge support education outside of formal curricula (β = .185, p = .007), and the use of guidelines and manuals (β = .177, p = .008) were significantly associated with better discharge support practice scores.

Conclusion: In acute care hospitals, the discharge support practices of ward nurses for stroke patients were found to be associated with higher levels of practical competence in the following order: use of discharge support conferences, collaboration with physicians, participation in discharge support education outside of formal curricula, and the use of procedural manuals and guidelines.

Aim: The objective of this study was to examine the relationship among stressor associated with patient interaction (patient-related stressor), emotion work, and emotional exhaustion in psychiatric nurses.

Methods: Data from 162 psychiatric nurses(mean age: 38.24 ± 11.59 years) were analyzed to examine the relationship among patient-related stressor, emotion work (negative and empathetic/positive emotional expression towards patients), and emotional exhaustion using covariance structure analysis.

Results: The analysis revealed that patient-related stressor was directly associated with emotional exhaustion and also demonstrated a significant positive association with emotional exhaustion mediated by negative emotional expression towards patients. Moreover, while patient-related stressor demonstrated a significant positive association with empathetic/positive emotional expression towards patients, empathetic/positive emotional expression towards patients were not significantly associated with emotional exhaustion.

Conclusion: To mitigate emotional exhaustion, it would be effective to alleviate negative emotional expression towards patients by promoting the regulation of negative emotions caused by patient-related stressor.

Purpose: To clarify the features of skin physiological functions by age range at 16 sites on the body.

Methods: The subjects comprised 124 men and women aged in their 20s to 80s. Stratum corneum moisture content (hereinafter, ‘moisture content’), sebum content, trans epidermal water loss (TEWL), and pH were measured at 16 points on the body and compared according to the three categories: young/young adult, middle-aged, and elderly.

Results/Conclusions: Water content was higher in the forearm flexor region and lower on the foot dorsum in elderly subjects compared to young/young adult and middle-aged subjects. Sebum content was higher on the posterior neck and upper back regions in young/young adult subjects compared to middle-aged and elderly subjects. Further, TEWL was lower in the forearm extensor region in elderly subjects compared to young/young adult subjects, and lower in the forearm flexor region in middle-aged subjects compared to young/young adult subjects. Although some variation was observed by site, pH was weakly acidic for all age ranges. Despite there being some age-related drops, overall evaluation based on water content, sebum content, and TEWL clarified sites with good overall evaluation (upper back region, anterior chest region) and sites with bad overall evaluation for all age ranges (hand dorsum, foot dorsum, femoral region, abdominal region). Results revealed sites requiring interventions, such as supplementing moisture and sebum content, and wiping gently without chafing while caregiving.

Objective: To clarify the experiences of mothers with children hospitalized in the NICU/GCU, with a focus on the interpersonal environment.

Methods: Semi-structured interviews were conducted with mothers who gave birth to low birth weight infants, and the results were analyzed qualitatively and descriptively.

Results: A total of 13 mothers were included. The mothers’ experiences extracted were “psychological inhibition caused by the unfamiliar environment of the NICU,” “inner conflict discouraging conversation,” “relief gained from interacting with other mothers visiting the NICU,” “awareness and mutual influence among mothers visiting the NICU despite lack of interaction,” “loneliness stemming from the complexity of emotions that only those involved can understand,” “expectations and hesitations about communicating with healthcare professionals,” and “recognizing the importance of family.”

Conclusion: The results suggest the necessity of providing mothers with experiences that make them feel they have done something for their children, support based on their circle of relationships, and opportunities for them to connect with other mothers.

Aim: In this study, we aimed to develop and validate the Interdisciplinary Integrated Team-Based Home Palliative Care Practice Evaluation Scale designed to evaluate palliative care practice quality provided by multidisciplinary integrated teams to support patients with terminal-stage cancer in achieving home death.

Methods: We developed a preliminary scale consisting of 61 items based on qualitative interview data from diverse healthcare professionals engaged in home-based palliative care. We conducted a nationwide web-based survey among home care physicians, visiting nurses, care managers, certified care workers, and pharmacists, dividing the collected data into three subsets for sequential exploratory and confirmatory factor analyses to assess the construct validity and reliability of the scale.

Results: In total, we obtained 914 valid responses (response rate: 8.4%). Our factor analysis identified a two-factor structure [i.e., (1) Timely and Flexible Support for Realizing Patient and Family Wishes and (2) Proactive Pain Relief Based on Prognostic Anticipation] comprising 17 items. The model demonstrated a good fit (GFI = .95, AGFI = .93, CFI = .95, RMSEA = .05), and McDonald’s ω coefficients exceeded 0.85, indicating satisfactory internal consistency.

Conclusion: The Interdisciplinary Integrated Team-Based Home Palliative Care Practice Evaluation Scale demonstrated acceptable reliability and validity. Further investigation would be required to confirm its practical utility and relationship with patient-centered outcomes in home-based palliative care.

Aim: This study aimed to clarify the nature of feeling of self-growth among community-dwelling individuals with schizophrenia.

Methods: Ten individuals diagnosed with schizophrenia were recruited. Semi-structured interviews were conducted individually, and responses regarding feeling of self-growth were analyzed qualitatively using an inductive approach.

Results: Four categories emerged regarding feelings of self-growth in individuals with schizophrenia: “reconstructing one’s life while coming to terms with loss and reality,” “discovering new meaning in one’s experiences with schizophrenia and events in one’s daily life,” “understanding and accepting oneself and one’s condition while rediscovering the self,” and “rebuilding connections with others while deepening one’s relationships to the point at which mutual support is possible.”

Discussion: Feelings of self-growth in individuals with schizophrenia are a combination of loss and advancement described as “a sense of self-growth amid instability” resulting from repeated self-adjustment and advancement while wavering between feelings such as hope and anxiety. Results suggest that this process is characterized by reconstructing one’s life, discovering new meaning, recovering one’s sense of self, and feeling connected to others.