It is worth noting that childbirth is an experience of emotional loss in some aspects of one's valuable self as well as a blissful experience. In this work the authors try to analyse in terms of review, 1) loss experienced during child bearing, 2) the extent of loss, 3) effects brought about by review.
As a result of the study, the internal factors affecting the reaction of loss at childbirth have turned out to be fear, guilt feeling, loss of control, factual experience as well as discrepancy between expectations and reality, and negative interpretations of phenomena by a parturient woman: as the external factors have been characterized 1) Operative delivery 2) traumatic experience either verbal or non verbal behavior of medical and Nursing personnel which might hurt one's self-esteem, and physical discomfort: and farther classified discrepancy between real and expected feature appearance of the infant and reaction to loss in regards to body image, role, value and expectation of the “self”
The conclusion derived from this study is that review should be effective for the recovery from traumatic experience on the ground that it has not only served as the means of collecting data on the experience of loss but also helped release 34 parturient women(94%) of those who have shown feeling of loss caused by childbirth.

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Changes of systolic and diastolic blood pressure, heart rate, and pressure-rate product (PRP) during bathing (washing body with soap and shampooing, showering and bathing in hot water) were studied on a 70 year-old male patient in chronic phase with extensive acute myocardial infarction (AMI), comparing with the data of 28 patients with AMI in our previous paper.
During having the bath, the PRP increased more significantly than the data in the previous paper.
This significant increase may be attributed to the severity of the disease and the old age, in addition to the exercise load, the isometric load, the Valsalva maneuver and the increased output.
Bathing in hot water, the systolic blood pressure decreased extremely. It is considered that this phenomenon was due to the hemodynamical instability by the weak vasomotor reflex and the low cardiac function. The change soft blood pressure and PRP during bathing were not so significant when the temperature of water was increased gradually from 38°C to 44°C. On the other hand, the heart rate was increased when the temperature of the water was higher than 41°C.
We must always take care of patients not to increase cardiac burden during bathing especially for the old people with AMI such as the present patient.

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The purpose of this studies is to find a measure to estimate the developmental of self-care behaviors of diabetic children. A questionnaire was constructed, using the theories of transactional-analysis and personality development, to investigate (1) how diabetic children were feeling about insulin injections and (2) how they were feeling toward others when doing injections.
35 couples of diabetic children and their mothers completed the questionnaire independently.
The data were analyzed in terms of the degree of agreement between children and mothers, and the developmental levels of children's attitude toward injections. Also they were compared with clinical observations of nurses in Diabetic Clinic.
The results indicated the usefulness of the questionnaire as a measure to estimate the developmental status of self-care behaviors. More favorable feelings and attitudes toward injections and mothers appeared to exist among children with good clinical evaluation, less favorable and immature feelings and attitudes among those with poor clinical evaluation.
Further studies is expected to revise the questionnaire to get more accurate estimation with higher reliability.

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The purpose of this research is to evaluate the effect for countermeasure services for circulatory diseases, carried out for the past six years in Taiho-cho, Kochi Prefecture, from the following three aspects: 1. to identify high-risk people, 2. to reduce the number of high-risk people, 3. to decrease the number of cerebral apoplexy patients and to improve the care during the rehabilitation process.
Available materials from 1978 to 1983, which are related to countermeasure services for circulatory diseases were analyzed.
The ratio of identified high-risk people was raised by a rise of number of people received the medical treatment and the follow-up care. Especially, hypertensive persons were remarkably reduced by half for the past six years. As compared the first term with the latter term of countermeasure services, the hypertensive persons among the age of 40 to 69 were significantly decreased. This demonstrates that the countermeasure services were spread throughout the community and their effect was highly evaluated.
The both the number and ratio of cerebral apoplexy patients were reduced, and no stroke person among the age of 30 to 59 was found in 1983. In comparison of cerebral hemorrhage with cerebral infarct, it was found that the former tended to be decreased.
In regard to the evaluation for countermeasure services for circulatory diseases, it seems that the effect for the services can be judged in reference to a shift of subject and prevention of cerebral apoplexy.

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This research focused on the relationship between Japanese nurses' burn out and their social, behavioral patterns, in comparison with those of internists, surgeons, and psychiatrists. The samples (nurse: 300, internist and surgeon:600, psychiatrist:300) were randomly chosen through the members of each professional organization. The variables of burn out, motivation and morale, working environment, perceived support and expectation from health professionals, social support, learned helplessness, recent life events, daily hassles, type A behavior, and coping behavior were measured.
The nurses' burn out rate was twice as much higher than that of the internists and the surgeons. Nurses, who are in late twenties, single, separated or divorced, 6-9 year's clinical experiences at the same institution, working on three shift, and working as a staff nurse, were identified as a high risk group for burn out. The following factors, which were closely interweaved, brought into the nurses' burn out: 1) motivation and morale, 2) working environment, 3) perceived support and expectation from health professionals, 4)learned helplessness, 5)recent life events, 6) daily hassles.
Among these factors, interpersonal conflicts at work, nurses' low motivation and low morale, daily hassles were the major causes of the nurses' burn out. Positive coping behavior and social support system alleviated job strain.
Considering these research results, nurses' supervisors could play a crucial role in prevention of nurses' burn out.

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The purpose of this study was to find the most effective frequency of the practice session in the closed chest cardiac massage. Fifteen healthy nurse-school female students were randomly divided into three different experimental groups (n=5). The first group (M-g) practiced once a week for one month. The second group (W-g) exercised one practice session per day for four days, and the third group (D-g) four practice sessions in one day. Each practice session consisted of one minute of intensive training under the supervision of the present investigators. The thorax compression force was measured using a force measurement device attached to a cardiac massage dummy (the Leardal's Recording Resuci Anne), and the angle of elbow was also measured by means of an electro-goniometer system. The measurement was done before and after each practice session, and one month and 6 months after the final practice session. During each practice session each subject was instructed that an ideal magnitude of the force was 40 kg, and the elbows were straightened (0 degree) throughout the compression phases.
It was found that the compression forces before the first practice session were 34.94±1.22 kg, 35. 3±2.24 kg, and 34.9±3.39 kg for M-g, W-g, and D-g, respectively. There were no significant differences in these mean values of three groups. The compression force after the four practice sessions for each group was significantly larger than its corresponding initial mean value. The M-g had 42.1±0.97 kg, and the W-g and D-g had 39.5±1.05 kg and 39.5±0.20 kg, respectively. It was noted that these values were similar to the ideal force of 40 kg, suggesting that each training method was equally effective.However, there were significant differences in the compression forces when measured 6 months after the final practice session. The W-g and D-g had an apparent decremental effect in the compression force, and the greatest change was seen in D-g. There were no significant changes in the elbow angle due to the effects of time. These results suggested that lessons of the cardiac massage should be spaced over a relatively longer period of time.

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We studied how learning effects of clinical nursing practice and relationship with the patients were affected by characteristic of patients, practice fields, and reference groups, using self-evaluation of nurse students. 77 nurse students were asked on the last day of the nursing practices of every 3 weeks, by the questionnaire sheets concerning the nursing process and relationship with their patients.
The results were as follows:
1) There were the differences within and without practice fields, regarding learning effects of elements of nursing process. Likewise, there were the differences in groups.
2) There were the differences in a pediatrics nursing practice and total adult nursing practices, regarding the relationship with the patients. As was above-mentioned, there were the differences in a medical nursing practice (end stage patients) and the other adult nursing practice.

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