Aim: The aim of this study was to clarify the structure of “Work Attitudes Affecting Nurses’ Health” and to examine the concept’s applicability.

Methods: The study utilized Rodgers & Knafl’s (2000) concept analysis approach, analyzing 46 references from four databases.

Results: The analysis identified six attributes of work attitudes affecting nurses’ health:, low opinion of oneself, feeling confused about how to be as a nurse, self-deception about one’s true feelings, feeling the pressure of the role, prioritizing others at one’s own expense, and losing oneself in one’s work. Five antecedents and three consequences were identified.

Conclusions: Work attitudes that affect nurses’ health were defined as a state in which nurses are positive, putting patients before themselves out of a sense of responsibility and devoting themselves to their work, but are at risk of choosing a way of working that could affect their own health due to confusion about how to be a nurse, combined with pressure to work due to a low self-esteem. This concept highlights the importance of self-awareness in balancing work and health and is recommended for inclusion in basic nursing education to help students manage their health and foster psychological safety within organizations.

Objective: The purpose of this study was to clarify the concept of meaning-making, examine its characteristics, and explore its applicability to psychological care.

Methods: A conceptual analysis of 30 domestic and international publications was performed using Rodgers’ method.

Results: The attributes identified include “confrontation with the self,” “transformation of thinking,” “discovery of a new self,” and “new interpretations.” Six categories of antecedents and three categories of consequences were derived.

Conclusion: The concept of meaning-making was defined as “the process of confronting oneself in challenging situations, transforming one’s way of thinking, discovering a new self, and reinterpreting oneself.” This cognitive approach aimed at overcoming difficulties was shown to play a crucial role in promoting personal growth and adaptation. The study also suggested the possibility of applying the concept of meaning making to psychological care.

Objective: To review the literature on employment and psychiatric comorbidities in adults with childhood-onset epilepsy and to investigate study trends and challenges in transition support.

Methods: Databases utilized included PubMed, CINAHL, and Ichushi WEB. The inclusion criteria for literature selection required that the subjects be patients with childhood-onset epilepsy and that the literature describe psychiatric symptoms and employment.

Results: A total of 27 pieces of literature were analyzed. Four studies indicated a significant association between psychiatric symptom comorbidity and employment, whereas four studies reported no association, presenting contradictory results across the literature. Furthermore, patients’ quality of life was correlated with the presence of psychiatric symptoms, employment status, seizure frequency, and side effects of antiepileptic drugs. Intervention research indicates that group sessions and telephone contact with nurses are effective in alleviating psychiatric symptoms.

Conclusion: There is a need for qualitative research on negative experiences at work and on readiness to cope with stress and self-management during the transition period.

Aim: The aim of this study was to clarify the attributes, antecedents and consequences of the concept, dementia-related caregiver burden.

Method: Based on a Rodgers’ concept analysis approach (Rodgers & Knafl, 2000), 54 articles until 2023 were fully reviewed in both Japanese and English.

Results: The four attributes were extracted: negative feelings to care recipients, exhaustion from dealing with BPSD, anxiety about difficult dementia care, moral distress. Also, four antecedents and three consequences were identified.

Conclusions: The burden on formal caregivers for residents with dementia was defined as a circumstance where formal caregivers have negative feelings, feel exhausted from dealing with BPSD, feel anxious about difficult dementia care and have moral distress. In order to ensure the quality of dementia care and secure human resources, it is important to alleviate the dementia-related caregiver burden on care practitioners.

Objective: This study aimed to obtain a definition of clinical judgment in spiritual care.

Methods: Six databases were searched: Ichushi-Web, CiNii, PubMed, CINAHL, Academic Search, and ScienceDirect. Search terms included “clinical judgment” and “spiritual care.” Meeting the criteria were 36, which were analyzed using Rodgers’ evolutionary method of concept analysis.

Results: The following four attributes were extracted: “gaining clues about the patient’s spirituality through everyday observations,” “Seeing the patient as a whole person and thinking deeply about even the inner world of a patient,” “deciding the timing of care while considering the time limit,” and “deciding the direction of care for healing or self-exploration.”

Conclusion: This concept of clinical judgment in spiritual care is defined as follows: identifying clues related to the patient’s spirituality through daily observations, while being mindful of limited time, and understanding the patient’s inner world holistically, in order to determine the direction of care for healing or self-exploration.

Objective: We conducted a scoping review to identify effective interventions delivered to mothers to promote cervical cancer prevention behaviors among young women in Japan and to explore research gaps in the literature.

Methods: The electronic databases PubMed, CINAHL and Ichushi Web were searched for original articles published in English and Japanese between June 2006 and August 4, 2024, describing cervical cancer prevention interventions delivered to mothers. Fourteen original research papers were analyzed.

Results: Effective intervention methods were identified that enhanced mothers’ intensions of cervical cancer prevention in their daughters. These included the distribution of media content recommending vaccination against human papillomavirus and incorporating kinship caregiving messages that encourage actions to protect children’s health and future, combined with educational information; narrative messages from mothers whose daughters have experienced cervical cancer; the distribution of information leaflets combined with information provided by physicians in face-to-face settings; and the mailing of individual vaccination invitation notifications and educational materials from local government. Future studies are needed to develop an effective media strategy to deliver educational materials, conduct long-term evaluations of intervention effects, and identify effective intervention strategies to promote cervical cancer screening targeted at mothers with daughters of approximately 20 years of age.

Conclusion: Effective interventions to promote cervical cancer prevention behaviors targeted at mothers were identified. These findings provide valuable insights for planning cervical cancer awareness and education programs.

Aim: This study aimed to assess the content and effects of nursing practice using digital technology to care for patients with mental disorders in psychiatric outpatient departments.

Methods: Relevant articles on nursing practice were identified in Japanese and English from the key databases PubMed, CINAHL, and Ichushi-Web, using thesaurus-based keywords such as “Digital Technology” and “Telemedicine”.

Results: A total of 14 articles were included in the analysis. Inductive integration of their content revealed three categories: (1) educational guidance and consultation (seven articles), (2) symptom monitoring (four articles), and (3) implementation of treatment programs (three articles). Positive changes were reported in seven of the eight articles that focused on symptom improvement. Nursing practices using digital technology were implemented regardless of disease type or severity. Videoconferencing systems were the most used technology, reported in seven articles.

Conclusion: These findings suggest that nursing practice using videoconferencing systems may contribute to symptom improvement in patients with various mental disorders and levels of illness severity.

Purpose: The purpose of this study was to review the educational methods and their effectiveness in existing educational intervention studies focusing on the emotional intelligence (EI) of nursing students, and to obtain suggestions for effective educational methods to improve EI.

Methods: A scoping review was conducted based on the JBI guidelines. We identified educational intervention studies focusing on nursing students’ EI, and extracted educational content and methods, evaluation measures, and main outcomes and challenges.

Results: Seventeen studies were included in the literature, and we found that a variety of educational programs were developed on topics such as communication skills and stress management competencies. The educational methods were focused on dealing with the students’ own feeling and deepening their self-reflection, and the results confirmed the improvement of various competencies essential to nursing practice, such as interpersonal skills and problem-solving skills. However, considerable influence of the students’ knowledge and practical experience was found to be an issue.

Conclusion: This study demonstrated the significance of education for improving nursing students’ EI. Continued empirical studies are needed to build evidence and to systematize education in accordance with the readiness of students.

Objective: Using integrative review, this study aims to identify and clarify the components of core competencies in nursing for cancer patients who use complementary and alternative medicine (CAM).

Method: Ichu-shi Web, MEDLINE, CINAHL, CiNii books, and WorldCat were searched for various types of research papers, commentaries, and books by combining search terms such as “CAM,” “cancer,” “clinical ability,” and “professional ability.” The extracted data was analyzed using a qualitative inductive method.

Results: A total of 39 articles were adopted: ten qualitative studies, eight quantitative studies, four mixed studies, ten reviews, and seven commentaries. Results of the analysis identified 5 knowledge categories including “Basic knowledge about CAM including pharmacological effects and history” and “Types of CAM modalities used to manage symptoms of the cancer itself as well as cancer treatment,” 11 skills categories including “Ability to carefully examine own CAM knowledge and update information” and “Evaluation of CAM usage status based on patient’s current health status and target health status,” and 4 attitudes and values categories including “Respecting patient values and wishes regarding CAM” and “Open attitude toward CAM and CAM users.”

Conclusion: The findings suggest that core competencies are characterized as the ability to support patients in achieving their goals by fostering nurse–patient relationships grounded in knowledge acquisition and by applying the attitudes and skills developed through experience in cancer nursing.

Objective: This study aimed to investigate the conceptual structure of operating room (OR) nurses’ roles within contemporary surgical care in Japan and to define their role.

Methods: The concept analysis method by Walker and Avant was employed. Definitions and distinctions from related concepts were examined using dictionaries and relevant literature. Attributes, antecedents, and consequences were extracted from 35 published papers.

Results: The attributes identified were “clinical judgment for intraoperative nursing,” “advocacy for patient rights,” “intraoperative safety measures,” and “providing reassurance.” There were three prerequisites and three consequences for each attribute. The role of OR nurses in Japan was defined as “conducting clinical judgment for intraoperative nursing, implementing intraoperative safety measures, and providing reassurance while upholding patient rights.”

Conclusion: This study investigated the characteristics of the role of OR nurses in Japan, highlighting how they have evolved in response to societal and clinical changes. This conceptual framework can be utilized as a reference for developing a nursing practice model for OR nurses in Japan.

Objective: To clarify the experiences of women who continued breastfeeding after returning to work from domestic and foreign literature, and to obtain suggestions for support.

Methods: Using the Web version of the Central Journal of Medicine and PubMed, we selected nine original articles on the experiences of women who continued breastfeeding after returning to work, and clarified the women’s experiences by comparing the subjects of the research, factors that influenced the continuation of breastfeeding, and actual conditions such as challenges faced in each article.

Results: The women’s experiences included: [psychological conflicts that oscillated between the intention to continue breastfeeding and the reality], [emotional support from those surrounding the women], [physical discomfort and pain], [inconvenience of the work environment], [acquisition of a child-rearing style], [emotional rest from their children], and [formation of a new identity as a mother].

Conclusion: The results suggest that, for breastfeeding support after returning to work, it is important not only to improve the physical and human environment at the workplace, but also to provide various information to the women and their surroundings and continuous emotional support from the pregnancy period.

Objective: The aim was to elucidate the pathways and experiences of novice nurses who choose to continue working despite experiencing communication difficulties in the workplace.

Methods: Semi-structured interviews were conducted with five novice nurses. Themes were extracted using phenomenological methods and were subsequently used to model the process through Trajectory Equifinality Modeling.

Results: From the interviews, four thematic stages were identified: (1) Frustration and distress from being unable to demonstrate one’s worth to senior nurses, (2) Putting on a brave front, (3) Struggling to find one’s ideal nursing practice despite inadequate job performance, and (4) Achieving growth as a ‘nurse’.

Conclusion: Novice nurses experience communication difficulties with senior members of staff and through incidents and interactions with their peers, recognize their own growth, interpersonal relationships, and support from their environment. This recognition leads to a renewed motivation for growth and the choice to continue in their profession. This process can be considered as the emergence of ‘self-transformation’.

Objective: This study aimed to clarify the actual conditions of the frequency of self-management (SM) education, nursing issues, frequency of collaboration with other professionals, difficulties faced by home-visit nurses for patients with chronic obstructive pulmonary disease (COPD), and the relationship between these experiences and home-visit nurses’ clinical experiences.

Methods: A postal questionnaire survey was conducted with 3,000 home-visit nurses nationwide. After calculating the basic statistics, the differences between the frequency of SM education, nursing issues, frequency of collaboration with other professions, and clinical experiences were analyzed using the Mann–Whitney U test. The free-description categories of difficulty were extracted using content analysis.

Results: The analysis included 305 participants. Regarding the frequency of SM education, instruction on the assessment of shortness of breath was the least common and significantly less common in the group with no experience in respiratory wards. Additionally, the group with no experience in respiratory wards was more likely to experience difficulties in home-visit nursing for patients with COPD.

Conclusion: To promote SM education among home-visit nurses, there is a need to disseminate expertise and reduce feelings of difficulties.

Objective: This study aims to identify issues in the health-seeking behaviour of international students in Japan as perceived by teaching staff at Japanese language schools.

Methods: We conducted semi-structured interviews with 10 teachers and staff from Japanese language schools. The data obtained were analysed using qualitative descriptive methods.

Results: “Disadvantage in receiving medical examinations due to being an international student in Japan”, “Due to the limitations of Japanese language skills, conversations during medical examinations do not convey the true meaning”, “They have to rely on teachers to make decisions, including whether they need to see a doctor.” It was shown to be the case. In addition, “Due to differences in social systems and customs from their home country, they are not familiar with typical healthcare-seeking behaviors in Japan.” This they faced. “Health-seeking behaviours are burdensome due to residency in situations where economic resources are not available.” This has been shown to be the case.

Conclusion: It has been suggested that, in order for international students living in Japan to make use of medical institutions, it is necessary not only to improve the systems on the part of the medical institutions but also to provide information to the students and Japanese language schools, and to establish support systems by medical professionals.

Purpose: Small-scale multifunctional in-home nursing care, called Kantaki, is a new service that combines day care, home-visit nursing, and short-stay services. This study developed a self-assessment scale for practical nursing skills required by nurses engaged in Kantaki and examined its validity.

Methods: Using the developed assessment instrument, a questionnaire survey was conducted with registered nurses from 729 Kantaki facilities that were open by the end of June 2021. The scale’s factor structure was determined, and the internal consistency, content validity, construct validity, and criterion validity were evaluated.

Results: From the 949 distributed questionnaires, 865 responses were received. Of these, 649 questionnaires with responses to all items were analyzed. Subsequently, a scale comprising 59 items and nine factors was developed. Cronbach’s alpha coefficient was greater than 0.9 for each factor. Content and construct validities were sufficient, and the factor points of each factor for participants with more than three years of clinical experience were significantly higher than for those with less than three years of clinical experience.

Conclusion: The developed scale had adequate validity, and can be used to evaluate care provided by nurses in Kantaki.

Objective: To find an association between career plateau measurement scale scores and the intention to continue working in the current position among mid-career nurses.

Methods: A total of 528 mid-career nurses underwent a survey on the intention to continue working in the current position and career plateau. The career plateau measurement scale for mid-career nurses was used to measure career plateau. The cutoff score of the scale for the intention to continue was calculated through receiver operating characteristic analysis and used to divide the nurses into “plateau group” and “non-plateau group.” Then, a binomial logistic regression analysis was conducted using the intention to continue working in the current position as a dependent variable and the presence or absence of a plateau or scale score and potential confounding factors as explanatory variables.

Results: The career plateau was significantly associated with the intention to continue working in the current position (adjusted odds ratio 2.70, 95% confidence interval [CI] 1.83–3.98, p < 0.001). The scale scores were also significantly associated with the intention to continue working in the current position (adjusted odds ratio 0.97, 95% CI 0.95–0.98, p < 0.001).

Conclusion: The career plateau measurement scale score for mid-career nurses may be a useful measure associated with the intention to continue working in the current position.

Objective: This study aims to identify factors influencing healthcare-seeking behavior for late-onset hypogonadism (LOH), focusing on age, awareness, and AMS score.

Methods: A web-based survey was conducted with 1,500 men aged 20 to 69 across Japan, gathering open-ended responses on factors that encourage health-seeking behaviors for LOH symptoms. A total of 1,168 responses were analyzed using text mining with KH Coder.

Results: Based on 2,091 extracted words, four categories emerged: (1) conditions and support that promote health-seeking behaviors, (2) economic and social barriers to seeking care, (3) psychological and knowledge-related barriers, and (4) limitations in the healthcare system and institutional structure.

Conclusion: Support from the workplace and family, enhancement of financial assistance, and the development of specialized healthcare systems are essential for promoting healthcare-seeking behavior.

Aim: This study aims to elucidate the help-seeking process of mothers experiencing parenting difficulties with their infant children.

Methods: Semi-structured interviews were conducted with 26 mothers who have experienced parenting difficulties with their infant children. The data were analyzed using the Modified Grounded Theory Approach for qualitative research.

Results: Mothers experiencing [perceived sense of parenting difficulties] [seek help] to resolve their difficulties and [explore optimal parenting methods]. They [select methods] based on [relationships that facilitate help-seeking] in daily life, and «seek relief», which ultimately leads to [obtaining reassurance]. Mothers who feel [resistant to help-seeking] and have [a sense of giving up on help-seeking] in face-to-face contexts often opt for [online help-seeking], which also helps them [obtain reassurance].

Conclusion: This study identified the help-seeking process of mothers experiencing parenting difficulties with their infant children. It is essential for nursing professionals to promote awareness of this process and incorporate this understanding into their nursing practice.

Purpose: The purpose of this study was to elucidate the process of harmony in the lives of recurrent and metastatic cancer survivors during recuperation.

Methods: Semi-structured interviews were conducted on 16 participants, and the data were analyzed using the Modified Grounded Theory Approach (M-GTA).

Results: The process of harmony in the lives of recurrent and metastatic cancer survivors during recuperation centered on “Living with a neutral self”, in which there was an expansive process of self-awareness from [Wavering self-existence in changing circumstances] to [Putting death aside and remaining true to oneself], [Cancer is a part of me], and [Perceiving expansion of the self]. This was supported and facilitated by the interactions of strategies for [Directing one’s attention to what one has at the moment] and [Maintaining a stable self]. “Living with a neutral self” is a state in which the individual maintains an unwavering self amid the constant changes that occur during the process of repeated rounds of recurrence and metastasis of cancer, and was strengthened by cycling through this process.

Conclusion: These results suggest that promotion of the recovery and the expansion of self-awareness and sense of control that centers on “Living with a neutral self” serve as support for survivors’ recuperation in maintaining the best possible health.

Objective: To identify the state of self-neglect among elderly and classify.

Methods: A self-administered questionnaire survey was conducted among professionals with experience in dealing with self-neglect cases at comprehensive community support centers and social welfare councils in six Kinki prefectures. Responses were obtained for 151 self-neglect cases.

Results: A principal component analysis was conducted on responses to 34 items describing self-neglect conditions and behaviors. Five components were extracted: unsanitary living environment, inappropriate healthcare behaviors, unhygienic housing environment, poor money management, and poor interpersonal relationships. A cluster analysis using these components revealed four self-neglect types: poor interpersonal relationships (34%), money management difficulties (26%), overall low group (23%) and poor living environment group (14%). There were differences between the clusters in the degree of independence in daily living of the disabled elderly and the elderly with dementia, the type and severity of self-neglect, and the older people’s own acceptance of others.

Conclusion: The self-neglect status of older people can be typified into four groups, and the characteristics between the clusters of typologies suggest the need for interventions and support accordingly.

Objectives: This study aimed to clarify parental involvement in the transition to self-care for school-aged children with type 1 diabetes.

Methods: We conducted semistructured interviews with 10 parents of children of school age or older, who were diagnosed with type 1 diabetes before the age of 9 years. The interview data were analyzed using qualitative inductive methods.

Results: All study participants were mothers, and all children were using continuous subcutaneous insulin infusion. Based on the analysis, six categories were extracted: “Complementing diabetes management that is difficult for the child to manage by themself,” “Managing diabetes with the child,” “Gradually promoting the child’s self-management of diabetes under parental supervision,” “Collaborating with school staff to manage diabetes in school,” “Establishing a safe and secure environment for children,” and “Devising ways to encourage the child’s independence”.

Conclusion: Parental involvement in the transition to self-care helps children will take the intiative in managing diabetes and live with type 1 diabetes.

Objective: This study aimed to develop a scale for measuring the leadership behaviors of visiting nurse managers.

Methods: A nationwide survey was conducted using internet-based or mailed questionnaires targeting 3,000 visiting nurses across Japan. The survey included a 39-item scale designed to evaluate managers’ leadership behavior from the perspectives of their subordinates. The reliability and validity of the scale were also assessed.

Results: In total, 577 responses were received (response rate: 19.3%). Exploratory factor analysis identified 16 items organized into two factors. The model fit indices were as follows: GFI = .936, AGFI = .909, CFI = .973, and RMSEA = .062. Correlation coefficients with external criteria ranged from r = .768 to .818. Cronbach’s alpha for the complete scale was .959, and the test-retest correlation coefficient was r = .716.

Conclusions: The scale demonstrated strong reliability and validity, as well as favorable model fit indices. This suggests that it is a robust tool for evaluating visiting nurse managers’ leadership behavior.

Objective: The purpose of this study was to clarify the perceptions of clinical practice instructors and university faculty regarding responsible behavior of nursing trainees.

Methods: Data was collected using semi-structured interviews with 21 instructors and 22 faculty members, and a mixed methods of quantitative analysis using text mining and qualitative inductive analysis was used.

Results: The agreement rate of the main words in both was 85.3% and the Kappa coefficient was 0.71. As a responsible behavior, trainees take “Behavior to face their own anxiety” before the practice; and during the practice, while development of “Behavior of learning how to learn to improve practical skills,” “Learning behavior reflecting on nursing practice,” “Behavior showing interest in the other person’s state,” “Behavior considering the other’s point of view,” “Behavior that understands and conveys meaning,” “Obeying rules while thinking about reasons,” “Behavior that control safety,” “A practical attitude that builds trust,” and “Behavior that evaluates one’s own efforts,” was required.

Conclusion: Both considered responsible behaviors to be taken by the trainees to learn, as well as behaviors that are controlled with consideration for the client’s safety and relationship building.

Purpose: This study aims to clarify the process of how clinical nurses’ recuperation support promotes behavior change in hospitalized patients with predialysis chronic kidney disease.

Methods: Semi-structured interviews were conducted with ten clinical nurses who provided kidney disease guidance to hospitalized patients, and the results were analyzed using the Modified Grounded Theory Approach (M-GTA).

Results: In recuperation support, the clinical nurse works with the patient to find recuperation behaviors in which the patient is willing to engage. In this process, the nurse begins by “perceiving the patient’s recuperation experiences and wishes.” This leads to the nurse “getting approved by the patient,” “taking time to confirm the patient’s words (thoughts) and explain things to the patient,” and “building rapport and working with the patient to find suitable recuperation behaviors for the patient,” which promote the patient’s behavior change. When the nurse listens to the patient’s story, actions that may suppress behavior change, such as the nurse “being hesitant” and “giving one-sided guidance,” are still observed. However, continuous recuperation support that promotes behavior change can be accomplished by “supporting the patient as a team.”

Conclusion: This study suggests that “getting approved by the patient” by “perceiving the patient’s recuperation experiences and wishes” is important in helping the nurse provide recuperation support that promotes behavior change in hospitalized patients with chronic kidney disease.

Objective: To clarify nursing practices with a focus on life after discharge in preoperative outpatient care.

Methods: Semi-structured individual interviews were conducted with nurses providing preoperative outpatient care. The interview content was then analyzed using the Klaus Krippendorff’s method. The verbatim transcripts for each participant were carefully read. The narratives of nursing practices in preoperative outpatient care were extracted in the participants own words, written down to clarify the content, and then coded. The codes for all participants were categorized and subcategorized into common items while the similarities and differences in meaning were examined.

Results: Six nurses were included with a mean interview time of 43 min. Through content analysis, nursing practices in preoperative outpatient care with a view of life after discharge were represented by 235 codes, 53 subcategories, and 9 categories.

Conclusion: Support for physical readiness for safe perioperative management was provided in collaboration with other nurses and multidisciplinary staff. Additionally, nurses focused on understanding the patient’s thoughts, values, and living situation according to mental and social information, and provided support for decision-making and living with postoperative changes.

Purpose: To examine the feasibility of nursing intervention to reorganize movements in patients in the acute phase immediately after the onset of stroke. Specifically, the purpose of this study is to clarify the sample size and the validity of the indices necessary to verify the effectiveness of the intervention, as well as the issues to be addressed in order to conduct a full-scale study.

Methods: This study included 40 patients (control group, n = 20; intervention group, n = 20) 60–85 years old who were admitted to the Stroke care unit within 3 days after the onset of stroke. Nursing intervention to reorganize movements was performed from days 4 to 15 after the onset of stroke, and the effectiveness of the intervention was analyzed using the Functional Independence Measure (FIM).

Results: There was no statistically significant difference in the outcome measures between the control and intervention groups. In an analysis limited to patients with NIHSS <20 on admission, the intervention group had a higher FIM cognitive score improvement on day 15, which was a statistically significant difference.

Conclusion: The results of this study revealed the issues associated with conducting a full-scale study in the future, such as establishing the necessary sample size, the need to standardize the assessment instruments, the methodology, and the other research methods.

Purpose: The purpose of this study was to find out what women diagnosed with cancer during pregnancy experienced in their cancer treatment and childcare.

Methods: Narrative analysis was conducted in March-July, 2023 after interviewing two women who had been diagnosed with cancer during pregnancy.

Results: The following themes (in quotation marks) were identified. Ms. A underwent anticancer drug therapy during her pregnancy for breast cancer and “kept being worried about her fetus, feeling anxiety, sense of being alienated and loneliness.” After giving birth, she “struggled every day and barely managed to take care of her baby while continuing hospital visits for cancer treatment.” After several years, she “is happily enjoying ordinary daily life, which she appreciates.” Ms. B underwent surgery during her pregnancy for a soft tissue tumor. She “felt anxious, alienated, and lonely, and was more worried about whether she would be able to give birth to her baby than about her own cancer.” She did not feel well after giving birth and she “could only manage daily care of her baby, neglecting her own body as secondary importance,” but gradually began to “pay attention to her own life while cherishing time with her baby.”

Conclusion: It is extremely difficult to assume the role of mother, including breast feeding and childcare, while at the same time being an outpatient with poor physical and mental condition due to cancer treatment. A support system needs to be established for such women and their families.

Objective: This study aimed to explore how adults with mental illness who experienced child maltreatment from caregivers in childhood narrate and reinterpret their life stories.

Methods: Guided by a dialogic constructionist approach, we conducted a life story study with three female participants. Each participant underwent three sessions of non-structured, in-depth interviews, which were audio-recorded and transcribed verbatim. Data analysis proceeded in two phases: (1) examining “tale worlds” to identify narrative content and themes, and (2) focusing on “story realms” to investigate how interviewer–interviewee interactions shaped the storytelling process. The research received ethical approval from the university’s Ethics Committee (Approval No. 2023N-024), and informed consent was obtained from all participants.

Results: Although participants described various traumatic childhood experiences and ongoing struggles with mental illness, they also identified subtle positive elements that contributed to their current sense of self and relationships. These findings revealed a complex interplay between negative past events and newly discovered meanings, indicating potential pathways for resilience and growth.

Conclusion: The study highlights the value of narrative-based support that respects the multifaceted contexts of survivors rather than focusing solely on pathology. Recognizing both adversity and positive aspects within their life stories may enhance clinical and community interventions for individuals seeking to make sense of their past experiences and move toward recovery.

Aim: The purpose of this study is to elucidate the care innovations practiced by advanced practice nurses (geriatric nurses and certified dementia nurses) on elderly dementia patients during the postoperative bed rest period to provide optimal rest for both patients and nurses.

Method: Semi-structured interviews were conducted with six advanced practice nurses working in acute care hospitals, and a qualitative content analysis was carried out.

Results: The analysis also clarified the three categories [early response to signs that may lead to agitation or confusion], [reduction of pain associated with bed rest], and [innovations for postoperative management that do not rely on physical limitations] to achieve these categories. These innovations not only reduced the discomfort and pain caused by postoperative bed rest, delirium, and confusion in elderly dementia patients, but also reduced care difficulties for nurses.

Conclusion: Nursing practices that address the discomfort associated with bed rest, determine the appropriate timing for medication, ensure pain relief and adequate sleep on the surgery day, and focus on removing physical restraints can provide comfort to both patients and nurses.

Objective: This study aimed to clarify the process of caregiver-supplemented self-care needed for children with atopic dermatitis during late infancy.

Method: Semi-structured interviews were conducted with 16 mothers of children who were aged 3–11 years and diagnosed with atopic dermatitis in infancy. Data were analyzed using the grounded theory approach.

Results: Mothers continued to “dialogue with the child as he/she is,” and repeated “strategies to ensure care becomes part of the child’s daily life,” “daring to create a void” and “readjustment of the complement,” which led to the development of their children’s self-care skills by adjusting the complementary care.

Conclusion: Expanding a child’s self-care abilities in late infancy is challenging and requires sustained support for mothers to integrate care into child’s daily life, adopt the perspective of “creating a daring void” to adjust retention and release of care while considering atopic dermatitis symptoms. Support that can expand both child’s self-care and the mother’s ability to provide effective care is essential.

Objective: To clarify the difficulties breast cancer patients living on remote islands perceived when visiting specialized breast cancer medical institutions outside the island for treatment and subsequent follow-up care.

Method: Semi-structured interviews were conducted with 14 breast cancer patients living on remote islands, and qualitative descriptive analysis was conducted.

Results: Breast cancer patients living on remote islands held physical, mental, and financial difficulties associated with the procedures and arrangements required to travel outside the island to visit specialized breast cancer medical institutions outside the island. In addition, difficulty in obtaining support from family and medical professionals during treatment was also identified as a difficulty. Breast cancer requires long-term treatment and follow-up, and difficulties were identified in traveling outside the island for long periods of time.

Conclusion: Breast cancer patients living on remote islands felt difficulties unique to remote islands when accessing specialized cancer medical institutions outside the island. In the future, continuous support system will be established, for breast cancer patients living on remote islands to visit institutions outside the island, and strive to reduce these difficulties.

Purpose: Development of a “Self-Diagnosis Scale of Medical Accident Prevention Competency for ICU Nurses” with the aim of ensuring patient safety.

Methods: Identifying ICU nurses’ medical accident prevention behavior through qualitative research, development and scaling of 29 items based on the results of qualitative research, selection of questionnaire items using item response theory, and nationwide mail survey. The scale items were collected individually by anonymous mail.

Results: A total of 907 questionnaires were distributed and 304 valid datasets were analyzed. 15 items were selected using IRT, and a final version scale was produced therefrom. The information content of the scale was more than 9.24, the Cronbach’s alpha was .91, and the contribution to the first component by principal component analysis was 44.02%. Four hypotheses were supported by the known-group technique. The correlation coefficient using the retest method was .50, and the results of the confirmatory factor analysis were CFI = 0.88 and RMSEA = 0.09.

Conclusion: Although in terms of validity, the structural aspect of this scale remains an issue, it contains evidence from multiple facets and can be utilized as a measurement tool.

Purpose: This study aimed to elucidate the process by which young adult cancer survivors seek information that helps them in managing their daily lives following their diagnosis.

Method: Nineteen cancer survivors participated in semi-structured interviews, which were subsequently analyzed using M-GTA.

Results: Cancer survivors “obtain information on living with cancer from those who have experienced it and then share it themselves in order to connect with their peers.” They “look for ways to organize their lives by overcoming physical and mental pain and financial problems.” Furthermore, they “continue to seek information on living a life that is in line with their life cycle while living with cancer.” They encounter challenges when interacting with their children and parents and attempt to resolve issues through trial and error. Nevertheless, they also endeavor to prevent their children from experiencing hardships in the event of an emergency. Cancer survivors possess their own perspectives when it comes to gathering information.

Conclusion: It was evident that cancer survivors are actively pursuing ways to mitigate the pain associated with the disease, maintain social connections, and coexist with cancer while thinking about their families.

Purpose: This study aimed to verify the content validity of an on-the-job training case conference model designed to enhance the caring practices provided by public health nurses (PHNs) to their clients. This model was specifically intended for PHNs in managerial roles.

Method: The research process included three key stages: developing the model, assessing its content validity, and finalizing the model. Experienced managerial PHNs who had previously implemented case conferences participated in the content validity assessment. The validation process involved two rounds of questionnaire surveys, interspersed with a meeting to discuss the findings.

Results: Eight professionals participated in this study. The second survey revealed that 120 of 124 items were valid, with four items classified as indeterminate and subsequently removed. The final version of the model was developed integrating feedback from the second survey. The model comprises four core concepts: “management actions to conduct case conferences in an organized and effective manner,” “OJT case conferences to enhance the caring practices provided by PHNs,” “outcomes of case conferences,” and “requirements for case conferences.”

Conclusion: The content validity of the model was confirmed based on validation findings and by cross-checking with the caring theory and other relevant literature.

Objective: This study aimed to evaluate the effectiveness of a nursing practice awareness program designed to prevent child maltreatment, targeting nurses working in maternity wards at obstetric medical institutions.

Methods: A randomized controlled trial was conducted with 61 participants—31 in the intervention group and 30 in the control group. The intervention group received a program consisting of the combination of e-learning and group work. The effectiveness of the program was evaluated using the NES-CMP (Nursing Evaluation Scale for Child Maltreatment Prevention), as well as through the observation of changes in their awareness, motivation, and confidence related to nursing practice.

Results: Data belonging to 28 participants in the intervention group (attrition rate: 9.7%) and 26 in the control group (attrition rate: 13.3%) were analyzed. Although there was no significant difference in NES-CMP scores between the groups, the intervention group displayed significantly higher changes in awareness, motivation, and confidence in comparison to the control group.

Conclusion: The program was effective in enhancing awareness, motivation, and confidence in nursing practice. However, further research is needed to explore the sustainability of these effects and the applicability of the program to a broader range of nursing professionals.

Objective: This study explored the experiences of mothers accompanying children requiring medical care at special needs schools.

Methods: Semi-structured interviews were conducted with 11 such mothers and analyzed using grounded theory.

Results: The mothers had “Choosing the Right School for the Child”. They sometimes felt “Uncertainty About School Support for Medical Care”. They made efforts for “Creating a Learning Environment Suitable for the Child”. However, when their questions remained unresolved, they ended in “Compromise with the Current Situation” and continued to accompany their children. On the other hand, through “Proactive Support for Independence received from the faculty”, “Awareness of the Child’s Social Development” was encouraged, and they began to be conscious of letting go, and reached “Self-Rediscovery through Letting Go of the Child”. Additionally, the mothers still had “Emotional Turmoil Caused by the Child’s Health Condition” while chaperoning their children, which interacted with other phenomena.

Conclusion: The mother’s accompaniment was a process of creating a learning environment for the child and reconstructing the mother’s own role. It is necessary to consider the nature of the accompaniment based on assessments of the child’s health status, psychosocial development, and the mother’s emotional fluctuations.

Objective: To clarify the psychological process experienced by mothers of children (patients) with severe motor and intellectual disabilities, in institutions from the time they began to consider institutionalization for their child up until the present day.

Methods: Semi-structured interviews were conducted with 26 mothers of children (patients) with severe motor and intellectual disabilities currently institutionalized, and analysis was conducted referring to a grounded theory approach.

Results: The process of entrusting their children to an institution “did not change their responsibility as mothers to protect their children.” Based on “the responsibility as mothers to protect their children,” 11 categories were formed, including “anxiety about not being able to protect their children,” “thinking about whether to entrust their child to an institution,” “not even considering institutionalization,” and “having no choice but to entrust their children to an institution.” In addition, conflict and anguish regarding entrusting their children to an institution were also present in this process.

Conclusion: The results suggested that it is important to listen to the mothers’ thoughts and accept them as they are, while at the same time, understanding the current nature of the psychological state of the mothers in the process.

Purpose: The purpose of this study was to clarify the various phases of caregiving by caregivers experienced in elder abuse, from assuming the care of the abused to re-establishing a stable lifestyle after the role dysfunction (abuse) that hindered care.

Methods: Semi-structured interviews were conducted with five caregivers from Prefecture A with experience in committing elder abuse. The interviews were qualitatively analyzed by directed content analysis based on a conceptual framework derived by the authors from Meleis’ Transitions Theory.

Results: Results: The results revealed that in situations where [caregivers assume the caregiver role on their own], they take on caretaking responsibilities and are relieved from role dysfunction situations in which [they feel trapped or are suffering under the current circumstances] by receiving caregiver support. Receiving support allowed the caregivers to re-establish stability in their day-to-day life.

Conclusion: After taking on a caregiving role, a temporary shift in the caregiving role was observed due to the support of public health nurses, other health care workers, and support services. If appropriate support was not received by caregivers, the caregiver’s burden was not relieved, leading to accumulation of burden and role dysfunction (or abuse). However, it was revealed that appropriate support interventions prevented abuse and relapses, which led to the caregiver being able to re-establish stability in their day-to-day life.

Objective: This study aims to verify the validity and usefulness of a case conference sheet designed to facilitate the identification of community health needs from individual cases at health checkups for infants and toddlers, as well as the deliberation of potential solutions.

Methods: We developed and implemented a case conference sheet to facilitate the identification of community health needs in individual cases and the deliberation of potential solutions. The validity of the sheet, which incorporated elements of public health nursing competencies, was verified through participant observation during case conferences. Furthermore, a questionnaire survey was conducted to assess the sheet’s usefulness in terms of effectiveness and efficiency.

Results: Analysis of 28 individual cases led to the identification and examination of eight community health needs. The content of the form was found to be aligned with the elements of public health nursing competencies, confirming its validity. The usefulness of the sheet was demonstrated through changes in public health nurses’ awareness, who indicated it was an effective and efficient tool that helped them to recognize commonalities among individual cases, understand the process of conceptualizing community health needs from individual cases, pay attention to community environment, and improve the visualization and efficiency of information sharing.

Conclusion: This case conference sheet was confirmed to be a valid and useful tool for facilitating the identification of community health needs from individual cases and deliberation of potential solutions.

Aim: To outline career adaptability among novice nurses.

Methods: Semi-structured interviews were conducted with 12 third-year nurses, whose responses were qualitatively and descriptively analyzed.

Results: The following themes were extracted from the data: “Felt the power of nursing and thought about my future career,” “Had a senior nurse whom I respected,” “Wanted to become independent as a nurse and as a member of society as soon as possible,” “Felt I had to fulfill my responsibilities as a nurse,” “Controlled my feelings to continue working,” “Valued building relationships with patients,” “Was conscious of grasping the key points of the work,” “Was conscious of learning actively and systematically,” “Was able to recognize my own growth,” “Did not want to be perceived as someone who could not do the job,” “Was conscious of building good human relationships,” and “Was able to recognize that the work environment was dependable.”

Conclusions: Career adaptability among novice nurses showed similarities with the concept of Career Construction Theory. By contrast, the responses highlighted a sense of security, which is not something that forms part of the existing theory.

Purpose: This study aimed to elucidate the perspectives of biological women who do not self-identify as women and have experienced childbirth regarding the physical and mental changes associated with pregnancy, childbirth, and the postpartum period.

Participants and Methods: Semi-structured interviews were conducted with trans-men (biological female and self-identified as male) or X-gender individuals (biological female and self-identified as neither female nor male), and those who had experienced pregnancy, childbirth, breastfeeding, and childrearing. Thematic analysis was the chosen methodological approach.

Result: Four themes were extracted from the narratives of pregnancy, childbirth, and postpartum experiences of six participants; “emotional turmoil about life after pregnancy and childbirth,” “awareness of physical changes as women during pregnancy, childbirth, and the postpartum period ,” “discomfort with the general gender norms that pregnancy, childbirth and breastfeeding are for women and mothers,” and “different feelings arising from the relationship with the health care providers based on disclosure of gender identity.”

Conclusion: The present study suggests that midwives should provide care that is not only cisgender-based, but should also embrace a commitment to exploring ways in which they can care for diverse genders and sexualities.

Purpose: The purpose of this study was to clarify mental stages of mothers of children with moderate to severe congenital heart disease (CHD) experience in developing an autonomous parenting method, and to describe how these mothers establish stable home care for their CHD children after discharge from a hospital.

Methods: Seven mothers of children (age range: 0 to 8 years) with CHD who used home care nursing services were interviewed using the retrospective method from December 2021 to June 2022, with informed consent obtained to participate in our study. A qualitative and descriptive investigation was conducted and the results were analyzed using the Trajectory Equifinality Mode (TEM) and the Kolb’s experiential learning theory.

Results: Before reaching a state of “living calmly with a CHD child”, the mothers experienced 4 bifurcation points: “deciding to raise the child by her own will,” “prioritizing stabilization of the child’s symptoms,” “valuing the child’s growth as the most important,” and “choosing to occasionally access to the government’s social resources and local childcare resources”.

Conclusion: To facilitate autonomous child-rearing methods for mothers of children with CHD receiving home care, it is essential to prepare optimized care suited to each mother’s specific circumstances. This requires consideration of specifically tailored support methods that account for both promoting factors and inhibiting factors within their environments.

Objective: To elucidate the support process provided by experienced nurses to novice psychiatric nurses who have experienced violence from patients.

Method: Interviews were conducted with 12 nurses who met at least one of the following criteria: over 10 years of experience in psychiatric nursing, nursing management position, or certified psychiatric nurse specialist. The data were analyzed using a Modified Grounded Theory Approach (M-GTA).

Results: Experienced nurses assessed the need for support by “identifying subtle maladaptive responses” and “exploring tendencies toward isolation.” They also reported “missing the appropriate timing to provide support in cases of verbal abuse.” Once the need for support was established, they transitioned from psychological support—“creating an environment where the novice nurse felt safe to consult,” “helping to manage and accept suppressed emotions,” and “encouraging the surrounding staff to provide further assistance”—to educational support aimed at “facilitating self-reflection to connect experiences of violence with future Care.”

Conclusion: The transition from psychological support to educational support was a process that emphasized preventing secondary harm while assisting in emotional regulation. In addition, establishing a support system for victims of verbal abuse was considered an ongoing challenge.

Objective: The purpose of this study was to identify the impacts on nursing tasks of delegating medical practice from medical doctors to nurses in advanced acute care hospitals.

Method: Data were generated through semi-structured formal interviews with 16 nursing managers.

Results: From the results of the text interpretation, nine subcategories, and four categories were extracted, including the following: 1) Improvement in autonomy; 2) Improvement in practice skills; 3) Improvement in the nursing services that can be provided; and 4) Obstacles to providing necessary nursing services.

Conclusion: As delegating medical practice from medical doctors to nurses has been promoted, nurses have had more opportunities to demonstrate their expertise; however, they have been unable to adequately assist with patients’ activities of daily life, which is necessary for them to demonstrate their expertise. In order to make policies that promote task shifting and sharing from medical doctors to nurses conducive to the exercise of nursing expertise, it is necessary to create an environment in which nurses can adequately assist with patients’ activities of daily life.

Objective: The objective of this study was to ascertain factors contributing to the reduced utilization of ambulance services and the provision of assistance to homebound older adults who are recuperating.

Methods: One thousand visiting nurses participated in the study. A questionnaire survey was conducted using the two-stage Delphi method. The survey’s first and second stages garnered 70% and 80% consent rates, respectively.

Results: In the initial survey, a consensus rate of 70% or higher was achieved for 14 of the 18 factors hindering homebound older adults from utilizing ambulances with greater frequency. This consensus was reached for 20 of the 21 items designed to assist homebound older adults. In a subsequent survey, the agreement rate surpassed 80% for 13 of 14 factors hindering the utilization of ambulances by homebound older adults, along with 19 of 20 items designed to enhance their well-being.

Conclusion: The factors that inhibited homebound older adults from the frequent use of ambulance services were the ability to understand and respond to symptoms, access to necessary home health care, and the transition from the hospital to home. Thus, the provision of clear explanations regarding urgent conditions and assurance of the constant availability of support are necessary.

Objective: This study examines the current state of monitoring of older adults by parents of school-age children.

Methods: An anonymous, self-administered questionnaire survey was administered to the parents and guardians of three elementary schools.

Results: Of the 344 respondents analyzed, 39 (11.3%) reported being concerned about an older adult, and 16 (41.0%) of them regularly checked on the well-being of the older adult they were concerned about. Among older adult monitoring indicators, items such as “yelling and screaming coming from inside the house” and “the older adult walking unsteadily, appearing unwell” were rated “very worrisome.” Items associated with older adult monitoring included childcare support from older adults in the community, interaction with older adults through neighborly relations and community activities, and a sense of community attachment.

Conclusion: Monitoring was observed regardless of kinship or roots in the community; therefore, enhancing intergenerational interaction and strengthening the sense of community attachment may encourage parents of school-age children to monitor older adults.

Objective: To develop a Japanese version of Nurses’ Moral Courage Scale for Psychiatric nurses (J-NMCSP) and to assess its reliability and validity.

Methods: This study included 2,601 psychiatric nurses who were administered the J-NMCSP, which was developed through a translation process. The construct validity was evaluated through an exploratory factor analysis, whereas the model fit was confirmed through a confirmatory factor analysis. Subsequently, item analysis, reliability confirmation, and validity were performed.

Result: The results of the exploratory factor analysis showed that the four-factor model had high goodness-of-fit indices (GFI = .903, AGFI = .876, CFI = .893, RMSEA = .072, AIC = 1,100.539, BIC = 1,102.517), and Cronbach’s alpha coefficient for the entire J-NMCSP was 0.910. Moreover, Cronbach’s alpha coefficient for the entire J-NMCSP was 0.910.

Conclusion: The J-NMCSP has been shown to be an effective and reliable scale for measuring the moral courage of Japanese psychiatric nurses. However, since the factor structure of the J-NMCSP differs from that of the original untranslated version, caution should be taken when conducting international comparisons.

Background: Cancer education in schools began following the revision of the Cancer Control Act. However, there is little data on the actual knowledge and images of cancer among junior-high and high school students who have received cancer education.

Objective: We aimed to explore the knowledge and images of cancer among junior-high and high school students who received cancer education at school.

Methods: Between March and July 2022, a total of 842 first- and second-year junior-high school students and first- and second-year high school students from areas near Tokyo, Japan, participated in a questionnaire and web-based survey. Background information, including grade level and exposure to cancer education, was collected. Knowledge of cancer was assessed using a three-choice format with 26 items, while images of cancer were measured using the semantic differential method with 12 pairs of adjectives.

Results: In terms of cancer knowledge, the correct response rate was high for topics regarding cancer screening and preventive behavior. However, it was low for specific treatment methods and the timing of initiating palliative care. The images of cancer held by junior-high and high school students tended to be strongly associated with fear and pain. Students who had not been exposed to cancer-related education or experiences had more negative images.

Conclusion: Junior-high and high school students showed both accurate and limited knowledge of cancer, depending on the topic. Nurses need to provide appropriate information and support based on these characteristics.

Purpose: This study aimed to identify factors that hinder or facilitate reflection among head nurses and to explore strategies for promoting effective reflection in nursing management.

Methods: This study adopted a qualitative descriptive design. Semistructured interviews were conducted with 16 head nurses from six hospitals, and content analysis was used to analyze the transcripts.

Results: The analysis extracted six categories of factors hindering reflection, including time constraints, psychological resistance, limited understanding of reflection, dysfunction of facilitator roles, and difficulty in behavioral change. Conversely, factors facilitating reflection were classified into three core categories: individual factors, environmental/cultural factors, and process-related factors. In particular, individual factors such as intrinsic motivation for self-growth and flexible attitudes appeared to be unique to head nurses. Furthermore, the findings suggested a learning structure in which head nurses develop themselves through the growth of others.

Conclusion: Three key strategies were identified for effective reflection among head nurses: (1) assessment of head nurses’ psychological readiness, (2) establishment of psychologically safe and open forums for sharing experiences, and (3) development of organizational systems that enable continuous reflection. These strategies are interrelated and provide a foundation for transforming reflection from a superficial exercise into a sustainable learning process that fosters behavioral change and contributes to organizational learning in nursing management.

Objective: This study aimed to explore the leadership behaviors of visiting nurse managers that contribute to job retention among visiting nurses.

Methods: Semi-structured interviews were conducted with 20 participants, including 10 visiting nurse managers and 10 visiting nurses. The data were analyzed qualitatively and inductively using the Steps for Coding and Theorization (SCAT) method.

Results: A total of 353 segments related to managers’ leadership behaviors were extracted for all cases. These segments were categorized into five overarching themes: psychological safety, ability to inspire others, emotional intelligence, advanced practical competence, and leading by example. Additionally, 39 subcategories of leadership behavior were identified.

Conclusion: The leadership behaviors identified in this study were not limited to a single style. Still, they represented a multidimensional and practical set of actions tailored to the context of home-visit nursing. These behaviors included elements that conventional leadership theories in hospital-based settings have not fully captured and may serve as a foundation for future theoretical development and practical application.