Journal of Japan Academy of Nursing Science
Online ISSN : 2185-8888
Print ISSN : 0287-5330
ISSN-L : 0287-5330
Current issue
Displaying 1-50 of 106 articles from this issue
Issue
  • Kiyomi Karasawa
    Article type: Issue
    2021 Volume 41 Pages 718-722
    Published: 2021
    Released on J-STAGE: February 18, 2022
    JOURNAL FREE ACCESS FULL-TEXT HTML

    Single-case research in nursing science has a number of benefits. First, it can provide a focused verification by retroactive reasoning from the time point when a good outcome is confirmed. In addition, it can provide hints regarding nursing practice according to situation, by describing the background of actual nursing. Finally, it can evoke the emotions of readers through narratives that describe a course of events.

    These benefits help to bring to light the phronesis (practical wisdom) that is contained in the nursing prowess generated through one-time practice. Modern science places an emphasis on “nomothetic knowledge demonstrated based on empirical methods such as observation and experiments.” However, nursing requires responses to individual needs, and although it is based on scientific knowledge in practice, it creates “phronesis” through improvisatory and incidental responses. In order to build a “fruitful relationship between theory and practice,” it is necessary to retain and accumulate phronesis, and I believe that single-case research can contribute to this process.

Reviews
  • Shiho Nishida
    Article type: Review
    2021 Volume 41 Pages 1-10
    Published: 2021
    Released on J-STAGE: June 10, 2021
    JOURNAL FREE ACCESS FULL-TEXT HTML

    Purpose: The purpose of this study was to analyze the concept of advanced care planning for patients with chronic heart failure.

    Method: The analysis was conducted on 49 reports using the Rodgers’ evolutionary concept analysis.

    Results: The following eight categories were extracted as attributes of advanced care planning: information that needs to be shared and discussed, exploring of humanity, foresee the end-of-life, promoting decision-making process, construction of system for seamless care, partnership, dialogue, and continuous and repetitive process. In addition, seven antecedents were extracted: social background, cultural background, background of medical personnel, timing of confirmation of intention by individual judgment, gap of heart failure perception, uncertainty of medical condition, treatment and care of heart failure, and lack of end-of-life care. Finally, five considerations were extracted: improvement of patient and family satisfaction, relief of total human suffering of patients and families, internal change of patient, realization of that patients’ way of life, and medical outcomes improvement.

    Conclusion: Advanced care planning for chronic heart failure patients is defined as a process whereby, in preparation for the decline of the patients’ decision-making ability, patients, families and healthcare professional dialogue as they explore the patients’ humanity while looking at the disease processes specific to chronic heart failure, and continuously and repeatedly work together for the realization of the patients’ autonomous intentions and desired way of life.

  • Miki Eguchi, Hiroko Kunikata
    Article type: Review
    2021 Volume 41 Pages 160-165
    Published: 2021
    Released on J-STAGE: September 10, 2021
    JOURNAL FREE ACCESS FULL-TEXT HTML

    Aim: To analyze the concept of rumination and shed light on its structure in examining the effectiveness of using the concept in nursing practice.

    Methods: This study analyzed 91 papers by using Rodgers’ concept analysis approach.

    Results: The following one attribute category was extracted: “uncontrollable thoughts.” Five categories were extracted for prerequisites and another three for consequences.

    Conclusion: The findings suggested that the concept of rumination means “uncontrollable thoughts” which people experience when they have “mental pain,” “negative belief,” “lack of objective vision,” “nonadjustable attention,” and “biologic profile.”

    As a result of rumination, “aggravation of mental health,” “ aggravation of physical health,” and “aggravation of stress or Recovery from the event”arise. To use the concept of rumination towards nursing, brings a novel viewpoint to the existing nursing practice.

  • Kayo Kawahara
    Article type: Review
    2021 Volume 41 Pages 279-285
    Published: 2021
    Released on J-STAGE: October 19, 2021
    JOURNAL FREE ACCESS FULL-TEXT HTML

    Aims: Recent initiatives in advance care planning (ACP) are drawing attention in Japan as well. Patients with chronic diseases are not exceptions to this and demand clinical practice of ACP; however, there is no consensus on this topic. Thus, we performed a concept analysis to obtain a clear definition of ACP for patients with chronic diseases.

    Methods: The Walker & Avant’s method of concept analysis was performed on 14 articles.

    Results: The following were extracted as attributes of ACP: understanding required for self-decision-making, relationship between people, emotional vacillation, self-decision-making, ease of access to decisions, and continuity and revision. The antecedents to ACP were appropriate timing to think about ACP while living with illness, being noticed by people involved, and inexperience and preparation of healthcare providers. The consequences of ACP were care that meets the patients’ wishes and having an insight for the future.

    Conclusions: The ACP for patients with chronic diseases was defined as the timely and cyclical process of drawing out treatment or care goals by adequate communication between healthcare providers and the patients and their families as they experience vacillating emotions.

  • Yukari Taira, Midori Kamizato
    Article type: Review
    2021 Volume 41 Pages 382-390
    Published: 2021
    Released on J-STAGE: November 06, 2021
    JOURNAL FREE ACCESS FULL-TEXT HTML

    Objective: This study aimed to understand the trend of research on insomnia in patients with coronary artery disease.

    Methods: We searched the literature registered in July 2020 using the web version of the Ichushi, PubMed, and CINAHL databases.

    Results: A total of 31 documents were extracted; 29 and 2 were quantitative and qualitative studies, respectively. Of these, 6 were intervention studies; 14, nurse studies. Prevalence and related factors were examined using a subjective scale and sleep pattern analysis was performed using an objective method. Insomnia was seen in 21%–69% of patients and it was related to women and depression. The patients were devised to practice a sense of security from the experience of losing sleep because of chest pain. Nursing support has been mostly studied for hospitalized patients and support and education utilizing relaxation have been considered.

    Conclusion: There is a need to explore specific support that considers factors related to insomnia and disease-specific effects. Therefore, it is necessary to clarify the definition of insomnia in patients with coronary artery disease and consider the steps to provide the necessary support after their discharge.

  • Hiromi Nakamura, Akira Nagata, Keiko Ito
    Article type: Review
    2021 Volume 41 Pages 546-555
    Published: 2021
    Released on J-STAGE: December 25, 2021
    JOURNAL FREE ACCESS FULL-TEXT HTML

    Objective: The study aimed to clarify the structure and function of the concept of self-acceptance in Japanese adolescents and examine the acceptance process and modes of interaction with those around them.

    Methods: The analysis was performed using Walker & Avant’s concept analysis method. After examining the differences in definitions and similar concepts published in dictionaries and books, attributes, antecedent requirements, and consequences were extracted from the target literature.

    Results: Four items of attributes, eight items of antecedent requirements, including involvement with others and conscious work on one’s inner self, and five items of consequences were extracted.

    Conclusion: The concept of self-acceptance in Japanese adolescents is defined as “the state of understanding and trusting oneself in response to involvement with others and conscious work on one’s inner self. By accepting oneself tolerantly and reconciling one’s challenges, fulfillment is brought about in the relationship with others and one’s condition.” To promote self-acceptance in adolescents, it is important to focus on the developmental issues and relationships of the people around them according to their roles and positions.

  • Yumiko Saito, Rie Wakimizu
    Article type: Review
    2021 Volume 41 Pages 583-593
    Published: 2021
    Released on J-STAGE: January 18, 2022
    JOURNAL FREE ACCESS FULL-TEXT HTML

    Purpose: In this study aimed, we conduct a conceptual analysis of end-of-life care in the neonatal intensive care unit and clarify the definition.

    Methods: Fifty-five documents were analyzed using the concept analysis approach of Rogers.

    Results: Eight attributes were identified: “promotion of attachment formation,” “support for the acquisition of parental roles and family formation,” “collaborative decision-making between family and medical professionals based on the best interest of the child,” “alleviation and elimination of the child’s physical pain,” “support for the child’s final days with the family,” “grief care for families who have lost a child,” “family-centered-care for family mental and physical care,” and “multidisciplinary collaborative support.” Five prior requirements and four consequences were extracted.

    Conclusions: This concept was defined as “promotion of attachment, parent role acquisition, and family formation, collaborative decision-making between family and medical personnel based on the best interest of the child, support for the child to reach the end-of-life with the family without pain, and grief care for the family, based on family-centered-care and multidisciplinary collaboration.”

  • Ryo Hayashi, Miyuki Nishida
    Article type: Review
    2021 Volume 41 Pages 850-856
    Published: 2021
    Released on J-STAGE: March 09, 2022
    JOURNAL FREE ACCESS FULL-TEXT HTML

    Objective: This research aimed to differentiate and redefine the concept of capability in health science by reviewing the literature on capability in healthcare.

    Methods: By using the method of concept analysis described by Rodgers, a total of 30 literature references were assessed.

    Results: We extracted [achievable health functionings based on available opportunities], [ability to select health functionings according to values], and [ability to utilize opportunities to achieve functionings] as attributes. [Social resources related to health choices], [individual characteristics], and [health status and impact on life] were extracted as antecedents. As consequences, we extracted [improvement of QOL by achieving desired health condition], [enrichment of life], and [health based on one’s own value standard]. Capability in health science is available and can be achieved. From the achievable health functionings, the ability to select and achieve a desired health condition on the basis of one’s own value standard was defined.

    Conclusion: Concept analysis showed that capability in health science is the ability to select and achieve health status according to one’s own value standards on the basis of the available opportunities and functionings that may be achieved. Additionally, our results suggested that capability is also a valid concept in nursing science, in terms of health professionals’ understanding of the effects of diseases and disorders on patient functionings, as well as in terms of health professionals’ support for patients in making decisions on the basis of that understanding.

Original Articles
  • Masahiro Kobayashi, Hideko Kojima
    Article type: Original Article
    2021 Volume 41 Pages 11-19
    Published: 2021
    Released on J-STAGE: June 10, 2021
    JOURNAL FREE ACCESS FULL-TEXT HTML

    This study aimed to understand the difficulty and learning needs of nurses caring for adolescent cancer patients. The participants consisted of two groups of nurses: 1. seven nurses with less than five years of nursing experience, and 2. eight nurses with more than five years of nursing experience. The research was conducted using group interview method. Results showed that, in Group 1, nurses had the following difficulties: “confusion regarding a sense of distance from elusive patients” and “having uncertainty on how to care for particular patients in the future”. Their learning needs were as follows: “knowledge of caring for adolescent cancer patients,” and “making up for one’s lack of experience by learning from others’ experiences and practices.” In Group 2, nurses had the following difficulties: “concern regarding forming relationships with patients developing autonomy” and “difficulty in staying close to patients who are losing hope”. Their learning needs were as follows: “knowledge of caring for adolescent cancer patients,” and knowledge of social support resources available to patients.” It was thought that in Group 1, nurses have lack of knowledge and lack of confidence in nursing practice due to the difficulty of accumulating care experience, and in Group 2, nurses have concerned about anxiety caused by past care experience.

  • Masami Tanaka
    Article type: Original Article
    2021 Volume 41 Pages 20-28
    Published: 2021
    Released on J-STAGE: June 10, 2021
    JOURNAL FREE ACCESS FULL-TEXT HTML

    Aim: This study aimed to describe the experience of proxy decision-making among mothers of infants born at the limits of viability in the medical context.

    Methods: Data were collected through unstructured interviews and analyzed using phenomenological methods.

    Results: The mother’s proxy decision-making experience was divided into two themes: “leaving subject” and “regaining subject.” The child was deprived of subject through being categorized by medical findings and the mother concealed her actual self by acting as the “mother” desired by the patient care team. However, as the mother developed her support by becoming involved in the world created by the patient care team, she gradually regained her child and her own subject within that world.

    Conclusion: Offering support with a full view of motherhood limited the mother’s requests for support, but also provided an opportunity to change mother’s viewpoint over time. It was suggested that it is important for the patient care team to be introspective and consider those in need.

  • Naoko Otsuki, Kasumi Ikuta, Sakiko Fukui
    Article type: Original Article
    2021 Volume 41 Pages 29-36
    Published: 2021
    Released on J-STAGE: June 10, 2021
    JOURNAL FREE ACCESS FULL-TEXT HTML

    Aim: This study aimed to investigate the factors determining whether children in need of medical care are accepted into after-school daycare and child development support centers.

    Method: The study design was a cross-sectional study. A survey questionnaire was distributed to 1556 after-school daycare offices and child development support centers between January and February 2019. Statistical analyses were performed using the χ2 test, Wilcoxon rank-sum test, and logistic regression.

    Results: There were 292 responses (response rate: 20.7%), of which 249 were complete enough to be analyzed. Factors related to the acceptance of children requiring medical care include “paralleled with visiting nursing offices (odds ratio (OR) = 4.55),” “cooperation: knowing local resources specifically (OR = 1.18),” and “the number of nurses (OR = 14.94).”

    Conclusion: According to this study, acceptance of children requiring medical care in after-school daycare and child development support centers was related to the arrangement of nurses and cooperation to support children with medical care in the community. Therefore, it is hoped that medical welfare cooperation and appropriate staffing will be promoted in the future.

  • Koji Makino, Hayato Higa
    Article type: Original Article
    2021 Volume 41 Pages 37-44
    Published: 2021
    Released on J-STAGE: June 16, 2021
    JOURNAL FREE ACCESS FULL-TEXT HTML

    Objective: This study was conducted to clarify the process of nurse dedication in nurse-patient relationships.

    Methods: Semi-structured interviews were conducted with 12 nurses working in a general hospital and the results of the interviews were analyzed using the modified grounded theory approach.

    Results: Nurses concentrated on “building relationships with patients living in the community,” focused on “showing consideration for patients’ feelings,” and were devoted to “responding to patients’ feelings.” In this process, nurses also experienced “nurses’ own emotional response,” but concentrated on “personalized care” through “maintaining a nurse-patient relationship.” Accordingly, nurses tried to dedicate themselves to fundamentally “focusing on the patient.” This process was perceived as ‘fluid dedication.’

    Conclusions: Nurses should be capable of assessing what is happening to patients, reflect on what is happening in their own emotional response and in the patient–nurse relationship, and rededicate themselves to patients by providing nursing care that incorporates the “nurse’s own emotional response” instead of suppressing or discarding it as a personal problem that is not related to care, and by perceiving the “nurse’s own emotional response” within the conceptual framework of involvement in the patient–nurse relationship.

  • Hiromi Arashi
    Article type: Original Article
    2021 Volume 41 Pages 52-60
    Published: 2021
    Released on J-STAGE: June 29, 2021
    JOURNAL FREE ACCESS FULL-TEXT HTML

    Purpose: The purpose of this study was to describe psychiatric nurses’ understanding and practice with regard to the care of patients with schizophrenia by examining the nurses’ embodied experience of providing that care.

    Methods: Semi-structured interviews regarding episodes of providing care for patients with schizophrenia were conducted with 15 nurses who had three or more years of experience working with such patients. Data were analyzed using a phenomenological approach based on Merleau-Ponty’s ideas on embodiment.

    Results: 1. The nurses’ embodied understanding of patients with schizophrenia and how to care for them was found to have two dimensions: corporeal and linguistic.

    2. According to the nurses, living was found to be difficult for patients with schizophrenia for three reasons. Two related to corporeality: “They can’t adapt to their bodies” and “They feel threatened by the bodies of others.” The other related to expressing themselves through language: “They have difficulty living their lives in a way that they can be themselves.”

    3. In the nurses’ care practices related to each of these difficulties, they tried to “Treat the patient’s illness by relating to them,” “Resonating,” and “Being responsive.”

    Discussion: The results suggested that through the phenomenon of intercorporeality, the psychiatric nurses were able to treat the difficulties that patients with schizophrenia had in life—which stemmed from their “malformed sense of self”—by relating to them using embodied knowledge about how to interact with them.

  • Takayuki Shimizu, Makiko Mori
    Article type: Original Article
    2021 Volume 41 Pages 61-70
    Published: 2021
    Released on J-STAGE: July 14, 2021
    JOURNAL FREE ACCESS FULL-TEXT HTML

    Aim: The purpose of this study was to describe the recovery process of patients with symptoms of obsessions and/or compulsions and discuss nursing support.

    Methods: Seven illness narratives published in Japan were analyzed by using the grounded theory approach (Strauss & Corbin version).

    Results: One core category, which is “Asking oneself about the continuation of the consultation with medical institutions”, seven subcategories which explain core category, and three storylines were generated from analysis of illness narratives. The extracted three storylines were as follows.

    (1) The first route shows patients who visited medical institutions and were successfully treated.

    (2) The second route shows the exacerbation of symptoms by discontinuing medical treatment because of the burden that patients experience during their visits to medical institutions.

    (3) The third route shows patients’recovery by seeking measures to improve their symptoms instead of discontinuing medical treatment.

    Conclusions: Three recovery processes are described. For patients’ recovery, several factors are important, including improvement of symptoms and recovery of personal autonomy through treatment, acceptance of their current situation, and change of perception about their outlook on life with illness. This suggests there is a need for nursing support for patients, so they may continue to receive treatment and regain their autonomy.

  • Morikatsu Tsuchiya, Kohta Ito, Seiichi Takahashi, Takayuki Sakagami, K ...
    Article type: Original Article
    2021 Volume 41 Pages 71-78
    Published: 2021
    Released on J-STAGE: July 20, 2021
    JOURNAL FREE ACCESS FULL-TEXT HTML

    Objectives: The purpose of this study was to compare differences between expert and novice flight nurses in pre-hospital care by activity measured from optical flow of captured video (hereafter referred to as “video activity”) and investigate the classification performance of machine learning. The results of this study are expected to save labor and improve efficiency of education and work in clinical settings.

    Methods: A total of 30 expert and novice flight nurses were included in the study. The subjects were engaged in pre-hospital care with a wearable camera on their chest. To classify expert and novice flight nurses, we used machine learning and linear discriminant analysis to validate the classification performance of expert and novice flight nurses.

    Results: The median entropy of video activity was significantly lower in expert flight nurses. The classification performance (precision, recall, F1-measure) for each analysis method was higher in support vector machines and random forests.

    Conclusions: We found that the entropy of video activity can be an indicator of proficiency and that applying machine learning to changes in entropy over time shows high classification performance.

  • Makoto Kannari, Izumi Sawada, Ryoko Michinobu, Junichi Yoshino
    Article type: Original Article
    2021 Volume 41 Pages 88-97
    Published: 2021
    Released on J-STAGE: July 29, 2021
    JOURNAL FREE ACCESS FULL-TEXT HTML

    Purpose: To clarify the function of ward rules within the therapeutic framework of psychiatric hospital wards.

    Methods: We conducted ethnography once a month for 6 months at 4 psychiatric wards at 3 medical institutions, and then performed qualitative inductive analysis from the theoretical perspective of structural functionalism.

    Results: The “pattern of top-down administration-directed implementation of group-subordinate ward rules” functioned positively in order to ensure the continuation of a therapeutic framework based on a “closed facility environment wherein inpatients can live safely in a manner enabling peace of mind among members of the local community and psychiatric ward personnel.” The “pattern of dialog-supportive implementation of individual-oriented ward rules” functioned positively in order to ensure the continuation of a therapeutic framework in which “patients who had emerged from acute-stage psychiatric care and patients with chronic-phase conditions can receive medical care enabling them to move towards community interaction”.

    Conclusion: Psychiatric ward rules served the functions of providing patients with medical care and protection, protecting members of society, and preparing patients for social rehabilitation. Our findings suggested that ward rules that support individual patients and their implementation utilizing dialog achieved the function of preparing patients for social rehabilitation.

  • Hiroe Yamamoto, Mari Ikeda
    Article type: Original Article
    2021 Volume 41 Pages 106-113
    Published: 2021
    Released on J-STAGE: July 29, 2021
    JOURNAL FREE ACCESS FULL-TEXT HTML

    Purpose: This study explored the possibility of early detection of postpartum depression by mothers’ partners.

    Methods: The Edinburgh Postpartum Depression Scale Partner (EPDS-P) was translated into Japanese and back-translated by several bilingual translators and discussed with the original author to establish semantic equivalence. The participants were 147 couples whose infants had check-ups 1 month after delivery at a university hospital and an obstetrics clinic. The mother’s questionnaire consisted of the EPDS and questions about physical symptoms of postpartum depression. The partner’s questionnaire consisted of the Japanese version of the EPDS-P (EPDS-P-J) and questions about their perception of the mother’s physical symptoms.

    Results: The average EPDS score of the women who participated was 4.4 (3.4), with a cut-off of 9 points at 12.2%. Analysis showed a positive correlation between mother’s EPDS score and partner’s EPDS-P-J score (rs = .27; p < .01). Cronbach’s α for the EPDS-P-J was 0.83, suggesting sufficient reliability. Unhappiness and crying, self-blame, unhappiness and difficulty falling asleep, sadness, and able to laugh showed significant correlations between EPDS and EPDS-P-J (rs = .37, rs = .29, rs = .20, rs = .20, rs = .19, p < .05, respectively). Physical symptoms of postpartum depression also showed a significant correlation. Partners rated the women’s symptoms more seriously than the women rated themselves.

    Conclusion: The EPDS-P-J was found to a significant correlation with the mother’s EPDS. The results of this study suggest that partners can detect early postpartum depression in mothers.

  • Yukiko Iioka, Tomoko Kamei
    Article type: Original Article
    2021 Volume 41 Pages 114-121
    Published: 2021
    Released on J-STAGE: August 12, 2021
    JOURNAL FREE ACCESS FULL-TEXT HTML

    Aim: This study aimed to examine the reliability and validity of the Team Approach Assessment Scale (TAAS), which assesses a team approach based on individual perceptions, to develop a revised version (TAAS- Revised Edition) using an interdisciplinary team.

    Method: An anonymous, cross-sectional questionnaire survey was conducted using TAAS on medical professionals at three general hospitals in prefecture A. The alpha coefficient was calculated for the scale’s reliability, and exploratory factor analysis (EFA) was conducted for validity. This study was carried out after being approved by research ethics reviews at the facility to which the researcher belongs and cooperating research facilities.

    Results: There were 789 valid responses with a response rate of 27.1%. The EFA results yielded a 5-factor structure with 22 items using the maximum likelihood method and promax rotation. The factors of TAAS-R changed from four to five. There were nine items for “team functions,” five items for “contributions to team,” three items for “importance of team activities,” three items for “team member role performance,” and two items for “clarification of goals and roles.” The alpha coefficient for the overall scale was 0.93, while the scope of each factor had a range of 0.68–0.91.

    Conclusion: This study almost confirmed the reliability and validity of the resulting TAAS-Revised Edition with a 22-item, 5 factor structure.

  • Yukari Nagami, Mahiro Fujisaki-Sueda-Sakai, Maiko Noguchi-Watanabe, No ...
    Article type: Original Article
    2021 Volume 41 Pages 122-131
    Published: 2021
    Released on J-STAGE: August 12, 2021
    JOURNAL FREE ACCESS FULL-TEXT HTML

    Purpose: This study aims to examine the relationship between the work-related burden of traveling and the manager’s support for home care nurses and home care nurses’ intention to remain employed.

    Methods: A self-administered questionnaire survey was conducted with homecare nurses and managers working at 103 home-nursing provider offices. A multilevel binomial logistic regression analysis was conducted with the intention to remain employed as the dependent variable.

    Results: Responses from 38 managers and 221 home care nurses (effective response rate: 32.5%) were analyzed. The mean age of the home care nurses was 46.4 ± 7.9 years, 214 (96.8%) were female, and 151 (68.3%) had the intention to remain employed. The burden of traveling expressed as inefficient visit schedules (Odds Ratio(OR) = 0.41, 95% Confidence Interval(CI): 0.22–0.78), and managers’ support, expressed as sharing accessible routes to travel (OR = 2.49, 95% CI: 1.20–5.17), ensuring visit intervals (OR = 2.72, 95% CI: 1.19–6.21 ), and providing estimated travel time (OR = 0.43, 95% CI: 0.21–0.92), were associated with home care nurses’ intention to remain employed.

    Conclusions: These results suggest that developing management support systems regarding the travel itself, such as ensuring intervals between visits, sharing accessible routes to travel, and providing an estimated travel time, may be useful for supporting home care nurses’ intention to remain employed.

  • Kazuyoshi Nishizawa, Yumiko Oshima
    Article type: Original Article
    2021 Volume 41 Pages 132-140
    Published: 2021
    Released on J-STAGE: August 27, 2021
    JOURNAL FREE ACCESS FULL-TEXT HTML

    Objectives: The purpose of this study is to clarify defining characteristics with content validity for nurses to make clinical judgment of impaired swallowing, as well as the major and minor characteristics.

    Methods: Fehring’s DCV model was used in this study. We conducted a questionnaire survey on 672 experts of nursing diagnosis of impaired swallowing. The five-point Likert Scale was used to examine the extent to which 78 defining characteristics indicated impaired swallowing. For each defining characteristic, response was scored and DCV score (average) was calculated. Each defining characteristic was divided into major, minor, and exclusion characteristics according to DCV scores.

    Results: Valid responses were obtained from 327 experts. There were 11 major characteristics (cyanosis during the meal, respiratory distress after swallowing, abnormal pharyngeal phase of swallow study, wet respiratory sounds after swallowing, choking, muddy sounds during or after a meal, inadequate laryngeal elevation, delayed swallowing, choking prior to swallowing, gargling breath sounds after swallowing, and nasal reflux). There were 52 minor characteristics and 15 exclusion characteristics.

    Conclusions: We clarified defining characteristics of impaired swallowing with content validity based on opinions of experts familiar with nursing diagnosis of impaired swallowing.

  • Yumi Takada, Kazumi Natsuhara
    Article type: Original Article
    2021 Volume 41 Pages 166-174
    Published: 2021
    Released on J-STAGE: September 10, 2021
    JOURNAL FREE ACCESS FULL-TEXT HTML

    Aims: The purpose of the present study is to elucidate the type of learning obtained through the master’s program by adult students with practical nursing experience and how adult students apply their learning at work.

    Methods: We conducted a focus group interview of 8 nurses who completed nursing graduate school A, and conducted a qualitative analysis of the data obtained by inductive approach.

    Results: We obtained 5 categories of “adult students’ learning and awareness at school” and 6 categories of “adult students’ application of learning and new awareness after returning to work as a nurse.” The adult students acquired learning at school such as the “basics of the ability to think matters through” and after returning to work, they encouragedstaff members to search questions using the database, or in other words, they put into practice “establishing the habit of thinking matters through.” On the other hand, owing to the actual time restrictions of their duties, they also experienced “challenges in applying the graduate school learning to clinical practice.”

    Conclusion: Based on the learning of adult students at graduate school, it was suggested that recommending staff to practice nursing that uses scientific grounds improves the quality of nursing.

  • Mari Abe, Keiko Sekido
    Article type: Original Article
    2021 Volume 41 Pages 175-183
    Published: 2021
    Released on J-STAGE: September 10, 2021
    JOURNAL FREE ACCESS FULL-TEXT HTML

    Purpose: The purpose of this study is to clarify how nurses, who graduated two years ago, had grown through their nursing practice.

    Method: We recruited as research collaborators eight nurses, who were between the end of their second year after graduation and the beginning of their third year. We analyzed all the data we obtained from semi-structured interviews.

    Results: Nurses in the 2nd year “felt the ability to cope” through “a mixture of confused inexperience and freedom” early in the 2nd year. After that stage, they experienced multiple times a process of “becoming empowered to overcome fear” by “confronting their lack of abilities” through facing new challenges. As a result, they were able to reach “the feeling of overcoming fear” and “the feeling of becoming a team member”. In the end, they achieved “readiness for the 3rd year”. In addition, growth of nurses through the year had been “supported by their seniors” during this 2nd year.

    Conclusions: It was found that nurses in the 2nd year looked ahead to the 3rd year of their careers and noticed the growth they had achieved by trying to overcome many challenges themselves, through the period of anxiety experienced early in the 2nd year. We understood, therefore, that the provision as appropriate of both challenge and support by senior nurses had been very important for growth of nurses in the 2nd year.

  • Mayumi Watanabe, Masako Kanai-Pak
    Article type: Original Article
    2021 Volume 41 Pages 192-200
    Published: 2021
    Released on J-STAGE: September 23, 2021
    JOURNAL FREE ACCESS FULL-TEXT HTML

    Objective: This study aims to clarify the degree of discrepancy between nurse managers’ intended leadership and staff nurses’ perceptions of leadership.

    Methods: An anonymous self-administered questionnaire examining leadership recognized by nurse managers and staff nurses was distributed, and data from 41 nurse managers and 592 staff nurses in 41 wards were analyzed through a multi-level structural equation modeling analysis.

    Results: There was a curvilinear relationship between nurse managers’ intended leadership and the perception of leadership by staff nurses. When the intended leadership score was higher than medium, the staff’s perception score decreased as the intended leadership score increased.

    Conclusion: There is a discrepancy between nurse managers’ intended leadership and staff nurses’ leadership perception, suggesting that this gap may increase as the nurse manager perceives his or her leadership as superior, particularly when they recognize it as better than medium.

  • Kaori Uchida, Kiyoko Aoki
    Article type: Original Article
    2021 Volume 41 Pages 201-210
    Published: 2021
    Released on J-STAGE: September 23, 2021
    JOURNAL FREE ACCESS FULL-TEXT HTML

    Objective: This study aimed to clarify the actual support situations of mutual agreement among family members of stroke patients on selecting the place of treatment after acute care, and related factors.

    Methods: A questionnaire was administered to nurses working in stroke care. The reliability and validity were examined using factor analysis, and associations with related factors using multiple regression analysis.

    Results: We extracted 20 items and five factors through factor analysis of 756 valid answers. The factors are as follows: “support to move toward to the best decision”, “supporting the thinking of concrete ways”, “support their understanding of the situation and the organization of problem awareness”, “supporting family members’ wishes and hopes”, and “supporting decision making based on their strengths”. Multiple regression analysis identified, “professional autonomy in nursing” to be the most influential factor in supporting family members achieve mutual agreement.

    Conclusion: “Professional autonomy in nursing” had greatest impact on supporting family members of stroke patients to achieve mutual agreement on selecting the place of treatment, indicating that it is necessary to improve independent judgment and appropriate nursing practices; these results suggest the importance of a team approach to ethical issues.

  • Misato Nakahara, Mikie Hidaka, Kazuo Sakai
    Article type: Original Article
    2021 Volume 41 Pages 211-219
    Published: 2021
    Released on J-STAGE: September 23, 2021
    JOURNAL FREE ACCESS FULL-TEXT HTML

    Objective: The purpose of this study is to identify the recognition and expectation of nurses for Nurse Practitioners (NPs), the potential situation of nurses who want to become NPs, and to examine the issues for the future development of NPs.

    Method: A cross-sectional survey on recognition, expectation and interest in becoming NPs was conducted online; its targeted respondents were nurses who worked at hospitals, clinics, nursing homes, and visiting nursing stations in Meguro-ku, Tokyo.

    Results: A total of 818 copies of research materials were mailed to 110 facilities; 72 responses were received.

    Multiple logistic regression analysis revealed that nurses working in facilities with NPs had higher recognition (odds ratio 61.62, p < 0.01) and higher expectation (odds ratio 9.219, p < 0.05) of the profession than those working in facilities without NPs. On the other hand, only 13.9% of nurses potentially aspired to become NPs.

    Conclusion: Recognition and expectation of NPs should be enhanced by enrolling them in as many facilities as possible.

  • Azumi Hara
    Article type: Original Article
    2021 Volume 41 Pages 220-229
    Published: 2021
    Released on J-STAGE: September 23, 2021
    JOURNAL FREE ACCESS FULL-TEXT HTML

    Purpose: To clarify the construct of empowerment of nursing students in clinical practice with reference to the CLEQ (The Conditions for Learning Effectiveness Questionnaire) scale developed by Siu et al. (2005), as the first step of scale development.

    Method: Semi-structured interviews were conducted with six 4th-year nursing students then categorized by content analysis.

    Results: Through comparison with the CLEQ scale construct, it was confirmed that, in addition to the “support,” “opportunity,” “resources” and “information” subscales, “an environment that gives peace of mind” and “relationship with patients” were newly clarified as an important element.

    Conclusion: “An environment that gives peace of mind” and “relationship with patients” are characteristics in order to demonstrate the empowerment of Japanese nursing students in clinical practice, and it was suggested that these aspects should be included in the construct of empowerment of nursing students in future scale development.

  • Sakai Shima
    Article type: Original Article
    2021 Volume 41 Pages 241-249
    Published: 2021
    Released on J-STAGE: October 06, 2021
    JOURNAL FREE ACCESS FULL-TEXT HTML

    Aims: To develop the Transitional Care of Outpatient Department Nurses (TCODN), a self-evaluation instrument for transitional care practices among outpatient department nurses.

    Methods: Based on a literature review and in-depth interviews, we developed a measure for outpatient department nurses to self-evaluate their transitional care practices. A questionnaire survey was conducted with outpatient department nurses in 805 hospitals across Japan, and the validity and reliability of the scale were investigated.

    Results: A total of 360 responses (22.3%) were analyzed. An exploratory factor analysis helped identify four factors (25 items): [Standing with patient's intention and support for continuation of their home care life], [Information sharing between the multidisciplinary and support for the patient’s self-care], [Support for planned inpatients and ward cooperation], and [Support for understanding the medical condition]. The goodness of fit of the model was as follows: GFI = .845, AGFI = .812, CFI = .904, and RMSEA = .073. The convergent validity was .741 (p < .001), divergent validity was -.471 (p < .001). Cronbach’s α for the overall scale was .945, and the corresponding values for the subscales ranged from .771 to .915.

    Conclusions: The results of this study suggest that the validity and reliability of the scale were within the permissible range. The scale can be used as a quality indicator in transitional care practices by outpatient department nurses and to evaluate the effectiveness of educational training.

  • Masako Tomita, Chizuyo Sato, Hiroko Suzuki, Murata Kanako, Mitue Watan ...
    Article type: Original Article
    2021 Volume 41 Pages 250-258
    Published: 2021
    Released on J-STAGE: October 19, 2021
    JOURNAL FREE ACCESS FULL-TEXT HTML

    Objectives: This study aimed to elucidate the awareness of home-visit nurses toward the specified medical acts system in home care and relationship with the desire to participate in a training program.

    Methods: Questionnaires were mailed to 3,000 nurses working at 1,000 home-visit nursing stations that were registered as regular members of the National Association for Visiting Nurse Service.

    Results: We collected and analyzed 459 questionnaire responses. Survey participants showed interest in a training system for specific medical acts performed in home care. However, only a small percentage of participants understood the system details. A few participants were interested in participating in a training program. When participants’ interest in and expectations for the training system were high, they perceived the system’s necessity highly. And when their uneasiness and resistance to the training system were high, their perceptions of the system’s necessity were low. Furthermore, their perception for the necessity of the training system was related to their desire to attend the training course.

    A large percentage of participants felt that there were obstacles to participating in a training program and challenges that may arise when introducing the system. The obstacles and challenges identified were not directly related to the need for the system or the interest in participating in a training program.

    Conclusion: To increase the number of participants in the specified medical acts training in home care, it is necessary to raise further awareness of the system, dispel their concerns as much as possible, and deal with the challenges experienced by many visiting nurses.

  • Mieko Aruga
    Article type: Original Article
    2021 Volume 41 Pages 259-268
    Published: 2021
    Released on J-STAGE: October 19, 2021
    JOURNAL FREE ACCESS FULL-TEXT HTML

    Purpose: This study aimed to identify the ways and means for support by Yogo teachers for high school students with suspected mental disorders. Yogo teachers are special licensed educators who support children’s growth and development through health education and health services on the basis of principles of health promotion in all areas of educational activities in school.

    Methods: Semi-structured interviews were conducted with 8 Yogo teachers working at high schools in Japan.

    Results: The Yogo teachers provided three “direct support”: (1) support of students and their families to be able to provide peace of mind when expressing suffering, (2) support of students and their families to be able to decide on consultation with health care professionals, and (3) adjust arrangements so that students and their families can easily consult professionals. In order to effectively promote these three elements, there are three ways of “indirect support”: (1) collect information about the time in junior high school and the usual situation and use these in the support, (2) share information and support policies with teachers and encourage teams to engage in the support, and (3) seek consultation with professionals and make use of any advice in the support.

    Conclusions: It is suggested that the necessity of (1) supporting of students by staying close to the thoughts of their families and building relationships, (2) sharing information with health care professionals in advance and supporting of students and their families behind the scenes at their convenience, and (3) playing the role of managing the support team in the school with considerations for relationships as well as telling teachers about the support in the school health room and to use that to support other students.

  • Sachiko Takahira, Hiromi Kobayashi
    Article type: Original Article
    2021 Volume 41 Pages 269-278
    Published: 2021
    Released on J-STAGE: October 19, 2021
    JOURNAL FREE ACCESS FULL-TEXT HTML

    Aim: This study identifies how expert nurses provide medical care support for outpatients with liver disease.

    Method: Semi-structured interviews were conducted with eight expert nurses who have experience in nursing outpatients with liver disease. The interview data were analyzed using a qualitative synthesis method (KJ method).

    Results: Our study extracted seven symbolic marks of medical care support for outpatients with liver disease by expert nurses: focalizing interventions and building a cooperative system; supporting patients from the bottom using a polite and reassuring approach; recommending risk-prediction-based treatments and intensive support; assuming the burden and drawing on the patient’s original strength; reduced care opportunities due to the reduced side effects of hepatitis treatment; current situations where end-of-life patients with cirrhosis have to be cared for in acute hospitals; and nurses acquiring the ability to face society.

    Conclusions: The characteristics of medical care support for patients with liver disease were identified. It is suggested that an important factor of outpatient nursing for liver disease is nurses acquiring the ability to face society.

  • Sumire Shinjo, Yumiko Yatomi
    Article type: Original Article
    2021 Volume 41 Pages 286-295
    Published: 2021
    Released on J-STAGE: October 19, 2021
    JOURNAL FREE ACCESS FULL-TEXT HTML

    Objectives: This study identified clinical judgment-based practices of ICU shift-leader nurses.

    Methods: Data collected through using observation methods and semi-structured interviews. Study participants were those with at least one year of shift-leader experience in the ICU.

    Results: There were 15 research participants, with a mean number of years of leadership experience of 4.5 years. The analysis resulted in the extraction and discovery of 8 categories: (1) identifying and applying information-gathering methods to determine patient information, as needed; (2) paying attention and anticipating unforeseen circumstances in the treatments; (3) launching a crisis management system based on rapid assessment of patient crises; (4) rebalancing the nursing team by continually evaluating patient status to leverage the abilities of the nurses; (5) leading medical teams in response to changes in patient problems; (6) promoting team collaboration to form a shared awareness among healthcare professionals; (7) distributing resources based on treatment appropriateness and nursing-provision status; and (8) providing nursing education on critically ill patients based on an assessment of the nurses’ capabilities.

    Conclusion: The practices of ICU shift-leader nurses range from patient life maintenance to nurse education.

  • Hiroko Nagayama, Chie Ogasawara, Yuri Tainaka
    Article type: Original Article
    2021 Volume 41 Pages 296-304
    Published: 2021
    Released on J-STAGE: October 19, 2021
    JOURNAL FREE ACCESS FULL-TEXT HTML

    Objectives: To develop and verify a scale of nurses’ views on death and dying based on the views of nurses working in a general hospital, and to clarify the constituent elements of nurses’ views on death and dying.

    Methods: The scale of nurses’ views on death and dying was developed based on a systematic review of qualitative research into nurses’ views on death and dying and evolutionary concept analysis. A draft scale of 35 items was developed, and the questionnaire was distributed to 630 general ward nurses. Subsequently, the reliability and validity of the scale were examined.

    Results: Of the distributed questionnaire forms, valid response rate was 54.4%. Principal factor analysis was conducted to identify constituent elements. The scale was ultimately composed of 18 items and five subscales. The reliability of the scale was confirmed with Cronbach’s alpha internal consistency reliability coefficient of .801 and test-retest reliability coefficient of .681. As for the validity of the scale, criterion-related validity and construct validity were confirmed.

    Conclusion: The analysis identified five constituent elements: “The quality of death and dying by the family,” “The teachings of people who are dying,” “Negative feelings about death,” “Death is a law of nature,” and “Suggestions for spending the end-of-life stage.”

  • Tomoko Hosno
    Article type: Original Article
    2021 Volume 41 Pages 305-312
    Published: 2021
    Released on J-STAGE: October 19, 2021
    JOURNAL FREE ACCESS FULL-TEXT HTML

    Purpose: To phenomenologically describe the experience of living with diabetes based on the narrative of a person who did not record diabetic indexes.

    Methods: A phenomenological approach was employed, which describes the world as it appeared to the person. This article is based on the narrative obtained from an unstructured interview of a participant the author met during a diabetic logbook development project and found that she was not keeping a record of her diabetic indexes.

    Results: After experiencing a huge earthquake Ms A, due to her various concerns for her loved ones and business, spent more time worrying about them without really paying attention to her own illness of diabetes. As her condition worsened, she was required to get a regular injection which she decided not to do herself but to get from a doctor. This made her become kinder to herself. This change of attitude was derived from the way she perceived her time and the way she cared for herself.

    Conclusion: The experience of the rejuvenating time generated from the rhythm of caring for herself by regularly seeing the doctor was also representative of her recovery from the disaster. Ms. A, who chose to care for herself by relying on the doctor and valuing the conversations with him, may not have needed to self-monitor the indexes. Her case suggests a new way of self-caring that does not necessarily require self-monitoring.

  • Emi Yoshioka, Sayuri Kaneko
    Article type: Original Article
    2021 Volume 41 Pages 313-323
    Published: 2021
    Released on J-STAGE: October 29, 2021
    JOURNAL FREE ACCESS FULL-TEXT HTML

    Aim: To clarify the influence of educational support in nursing ethics on the ethical competence of nursing students’ care and obtain suggestions for scientific and effective nursing ethics education.

    Methods: A questionnaire survey was administered to 4,930 final-year nursing students in Japan. First, factor analysis of educational support for ethical competence of care was conducted to confirm validity and reliability. Next, a multiple regression analysis was performed using educational support as an independent variable and factors related to ethical competence of care as dependent variables.

    Results: Four factors were identified as educational support for ethical competence of care. The factors of the educational support for which a common influence on the five factors of “ethical competence of care scale for nursing students” was apparent were F1 “sharing of successful experiences in dealing with ethical issues among students in lectures,” F3 “advice in the process of analyzing ethical issues by instructors in the practical training,” and F4 “charter of patient rights.”

    Conclusion: In providing effective nursing ethics education, teachers need to use the items of educational support that have been found to be influential in designing classes.

  • Yuko Ogata
    Article type: Original Article
    2021 Volume 41 Pages 324-333
    Published: 2021
    Released on J-STAGE: October 29, 2021
    JOURNAL FREE ACCESS FULL-TEXT HTML

    Aim: To investigate the reliability and validity of a scale to reflect on nursing support in patients’ treatment decisions by nurses who provide nursing support for treatment decisions on a daily basis.

    Methods: A self-administered questionnaire was distributed to nurses, and were collected by mail. The contents of the survey include the attributes of the subjects, the background of nursing support in the treatment decision for the patient, the scale that reflects the nursing support in patients’ treatment decisions, their orientation toward social critical thinking scale, and a moral sensitivity test for clinical nurses.

    Results: We received 539 (39.7%) effective responses. The items and exploratory factors were analyzed, and the structure of 21 items and 5 factors was confirmed. Model fit by confirmatory factor analysis, and the correlation with external criteria is Admitted. Cronbach’s α coefficient was .935 for all items and .875 to .696 for each factor.

    Conclusions: This scale has a certain reliability and validity, making it is possible for nurses to do self-evaluation of their judgment in giving support of treatment decisions in clinical settings.

  • Eri Minematsu, Kotomi Akahoshi, Sachiyo Murashima
    Article type: Original Article
    2021 Volume 41 Pages 334-343
    Published: 2021
    Released on J-STAGE: October 29, 2021
    JOURNAL FREE ACCESS FULL-TEXT HTML

    Purpose: This study focuses on older adults who voluntarily surrendered their driver’s license, and clarifies why they surrendered their driver’s license, how their frequency and manner of leaving home changed, how their health condition changed, how they perceived those changes.

    Methods: A semi-structured interview was conducted with 13 former drivers living in areas with limited public transportation options and the results were analyzed qualitatively and descriptively.

    Results: The subjects surrendered their driver’s license due to the following three reasons: dementia/cognitive decline, physical decline, and accident prevention. While alternative means for grocery shopping and medical appointments were secured by subjects following the surrender, some of them were not able to find alternative transportation for farming, entertainment and friends. Some of them accepted and were satisfied with their life without a car, while others experienced a decline in their physical functions or became housebound because they could no longer go out as they used to before the license surrender.

    Conclusion: As a solution, it is necessary to introduce a limited conditional license as a means of transportation for farming. It is also necessary to examine the nature of mobility support services from the perspective of strengthening community resilience.

  • Takahiro Igarashi, Mikako Arakida, Mitsuko Sato
    Article type: Original Article
    2021 Volume 41 Pages 344-353
    Published: 2021
    Released on J-STAGE: October 29, 2021
    JOURNAL FREE ACCESS FULL-TEXT HTML

    Purpose: A scale to measure help-seeking engaged in by university nursing students in relation to clinical instructors (hereafter “help-seeking scale”) was developed and examined for reliability and validity.

    Method: Questionnaires were administered to 2,120 third- and fourth-year students at nursing universities in 11 Japanese prefectures in February 2020. Questionnaire items included a proposed help-seeking scale (40 items), profiling questions, and a help-seeking style scale. In addition, retests were conducted with 375 students at two universities.

    Results: A total of 808 students were analyzed (valid response rate: 38.1%). Item and factor analysis yielded two factors, “awareness of the costs of not seeking help” and “awareness of the benefits of receiving help,” and eight question items, and the fitness of the model was confirmed. The correlation coefficients between the overall scale and the help-seeking style scale were r = –.257 for avoidance style and r = .311 for independence style. Cronbach’s alpha (α) was .836. In addition, a total of 116 students were analyzed in the retests (valid response rate: 30.9%). The interclass correlation coefficient (r) was .860.

    Conclusion: Based on the nature of the two factors, the name of the scale was revised to “Decision-making Scale to Measure Help-seeking by University Nursing Students in relation to Clinical Instructors.”

  • Minako Kawata, Taeko Shimazu, Shigeaki Watanuki
    Article type: Original Article
    2021 Volume 41 Pages 354-362
    Published: 2021
    Released on J-STAGE: November 03, 2021
    JOURNAL FREE ACCESS FULL-TEXT HTML

    Objective: To clarify the family resilience in family carers of people with Parkinson’s disease.

    Methods: Semi-structured interviews were conducted with 11 family carers and contents were analyzed qualitatively and descriptively.

    Result: Family carers had hope even in adversity, dealt with difficulties with a [positiveness that is not affected by swaying symptoms] as their motivation, and could [flexibly draw out the power of the family] that they had cultivated while living together. Even if it was an intractable disease that was difficult for people around them to understand, they tried to [connect with people outside the family without creating a wall in the mind]. They identified a reasonable coping method for each family member [shared with the family on a daily basis even if the situation swayed due to symptoms], and responded to long-term medical treatment. Overcoming adversity, they became more confident and their [positiveness that is not affected by swaying symptoms] was further strengthened.

    Conclusion: It was suggested that the family resilience shown in this study may contribute to reducing the burden on family carers and promoting mutual understanding among families.

  • Wakanako Ono, Tomoko Nagai
    Article type: Original Article
    2021 Volume 41 Pages 363-372
    Published: 2021
    Released on J-STAGE: November 03, 2021
    JOURNAL FREE ACCESS FULL-TEXT HTML

    Objectives: We aimed to clarify the implementation status of bereavement supports in Community General Support Centers (CGSCs) and characteristics of CGSCs that provided bereavement support, to consider the issues on implementation.

    Methods: Data were generated using a self-administered questionnaire sent to CGSCs throughout Japan. Descriptive statistics, Chi-square test were used to analyze the data.

    Results: The valid questionnaire response was 738 (29.5%). Of those 472 (64.0%) had provided bereavement support. As a result of the Chi-square test, the CGSCs that had provided bereavement consultations were characterized by (a) a large population of municipalities, (b) provided end-of-life patient conferences and death conferences, and (c) provided bereavement services for citizens.

    Conclusions: The CGSCs were providing bereavement support. Their role as a social resource for bereavement support will increase in the future.

  • Shiori Usami, Sonoe Mashino
    Article type: Original Article
    2021 Volume 41 Pages 373-381
    Published: 2021
    Released on J-STAGE: November 06, 2021
    JOURNAL FREE ACCESS FULL-TEXT HTML

    Purpose: The purpose of this study was to evaluate an intervention program designed to prevent the worsening of depression and Post-Traumatic Stress Response (PTSR) among nurses who were victims of the Kumamoto Earthquake themselves and provided care to others.

    Method: This study carried out a quasi-experiment among two groups: an intervention group (n = 230) who participated in a preventive intervention program for depression and PTSR, and a control group (n = 270) to whom questionnaires were administered. The preventive intervention program comprised a two-hour psychoeducation session on self-care and a three-hour dynamic group psychotherapy session intended to promote self-care, totaling five hours. Evaluation was conducted before and after the intervention, one month later, three months later, and six months later. The evaluation indicators were depression scores, PTSD positive rates, DCTR (Dynamic Change for Trauma Response), and SF-8 (Health-related Quality of Life).

    Results: One year and seven months after the Kumamoto Earthquake, depression scores and PTSD positive rates were high in the intervention group. However, after the intervention program, improvement was observed in the depression scores, PTSD positive rates and DCTR scores.

    Discussion: The implementation of the preventive intervention program, depression levels and the PTSD positive rates also decreased. However, depression was still persistent, suggesting that the intervention group was leading a life under stress after the earthquake.

    Conclusion: Preventive intervention program brings change PTSD positive rate and DCTR, even if it had passed one year and seven months after disaster.

  • Ryohei Nishina, Shigeko Saiki-Craighill, Masayuki Iwata
    Article type: Original Article
    2021 Volume 41 Pages 395-404
    Published: 2021
    Released on J-STAGE: November 13, 2021
    JOURNAL FREE ACCESS FULL-TEXT HTML

    Purpose: To identify the processes by which medical personnel can support siblings visiting children hospitalized in pediatric intensive care units (PICUs).

    Method: We observed 15 visitations by siblings and conducted semi-structured interviews with 15 medical personnel (9 nurses, 5 child life specialists, and 1 childcare worker). The observational and interview data were analyzed using a grounded theory approach.

    Results: The medical personnel supported siblings and parents by [making a place for siblings], <connecting siblings with the hospitalized child>, and <connecting siblings with their parents>. If the parents were able to <share experiences with the siblings>, the siblings, parents, and the hospitalized child experienced <a sense of family unity>.

    Conclusion: For siblings to experience <a sense of family unity> when visiting a child hospitalized in a PICU, it is important for medical personnel to strive to [make a place for siblings] and support <parents’ sharing experiences with the siblings>.

  • Fumie Shimizu
    Article type: Original Article
    2021 Volume 41 Pages 405-413
    Published: 2021
    Released on J-STAGE: November 13, 2021
    JOURNAL FREE ACCESS FULL-TEXT HTML

    Aim: This study explored the nurses’ clinical judgement of endotracheal and oral-nasal suctioning for technology-dependent children attending special needs schools.

    Methods: A descriptive qualitative research design was used. Semi-structured interviews with 18 nurses working for technology-dependent children in Japanese special needs schools were conducted, and data were qualitatively and inductively analyzed.

    Results: Nurses judged whether the endotracheal and oral-nasal suctioning was necessary based on not only the child’s physical condition but also the empirical knowledge of the child’s bronchial drainage patterns, the strength of keeping smooth respiration, and the effects of suctioning. Nurses found the best timing of suctioning not for interrupting educational activities with focusing parents’ desires and drawing teachers’ and other nurses’ judgements.

    Conclusions: Knowing the child and the parents’ desires are important for nurses’ clinical judgement of endotracheal and oral-nasal suctioning for technology-dependent children attending special needs schools. In addition to that, sharing judgements with others is essential to choose the best timing of suctioning.

  • Mikiko Iwatani, Mari Ito, Takako Ashiwa
    Article type: Original Article
    2021 Volume 41 Pages 414-422
    Published: 2021
    Released on J-STAGE: November 13, 2021
    JOURNAL FREE ACCESS FULL-TEXT HTML

    Objective: To investigate and clarify the association between the intensive care experience and the psychological outcomes of ICU survivors 3 months after being discharged from the ICU.

    Methods: The participants were 201 adult patients who were intubated, mechanically ventilated and stayed in an ICU for more than 48 hours. The intensive care experience was measured by the Intensive Care Experience Questionnaire 1–2 weeks after ICU discharge. The psychological outcomes were the prevalence of PTSD-related symptoms, anxiety and depression 3 months after ICU discharge, defined as an Impact of Event Scale-Revised score ≥ 25 and a Hospital Anxiety and Depression Score ≥ 8. Logistic regression analysis was used to identify any association between the intensive care experience and psychological outcomes.

    Results: Of the 201 patients, 141 completed a 3-month follow-up. Substantial PTSD symptoms were prevalent in 17.0% of patients (95% CI 11.2–24.3), anxiety in 19.9% (95% CI 13.6–27.4) and depression in 36.9% (95% CI 28.9–45.4). Overall, 43.3% (95% CI 35.0–51.9) of patients had one or more substantial symptom. The intensive care experience was not found to be associated with psychological outcomes (adjusted OR = 1.30, 95% CI 0.61–2.76), but was associated with agitation, anxiety and depression early ICU discharge.

    Conclusion: In this study, as many as 40% of patients had PTSD-related symptoms, anxiety or depression, singly or in combination, 3 months after being discharged from the ICU. Future studies are needed to clarify the relationship between sedation practice and psychological outcomes after ICU discharge.

  • Mari Yano, Hiromi Kobayashi
    Article type: Original Article
    2021 Volume 41 Pages 431-440
    Published: 2021
    Released on J-STAGE: November 20, 2021
    JOURNAL FREE ACCESS FULL-TEXT HTML

    Aim: The present study aimed to clarify the framework for how expert nurses at acute care hospitals comprehend the intentions of oldest-old patients and their families and implement decision-making support with regard to the selection of care location of end-of-life care for oldest-old.

    Method: Semi-structured interviews conducted on 10 participants were analyzed using qualitative synthesis method (KJ method).

    Results: Expert nurses respected “the dignity of the person at the center of the decision about the selection of care location” from the perspectives of “seeking to understand the oldest-old” and “seeking to understand the family”. They understood the values and an experience of the oldest-old in order to provide “optimal medical care from the oldest-old perspective” and they made adjustments to determine “optimal medical care from the medical care providers’ perspective”. While protecting “the dignity of the person at the center of dependency on hospital medical care”, they provided “support for the feasibility of the desired location of care”. Based on the above results comprised the framework for decision-making support by expert nurses.

    Conclusion: The present findings suggest that expert nurses take on the challenge of medical care for oldest-old while maintaining dignity for these patients.

  • Mika Kamikokuryo, Naomi Funashima
    Article type: Original Article
    2021 Volume 41 Pages 441-448
    Published: 2021
    Released on J-STAGE: November 20, 2021
    JOURNAL FREE ACCESS FULL-TEXT HTML

    Purpose: To develop a “Self-Evaluation Scale of Medical Accident Prevention Behaviors for Head Nurses” with the aim of ensuring patient safety.

    Methods: The items of the scale were generated based on the result of a qualitative study. A national survey was conducted using a 29-item scale reconstructed by a panel of experts and a pilot study. The reliability and validity of the scale were verified by statistical methods using the collected data.

    Results: A total of 1,154 questionnaires were distributed, 672 (58.2%) questionnaires were returned, and 580 valid data sets were analyzed.

    The results of confirmation of the score distribution of the scale showed that there were no question items with a notable response concentrated on specific options. The item-total correlation coefficients ranged from .39 to .64. Cronbach’s alpha of the scale was .91. The hypotheses which were used to evaluate construct validity by known-groups method were supported. The test-retest reliability was .85. The results of principal component analysis showed a loading of .37 or more for the first component. The contribution rate was 28.3%.

    Conclusion: The results support the fact that this 29-item scale has adequate reliability and validity.

  • Nozomi Sonoda, Kaori Takahata, Shigeko Horiuchi
    Article type: Original Article
    2021 Volume 41 Pages 449-457
    Published: 2021
    Released on J-STAGE: November 20, 2021
    JOURNAL FREE ACCESS FULL-TEXT HTML

    Objective: To examine the effect of interaction with an infant in primiparas with no experience interacting with infants.

    Method: This two-armed randomized controlled trial compared: 1) 30 minutes of interaction with the infant (face-to-face experience group); and 2) 30 minutes of watching a video on how the infant plays, breastfeeding, and the infant falling asleep (video experience group). The outcomes were the amount of change in the emotion score for approaching infants, the emotion score for avoiding infants, and the anxiety score before and after the intervention.

    Results: The emotion score for approaching infants increased after the intervention for both groups; however, comparing the quantity of change, the score in the face-to-face experience group was 3.5 ± 3.5, and for the video experience group was 1.2 ± 3.6, with the quantity of change significantly greater for the face-to-face experience group with a medium effect size (t = 2.896, p = 0.01, d = 0.66). The emotion score for avoiding infants and the anxiety score decreased in both groups after the intervention; however, the quantity of change was not significantly different between the two groups (t = –1.530, p = 0.13, d = 0.34; t = –1.243, p = 0.22, d = 0.29).

    Conclusion: The amount of change in the approach score was significantly higher in the face-to-face experience group. In both groups, approach scores increased and avoidance scores and state anxiety scores decreased after the intervention. Based on these results, it is necessary to create opportunities for primiparas to interact with infants.

  • Yuka Hayashi, Jiro Takaki, Shinya Saito
    Article type: Original Article
    2021 Volume 41 Pages 458-466
    Published: 2021
    Released on J-STAGE: November 25, 2021
    JOURNAL FREE ACCESS FULL-TEXT HTML

    Objectives: Job crafting (JC) is defined as “the physical and cognitive change individuals make in the task or relational boundaries of their work.” The purpose of this study was to examine the interaction effects of job stressors and JC on health outcomes of nurses in Japan.

    Methods: In a cross-sectional study with nurses of five organizations, 148 nurses completed a self-administered questionnaire (response rate = 79.7%). JC was assessed using the Job Crafting Questionnaire, which comprises four subscales, increasing structural job resources (JC1), reducing hindering job demands (JC2), increasing social job resources (JC3), and increasing challenging job demands (JC4). Job strain based on the demands-control model, and workplace bullying were assessed as job stressors. Psychological distress (PD), fatigue, and work engagement were assessed as health outcomes. After confirming the validity of the measurements, the interaction effects of job stressors and each subscale of JC on health outcomes were assessed using hierarchical linear regression analyses. We constructed regression lines and predicted values with significant (p < 0.05) interactions.

    Results: The interaction effects of job strain and JC1 on PD, of person-related bullying and JC2 on work engagement, of person-related bullying and JC3 on fatigue, and of person-related bullying and JC4 on PD were significant (p < 0.05). After adjustment for sociodemographic factors, only the last interaction effect was significant (p < 0.05).

    Conclusion: We found the interaction effects of job stressors and JC on health outcomes of nurses. JC4 attenuated the increase in PD accompanying the increase in person-related bullying.

  • Yumiko Kuraoka
    Article type: Original Article
    2021 Volume 41 Pages 467-475
    Published: 2021
    Released on J-STAGE: November 26, 2021
    JOURNAL FREE ACCESS FULL-TEXT HTML

    Purpose: This study aimed to clarify the process underlying the creation and operation of a hospital admission system for patients with coronavirus disease 2019 (COVID-19) from the perspective of nurse managers.

    Methods: This qualitative descriptive study was conducted with eight nurse managers who were involved with the creation and operation of a hospital admission system for patients with COVID-19 in Kyushu region. Data were obtained through individual semi-structured interviews and then subjected to descriptive analysis.

    Results: The admission system involved the following phases. During the first wave of the pandemic, (1) nurse managers decided to accept patients with COVID-19 in their own department, and (2) the nurse managers quickly created a COVID-19 patient admission system, (3) the hospital introduced a stabilized treatment and nursing system for patients with COVID-19, and (4) nurse managers struggled with the operation of a hospital admission system for patients with COVID-19 and coping with re-expansion and prolongation of infection.

    Conclusion: These results provide insight into the process underlying the creation and operation of a hospital admission system for patients with COVID-19, and could help to facilitate the introduction of similar systems for emerging infectious diseases in the future.

  • Satomi Arai, Yukari Nakada, Hayato Higa
    Article type: Original Article
    2021 Volume 41 Pages 476-485
    Published: 2021
    Released on J-STAGE: November 27, 2021
    JOURNAL FREE ACCESS FULL-TEXT HTML

    Purpose: The purpose of this study was to describe and consider the process of changes that occurred in nurses’ perceptions and practice of patient education through two sessions: a debriefing session on the recovery experience of patients with chronic kidney disease and a study session on the concept of concordance.

    Methods: This study was conducted based on action research between May 2018 and March 2020. After conducting a debriefing session and a study session for the ward nurses, we interviewed four nurses two times. The contents of the interviews were analyzed qualitatively.

    Results: The nurses said that the debriefing and study sessions clarified the current problems in patient education, and they were able to reconsider the perspectives of patient education. The nurses “realized that unilateral patient education was a problem,” so they “tried to have the patients speak in their own words.” Because nurses “tried to listen to the patients without preconceptions and with awareness of the patients’ own situations,” changes in practice such as “discussing alternatives that fit the patients’ life” were observed.

    Conclusion: Our study suggested that learning about the patient’s recuperation experience and being aware of the concordance concept are effective in conducting recuperation assistance for behavior change in patients.

  • Sachiko Fukui, Saori Yasuoka, Jun Nakahara, Hisako Yano, Kayoko Ohnish ...
    Article type: Original Article
    2021 Volume 41 Pages 486-493
    Published: 2021
    Released on J-STAGE: December 04, 2021
    JOURNAL FREE ACCESS FULL-TEXT HTML

    Purpose: This study aimed to explore the ethical behavior of healthcare professionals towards people with infectious diseases, and examine the ethical behavior required of medical staff based on their experiences at the time of diagnosis and the most recent examination.

    Methods: We conducted a self-administered questionnaire survey with scores recorded on a 5-point Likert scale targeting carriers of hepatitis B virus, and analyzed the results with the paired t-test, after exploratory factor analysis.

    Results: The questionnaire consisted of four factors and 18 items, and the Cronbach’s coefficient alpha was .902. The mean ± standard deviation score at the time of initial diagnosis (median year: 1990) and most recent examination (2018), respectively, were 2.0 ± 1.1 and 2.2 ± 1.1 (p < .05) for “Factor I: Sympathetic nursing that soothes feelings of anxiety”; 3.0 ± 1.3 and 3.6 ± 1.2 (p < .01) for “Factor II: Explanation that enables understanding and acceptance of disease”; 4.3 ± 1.0 and 4.7 ± 0.6 (p < .01) for “Factor III: Fair handling”; and 2.9 ± 0.9 and 3.2 ± 1.0 (p < .01) for “Factor IV: Support for positive living.”

    Conclusion: The reliability and validity of the questionnaire on ethical behavior of healthcare professionals towards people with infectious diseases were verified. Significant difference was observed in “Factor I: Nursing that is close to anxious minds,” although the score was low.

feedback
Top