To clarify the occupational stress for psychiatric nurses, I studied the effects of occupational stress that on depressive mood, quality of life (QOL) and the relationship between them. The subjects are 211 of phychiatric nurses. I used the questionnaire as follows: a simple questionnaire on occupational stress, a Self-Rating Depression Scale, a WHOQOL26 survey, and a demographic survey including sex, age, work unit (acute or chronic), and the number of years working in psychiatry. The most common stress was "degree of burden from the job", and the ratio of the nurses working in the acute ward was high. With regard to "degree of control of the job", the ratio of the nurses working in the chronic ward was high. Moreover, the level of stress in "interpersonal relationships" increased with age. High stress claims regarding "compatibility" issues were found among male nurses, nurses with less than one year on the job, nurses with eight to ten years of experience, and nurses with more than 21 years of work experience. Over 65% of nurses had mild depressive mood. According to the results of the WHOQOL26 survey, female nurses scored lower in general in all aspects than their male counterparts except in the workplace environment domain. It appears that the pressure of balancing a family and nursing job was factors in the decline of QOL as the age of nurses increased. The results indicate that a relationship was found between stress, SDS and QOL, which suggests that a nurse's burden varies with the duties of his or her position, and because of this, nurses were easily susceptible to depressive mood, which decreases QOL.

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[Purpose] Describe drug addiction nursing experiences based on interviews with nurses who have experience nursing drug addicts, thereby clarifying the meaning of nursing for drug addicts. [Method] Qualitative research based on semi-structured interviews. Interview period: July-September 2003. Number of participants: 12. Questions: (1) Impressive events relating to nursing. (2) Interviewee's feelings about those events. Total interview time: 700 minutes. [Results and observations] "Unconscious symmetry" was observed between nurses' emotions and those of drug addicts. While interviewees tried to not get too involved with patients or to be defeated by patients in their nursing practice, nurses found it difficult to encourage their patients to quit using drugs. Awakened to their own limitations and sense of powerlessness, nurses began to develop collaborative dialogue-based relations with patients, while continuing to experience inner conflict. Interview results reveal that nurses' realization of their own limitations and sense of powerlessness marked a major qualitative turning in their nursing activities. These findings also suggest that drug addiction nursing is meaningful in that it helps nurses grow together with patients through the collaborative relations formed with them.

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Objective The aim of this study was to gain the suggestion about psychiatric out-patients' needs through the impression of the nursing students during the simulation as outpatients. Methods Written reports were collected from the nursing students and analyzed by framework approach. The nursing students were guaranteed to refuse participation and no impact upon their degree. Results As impression of the nursing students about environment, 【discomfort】 and 【long waiting times】 were extracted. Furthermore, they felt anxiety and endured for other patients' behavior, therefore 【discomfort with other patients' behavior】 was extracted. Further, the nursing students reported loneliness because they had no one to talk with. Hence, 【very lonely】 was the core emotional theme for the nursing students. Conclusion These findings seemed to have a possibility suggesting the needs of psychiatric out-patients. Nurses are supposed to pay close attention to those out-patients. And improving usefully their waiting times is needed.

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The purpose of this study was to describe how the middle aged women with depression do housework after discharge from the hospital and what makes them have difficulty with certain types of housework. One-hour semi-structured interviews were performed with 8 middle aged women who were hospitalized for depression and who received outpatient treatment after the discharge. The data were analyzed qualitatively. The results almost show a common pattern in the housework that the participants can do and cannot do. They could do the housework which they do not have to make decisions. They could not do the housework for which they need decision. The difficulties which they face in their daily life due to the housework that they cannot do come from their feeling that they cannot respond to their role expectations and they tied to their role consciousness. Based on the study, the difficulties were assumed as follows. Since the obstacle special to depression related to thinking, volition, action, remained after discharge, the distress that could not respond to their role expectations leaded to their role conflict. Then the feeling that they tied to their role consciousness induced difficulties in their daily life. The way of could support middle-aged women with depression was discussed.

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The purpose of this study is to clarify the meaning of physical care art for patients diagnosed with schizophrenic spectrum disorder based on Nakai's "the recovery process model of schizophrenia viewed from the triadic relations of the body, body image and ego". Qualitative analysis of data obtained from participant observation of nursing care, revealed that an impairment of subjects' tripartite relations of body, body image and ego recovered in order of body, ego and body image. Likewise, the focus of nurses' physical care art shifted in order of body, ego and body image yet ahead of the impairment recovery. In addition, it was determined that physical care art consisted of five techniques: (1) observing and comprehending the psychopathological and physical status; (2) promoting recovery by substituting the function of a physical sense for patients; (3) protecting and supporting the ego; (4) preventing the patients' feelings of nothingness through assuring physical presence of the nurse; and, (5) promoting the recovery of body image. Of particular importance was "promoting recovery by substituting the function of a physical sense of patients". These results support Nakai's recovery process. Physical care art for the schizophrenic patients had meaning in building a bridge between the split of mind and body and promoting recovery from schizophrenia, by working directly on the tripartite relations of body, body image and ego.

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The objective of this study is to clarify the structure of nursing care in discharging of long-term mentally ill patients. Data was collected through interviews using semi-structured questionnaires given by 25 nurses at nine mental hospitals. Collected data was analyzed using the KJ method. Nursing care was given to "the patient," "the patient's family" and "the support team." Nine categories were identified from the data of nursing care for "the patient." Seven categories were identified from the data of nursing care for "family." Six from that of "the support team." Nursing care was composed of three stages "provide incentives to discharge," "prepare patients for discharge," "support patients to start their discharge plans." Focus of nursing care was on the recovery of patients' self-esteem and to schedule a reasonable pace toward the discharge according to patients' self-care ability and their concerns. Results suggest that nurses took an active role in re-establishing the relationship of patients and their families and in coordinating the support team according to patients' ability and the family's preparedness to accept responsibility for the patients return.

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This study intends to elucidate emotional conflict experienced by nurses who attend patients who are under physical restraint, and to consider support for their nursing care. At a private hospital in the Kanto area, semi-structured interviews were conducted with five nurses who have one to six years of clinical experiences in the psychiatric ward. The results are analyzed qualitatively and inductively. The subjects talk about their conflict, situations that lead to the conflict and their emotion associated with the conflict. Six themes are extracted through analyzing the interview data: 'nurses' ambivalence caused by doctor's instruction to restrain patient', 'lack of communication among nurses', 'safety and deterioration of patients' QOL due to physical restraint', 'restraint and experience of being threatened by the patients', 'getting accustomed to physical restraint', and 'insufficient opportunities to support the nurses'. The conflict involves various emotions. It is suggested that providing opportunities for them to express their feelings to third parties so that they can face their conflicts would enable them to make more multifaceted nursing decisions on physical restraint.

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The purpose of this study is to unveil thoughts of the people with mental disability that support motive for work activities, and, for our part, to give them necessary suggestions to support them at work. We have observed and conducted an interview on their thoughts that support motive for work activities at their community workshops, and then analyzed the collected data from the view point of the quality of work activities. As a result, we have gained five different categories. Among others, all the interviewees replied that they had considered the work activities as a means of improving their situation to get away from their present state. In addition, they have acquired the ways to live with happiness by gaining hobbies and pleasure from work activities, which give them tension and duty to maintain their life. Through their work activities, they have felt success, gained confidence and pride, wanted to regain the connection with the person, expectation for change of oneself, and felt that they were accepted by the society. Thus, they were able to control their anxiety caused by shaky identity having realized that they were helpful to the society and were supported by the people around them. Those statements were connected with the motives of work. Over all, from our research, we have found out that it is necessary for us to provide them with the experience to strengthen their identity and encourage the attitude to challenge themselves through work activities.

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The purpose of this study was to determine whether there were any changes in lifestyle, and if so, the details, in recovered depression patients from the perspective of "Situierung." Participants were 5 recovered depression patients. Semi-structured interviews were performed 3 to 4 times for each patient to analyze changes in situierung. Verbatim records were classified both temporally (up to disease development, period with the disease, and the present) and based on situierung. Changes in situierung among participants were observed with the following commonalities: (1) shifting the main coping point from vocational-domains to self-domains, (2) withdrawing from relationships with others, and (3) the presence of a person or environment that facilitated coping through expressing one's true self. From the perspectives of both nursing assistance and coming to terms with oneself, we propose that the following factors may provide momentum for changes in situierung: (1) curing the body, (2) the need to distance patients from the combined domain (work and self) by taking into account their situierung, and (3) the presence of others or an environment that does not threaten situierung.

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The purpose of this study is to clarify and to structure how schizophrenic patients experience their illness and how they recover continuing life-work activity in each area. Methods: Semi-structured interviews were carried out for three patients and KJ method was used to analyze. Results: The elements common to patients were dream, hope and active self-actualization. At last patients discovered their own places to stay and the definite aims to live and made them stable. Two patients found "a self-sense" in the recovery process, which had existed before onset, and consciously integrated themselves to recover (The self recovery process). The other patient grew up with being affected by ambient environment since childhood. He had "a self-sense" at the onset of the disease and "self-integration power" showed an effect by ambient support after a crisis (Passively recovery process). These results become a signpost to go ahead through a recovery process for the patients, promote to make the methods and the skills to support recovering patients for their standby.

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[in Japanese]

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