This study is aimed to clarify the relationship between somatic symptoms and mental symptoms in patients with major depressive disorder, to assess the somatic symptoms during recovery process, and to establish the criteria of somatic symptoms for discharge support plan. In this study, we examined the somatic symptoms as sleep disturbance, loss of appetite, weight loss, constipation, feeling of fatigue, pain (headache, back ache, joint ache and so on), dizziness and tinnitus, feeling of breathing difficulty, nausea and vomiting, and thirst. The Global Assessment of Functioning (GAF) and the Clinical Global Impression (CGI) by psychiatrist, and the Self-rating Depression Scale (SDS) were measured as the mental symptoms. And we compared the nursing assessment by the criteria of the somatic symptoms with the discharge permission judged by psychiatrist. Subjects were 10 inpatients of major depressive disorders (6 male and 4 female, mean age was 41.7; range 25-74 years old). The somatic symptoms were significantly correlated with the mental symptoms (p<0.05). After evaluating the criterion of somatic symptoms, the somatic symptoms and the mental symptoms did not change significantly during the period to discharge. The nursing assessment by the criteria of somatic symptoms is significantly earlier than the discharge permission judged by psychiatrist (p<0.05). These results suggest that the criteria of somatic symptoms are helpful for objective evaluation of patients with major depressive disorder during recovery process. And the nursing assessment by the criteria of somatic symptoms is helpful in planning discharge support. Thus, the criteria of somatic symptoms may be useful for making clinical path for discharge support plan.

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Autobiographical illness narratives are expected to be used as educational materials for nursing education. The aim of the present study was to reach deeper understanding of people with mental illness through analysis of the structure of the story of an autobiographical illness narrative book "What is the meaning of mental disease?: The experience of a patient with mental illness" written by Natsuko Furukawa. The body text was analyzed by the text mining technique and by the individual analysis method of autobiography. The results indicated that the text consisted not only of the author's personal experience but also of positive and concrete messages of expectation and hope for the surrounding people and the general society. This kind of integration of experiential story and positive social message ought to have impact for readers to better understand people with mental illness by reducing prejudice and taking in information to get along with them. This sort of autobiographical mentally illness narratives are to be utilized for education in the area of psychiatric and mental health nursing.

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The purpose of this study was to investigate the actual condition in which people experiencing difficulties in daily life due to mental health issues, but who are managing relatively well in community life, create a place to belong (ibasho) and subsequently gain self-motivation from this, and to clarify the factors to achieve this. Semi-structured interviews were conducted with 7 study participants, and descriptive data derived from the interviews were analyzed qualitatively and inductively. The results from some typical responses revealed that the respondents recognized their home, workplace, social rehabilitation facilities and hospitals, and places for community activities as the places where they belonged. In addition, they perceived such places as those where they could "maintain their own pace" and "be respected by others and express themselves", and furthermore, they found self-motivation in that they could "express themselves" and "play a social role". The factors extracted for building such self-awareness were "acceptance of their mental health issues", "building relationships with others to feel no sense of alienation" and "having hope for the future". It was suggested that they could cognize their place to belong and subsequent self-motivation in an integrated form only after they perceived the "times" and "places" that constitute "the very place they want to be".

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The present qualitative descriptive study aimed at elucidating the daily life experiences of patients forced to remain in a psychiatric hospital for prolonged periods of time. The study involved 12 patients who had been in a psychiatric hospital for 10 or more years. Data were collected from these patients by means of participant observation and semi-structured interview, and analyzed in a qualitative and inductive manner. The study revealed that long-term inpatients "had lost much and had experienced life-threatening events" but were finding daily life worth living, "supported by their own unique experiences of life before hospitalization," "small satisfactions found during their hospital stay," "attempts to make connections with society while living on the ward" and "dreams and desires focused on their own lives." These results indicate that the nursing care provided to long-stay patients must include sympathetic understanding of the patients' experiences of loss, and explore opportunities and personal relationship that facilitate patients' pursuit of their unique existences.

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[in Japanese]

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[in Japanese]

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