Mental health nursing is a stressful specialty, and mental health nurses have a high risk for clinical burnout syndrome. Our aim was to examine the effectiveness of a Stress Management-Empowerment Program for psychiatric nurses designed to alleviate their stress. Psychiatric nurses (n=30) were randomly assigned to the stress management empowerment program course group (intervention group) or control group. This program consists of a total of four sessions over 6 weeks, each of which takes two hours. A lecture was given during thirty minutes of each two-hour session. At the first session, we gave the participants information on stress, stress of specifically psychiatric nursing and stress management; at the second session, we provided information on cognitive-behavioral therapy and cognitive retraction; at the third session, we provided information on assertive communication; and at the fourth session, we provided problem-solving therapy. The remaining ninety minutes of each two-hour session involved group therapy using a problem-solving process. Participants replied to questionnaires about their stress and their mood before and after their participation and 1 month after the intervention. The results indicated that the psychiatric nurses' degree of mental health, as a primary outcome measured with K6, did not show significant improvements immediately after the intervention and 1 month after the intervention. However, the intervention group had significantly lower 'Tension-Anxiety' and 'Depression-Dejection' of POMS score immediately after the intervention (ANCOVA, P=.003, .008, respectively), and lower Anger-Hostility' of the POMS score at 1 month after the intervention (ANCOVA, P=.046).

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The purpose of this study was to assess the process of nursing care in relation to the use of seclusion and physical restraint among restless and excited psychiatric inpatients. Semi-structured interviews were conducted with 14 acute psychiatric ward nurses and the data were analyzed taking a modified grounded theory approach. Two categories and 13 concepts were established. The first category involved the "Process leading to seclusion and physical restraint." Concepts in this category included "Immediate judgments made to reduce restlessness and excitement," in which psychiatric nurses tried to calm restless and excited inpatients, and "Rapid cooperation of the medical team," during which the practice of seclusion and restraint was carried out. The second category, "Process to cease the use of seclusion and physical restraint," involved the period of time after patients had been secluded and physically restrained. Psychiatric nurses discussed processes that led to the release of inpatients from seclusion and physical restraint, including "Sharing various perspectives on ceasing seclusion and restraint treatment" and "Accumulating data concerning patient behavior." Concerning the nursing care use of seclusion and physical restraint, release should be decided as a result of medical team cooperation. In this study, rapid cooperation of the medical team enabled psychiatric nurses to cope with crisis situations and strengthen the information sharing network of the psychiatric ward.

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This paper describes how people changed their lifestyles after being discharged from an inpatient mental health treatment. I interviewed 11 people with mental illness using a semi-structured interview format. After discharge, they were inactive and felt powerless. Then, they began to lead a regular life style with Recovering their sense of power and took their doctor's advice. If they had an accident, they became fatigued, which complicated their symptoms. They then stopped the activity in their lives. However, upon finding such a life unacceptable, they decided to accept support from friends and try to live an active life again. This resulted in three life patterns: 'becoming active and developing,' 'maintaining the lifestyle,' and 'moving through stages in step.'

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The purpose of this research was to clarify why drinkers drink and why they resist intervention in their drinking. We conducted a group interview of 12 male drinkers and then analyzed the data acquired. The results indicated that drinking is one's life values and that drinkers tended to spare no effort to drink. Because life values are not easily changed, drinkers displayed a deliberate indifference towards moderation and a sense of justification in drinking, As for the intervention sobriety, drinkers showed a resistance because it is difficult for them to believe in the effectiveness of controlling the amount they drink. They also felt that it led to a denial of their life value. If drinkers cannot drink because of the damage to health caused by heavy alcohol consumption, then they are unable to express their life value. However, when the purpose of the intervention sobriety was explained as being able to drink indefinitely, resistance to the intervention sobriety was reduced. In conclusion, it is suggested that when performing the intervention sobriety, it is important to understand the drinker's life value of drinking.

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This qualitative study aims to clarify patterns of care-seeking behavior among people with schizophrenia receiving continuous medical care at a psychiatric day-care facility. Through this analysis, we hope to devise means of effectively supporting patients with delusions and cognitive impairment, in order to maintain their well-being while they reside in community without discontinuing medical treatment. Data were obtained through semi-structured interviews and participant observation at a psychiatric day-care facility. Content analysis showed three main themes in patients' care-seeking behaviors (1) being able to live without serious psychotic symptoms, with the help of medication and support from the treatment team; (2) attending daycare and following a healthy lifestyle; (3) a desire for a healthy relationship with other people and one's disease. They have difficulties in medication compliance, explaining their conditions to the doctor, commuting to the day-care facility, and maintaining a good relationship with other daycare patients. Thus, they require support so that they continue receiving medical treatment and attend daycare. The results of this study suggest that life satisfaction plays a key role in preventing persons with schizophrenia from getting engrossed in their delusions. Correlations were observed among life satisfaction, valuing ethics and group well-being over competitiveness and decisions based on delusional thinking, and cordial and supportive relationships that protect such patients from feeling alienated and traumatized.

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The objective of this study was to identify factors influencing psychiatric nurses' awareness of social rehabilitation support and the structure of the factors. We conducted a semi-structured interview with 25 nurses working in a private psychiatric hospital and an analysis focusing on factors influencing the nurses' awareness of social rehabilitation support and on the nurse's attitudes influenced by the factors. One of the identified factors, "experience of delivering successful support that had led to patients' reintegration into society" instilled confidence in the nurses regarding the recovery of mentally ill patients, resulting in an improvement in their awareness of social rehabilitation support. Another factor, "working in wards where social rehabilitation is actively encouraged" increased opportunities to think about social rehabilitation support, and "learning about social rehabilitation support" helped clearly define the goal of social rehabilitation, which also improved the nurses' awareness of social rehabilitation support. "Cooperative family members" allowed the nurses to have expectations of support of patients' family members, while "uncooperative family members" caused the nurses to have concerns about the social life of the patients after discharge, leading to a decline in the awareness level. The factors "prolonged hospitalization," "prejudice," and "poor social resources" also raised concerns about the social life of the patient after discharge and decreased the nurses' awareness of social rehabilitation support.

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This study aimed to reveal the significance of listening to schizophrenic patients who are in the process of social reintegration, a significant phase, by nurses. Semi-structured interviews regarding attentive listening by nurses were conducted with 10 patients suffering from chronic schizophrenia. Qualitative analysis of the data was performed according to the Kawakita Jiro method. The phases were in the form of a four-step structure, including factors that prevent from listening to the patient, identifying a nurse who is likely to listen to the patient, factors that allow a nurse to listen to the patient, and the listening technique of the nurse to determine whether the patients can describe their real intent. The fourth step was categorized into a listening technique that relaxes the patients' mind and a listening technique with tangential deviations. The significance of attentive listening by the nurse that was identified by the patients developed from the fourth step, i.e., the listening technique that relaxes the patients' mind. From this finding, three types of significance were identified: the patients' feeling of relief that their messages were understood, because they existed in a mixed state as a result of the symptoms of schizophrenia in the chronic stage; the patients' feeling of having shared their suffering during their search for a future way of life; and the patients' feeling of trust in a nurse that began to develop during the listening process. The results also indicate that whether or not a patient's intent is realized depends on the technique used by a nurse during listening and that this realization serves as a catalyst for personal growth.

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