The purpose of this study is to unveil the process of judgment and care provided by nurses in situations in which patients with chronic schizophrenia request ‘as required’ medication. We conducted semi-structured interviews with 10 psychiatric nurses of five or more years' experience, followed by an inductive analysis.

The results of the study showed that the nurses go through the following process: Assessment of the degree of urgency based on the observation of difference from the usual situation and comparison with past experiences; assessment of the necessity of ‘as required’ medication based on the information collected for making a decision by hearing the patient's complaint and assessment of the adequacy of the administration; judgment and care as to whether to provide ‘as required’ medication; and continuous observation and assessment of the patient's condition.

This process reflects the combined effect of nursing staff factors and environmental factors. Nursing staff factors include nurse's sense of values and convictions, relationship with patients, and emotional state. Environmental factors include the ward situation at that time, customs of the ward, and consensus among the nursing team.

Cognitive behavioral therapy (CBT) training courses for nurses have not yet been established in Japan. However, such courses that use nurses are being considered. We developed and evaluated a nursing CBT course. This qualitative study aimed to improve the course content and investigate the utility of a trial CBT training course. The subjects included 13 nurses; the study was conducted using focus group interviews. A qualitative analysis of the focus group feedback revealed six themes including: 1) repetition learning improves CBT practice; 2) attainment of CBT knowledge relates to learning level; 3) performing task exercises promotes an understanding of CBT; 4) experience of CBT strengthens motivation to practice CBT; 5) the benefit of interactive learning using a narrative style; and 6) the environmental coordination required to support repetition learning. These study findings suggest that a nursing practice CBT training course program needs a structure to support repetition learning, especially about the processes around introducing CBT into practice. We believe this study will contribute to programing CBT training courses for nurses in the future.

The purpose of this study is to clarify the perceptions held by psychiatric nurses charged with care of adolescents undergoing puberty about the rules in the place of treatment. Study participants were eight nurses with at least three years of experience working at psychiatric ward for adolescents undergoing puberty or at daycare facilities that accept puberty age patients.

Data were collected through semi-structured interviews using an interview guide. The abstraction level was enhanced through comparative examination, and subcategories and categories were generated. The results revealed that nurses perceived rules at the place of treatment in the following four categories: “means to protect the children,” “means for children to successfully interact with others given their own conditions and disabilities,” “means for children to maintain group life,” and “means for children to live beyond the limits created by adults.” In addition, this study indicated that there is a hierarchy to the rules that function as these means, and that psychiatric nurses charged with care of adolescents undergoing puberty play a significant role by using rules as means for children to achieve their goals.

This research aimed to clarify the practice content of expert psychiatric nurses in caring for patients with borderline personality disorder (BPD). Semi-structured interviews were carried out with 10 expert psychiatric nurses from 7 institutions (mean duration of experience: 16 years, 13 years in psychiatric nursing). Responses were analyzed by the KJ method and 115 codes were extracted and classified into 6 categories and 25 sub-categories. Being well informed of the pathology, nurses care for patients with BPD and relate to them in trying to “understand parents while listening into their difficulties with living and their true feelings,” “encouraging and putting them at ease by communicating that they care for patients,” and “building a relationship of trust by empathizing with patients without being overly concerned with ‘getting involved.’” Generally, nurses were shown to handle situations flexibly; to encourage appropriate growth for patients, nurses “accept patients as they are and provide support for patients' self-control” and “provide support for patients' self-control while adjusting frameworks as necessary, based on patients' circumstances.” With the aim of keeping a psychologically neutral position, nurses “accept themselves as they are and have their own self-control based in professionalism.” The results suggest that although BPD nursing is difficult, it is possible for nurses to maintain a good relationship with patients without falling into mental exhaustion by accepting patients and themselves as they are and having flexible attitudes toward altering frames of thought and actions.

This study aimed to describe the caring experiences of middle-aged (45–64 years old) parents whose adult children had mental illnesses in order to discuss how to support for the middle-aged parents. The qualitative descriptive study was conducted. Participants were 12 parents (11 mothers and 1 father) of 14 adult children. The average age was 56.8 (SD 5.5) years for the parents and 25.2 (SD 4.6) years for the children. Parents were interviewed regarding their experiences, process, perceived difficulties, and coping behaviors. Interview transcripts were coded with a focus on caring experiences and categorized them in chronological order. The theme extracted was “pursue recovery and growth through learning with children,” and it consisted of four categories: “caring for the child as usual,” “feeling isolated and helpless with changes in the child's condition,” “seeking better ways for the child's recovery,” and “recovery and growth through learning with the child.” An important component of support for middle-aged parents is family peer groups that promote awareness of ways in which parents can aid in their child's recovery.