With the aim of identifying the process of perspective-taking by expert nurses of schizophrenia patients showing unacceptable behavior, we conducted semi-structured interviews involving 11 expert nurses engaged in psychiatry. As the results of analysis using the modified grounded theory approach, 28 concepts, 5 sub-categories, and 9 categories were extracted.

The expert nurses faced conflicts and dilemmas because of 【intersecting thoughts】 about patients with schizophrenia showing unacceptable behavior. However, by continuously paying attention with 【a feeling of affection】 and interacting with patients while performing 【trials and errors to find a path to communicate】 with them, they became 【aware of patients' distress】. On the other hand, their 《desire for an improved situation》 and 【feeling of affection】 were so strong that they consequently 【aggravated patients' conditions on some occasions when they were expressed in a meddling manner】; however, 【reflection on their own speech and behavior】 helped them become 【aware of patients' distress】. A 【positive work environment】, a positive factor, has contributed to 【reflecting on their own speech and behavior】 and performing 【trials and errors to find a path to communicate】 with patients.

The results clarified the method of approaching schizophrenic patients with unacceptable behavior, and the importance of providing organizational support.

This study was performed with the aim of developing a self-evaluation scale in pain assessment for psychiatric ward nurses (SPAPN) and examining its reliability and validity. Ward nurses who had 5 or more years of experience in psychiatric nursing were given a survey questionnaire. We analyzed 1,010 out of 1,129 collected questionnaires (collection rate: 78.7%, valid response rate: 89.5%). Based on the analysis of each item, exploratory factor analysis, and confirmatory factor analysis, 25 items and 3 factors were used for the scale. Cronbach's coefficient alpha for the entire scale was 0.94, showing a high internal consistency. The 3 factors were “the method to grasp the painful condition,” “the method to differentiate mental and physical symptoms,” and “the method to collect multidirectional and multifaced information,” which showed a similar constructive concept with that in the preceding our qualitative study. Regarding the goodness of fit of the model, the comparative fit index (CFI) was 0.87, and the root mean square error of approximation (RMSEA) was 0.08, showing a certain level of model validity. Based on these findings, we confirmed that SPAPN would ensure reliability and validity for psychiatric nurses to evaluate the method that they use to assess pain in psychiatric patients.

This study was conducted to assess the characteristics of mental and physical symptoms in depressed home healthcare recipients in need of support or long-term care, and to identify factors associated with depressive states.

The study population comprised 111 persons aged 65 years or older who were certified to be in need of support or long-term care and able to express their wishes, selected from among the recipients of daycare services in Prefecture A. The following items were studied: basic patient attributes; depressive state determined on the Geriatric Depression Scale (GDS)-15 (Short Form); the three lower scales of the Tokyo Metropolitan Institute of Gerontology Index of Competence (instrumental independence, intellectual activity, and social roles); social support size score and exchange score; and mental and physical symptoms of depressive states.

The results identified 52 patients (46.8%) in mild depressive state (5 to 9 points of GDS score) and 8 patients (7.2%) in severe depressive state (10 points or higher). A logistic regression analysis (variable-increasing method) of GDS-correlated parameters with GDS score as a dependent variable found the number of physical symptoms (odds ratio OR=1.272) and the number of mental symptoms (OR=2.876) to be depressive state risk factors. In contrast, the size score (OR=0.891) was identified as a depressive state amelioration factor. Hypochondriac complaints were the most commonly detected physical symptom of depressive states. Mental symptoms included “inability to make up one's mind,” “decreased mental concentration,” “irritation,” and “seeming to have become weak-headed.”

Family support is very significant in the field of child psychiatry. However, it provided by nurses in child psychiatric wards have not yet been established in Japan. Therefore, the purpose of this study was to elucidate the support provided to families by nurses in child psychiatric wards. A self-administered questionnaire was distributed to 384 nurses in 20 child psychiatric wards, and answered by 246 nurses. Next, the questionnaire about a family support for nurses in child psychiatric wards was created and evaluated. Examination results confirmed the reliability and content validity. Using exploratory factor analysis, it was found that there were three factors in the family supports as follows: direct support for families (11 items), discharge support and interprofessional collaboration (nine items), and explanation and the supplement of diseases or disorders (three items). A one-way repeated measures ANOVA showed that the most practiced support among the three was direct support for families. On the other hand, discharge support and interprofessional collaboration was the least practiced. The two supports were very significant elements in family support for nurses in child psychiatric wards. Therefore, further study is required for a more concrete examination of family support, especially discharge support and interprofessional collaboration. In addition, there is a need to study the supports for the families with a lot of problems, such as mental diseases and low family function.

Purpose: This study aimed to elucidate the traits of nursing care provided by visiting psychiatric nurses that clients want to receive by analyzing clients' narratives.

Methods: Semi-structured interviews were conducted on 11 clients receiving care from visiting psychiatric nurses, and the responses were analyzed qualitatively.

Results: After analysis, six categories regarding visiting psychiatric nursing care were identified: “having fun and relaxing conversations with clients,” “listening to clients' narratives while being optimistic about clients' thoughts and potential abilities,” “listening to clients' narratives about their past experiences and hopes for the future,” “conversing with clients about their mental illness and supporting the ways clients cope and change,” “assisting in clients' daily lives based on understanding the effects of their mental illness,” and “being attentive to clients' physical condition and speaking with them on how to improve it.”

Conclusion: The results indicated the importance for nurses to recognize that “having fun and relaxing conversations with clients” and “listening to clients' narratives about their past experiences and hopes for the future” are important care components of visiting psychiatric nursing. It was also suggested that nurses need to reflect on their own values and attitudes and be aware of their personal preconceptions in order to be a reliable partner for clients. Furthermore, the significance of nurses' support for clients' physical health, mental health, and daily life through their focus on clients' experiences was indicated.

The objective of this study is to elucidate the experiences of community-dwelling schizophrenics in developing life prospects by a qualitative and descriptive analysis using semi-structured interviews with eight psychiatric day care users.

In developing life prospects, community-dwelling schizophrenics experienced an “orientation stage,” a “trial stage,” and an “action stage” in pursuit of their “life goals and image.” Each of these stages comprised “matters that affect prospects of life.” In other words, “a positive attitude towards mental disorders,” “support from family and friends,” and “use of social resources” improved patients' prospects of life, whereas “difficulty in living with the illness,” “the harsh reality,” “poor ability to reach a compromise with surrounding people,” and “the lack of confidence in daily life” obstructed the prospects of life. Furthermore, “the presence or absence of a sense of daily fulfillment” either improved or obstructed their prospects. Thus, to support the development of life prospects, supporters need to explore possibilities to achieve goals together with patients in a recovery-oriented manner and provide support that intervenes in “matters that affect prospects of life.”