Journal of Japan Academy of Psychiatric and Mental Health Nursing
Online ISSN : 2432-101X
Print ISSN : 0918-0621
ISSN-L : 0918-0621
Volume 31, Issue 2
Displaying 1-11 of 11 articles from this issue
Original Articles
  • Akiko Suda, Sachiko Deguchi
    Article type: Original Article
    2022 Volume 31 Issue 2 Pages 1-9
    Published: November 30, 2022
    Released on J-STAGE: November 30, 2022
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    In Japan, private psychiatric hospitals account for around 90% of the overall psychiatric hospitals. Literature showed that psychiatric hospitals have a high rate of job separation than general hospitals among new graduate nurses. This study aimed to explore psychiatric nursing experiences and consider ways to support new graduate nurses. We explored the psychiatric nursing care experience of eight new graduate nurses who worked at private psychiatric hospitals trough semi-structured interviews. The results were classified into two themes: (a) struggle of continuing to work as a psychiatric nurse and (b) the experience of an empowering and fascinating patient care. Over half of the participants experienced some violence from hospitalized patients, which is one of the factors considered for job separation. Another factor was, failing to establish a relationship with hospitalized patients, causing their loss of self-confidence on psychiatric care. Conversely, all participants were confident about the psychiatric care provided to hospitalized patients and the experience that might attract new graduate nurses. To support new graduate nurses to continue their job, two approach can be considered: creating opportunities to listen to narratives from senior mentors and establishing a peer support group among new graduate nurses.

  • Participant Observation in a Closed Psychiatric Ward
    Yuri Fushimi
    Article type: Original Article
    2022 Volume 31 Issue 2 Pages 10-18
    Published: November 30, 2022
    Released on J-STAGE: November 30, 2022
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    This was a qualitative descriptive study based on fieldwork using participant observation. It examined why patients complain of physical symptoms and what underlies their complaints. This was done through the process of interacting with patients who continue to complain of physical symptoms that are difficult to relate to and whose causes are uncertain. The study participants were two female patients who had been in a psychiatric hospital for a long time. Fieldwork was conducted a total of 50 times over a year. The specific difficulty in relating to the patients who complained of physical symptoms could be attributed to their unstable attachment patterns. Their narratives indicated that what underlay these patterns was a sense of isolation and helplessness generated by their traumatic experiences. The implications of their physical symptoms involved “ways to draw people closer to them” and “making sense of being in the hospital.” In the course of their interactions with me, they displayed “changes in narratives” and changes in “emotional expressions” “from passive to active;” my role in these interactions was “to continue to be there for them,” “to be a witness,” and “to provide timely interventions for physical care and other needs.”

  • Yoshitomo Fukuura, Kyoko Mayumi, Yoshiyasu Fujiwara, Akiko Matsushima
    Article type: Original Article
    2022 Volume 31 Issue 2 Pages 19-27
    Published: November 30, 2022
    Released on J-STAGE: November 30, 2022
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    This study aims to clarify the conflict felt by psychiatric nurses when faced with the repeated hospitalization and discharge of middle-aged patients and considers measures to promote discharge support. Semi-structured interviews were conducted of 20 nurses. Analysis using the Modified Grounded Theory Approach revealed 19 concepts, 8 categories and 1 core category.

    Nurses experienced a sense of powerlessness and “compromised with themselves” in interactions with patients because of their role. During hospitalization, a sense of discomfort due to this disconnect, including a sense of discomfort with the patient’s family, the patient themselves and impatience with negligent attitudes, deepened feelings of conflict and resulted in the evasion of discharge support and frustration at not providing support. Although some nurses showed awareness of a sense of disconnect, it did not lead to the provision of discharge support.

    Nurses were unable to bridge the disconnect with patients and family, and their anger was projected onto patients of the same generation. Results indicat the need for nurses to participate in home visits and job assistance to visualize life after discharge.

  • Benichi Moriwaki, Junko Tomikawa
    Article type: Original Article
    2022 Volume 31 Issue 2 Pages 28-37
    Published: November 30, 2022
    Released on J-STAGE: November 30, 2022
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    The objective of this study was to evaluate the nursing practice for patients with schizophrenia admitted to the seclusion room of the psychiatric emergency ward due to acute symptoms. Observations and semi-structured interviews were conducted on eight nurses with 5 or more years of experience in the psychiatric ward and 3 or more years of experience in the psychiatric emergency ward. Based on this analysis, they were grouped into four major categories, 16 categories, and 46 subcategories. The nurses “relaxed the restrictions according to the judged mental function” for patients with schizophrenia from their admission to the seclusion room of the psychiatric emergency ward due to acute symptoms until the patients left the room. Based on this premise, the following events were practiced: (1) when acute symptoms were observed throughout, the nurses “provided support for daily living activities while carrying out behavioral restrictions safely”, (2) with the availability of more time to communicate with the patient, the nurses “maintained patient rest for recovery while providing reassurance”, and (3) when the patient started carrying out their own daily life independently, the nurses “supported the patient in preparing for the discharge plans while observing their daily life.” These indicated that nurses carried out nursing practice based on the recovery of the patients’ mental function.

  • Yuki Hamada
    Article type: Original Article
    2022 Volume 31 Issue 2 Pages 38-47
    Published: November 30, 2022
    Released on J-STAGE: November 30, 2022
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    Objective: This study determines the experiences of mental health professionals working in cooperation with peer support workers.

    Methods: A total of 15 professionals, including psychiatric social workers, nurses and others, who had worked with peer support workers for more than a year, were interviewed one-to-one using an interview guide. The transcripts were analyzed qualitatively and descriptively.

    Results: To work in cooperation with peer support workers, professionals tried to “create opportunities for equal relationships and equal participation,” “learn from peer support workers,” as well as “understand the strengths of peer support workers,” “understand the concern of peer support workers,” “monitor the physical conditions of peer support workers,” “create opportunities for peer support workers to get used to work through practice,” “provide support according to the social experience of peer support workers,” “create a work environment where peer support workers are not isolated,” “recognize resistance to work with peer support workers,” and “examine employment methods.”

    Discussion: To work in cooperation with peer support workers, it is necessary to build a work environment in which such workers can continue to work by embracing the characteristic relationships of peer support, such as equality and reciprocity, in the organization.

  • Hiromi Toki, Masako Tai, Sayumi Nojima
    Article type: Original Article
    2022 Volume 31 Issue 2 Pages 48-57
    Published: November 30, 2022
    Released on J-STAGE: November 30, 2022
    JOURNAL FREE ACCESS FULL-TEXT HTML

    Aim: The purpose of this study is to shed light on the perception of self taken from the narratives of people with mild dementia. Method: The study uses a qualitative inductive research method. The collaborators in this study were 15 people who continued to live in the community after being diagnosed with dementia. Result: Results of the analysis show that perception of self among peoples with dementia includes elements of, “narrowing”, “being controlled by negative emotions”, “detachment”, “intense utilization of knowledge”, and “maintaining continuity”. Conclusion: For individuals with mild dementia perception the sense of self was influenced by cognitive impairment and the aftereffects of their diagnosis, and various interactions with others led the individual to inhabit a narrower, detached world while being controlled by negative emotions. However, they worked hard to live their own life by making full use of their knowing and maintaining continuity. We believe that carefully interpreting the meaning of words and actions based on this finding and developing nursing care will prevent threats to the certainty of self-existence and provide nursing care that will support the vitality of mild dementia people.

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