Objective: This cross-sectional study aimed to identify the influence of the practice environment and demographic characteristics on respiratory unit nurses’ self-rated ability to care for patients with chronic respiratory diseases, particularly chronic obstructive pulmonary disease (COPD).
　Methods: Self-administered questionnaires were sent to 464 nurses in advanced treatment hospitals and other hospitals. A total of 257 nurses (55.4% response rate) returned completed surveys. Questions covered areas such as demographic characteristics and the Six Dimension Scale of Nursing Performance scale (6D-scale), which assesses nursing practice abilities and self-rated abilities across seven areas: “understanding disease,” “understanding patients,” “respiratory rehabilitation,” “helping patients and families,” “protecting the rights of patients and families,” “cooperating with other health workers,” and “being a role model.” Welch’s t-test, Fisher’s exact test, and stepwise logistic regression analysis were performed.
　Ethics: The Research Ethics Committee of the Juntendo University Faculty of Medicine approved this study (No. 2014090).
　Results: Self-rated interpersonal relationship/communications on the 6D-scale were positively associated with “understanding patients,” “protecting the rights of patients and families,” “cooperating with other health workers,” and “being a role model.” Professional development activities were positively associated with “understanding disease,” “respiratory rehabilitation,” “protecting the rights of patients and families,” and “cooperating with other health workers.” Regarding care for patients with COPD, some nursing practice abilities were associated with self-rated nursing abilities.
　Discussion: Improvements in interpersonal relationships/communications and professional development activities may enhance self-rated nursing abilities.

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　The purpose of this study was to clarify experiences in light of growth-to-growth maturity from being an entry-level to a mid-career-level home-visit nurse who provides appropriate medical and nursing care to a variety of target patients. We conducted semi-structured interviews with 13 mid-career visit nurses working in home-visiting care offices to ask about their experiences connected with growth as a home-visit nurse. Qualitative analysis was performed using an inductive approach.
　Eight categories were extracted as growth experiences for mid-level career nurses:“learning from failure in home-visit nursing,” “transformation of the sense of values while being absorbed in the work,” “growth through trial and error with senior colleagues as a model,” “learning from consultations with specialists,” “mastery of multidisciplinary collaboration,” “finding an environment in which home-visit nurses can feel supported and effective”, “construction of the ideal home-visit nursing practice process,” and “awareness of the powerful charm of home-visit nursing.”
　Over the years, these home-visit nurses became able to solve problems independently and trust their own judgments. They had taken it upon themselves to take the necessary actions for growth through proper communication and by mastering multidisciplinary collaboration. Therefore, the basis of growth from an entry-level to mid-level home-visit nurse lies in the ability to create an environment that promotes growth, provides approval, and challenges them to set their own future growth goals.

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　This study aims to illuminate the practical difficulties experienced by discharge support nurses who are newly assigned to a discharge support department, as well as strategies adopted by these nurses in coping with such difficulties. We conducted a semi-structured interview with eight discharge support nurses at five acute care hospitals in the Kanto region. The interview explored participants’ experiences of practical difficulties and their coping strategies. Interview data were then analyzed qualitatively and inductively. Analysis results indicated the following six categories for practical difficulties experienced by newly assigned discharge support nurses：“lack of knowledge of how to use the social support system due to a limited understanding of the system”；“inability to communicate with physicians due to lack of confidence in working in an unfamiliar department”；“difficulty in identifying the appropriate timing for starting an arrangement by predicting the patient’s course of disease”；“inability to start building a relationship in a chaotic situation”；“inability to foresee the pathway to discharge due to confusion in determining whose opinion should take precedence”；and “lack of confidence in one’s own decisions.” The results also indicated the following seven categories for coping strategies adopted by participants:“engage in self-learning to overcome lack of knowledge”；“set aside considerable time to deeply engage in conversation with patients and families”；“build a relationship with physicians and ward nurses while supporting their ideas”；“wait for an opportunity to involve relevant health professionals”；“identify one’s own methods for providing support through consultation with others”；“take proactive actions and resolve issues”；and “hand over issues that have not been resolved during hospitalization to local specialists.” Findings suggest that a support system will henceforth be needed that helps newly assigned discharge support nurses reflect on their practice when they face difficulty so that they can learn from experience.

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 Objective：To elucidate the associations between learning promotion and self-regulated learning in teaching strategies for first- and second-year university nursing program students.
　Methods：An anonymous self-administered questionnaire survey was conducted with 1312 students who were in their first and second years of eight university nursing programs. Motivation, learning strategies, and metacognition were selected as the subscales for self-regulated learning, and questions about the degree of learning promoted by classes in primary and secondary forms of teaching strategies were asked.
　Results：Of the 326 participants, the 312 who responded to all questions were included in the analysis. Among these, 35.6%, 62.5%, and 76.8% indicated that learning was promoted by classes in the form of lectures, exercises, and practice, respectively, And the scores for learning strategies and metacognition in those students who indicated that learning was promoted by lectures were high. In addition, among students who showed no learning promotion by lectures, some stated that learning was promoted by teachers’ and students’ questions during the lecture, buzz learning, and role playing, and the scores for motivation, learning strategy, and metacognition in those students were high.
　Discussion：The lecture format did not promote learning in many students. The results suggest that students who indicated that learning was promoted by lectures were actively trying to learn using learning strategies and metacognition such as thinking while making connections to existing knowledge and self-assessing their learning progress and level of understanding. These results also suggest that the lecture format combined with secondary formats can promote self-regulated learning in students.

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[in Japanese]

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