Objective and Methods: A questionnaire-based survey of 4,542 students enrolled in 14 nursing schools was conducted in the Kanto region to examine the characteristics of the nursing students’ perspectives of nursing by college year. This study aimed to determine whether learning motivation, human factors, and basic attributes were associated with the students’ perspectives of nursing.
　Results and Discussion: A text-mining analysis of the sentences completed from four stems revealed the 471 nursing students’ perspectives of nursing (response rate, 10.4%). First-year nursing students regarded a nurse as an entity who possesses knowledge and skills. Second-year nursing students perceived nursing as assisting patients, including their family members, and supporting them Mentally. Third-year nursing students viewed nursing as supporting the mental aspect of patients’ health. Fourth-year students regarded nursing as having respect for patients’ lives and providing holistic and individualized medical care together with the physicians. More categories could be generated from the perspectives of the students from later school years. Moreover, the perspectives of these senior students were more pragmatic. In terms of the role of nursing in a multidisciplinary team setting, only collaboration with physicians was mentioned, suggesting the need for education regarding multidisciplinary collaboration. The results of a discriminant analysis of the participants’ nursing perspectives, learning motivation, human factors, and basic attributes showed the following factors to be associated with nursing perspectives: identification, which occurs when fourth-year students recognize learning motivation as a means to an end, and a patient’s family, which represents a human factor for third-year students.

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　The purpose of this study was to determine the content of support provided by occupational health nurses （OHNs） for workers with developmental disabilities （workers） and to obtain suggestions for appropriate support. Semi-structured interviews conducted with 10 OHNs were analyzed by qualitative induction. The results identified 5 core categories of support provided by OHNs; “Assessment to clarify problems in the workplace” and “Support to develop the ability of Workers to deal with problems,” as based on assessment; “Support to develop the authority of the workplace to deal with problems,” which was provided to supporters in the workplace who play important roles; “Adjustment to a feasible coping plan by Workers and supporters of the workplace” considered the way coping plans deal with problems; and “Maintenance of the support environment by cooperation with those who support it inside and outside the workplace,” which led to the selection of the most suitable supporters and the construction of a smooth support system. All support included efforts to address the characteristics of developmental disabilities and developed the nursing process as a means to solve problems. OHNs who supported workers took advantage of their expertise in responding to the characteristics of developmental disabilities, coordinate to build consensus between workers and supporters, and collaborated with supporters inside and outside the workplace. The necessity of establishing a system to facilitate cooperation and collaboration was also suggested.

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　Purpose：This study aimed to clarify the experience of families involved in surrogate decision making regarding treatment on behalf of patients with acute stroke whose reduced level of consciousness makes confirming their wishes difficult. The study also aimed to obtain basic data for developing interventions that can prevent anxiety and depressive symptoms associated with surrogate decision making.
　Methods：Semi-structured interviews were conducted with informed consent obtained from 7 family members of patients with stroke. Following qualitative and inductive analyses of the results, a structured crisis intervention was conducted based on crisis theory proposed by Aguilera and Messick.
　Results：The following 7 categories were derived: “I was unsure of what was happening, but I prioritized life-saving measures and left decisions to the doctor,” “I made decisions that prioritized the suggestions of medical staff, while having concerns about the treatment methods,” “I realized I would have a new way of life and financial problems caused by the illness,” “I was conflicted as to whether the proxy decisions were in line with the patient’s wishes based on the prognosis of the illness,” “I anticipated having interpersonal relationships and interactions with medical professionals who could give me peace of mind,” “Support from people around me gave me peace of mind,” and “I attempted to reduce my anxiety in the midst of a chaotic situation.” These categories were divided into four groups: “highly stressful encounters,” “perception of events,” “social support,” and “restraint coping”.
　Conclusion：The family members of patients with acute stroke made decisions that prioritized suggestions from medical professionals, while also expressing concern about the treatment method. They were concerned about their new way of life and financial issues associated with the patient having a stroke and surrogate decision making. They were also conflicted about making surrogate decisions that were in line with the patient’s wishes. They anticipated having interpersonal relationships and interactions with medical professionals who could give them peace of mind. In addition, the family members tried to adopt measures to reduce their anxiety despite their chaotic situation, while achieving peace of mind through support from others, such as relatives and friends. This experience was a determining factor in whether the family perceived events positively.

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　The objective of this study was to assess issues experienced by nurses and nursing care staff working at special nursing homes when implementing strategies to counter norovirus （NV） infections.
　The study involved one nurse, one certified care worker, and one nursing care staff member from each of 235 randomly chosen special nursing homes across Japan （705 participants in total）. The participants were asked to freely detail any challenges they encountered while implementing strategies to counter NV infections. Responses from 388 participants were obtained （response rate, 55.0%）. The following answer was received from 235 participants: “I have experience in implementing strategies to counter NV infections.” Among those participants, 228 （58.8%） provided descriptions that were analyzed qualitatively and descriptively. From those descriptions, 234 codes were derived and the following 4 categories were identified as major challenges: difficulties in implementing strategies to counter NV infections were associated with the characteristics of facility users, inadequate knowledge and ability of nurses and nursing care staff regarding strategies to counter NV infections, lack of manpower to implement strategies to counter NV infections, and difficulties in securing isolation spaces due to facility structures.
　This study highlights the importance of proposing strategies to counter NV infections that are practical, effective, and in accordance with the characteristics of facility users. In addition, educational methods should be developed to ensure all facility staff, regardless of profession, can implement evidence-based strategies to counter NV infections.

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 Objective: To clarify the effectiveness of teaching the “nursing process” to novice learners based on the goal-based scenario (GBS) theory from the perspectives of critical thinking disposition and metacognition.
　Methods: Based on the 7 elements of the GBS theory, a course that included examination of 3 simulated cases was developed to teach nursing college students the nursing process. The effectiveness of this course was evaluated by examining changes in scores along a critical thinking disposition scale and a metacognition scale for adults and by analyzing multiple comparisons of the GBS elements with these scales.
　Results: There were no marked changes in critical thinking disposition or metacognition scale scores after course completion. However, the following GBS elements were significantly different between the 2 scales: mission, cover story, role, learning goals, scenario operations, and digital resources.
　Conclusion: To help students become nurses, the nursing process should involve active learning with simulated cases to stimulate metacognition. Furthermore, the use of Web teaching materials as a digital resource could promote an “inquiry mindset,” which is a critical thinking disposition subscale. The inquiry mindset could also play an important role in preventing belief biases or underestimating evidence against individual beliefs and drawing appropriate conclusions in the nursing process.

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　Objective: We aimed to accumulate information on and demonstrate support methods used by ward nurses to encourage self-management among elderly patients hospitalized for acute exacerbation of chronic heart failure.
　Study Design: Qualitative descriptive study.
　Methods: Semi-structured interviews were conducted with a total of 13 nurses: 3 certified nurse specialists in chronic care nursing, 4 certified nurse specialists in gerontological nursing, 4 certified nurses in chronic heart failure nursing, and 2 head nurses in wards providing specialized nursing to elderly patients with chronic heart failure. These interviews were then analyzed qualitatively.
　Results: Support methods used to encourage self-management among elderly patients hospitalized for acute exacerbation of chronic heart failure consisted of the following four categories: “support to encourage patients to put self-management into action”, “support to encourage understanding of self-management”, “support to encourage patients to self-manage within their abilities”, and “self-management support that emphasizes patients’ values and lifestyles”.
　Discussion: “Comprehensive assessment of lifestyle and ways to confront illness” and “encouraging patients to express their values and thinking”, both of which are included in “self-management support that emphasizes patients’ values and lifestyles”, may be necessary in tandem with “support to encourage patients to put self-management into action”.
　Conclusion: The support methods identified in the present study may serve as hints for ward nurses as they provide support to encourage self-management among elderly patients with chronic heart failure. In the future, these support methods should be compiled and represented systematically.

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[in Japanese]

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[in Japanese]

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