The purpose of this study was to clarify the structure of support provided by Oncology Certified Nurse Specialists to families of elderly cancer patients who have difficulty making decisions, and to discuss the practical skills required of nurses. Data were collected through semi-structured interviews with eight Oncology Certified Nurse Specialists who had experience in providing surrogate decision-making support to families of elderly cancer patients. The method of analysis was qualitative inductive analysis. Support for family members who make surrogate decisions was summarized into four core categories: “lighten the burden borne of the family as much as possible,” “aim for decisions that reflect the elderly cancer patient’s wills,” “clarify family members who can carry out surrogate decision-making,” and “have family members be prepared to make proxy decision-making.” It was considered that support is continued from before the proxy decision is assumed to be made until after the proxy decision is made, interrelating, and aiming two goals that “lighten the burden borne of the family as much as possible,” “aim for decisions that reflect the elderly cancer patient’s wills.” The practical skills required of nurses include the ability to nestle the family, the ability to assess, the ability to build relationships with multiple professions, and the ability to respect the wishes of elderly cancer patients and to be aware of reducing the burden on the family.

　Purpose:To clarify the parenting process of fathers of children with severe motor and intellectual disabilities（SMID）who need medical care when they start school.

　Methods:Semi-structured interviews were conducted with fathers of children with SMID, mainly in the Tokyo metropolitan area, regarding their experiences during the schooling period. The interview content was analyzed based on a modified grand theory approach.

　Results:When fathers of children with SMID begin “To face the children’s challenges of schooling”, they “Assess the situation surrounding their children and families”, and “Take action to improve the living environment for their children and families”. Also, they “Have various feelings about schooling as a result of their actions”. In addition, by influencing each other, including mothers, fathers of other SMID, and professionals, they were “Supported in raising their children when they start school”. Fathers go through this process throughout schooling each time a new challenge arises, building on their experiences.

　Discussion:The fathers of children with SMID at the time of schooling looked at themselves, their families, and society from a bird’s eye view and assessed the situation surrounding their children and families. They struggled to balance work and family life and explored their role as fathers in the family, while taking action to maintain their children’s and family’s lives and to create an environment conducive to their children’s schooling.

　The purpose of the present study was to identify specific needs of chronic heart failure patients who are on cardiac （CRT） and continuous positive airway pressure （CPAP） therapy. Patients who underwent CRT/CPAP therapy for at least 6 months and visited our hospital as outpatients were included in the study after their consents were obtained. A semi-structured interview was conducted, and the responses were analyzed qualitatively. Our subjects consisted of 20 patients （13 male, 7 female） with a mean age of 72.4 years. Of them, 10 patients underwent CRT alone, 8 patients underwent CPAP therapy alone, and 2 patients underwent both CRT and CPAP therapy. Based on the responses from the interviews, we identified 13 categories that described the needs of patients receiving CRT/CPAP therapy. Among them, the following were considered specific to patients undergoing CRT/CPAP therapy: 1） I experienced pain associated with CRT/CPAP therapy, 2） I do not understand the purpose and effects of CRT/CPAP therapy, 3） I would have liked to get more information on social resources and employment after CRT/CPAP therapy, 4） I have difficulty wearing the mask during CPAP therapy, and 5） I experienced stress caused by restrictions and changes in my appearance due to CRT therapy. Collectively, our findings indicate that chronic heart failure patients undergoing CRT/CPAP therapy suffer from shoulder pain and dry mouth associated with CRT/CPAP therapy, have difficulty understanding and properly using the equipment for the treatments, have difficulty obtaining information on social resources and employment, and experience stress due to restrictions and appearance changes that are associated with the treatments. When providing care in an outpatient setting, it is important to recognize that these patients may have specific needs beyond common concerns and to provide appropriate care for those needs.

　Purpose：The purpose of this study was to clarify the difficulties faced by senior Japanese nurses when supervising Chinese nurses working in Japan.

　Method：Semi-structured interviews were conducted with 11 senior Japanese nurses who were supervising Chinese nurses, and the difficulties they faced when supervising Chinese nurses was qualitatively and descriptively analyzed.

　Results：Six categories were identified as the difficulties experienced by senior Japanese nurses when supervising Chinese nurses:“lack of understanding towards Chinese nurses working in Japan,”“difficulties in establishing smooth communication,”“exploring solutions to the challenges of Chinese nurses adapting to the workplace culture of medical settings,”“struggling to identify methods to help Chinese nurses understand medical care and nursing in Japan medical care and nursing in Japan,”“fatigue felt by not being able to master the nursing process even after giving guidance,”and“many challenges to independence and lack of support system.”

　Discussion：When senior Japanese nurses supervising Chinese nurses, it suggests that it is necessary to understand the readiness of Chinese nurses through effective communication and then construct an effective education plan. In order to alleviate instructors’ difficulties, it is necessary to establish a consultation desk that can provide support and cooperation to instructors.

　Objective:To develop a pilot version of the Education Program for Outpatient Nurses for Nursing Practice Empowering Patients Living with Cancer and to test its usability and feasibility for implementation at facilities.

　Methods:1） Developing the pilot program: The purpose of the program was to train outpatient nurses to enable the implementation of nursing practice that empowers patients living with cancer. The learners were nurses who were engaged in the care of outpatients living with cancer and who were able to perform basic tasks in their departments. The program consisted of five subprograms （SPs）, a checklist （CL） of practical skills, two supplementary materials, and five recording forms. Learners were asked to select their preferred SPs based on their needs. 2） Study procedure: Outpatient nurses who met the learner criteria （n=9） and their supervisors （n=9） at designated cancer care hospitals were asked to implement the program. After implementation, the nurses and their supervisors, as well as the nursing managers in charge of education at their facilities （n=5） were interviewed about the usability of the program and its feasibility in their facilities. In addition, CL scores before and after implementation were compared.

　Results:1） Usability: Outpatient nurses reported that the program allowed them to “steadily acquire competencies”, while their supervisors reported that the program “covered the necessary content for education”. The CL scores increased for 10 （90.9%） of the 11 SPs after the program was implemented. 2） Feasibility for implementation: Both the supervisors and managers indicated that the implementation of the program “would be possible with sufficient time and human resources”, and that the program “will need to be simplified for implementation”.

　Discussion:We demonstrated that the pilot version of the program may be effective for improving the ability for outpatient nurses to implement nursing practice that empowers patients living with cancer. The program needs to be simplified while maintaining its quality of education to facilitate its full implementation across facilities.

　Objective:This study sought to determine how ward nurses and discharge coordinating nurses provide discharge support to elderly patients living alone with dementia following hospitalization in an acute care hospital, and in particular examining discharge support that respects the patients’ wishes.

　Methods:A qualitative descriptive research design was used. Semi-structured interviews were conducted with four ward nurses and three discharge coordination nurses working in an acute care hospital. Their narratives were analyzed qualitatively.

　Results:The five aspects of discharge support discussed by the participants were “support in line with patient wishes”, “support to achieve discharge home”, “assessment for safe living after discharge”, “support for safe living after discharge home,” and “activities to improve discharge support”.

　Conclusion:In order to provide discharge support that respects the wishes of elderly persons with dementia who live alone, it is important to elicit the wishes of the elderly persons with dementia, to include support persons who support the elderly persons with dementia, to conduct assessments to ensure that the elderly persons with dementia can live safely after discharge, and to be involved in ensuring that support continues after discharge.

　Objective：We developed a mobile application (hereinafter referred to as “app”) for outpatients with cancer pain and created a nursing support program to improve self-management of pain through the app and nursing interventions. The purpose of this study was to determine the usability of the developed app for outpatients with cancer pain. Methods:Outpatients with cancer pain who had been taking opioids were asked to use the app for one week. We then administered a questionnaire that asked outpatients to rate the usability and other aspects of the app on a 5-point scale and calculated the mean scores. In addition, we conducted an interview to determine patient satisfaction and identify areas for improvement. The responses were qualitatively and descriptively analyzed. Results:A total of 9 outpatients participated. Mean usability ratings were as follows: over all ease of use (3.0), ease of understanding operation instractions (3.0), ease of understanding the configuration (3.3), ease of operation (4.1), ease of short time to complete operation (3.6), quick operation (3.9), readability of text (3.8), desire to use in the future (2.8), overall satisfaction (40-60%), and overall rating of the app (2.8). Seven participants used the app daily, while the remaining two participants used the app three times per week. These two participants were unable to use the app daily due to exacerbating pain or fever. The ability of the app to instantly display messages according to the information entered helped with laxative intake and led to participants’ reassurance. Areas for improvement suggested by the participants included changing the font size and adding a column for patients to record that they have taken their medication. Discussion:The developed app was generally considered useful in terms of effectiveness and efficiency, although its use may be burdensome depending on the physical condition of the patient. Future improvements are needed, such as changing the font size and adding a column for recording the intake of medication.

Objective:This study aimed to clarify the characteristics and perceptions of nursing students who participated as student assistants in community senior citizens club activities during the COVID-19 pandemic.Methods:The participants were 5 fourth-year nursing students. A mixed-methods approach was used to analyze quantitative and qualitative data obtained from self-administered questionnaires and interviews.Results:The average scores on the Volunteer Functions Inventory (VFI) scale were highest for ‘understanding’, followed by ‘career’ and ‘values’, while ‘protective’, which had the lowest average score, showed a significant increase after the activities (p < .05). Six categories emerged from the participants’ narratives: 【Readiness for Community Activities】,【Ease and Difficulty of Engagement in Activities】,【Benefits to Oneself from Activity Participation】,【Learning from Interpersonal Communication Opportunities】,【Necessity of Skills to Operate and Promote Activities】, and 【Expansion of a Nursing Perspective】.Discussion:Readiness for community activities contributed to recognizing the benefits of engagement and a proactive learning attitude, creating a positive cycle. While the initial motivations for participation were ‘understanding’ and ‘career’, increased opportunities for interpersonal communication during the activities led to enhanced ‘protective’ and emotional well-being. Through active participation, participants shifted from merely fulfilling assigned roles to actively learning, recognizing the necessity of skills to operate and promote activities, and expanding their nursing perspectives.