This study sought to identify distressing experiences of adolescent mothers who have just started parenting in the two months since giving birth and changes in how the mothers perceived those experiences. Participants were unemployed primiparas ages 17-18 who were interviewed in a semi-structured format two months after giving birth regarding (1) distressing experiences since giving birth, (2) adolescent mothers' changes through distressing experiences, and (3) hopes for the future. Their responses were subjected to qualitative content analysis. There were 10 participants in total; nine were married (seven resided with their husbands) and one was unmarried. (1) Their distressing experiences since giving birth fell into six categories: (a) the excessive burden of unplanned parenting, (b) excessive meddling in parenting by one's mother-in-law, (c) dissatisfaction with an immature husband, (d) anger at a partner who refuses to legally recognize the relationship, (e) failure to be acknowledged by the family of one's partner, and (f) disapproval directed towards adolescent mothers. (2) Adolescent mothers' changes through distressing experiences fell into four categories: (a) acquiring mental strength through maternal awareness and a sense of responsibility, (b) acclimating to and abandoning personal relationships, (c) acceptance of teenage childbearing, and (d) giving up hopes of having a legally recognized relationship with or living with one's partner. (3)Adolescent mothers' hopes for the future fell into five categories: (a) yearning for academic reintegration, (b) earning qualifications or receiving a license, (c) wishing to work part-time, (d) taking on different challenges, and (e) wanting to making up with one's partner. Through a variety of distressing experiences, adolescent mothers who have just started parenting became mentally stronger while acquiring parenting and social skills and they began to adapt to interpersonal relationships and accept stark realities. In light of the social circumstances that individual adolescent mothers face, additional support is needed to further the wishes and growth and development of these young women.

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The goal of this study was to verify clinically whether the concepts of Parse's theory could apply to nursing of elderly patients with urinary dysfunction in Japan. Parse's theory expressed that the role of nursing was defined as follows: "The nurse is the true presence for individuals and groups." The methods of clinical nursing were also defined as: 1. Illuminated meaning to the patient, 2. Synchronized rhythms with the patients and 3. Mobilized transcendence. Three elderly patients with urinary dysfunction were nursed and studied through the application of Parse's theory. The three patients selected a method for independently passing their urine with instruction from nursing. The process of how the three patients achieved independent urination was analyzed on the basis of Parse's theory. As the result, the three patients established their own way of passing urine. Their quality of life was also improved. The analysis of the process revealed that no phenomena foreign to the concepts of Parse's theory were identified. It also became clear that the process of care was divided into three stages that corresponded with the first, second and third principles of Parse's theory. Therefore, it was suggested that the application of Parse's theory in Japanese culture was highly possible.

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The purpose of this study is to clarify inductively the constructs "Nurse's autonomy concept" in clinical practice. Semi-structured interviews were conducted on 9 Clinical Nurse Specialist in a each field, and interview records were qualitatively and inductively analyzed. The characteristic and the change in the autonomous attitude and the autonomous behavior were inquired. The interview data were used to conceptualize the construct of "nurse's autonomy". As a result, eights subcategories were identified: ethical decision making; respect for patients' decision making; empowerment by interpersonal relationship; control of human feelings; readiness for professionals; responsibility as specialists; nurse's discretion; cooperation and negotiation. And four categories were emerged; patient protection; interaction with others; maturity as professionals; and organizational activity. The results suggested that neither empowerment by interpersonal relationship nor control of human feelings in subcategories are included in the constructs of the existing autonomy scale.

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The aim of this study was to evaluate the reliability of measurements of the interval between the tibia and femur and of the method of extraction of an ultrasonic image of the knee joint. Experiment (1): One examiner extracted 20 ultrasonic images (10 joint angles×the medial and lateral joint spaces) from the anterior and lateral surfaces of the joint in one healthy subject, and two examiners measured the interval between the tibia and femur on the images. One of the examiners made the measurement twice. Experiment (2): Two examiners extracted 20 ultrasonic images (as in Experiment (1)) from the anterior and lateral surfaces of the joint in one healthy subject, and one of the examiners extracted the images twice. The interval between the tibia and femur was measured by one examiner after the extraction procedure. In Experiment (1), the inter-examiner and intra-examiner interclass correlation coefficients (ICCs) of the measurements of the extracted anterior and lateral surface images were 0.999 and 0.998, respectively. The results of Experiment (2) showed that the inter-examiner and intra-examiner ICCs of the measurements of the extracted anterior surface images were 0.971 and 0.984, respectively. These were higher than those for the extracted lateral surface images. These results indicate that measurements of the anterior surface of the joint and extraction of the images from the anterior surface of the joint are more reliable than those for the lateral surface.

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