This study aimed to clarify the concept of "Toubyou-iyoku"-a volition of the fight against illness-among hospitalized children. In Japan, patients undergoing treatment are sometimes described as having "Toubyou-iyoku" based on their positive attitudes toward their illness and treatment. When hospitalized, if affected children have a positive attitude toward fighting a disease, this can lead to positive changes after discharge. However, the conditions under which they can be motivated to fight diseases are unclear. To address this issue, Walker and Avant's concept analysis method was used to analyze "Toubyou-iyoku." The analysis yielded seven attributes: confronting the disease head-on, recognizing the disease, eagerly receiving treatment, focusing on treatment, endeavoring to overcome the disease, trying to remain calm and maintain composure, and keeping hope alive. These are seven antecedent requirements and eight consequences that do not move in one direction but rather circulate. Hence, supporting not only the antecedents (factors that influence the volition of the fight against illness) but also their individual attributes and consequences is necessary. Hospitalized children's volition of the fight against illness was defined as their desire and hope to face illness and treatment, accept it with wavering feelings, and actively work to maintain treatment based on their innate ability to understand and cope with their illness and experiences associated with hospitalization.

Objective: This study evaluated the psychometrics of the Japanese version of the evidence-based practice beliefs (EBP-B) scale. Methods: The study design was a cross-sectional survey. An online survey was conducted from October 2021 to February 2022. A questionnaire including the 16-item Japanese EBP-B scale was distributed to 2,977 nurses in three university hospitals across Japan. After 14 days, the same questionnaire was distributed to all participants to measure test-retest reliability. The factor structure of the Japanese EBP-B scale was evaluated using principal component analysis, known-group validity, and test-retest reliability. Results: Five hundred fifty-one nurses (response rate, 18.5%) completed the first survey, of whom 309 (56.1%) were included in the test-retest analysis. Principal component analysis revealed that the Japanese EBP-B scale tended to be moderately similar to the original version. Regarding known-group validity, the total score of the Japanese EBP-B scale was positively associated with academic background, job title, years of experience, certification of advanced practice nurses, and experience with learning and implementing EBP and conducting nursing research. The weighted kappa coefficients ranged from 0.27 to 0.51 for all scale items. Conclusions: Overall, the Japanese version of the EBP-B scale demonstrated psychometrics similar to those of the original version. Test-retest reliability varied among the items.

Objective: We explored how the effects of obstructive factors changed according to the status of nursing researchers' activities during coronavirus disease 2019 (COVID-19). Methods: This study included two online questionnaires in 2020 and 2021 to explore the effect of COVID-19. Participants were 321 nursing researchers from the universities who answered both surveys. The participants were divided into four groups according to the change in research activity status. We compared the results between the four groups in the first survey and the changes between the two surveys in each group. Results: The 321 participants comprised 9.0%, 18.4%, 6.9%, and 65.7% in the "Well-maintained," "Improved," "Worsened," and "Difficulty-remained" groups, respectively. As a comparison of the scores of obstructive factors in the first survey between the four groups, the "Well-maintained" group's scores including "information and communication technology (ICT) proficiency needs and support for others" tended to be lower than that of the other groups. Furthermore, the "Improved" group's scores showed a statistically significant improvement in the second survey, particularly in ICT-related factors (p < .001). Although the scores for "family role burden and conflicts" tended to improve in the "Well-maintained" and "Improved" groups, the scores in the other two groups remained almost unchanged. Conclusions: The prolonged COVID-19 pandemic has had a negative effect on nursing researchers. The results revealed that ICT proficiency, effective use, and managing to balance family roles and work might be key factors in promoting family activities during difficult periods.

Objective: Changes in sleep are common among parents in the perinatal period. This study aimed to describe objective and subjective sleep quality in men during their partner's pregnancy and its association with depressive symptoms. Methods: We used cross-sectional data from a prospective observational study. Men in Japan with primiparous partners after 20 weeks of gestation were recruited. Objective and subjective sleep were measured using actigraphy and the Pittsburgh Sleep Quality Index, respectively, and depressive symptoms were measured using the Edinburgh Postnatal Depression Scale. This study was approved by the ethics committee of the principal investigator's institution. Results: A total of 15 men provided valid data for analysis. Actigraphy data showed that, on average, participants slept for 420.3 min per night, took 6.4 min to fall asleep, were awake for 11.3 min per night, and awoke 0.7 times during the night, with 97.4% sleep efficiency. There were no significant associations between sleep parameters and depressive symptoms, except for sleep latency (r = −0.59, p < .05). Conclusions: All participants had good sleep quality and few depressive symptoms, and there were no associations between overall sleep quality and depressive symptoms during pregnancy. This study provides baseline data for assessing changes in sleep after childbirth. Importantly, changes in sleep patterns after childbirth may stress fathers and lead to paternal depression. This illustrates the value of prenatal education, which covers postpartum sleep guidelines and information on infant care to help expectant fathers cope with sleep disruptions and adjust to fatherhood.

Objective: Although robot-assisted radical prostatectomy (RARP) is widely used for prostate cancer, postoperative deterioration of quality of life (QOL) remains an issue. Many previous QOL studies have used health-related QOL measures after surgery. However, life experiences of patients remain unknown, and QOL measures alone may not be sufficient for understanding multidimensional QOL. This study aimed to clarify the transition in life experiences of patients after RARP. Methods: A questionnaire survey that contained 17 independent items was administered to 108 patients at 1, 3, 6, 9, and 12 months after RARP to evaluate life experience. Cochran's Q test was used evaluate the change over time in life experience. Results: A total of 88 men were included in the analysis. Most participants did housework and worked as usual 3 months post-RARP; however, few participants went on trips. Although urinary dysfunction improved over time, participants exhibited long-term support needs, such as pad use. More than half of the participants were anxious about recurrence throughout the postoperative year. Conclusions: The transition of 17 life experiences of patients for 1 year after RARP was clarified. Patients presented diverse experiences, both positive and negative. The findings demonstrate a wide range of impacts on life after RARP, thus emphasizing the need for QOL support.

Objective: This study aimed to identify practical knowledge about the initial response at healthcare facilities in the event of a human-induced disaster, based on the narratives of healthcare personnel who experienced the initial response to victims of the sarin gas attack on the Tokyo, Japan, subway system. Methods: Six healthcare workers who were engaged in the initial response to the victims of the sarin subway incident were interviewed using semi-structured interviews. Results: The narrative was composed of 6 categories, 15 subcategories, and 105 codes. The categories identified were "Complementary clinical judgment," "Reflection on nursing and healthcare practice," "Passing on a unique experience," "Knowledge of biological and chemical weapons," "Responsibilities as a healthcare professional," and "Need for medium- to long-term care of victims." Conclusions: It became clear that the acquisition of knowledge and skills to protect oneself first and to minimize secondary disasters, along with the accumulation of daily nursing practice, is necessary. The need for the development of new knowledge and nursing education regarding man-made disasters, including terrorism, was demonstrated.

Objective: This study aimed to develop and assess the psychometric properties of the Engagement in Learning Activities Scale (ELAS) for newly graduated nurses. Methods: This cross-sectional study included 58 Japanese medical facilities with >200 beds. A total of 1,405 newly graduated nurses participated in the study, with 299 returning completed questionnaires and 290 providing valid data for analysis. Participants completed a questionnaire that included the ELAS, the Utrecht Work Engagement Scale, the Self-Directed Learning Readiness Scale for Nursing Education, and personal background information. Reliability and validity were assessed through item analysis, exploratory factor analysis, Cronbach's alpha coefficient, correlation with external criteria, and test-retest methods. Results: Item and factor analyses yielded 21 items across four factors. Confirmatory factor analysis demonstrated a good fit. Cronbach's alpha of the ELAS subscale ranged from.712 to.839, and test-retest reliability ranged from..45 to..72. The ELAS was correlated with the Utrecht Work Engagement Scale (r =.454) and the Self-Directed Learning Readiness Scale for Nursing Education (r =.393). Conclusions: The study yielded acceptable estimates of the consistency and construct validity of ELAS, thereby allowing for an objective evaluation of newly graduated nurses' learning efforts. However, stability was inadequate, demonstrating the need for further investigation.

Objective: To elucidate the impact of the coronavirus disease 2019 (COVID-19) pandemic on children and youth with special needs, their families, and their supporters in Japan. Methods: This qualitative descriptive study was carried out via focus groups. Participants were care providers and family caregivers of children and youth with special needs. In the survey, the participants were asked about the changes in physical and mental health, caregiving status, and multidisciplinary collaboration during the COVID-19 pandemic. Results: The categories of the impact of the COVID-19 pandemic on children and youth with special needs and their families were [Concentration of burden on primary caregivers], [Mental stress of the primary caregiver], [Mental and physical impact on children and youth with special needs], [Dissatisfaction/anxiety about changes in social interactions], [Sibling/family mental stress], and [Increased risk of abuse due to lack of respite]. The problems encountered by service providers during the pandemic included [Difficulty in utilizing social resources], [Disparities in the use of support services and systems], [Problems due to the changes in the way people go to the hospital], [Difficulties in assuring quality of professional care], [Challenges in organizing a pediatric home care team], and [Need to understand a diverse group of children and youth with special needs]. Conclusions: Our data suggest the need for support to replace family caregiving, as the burden is concentrated on the primary caregiver. In the future, a system will be required to promptly respond to the special needs of each child through the collaboration of the government, hospital, and community.

Objective: Given nurses' workload and demanding professional life, this study explored subjective well-being and associated factors among nurses employed in hospitals in Japan. Methods: An anonymous self-administered questionnaire survey was given to 1,359 nurses working in two university hospitals in Japan. Subjective well-being (mental health and fatigue) was assessed using the Japanese version of the Subjective Health Perception Scale. The relationships between work environment, lifestyle, and occupational stress were examined using multiple regression analysis. Results: Data from 589 female nurses (response rate: 43%) were analyzed. The proportion of participants in the low mental fatigue group was 49.4%. Factors associated with mental fatigue included items related to occupational stress, such as interpersonal stress at work, irritability, anxiety, depression, physical complaints, support from family and friends, and satisfaction with work and life (p < .05). Conclusions: Approximately half of the nurses working at university hospitals had high levels of mental fatigue. This study revealed associations between stress reactions and greater support from family and friends. Additionally, satisfaction with work and life is related to occupational stress, highlighting the importance of considering whether nurses perceive stress reactions and assessing the need for support based on support from family and friends.

Objective: The present study aims to develop the psychological adjustment in survivors of women's cancers (PASWC) scale and examine its validity and reliability. Methods: A draft scale comprising 32 items was prepared based on a pilot study. The participants for analysis were 304 survivors of women's cancers. A PASWC model was created, and the goodness of fit was evaluated based on the covariance structure for a confirmatory factor analysis. Results: Five subscales comprising 20 items were extracted as a result of the factor analysis. The statistical model fit the actual data: goodness of fit index, 0.903; adjusted goodness of fit index, 0.872; comparative fit index, 0.920; and root mean square error of approximation, 0.060. The subscales were as follows: "connecting with others," "being a charming me," "being myself," "overcoming pessimism," and "living more independently as a woman." The scale reliability was confirmed based on Cronbach's α for an internal consistency of 0.87 for the 20 items. The criterion-related validity was almost satisfactory for all areas. Conclusions: We confirmed this scale's reliability and validity; hence, it can become a useful tool for measuring the psychological adjustment of female cancer survivors in clinical settings.

Turnover of newly graduated nurses is an international problem. Although there are many studies on the learning process of newly graduated nurses, there is little research on why they were able to stay and survive. Therefore, this study aimed to clarify the survival processes of newly graduated nurses in clinical practice. Interviews were held with 12 nurses who had graduated from a 4-year nursing college, had 3-4 years of clinical experience in a general hospital ward, and were currently in a preceptor or similar educational role. Modified grounded theory was used for data collection and analysis. Consequently, we identified 1 core category, 1 category, 7 subcategories, and 31 concepts. The category "It's Sink or Swim" was a major turning point in the survival process of newly graduated nurses in the clinical field, after which the daily intention of the core category "Keeping my Commitment" continued with new realizations and repetitions of actions. The repetition of this routine also meant that the breadth of the newly graduated nurse's experience was broadened, and the burden of the core category "Keeping my Commitment" gradually reduced. In this way, new nurses survived in clinical settings. These findings showed that for newly graduated nurses to survive in a clinical setting, the core category of "Keeping my Commitment" while building relationships with their seniors was important. Therefore, it may be important for nursing education to strengthen not only supportive interpersonal relationships with patients but also foundational skills for interpersonal relationships with senior nurses.

Objective: This study describes and compares the practices of the nurses, pharmacists, and physicians from a Japanese university hospital on cancer patient support during pharmacotherapy and gather suggestions for enhancing the effectiveness of the pharmacotherapy delivery system for patients with cancer. Methods: This descriptive cross-sectional study involved 430 nurses, 76 physicians, and 22 pharmacists from a university hospital in Japan and was conducted from February to April 2022. A uniform questionnaire was distributed to all three groups of professionals. The practices of indication judgments for pharmacotherapy (e.g., confirming that it is an established standard or equivalent treatment for the cancer type concerned) were asked using six items on a four-point scale. Their perceptions of patient support issues were asked using five items. The data were analyzed using the Mann-Whitney U test and Fisher's exact test. The Ethics Review Committee of the Graduate School of Nursing of Chiba University approved the present study. Results: The analysis included a final number of 184 nurses, 35 physicians, and 12 pharmacists after applying the eligibility criteria. Statistically significant differences were observed in four items, including "Confirm that the treatment has been established as standard treatment or equivalent treatment for the cancer type in question." Variances regarding what are checked to judge pharmacotherapy indications were noted among the three groups of professionals. The common situation and practice identified across these professions included information exchange through electronic charts, sharing knowledge on managing new pharmacotherapies, and ensuring adequate time for patient self-care support. Conclusion: This study uncovered variations in the perceptions of nurses, physicians, and pharmacists on cancer pharmacotherapy. The key to fostering an effective collaboration is the implementation of a systematic approach for sharing patient information and pharmacotherapy knowledge while ensuring a clear understanding of the role of each profession.

The study aimed to develop a decision support tool for patients with Crohn's disease considering biologic treatment and evaluate its usability, validity, and acceptability. A prototype was systematically developed based on the Ottawa Decision Support Framework. The prototype met all the qualifying criteria of the International Patient Decision Aid Standards instrument. A questionnaire survey was designed to assess the prototype, with 22 patients and six clinicians recruited. We calculated the descriptive statistics for the survey data and analyzed the free responses using a qualitative content analysis and the prototype features requiring refinement extraction. The survey was completed by 18 patients and six clinicians. The prototype was assessed as "very useful" by 66.7% of the patients and clinicians and "quite useful" by 33.3%. The information that patients must know was considered to be "well represented" by the prototype, as expressed by 72.2% of the patients and 66.7% of the clinicians, and as "somewhat represented," as expressed by 27.8 and 33.3%, respectively. Most respondents reported that the content was "easy to understand" (patients: 83.3%; clinicians: 100%); the format was "easy to use" (patients: 77.8%; clinicians: 100%); and the information presentation was "well-balanced" (patients: 83.3%; clinicians: 100%). The patients suggested improvements, such as using figures to make the text concise and revising the checklist format and content to facilitate decision making. We created an evidence-based decision support tool after modifying the prototype according to the survey results. Further investigation of the tool effectiveness for Crohn's disease patients considering biologic treatment is needed.