Objective: This study aimed to clarify the attitudes of public health nurses (PHNs) endeavor to adopt when engaging in dialogue with parents and families for providing ongoing childrearing support. Methods: This was a qualitative descriptive study. We collected data through semi-structured interviews. The data were qualitatively and inductively analyzed. Results: The study participants were 10 PHNs with 6-30 years of experience; all of them had work experience in areas such as maternal/child health and child welfare. The PHNs' attitudes in the dialogue were as follows; the attitude of overlaying each other's stories, diversifying the narrative and leaving the conclusion to the future, and returning the story to the other party and being ready to resume the dialogue at any time. Conclusions: The PHNs tried to create a story together with the parents and family and continued the dialogue with the aim of letting the parents and family walk the story on their own. We propose a style of support called "dialogical childrearing support" which is the idea of supporting childrearing by continuing dialogue and co-creating the childrearing story.

Objective: The dynamics of what actually occurs when couples make treatment decisions have not been fully studied. This study aimed to identify the influence of male spouses on the primary treatment decisions of patients with breast cancer in Japan and to obtain ideas for nurses to effectively help patients with breast cancer make primary treatment decisions. Methods: This qualitative study included married patients with stage I-III primary breast cancer <6 months after surgery. Semi-structured interviews were recorded and analyzed inductively. Results: This study identified three core categories that reflect the influence of spouses of Japanese patients with breast cancer on decision-making regarding primary treatment: the basis, quality, and direction of decision-making. These comprised six categories: "obtaining support that enables me to make my own choices in comfort," "living true to myself became difficult because, contrary to my expectations, I was disrespected," "examining the options together with my spouse will help me recognize values and lead me to a rational choice," "self-determination is disturbed by over-interference and psychological pressure," "rethinking their present state as a couple and exploring the future of their life together," and "not trying to look ahead, just letting things happen." Conclusions: It is important to evaluate marital relationships and leverage the strengths of joint decision-making to achieve better-quality decisions.

Objective: Although bed transfers, which represent patient transfers within a ward, are common, we know little about how they should be managed. This study aimed to identify annual trends in bed transfers and evaluate the influence of patient inflow, outflow, and bed occupancy rate on the frequency of bed transfers. Methods: Using an exploratory observational design, we analyzed the medical data of four wards in a single hospital. The data were obtained from November 2017 to November 2018 and included the numbers of admissions, discharges, transfers into and from wards, inter-room transfers, intra-room transfers, and inpatient admissions. Admissions and transfers to wards were categorized as patient inflows. Discharges and transfers from the wards were categorized as patient outflows. Inter-room and intra-room transfers were categorized as bed transfers. Descriptive statistics were calculated to confirm the trends in the number of bed transfers. Autocorrelations for each variable and cross-correlations between bed transfers and each variable were examined. Multiple regression analysis based on an autoregressive model of order 1 and a non-time-series model was conducted, with the dependent variable being the number of bed transfers. Results: In winter, bed transfer, patient inflow, and beds occupancy were higher. We found that patient inflow had a significant effect on bed transfer. Conclusions: Bed transfers could be partially predicted by monitoring trends in patient inflow. When the number of bed transfers is high, appropriate staffing is necessary to assign patients to suitable beds by monitoring changes in their conditions.

Objective: To improve the side effects of chemotherapy, practicing self-care behaviors is important for patients with cancer to continue treatment and maintain their quality of life. Herein, we aimed to assess the association between personality traits and self-care behaviors among patients with gastrointestinal cancer undergoing outpatient chemotherapy. Methods: This study included patients who received intravenous chemotherapy at a designated regional cancer hospital in Japan between June 2020 and October 2020. A self-administered survey was conducted using the Japanese version of the Ten-Item Personality Inventory and a unique 29-item questionnaire to assess self-care behaviors. The correlation of each item was analyzed using Spearman's rank correlation coefficient. Results: In total, 53 (93.0%) responses were obtained from 57 participants, of which 52 (91.2%) complete responses on personality traits were valid. The mean personality trait scores ranged from 6.7 ± 2.8 for neuroticism to 11.0 ± 1.9 for agreeableness. A high degree of openness had a moderately significant positive correlation with adjustment of exercise (ρ =.49, p <.01) and adaptation to changes in appearance (ρ =.41, p <.01). Additionally, a high degree of conscientiousness had a significant positive correlation with the acquisition of information on disease and treatment (ρ =.30, p =.03) and confirmation of inspection results (ρ =.39, p <.01). Conclusions: Openness and conscientiousness were significantly associated with patients' self-care behaviors. Assessing these personality traits before initiating chemotherapy can predict self-care behaviors and provide individualized support, considering the limited involvement at outpatient visits.

Objective: To examine the effects of a self-management program for poststroke fatigue (PSF). Methods: The study participants included were 30 patients with early fatigue within 3 months after a stroke. During hospitalization, a 2-week-long self-management program for PSF was provided, consisting of components on problem-solving support, self-monitoring support, and education. The outcomes included fatigue (Multidimensional Fatigue Inventory [MFI]), motivation (Apathy Evaluation Scale [AES]), and self-management skills (correct answer rate on a knowledge evaluation questionnaire), with higher MFI and AES scores indicating more severe fatigue and reduced motivation. We then performed pre- and post-intervention comparisons to obtain the effect sizes. The ethics review committee approved this study. Results: A total of 25 participants completed the program (five dropouts). Regarding the pre- and post-intervention comparisons, MFI scores decreased significantly after the intervention (p =.00, Cohen's d = 1.48), with the proportion of those who exceeded the cutoff decreasing from 60.0% to 36.0%. AES scores also decreased significantly after the intervention (p =.03, Cohen's d = 0.45), with the proportion of those who exceeded the cutoff decreasing from 44.0% to 28.0%. Knowledge also increased significantly (p =.00, r = 0.86), suggesting the acquisition of self-management skills. Conclusions: After the intervention, fatigue and motivation improved, and self-management skills were acquired. Although we cannot deny the possibility that fatigue improved naturally, the program was likely effective to some extent. Further studies on the program are necessary, and a randomized controlled trial with an adequate sample size is warranted to examine its effects. Trial registration: UMIN Clinical Trials Registry (UMIN000048681)