The objective of the present study was to elucidate the relationship between visiting nurses’ views on life and death and their personal background. A survey was conducted on 354 visiting nurses working at one of 52 visiting nursing stations in Prefecture A, and a total of 221 responses were analyzed.

Analysis of the relationships between factors on the views on life and death scale and personal background using one-way analysis of variance, Tukey’s honestly significant difference HSD test, and t-test showed significant differences between “death as a form of liberation” and age (p 0.010), years of clinical experience (p =0.002), and having many years of clinical experience in internal medicine ( p 0.033). Significant differences were also seen between “fear and anxiety toward death” and age (p 0.037) and between “avoidance of the issue of death” and years of visiting nursing experience (p 0.024). “A sense of purpose in life” was higher in nurses who had a sense of satisfaction regarding past terminal care (p ＜0.001). These findings suggest that accumulation of experience while having a clear sense of purpose, specifically providing indirect support for patients and families without avoiding the issue of death until the very end so that patients can live their lives to the fullest and in their own way while positively accepting death, promotes the quality (sense of satisfaction) of terminal care and leads to enhancement of views on life and death.

The purpose of this study was to clarify the relationship between the accuracy rates of prognostic predictions by visiting nurses and the symptoms, explored by three categories of chronic diseases including cancer. A questionnaire survey of visiting nurses was conducted and 138 responses was obtained from 61 home care station facilities. For analysis, chi-squared test was used to investigate the discrepancies between the prognostic predictions and the actual progress, and one-way analysis of variance, paired t-test and two-way analysis of variance to investigate discrepancies between the prognostic predictions and the symptoms manifested at the second point in the terminal stage. We found that diagnostic predictions made by the visiting nurses had 50% accuracy in specifying the actual progress. The visiting nurses checked the basis of pain, general malaise, constipation and diarrhea, and edema for group A diseases, general malaise, edema, dyspnea and depression for group B, constipation and diarrhea and general malaise for group C. In addition, in all disease groups, worsening of dyspnea was observed when diseases are developing into the aggravation stage. We have realized that it is necessar y to conduct a prospective study to clarify the symptoms observed by visiting nurses and the standards of judgment they use to make judgments.

The purpose of this study is to assess SOC (Sense of Coherence) among male and female family caregivers who provide care to their family members at home and to find the directions of support based on the characteristics of gender differences in the caregivers. Postal self-completion questionnaires were conducted from September 14 to October 30 in 2012. The Japanese version of SOC-13 scale was used to evaluate SOC. We requested a total of 326 facilities of Community General Support Center and Home Care Support Services in Ishikawa Prefecture to deliver the questionnaires to male and female caregivers. 414 out of 633 male caregivers (65.4% response rate) and 658 out of 727 female caregivers (90.5% response rate) answered the questionnaires. As a result, for the scores of the manageability scale, men exceeded women. Men in the non-healthy group had a stronger sense of manageability. It is important for elder men aged over 65 to strengthen their sense of meaningfulness by making them aware of the reconstruction of their lives.

Purpose : This study aimed to elucidate the relationship between chronic stress and sleep disorder in family caregivers living with frail elderly.

Method and Results: The subjects were 36 family caregivers living with home-care elderly. A selfadministered survey was conducted and their salivar y samples were collected. The Pittsburgh Sleep Quality Index (PSQI) was used for sleep evaluation. Subjective evaluation, salivary cortisol, and secretory immunoglobulin A in saliva salivary (s-IgA) were used as indices for chronic stress. The stress score increased significantly as the PSQI score increased (β＝ 0.434, p ＝ 0.014). The log s-IgA value decreased significantly as the PSQI score increased (β＝− 0.411, p ＝ 0.031).

Conclusion : Increase in subjective stress and decrease in salivary s-IgA were significantly associated with sleep disorder in family caregivers living with frail elderly. Chronic stress increased with increased disturbance of sleep in family caregivers. The results suggest that improvement of sleep might lead to alleviation of chronic stress in family caregivers.

The objective of the present study was to elucidate the actual condition of disaster measures and disaster correspondences at visiting nursing stations in Gunma Prefecture both before and after the Great East Japan Earthquake, and to examine related issues. A self-report questionnaire survey was conducted by mail on administrators at 92 facilities in Gunma Prefecture, and data were analyzed using descriptive statistics and qualitative induction. Valid responses were obtained from 34 individuals (37.0%). The mean number of staff was 4.9 full time equivalents, and approximately 50% of them participated in disaster workshops. Prior to the disaster, approximately 60% had created disaster manuals, less than 50% had provided guidance to users and their families, and less than 20% had engaged in cooperation from the perspective of disaster measures. After the disaster, approximately 70% confirmed the safety of staff, and approximately 50% confirmed the safety of users. In addition, approximately 60% made preparations for rolling blackouts, approximately 90% had difficulty securing modes of transportation, and approximately 80% engaged in cooperation. The following issues were also considered: ① strengthening of guidance regarding disaster measures to users of medical devices: ② creation of a disaster manual that outlines the chain of command and provides tables detailing the division of roles, etc. during disasters: ③ cooperation with users, their families, and other organizations in the creation process; and ④ establishment of a system for securing fuel for priority vehicles.