The purpose of this study was to clarify motivational factors that cause visiting nurses to keep working.

A survey was conducted using self-administered questionnaires to 726 visiting nurses who had worked for at least 1 year at their current workplace in Tokai Area and did not hold administrative positions. A total of 389 completed responses were received (response rate, 53.6%). Multivariate analysis showed that positive recognition for their work, recognition by a specialist, relationships with their superior, and burden of decision-making were among the motivational factors that cause visiting nurses to keep working.

In order for visiting nurses to keep working, it is important that they be recognized for their work and are able to satisfy specialists. However, decision-making has been found to place undue burden on visiting nurses. Therefore, proper guidance and approval from visiting nurses’ superiors can lighten their burden and motivate them to work.

Aim: This study explored visiting nurses’ perceived difficulties in supporting the use of the social security system by clients in their care and suggests how education can provide a solution.

Methods: This study is a descriptive qualitative study using content analysis. Data were collected through semi-structured interviews about cases in which lack of understanding of the social security system affected clients’ care. Participants were 12 visiting nurses, with experience ranging from six months to five years.

Results: This study identified five categories; “lack of basic knowledge about the social security system soon after becoming a visiting nurse”, “not being able to grasp the overall picture of the social security system sufficiently to support clients’ daily lives”, “not being able to manage their clients’ daily lives by supporting the use of the social security services”, “not being able to capture adequate information in realtime”, and “being hard to learn by themselves”.

Conclusions: The study results indicate three possible effective strategies to improve visiting nurses’ ability to support the use of the social security system for their clients’ care. First, provide novice nurses with education soon after they become a visiting nurse that connects the nursing care they provide for their clients with information regarding the social security system. Second, cultivate a work environment where novice nurses can easily obtain guidance from senior nurses regarding social security services. Lastly, construct a step-by-step and systematic curriculum to educate nurses about the social security system.

Objective: The present study aimed to explore Home-Visit Nurses’ perceptions of Patient Safety Incidents (PSI) in home care. Methods: Semi-structured interviews were conducted with 15 Home-Visit Nurses (HVNs) who belonged to home visiting nurse stations in a Japanese Metropolitan area.

Results: The main categories that emerged were: “1) Events that resulted in direct harm to the client’s condition” and “2) Events that are likely to be the cause of harmful events for a client’s condition.” These were recognized as PSI by all participants in this study. When PSIs were reported, they were classified as one of the following three events: “Adverse event,” “Incident,” or “Unsafe Event”. There was diversity among the HVNs’ point of view on which event falls into which of these PSI classifications. To decide the PSI classifications, HVNs’ considered “Situation,” “Actor,” “Emphasis on the occurrence of events,” “Seriousness of event,” and “Barrier of occurrence avoidance”.

Conclusions: For standardization and accumulation of PSIs in home care settings, it is necessary to classify the three categories of PSIs and these five points of view may facilitate the development of the criteria of classification.

The purpose of this study was to clarify the concept of comfort in the daily life of people with dementia. We searched for Japanese articles using two databases, and for English articles using three databases. The keywords used included “dementia,” and “comfort.” A total of 16 Japanese articles and 10 English articles were extracted and analyzed with reference to Rodgers’ evolutionary method of concept analysis. The analysis revealed the following six attributes: fulfillment needs are secured, understood by others, undisturbed mind, calm mind, live in a familiar place, and peaceful living, Furthermore, two antecedents and two consequences were presented. The study revealed that comfort in the daily life of people with dementia is a situation experienced through the intensive understanding of others about comfort, that includes the subjective factor in comfort, and that comfort is a calm and relaxing situation that can be created by supports. It is also suggested that this comfort makes it possible for people to recover their independence and daily life.

A self-administered questionnaire survey was conducted to clarify the care and support provided by home-visiting nurses influencing the end-of-life of elderly individuals living alone who wish to continue living at their homes until death. The questionnaire comprised items about the physical and psychological states of elderly individuals during the last week until death or quitting home care, the family member’s support to the elderly individuals living separately, and the situation of the home medical care team. The participants were divided into two groups according to the end-of-life conditions in the elderly individuals they cared for: the completed group comprising elderly individuals who died at home (n =78 ; response rate = 59%) and noncompleted group comprising those who moved to a facility at some point (n =77; response rate = 55%). Multivariate analysis indicated that the completed group had “giving explanations to the separated family about the process of death of the single living elderly person” (support for the family living separately), “confirming the role sharing with multiple types of occupation” (multi-occupation collaboration and support), and “the nurses recognized that as a whole the elderly people living alone could spend their desired life” (support for elderly individuals living alone).

The present study aimed to examine ACP practices in the field of homecare by conducting a comparative analysis between cases where homecare nurses found ACP to be favorable and cases where they found ACP to be challenging. A total of 1100 subjects were selected at random from among staff working at homecare nursing stations registered by the National Association for Visiting Nurse Service, and a questionnaire survey was conducted by mail. The content of the survey focused on recent ACP cases that nurses felt were favorable and cases that they felt were challenging. Among the cases where nurses found ACP to be favorable, over half were terminal-stage cancer cases. Over 80% had discussed in their ACP the type of life they would like to lead from now on and where and how they would like to spend their final moments. Among the cases where nurses found ACP to be challenging, over half were non-cancer disease cases. Furthermore, the participation rate of the user, cohabiting family members and the attending physician was lower than the favorable cases. As for why they perceived ACP to be favorable, many nurses mentioned the following reasons: they were able to hear the wishes of the users and their family members and provide care in accordance with their wishes, the users were able to spend their last moments with their family members and nurses received words of gratitude from family/bereaved family members. On the other hand, the reasons why they perceived ACP to be challenging were because very often it was difficult to ascertain the wishes of the users and there was a difference in plans between the users and the family members or disagreement among family members.