AIM: To clearly define the term “patient anguish” and improve guidance for nursing based on this definition. METHODS: We conducted a literature review of the Ichushi-Web database. This study targeted 22 articles referring to patient anguish in the results and discussion sections of the 67 studies extracted. Additionally, 22 studies were analyzed using Walker ＆ Avant's conceptual analysis method (2008) . RESULTS: A conceptual analysis of “patient anguish” in the literature produced 13 categories of attributes, 7 of antecedents, and 6 of consequences. Patient anguish was defined from the constructed conceptual model as follows: Unpleasant emotions that include physical, mental, social, and spiritual aspects affected by personal or external circumstances; that are difficult to self-regulate;and have a chronic, negative effect on quality of life. DISCUSSION: It was again suggested that nurses should improve their knowledge and skills and build relationships with their patients to reduce “patient anguish.”

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Glutamic acid (Glu), an umami component in human milk, has been suggested to play an important role in the prevention of allergies and infections in infants, but the relationship between mothers' habitual diet and Glu in human milk is not clear. Therefore, we aimed to clarify the relationship between maternal dietary habits and Glu concentrations in durable milk during the first month postpartum in 41 lactating women using a cross-sectional prospective study. Metrics included habitual dietary intake at 1 month postpartum (Self-Reported Dietary History Questionnaire), Glu concentration in durable milk whey, and plasma at 1 month postpartum. There was no correlation between Glu concentration in plasma and durable milk Glu concentration at 1 month postpartum. Food items that were correlated with plasma and milk Glu concentrations were sparse in Glu or did not contain Glu; therefore, we could not determine the relationship between Glu concentrations in durable milk and maternal dietary intake. In addition, Glu concentration in durable milk was significantly higher among multipara than primipara and among mothers with a relatively high degree of physical activity. Although the study did not show that mothers' habitual dietary intake affected milk Glu, Glu concentrations in durable milk were approximately 30 times higher than those found in plasma. Further research is needed to clarify the relationship between individual factors and milk or plasma Glu.

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PURPOSE: The purpose of this research is to clarify the trends of nursing skill education research at nursing universities and to examine future issues. METHOD: Using Ichushi-Web (Japan Medical Abstracts Society), the search formula was “nursing skill education”, and the narrowing down was “original papers”. Of the 274 documents obtained by searching, students at nursing universities were targeted. Academic literature was selected. For the 37 cases that were analyzed, we organized the contents and methods of nursing skill education and analyzed the common characteristics. RESULTS: As a result of the analysis, more than 60% of the specialized fields of nursing skill are related to basic nursing skill, and some of them are systematized, such as reports showing the structure of the acquisition process of basic nursing skill with an awareness of the curriculum axis. CONCLUSION: It was suggested that the evaluation of nursing skill education, which was aimed at constructing various educational contents, should be a mutual evaluation that combines self-evaluation and others' evaluation. The challenge is to devise educational methods so that the skills acquired in various situations can be fully utilized while incorporating the opinions of medical institutions.

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