Purpose The purpose of the present study was to assess the support provided by transplant coordinators to living-donor liver transplant donors and their families in regard to decision-making.

Method A qualitative descriptive study was conducted. The participants were four nurses with experience as transplant coordinators. Data were collected using semi-structured interviews and analysis was performed with a focus on the actions of the transplant coordinators.

Results The analysis revealed the following four themes: facilitating relatives’ involvement in reaching a consensus; allowing each relative to consider the consequences of donation; sensing the candidate donor’s unwillingness and advocating the donor’s right to refuse; and helping potential donors prepare to become a donor. Subthemes were then identified based on these four themes.

Discussion These findings suggest that the core practice of transplant coordinators is to advocate the rights of the donor based on a consideration of ethical issues regarding the treatment of living-donor liver transplant donors and their families.

Objective: This study was aimed at identifying the difficulties that a shift leader nurse in a ward experiences in educational interactions with member nurses.

Methods: Open-ended questionnaire forms were distributed to 710 nurses with experience of working as shift leaders, and the responses were analyzed by the content analysis methodology.

Results: The difficulties that the shift leader nurses faced could be classified into 15 categories, as follows: [Finding time to know the degrees of readiness of member nurses, to give timely guidance, to confirm the degrees of understanding, and to explain the reasons for guidance], [Knowing the degrees of readiness of member nurses], [Lack of ability to interact with member nurses for educational purposes, such as coaching or motivating skill].

Discussion: The results indicate that the following support measures may be necessary to improve the difficulties that shift leader nurses face during educational interactions with member nurses: “building a framework that enables a shift leader nurse to secure time to perform his/her tasks as a leader, as well as to interact with member nurses for educational purposes,” “through group training, etc., raising awareness of the difficulties that a shift leader nurse experiences when he/she interacts with ward nurses for educational purposes,” “conducting training focusing on coaching and motivating, and providing instructions that are suitable for each individual member to raise their awareness and sense of responsibility.”

Purpose: The purpose of this study was to clarify how the difficulties experienced by graduates of a course for certified nurses in dementia nursing changed throughout the course while taking the lectures and the practicum and the subsequent clinical training.

Method: Focus group interviews were employed as the study method, with 12 nurses certified in dementia nursing participating.

Results and discussion: Before taking the course, the participants did not have a deep understanding of the rationale for dealing with persons with dementia, thus were unable to explain this to other nurses and had difficulty sharing their thoughts on nursing care that is demented person centric. During the clinical training, while the participants still could not make sufficient multi-faceted assessments of persons with dementia and faced difficulty articulating their assessments to others, they eventually re-examined their nursing care and succeeded in obtaining the perspective of understanding persons with dementia in a holistic manner. After the course, the participants became able to explain to others their perspective for nursing persons with dementia. Difficulties have persisted, however, in terms of verbalizing the demented-person-centric nursing care and sharing it with other staff. Lectures and practicums to enhance such capability of verbalization and sharing should be included in the curriculum in education for certified nurses in dementia nursing.

The purpose of this study is to clarify aspects and contexts of clinical autonomy of nursing practice at acute-care hospitals. Semi-structured interviews were conducted with four nurses working at an acute-care general hospital regarding situations where these nurses demonstrated clinical autonomy. The data obtained from the interviews were qualitatively analyzed. The results revealed that the nurses participating in this study displayed clinical autonomy in settings where they felt a conventional approach would be difficult. The demonstrating clinical autonomy began from the moment the nurses perceived the true needs of a patient, and the nurses were driven to demonstrate clinical autonomy after gaining empathetic understanding of the patient’s experience. Furthermore, the nurses did not only act or make decisions individually, they also adjusted their environment by influencing those around them and overcame difficult situations with support of others, which ultimately led to meeting the patient’s needs. This process also included behaviors such as recommending treatment plans to physicians and anticipating instructions. This analysis of characteristics to demonstrating clinical autonomy suggested that the demonstration of autonomy is influenced by the context which nursing teams acknowledge and endeavor to actively engage in nursing approaches and practices identified through tackling difficult situations.

The purpose of this study was to describe the characteristics of the interactions between a head nurse and nurses and to determine the factors necessary for effective workplace communication from the nurses’ perspective based on their interactions with the head nurse. The study was conducted through participant observation and semi-structured interviews with 3 head nurses and 24 nurses with more than 4 consecutive years of experience. Based on data analysis, 10 themes emerged from the 22 characteristics of interaction. Nurses acquired knowledge and judgment through interactions with the head nurse, which they reflected on and considered a bases for changing their thoughts and actions. The nurses’ learning from observing the behavior of the head nurse indicated that there are many interactions associated with education in workplace communication. However, nurses’ learning sometimes ended only with the interactions. Moreover, there were aspects that did not result in the sustained transformation of ideas and actions. It was thought that the main factor was that nurses’ learning depended on their interpretation, and assumptions constrained the view of the head nurse and nurses. It was suggested that it is necessary to communicate ideas and appropriate feedback from the head nurse among each other to develop the nurses’ learning into transformative learning.

Purpose: This study clarifies the meaningful experiences of expert nurses engaged in end-of-life care for cancer patient in Japan.

Method: Semi-structured interviews were conducted with eleven certified nurse specialists and certified nurses in cancer nursing. The interview questions centered on their positive and meaningful experiences while providing meaningful experiences with end-of-life care. Qualitative inductive content analysis was performed on all recorded interviews.

Results: The resulting 96 codes were grouped into nine categories under four themes. The first themes revolved around【The attitude that led to their pursuing nursing in palliative care】, such as the desire to “Challenge of pursuing nursing to its fullest” and “Contribute to reducing pain.” The second theme comprised 【Deep emotion and pride to share important moments of end-of-life】, which including “Expanding one’s view of life by learning about life and attitudes to life from patients” and “Pride in being at patients’ sides during an important time in their lives.” The third themes involved【Developing a cohesive sense of unity among family and medical staff with patient】and the last themes included 【Growth of the health care team members】.

Discussion: This study reveals the rich words to describe meaningful experiences of palliative care include contributing to reducing pain by a nurse and her team, challenging and pride to share the latest time to the patient.

Purpose: This study aimed to clarify how mothers who give birth to twins perceive the Maternal and Child Health Handbook.

Methods: Five mothers who had given birth to twins were interviewed using a semi-structured format. Data was analyzed by qualitative descriptive study.

Results: Results showed that these mothers who had given birth to twins, regarded the handbook as “evidence of their readiness to become mothers of twins,” “hope of becoming a good mother,” “something that should prevent anxiety related to having a high-risk pregnancy,” “a medical record that shows how the child is developing” and “they stopped using the handbook on their own.” Some mothers, the fact that the handbook’s fetal growth chart was for a single child strengthened the perception that their pregnancies were high risk. In addition, early hospitalization for monitoring during late pregnancy led to a lapse in the mothers’ awareness of the handbook as a personal tool.

Conclusion: In a twin pregnancy, it is important to try to reduce the mother’s anxiety by providing her with health-related guidance based on the physical indicators related to her health and to the health of her children. Moreover encourage twins mother to continue to use the handbook during early hospitalization for monitoring.

Purpose: Targeting chief nurses who had taken the gerontological nursing course, this study was conducted to clarify what changes their participation in the course had brought about in their perspectives of nursing care for the elderly.

Methods: Focus group interviews were carried out with four participants, the results of which were analyzed focusing on how they viewed care for the elderly differently after the course.

Results and discussion: The aspects of care where the chief nurses experienced renewed awareness include: the need to respect elderly persons as individuals living their own lives rather than persuading them to have normality of physical data; the importance of collecting a wide range of information and making multi-faceted assessments to understand the elderly holistically; the importance of judging nursing care from the perspective of the elderly rather than focusing exclusively on treatment and recovery; the importance of making nurses aware that ordinary daily care includes the aspect of respect for each elderly person; the need to foster nurses who can make independent and reasoned decisions rather than just following a routine; and the importance of working together to improve as a team by sharing their nursing experiences. It appears that the chief nurses’ perspectives changed from prioritizing effective treatment to stressing comfortable daily living on the part of each elderly person. They also took on board the ideal of an independent nurse who is capable of making rational and autonomous decisions.

In this study, the authors performed a semi-structural interview for seven public health nurses continuing nursing jobs in the stricken area and analyzed the results qualitatively and inductively, aiming at clarifying if public health nurses for the Fukushima first Nuclear Power Plant accident are able to continue their jobs from the disaster direct back to today. The result revealed that [Support by families and workplace environments are the backing for public health nurses’ jobs even in disasters], [Support for evacuees who help health nurses’ jobs] and [Public health nurses, other specialists, staff members of the local government are the support of the public health nurses’ jobs at the time of the disaster]. In addition, under severe conditions that change every moment, public health nurses in the stricken area continue their jobs by [Flexibility of the public health nurses themselves for managing long-term disaster reconstruction work] considering the [Mission given to local government’s public health nurses for the radiation hazard]. Furthermore, it has been revealed that the nurses continue their jobs recognizing [To live in the disaster area together with evacuees is the driving force of public health nurse activities] in the public health nurses’ jobs, which seem to be endless.

[Objective] In this study, we surveyed nurses engaged in cancer consultation to clarify the actual working support they provided to cancer patients, when they provided such support, and specific difficulties they experienced while providing such support.

[Methods] A questionnaire survey was conducted in May 2017 among nurses with at least 6 years of clinical experience who were mainly engaged in cancer consultation at 426 designated cancer hospitals, and responses were obtained from 106 nurses (recovery rate: 24.9%; valid response rate: 100%).

[Results] ‘Coordination with patient’s employer about working ability judgement’ and ‘information sharing with the place of employment’ were found to be difficult by approximately 90% of the nurses, while approximately 90% of the nurses were not practicing these support activities. The level of this difficulty differed significantly depending on the availability of a working support manual. The proportion of nurses experiencing difficulty and the level of their sense of difficulty at the time of ‘progression/recurrence/metastasis,’ ‘transition to palliative care,’ or ‘changes in physical conditions’ were greater than those at the time of any other event. Nurses with CNS/CN certificates experienced a significantly lower level of difficulties at the time of changes in physical conditions.

[Conclusions] The working support manual serves as an information source that nurses can rely on while cooperating with the place of employment. Conviction and confidence of CNS/CN in care results can reduce the expected difficulties in terms of working support when the future course of the patient’s physical condition is uncertain.

This study’s objective was to determine how students’ performance assessment scores in a training class for basic nursing techniques related to their skills in three domains: social, critical thinking, and supportive communication. First-year students (n=114) at a university nursing school were graded using the performance assessment and in terms of the three skills listed above. Students were divided into high- and low-scoring groups based on their assessments, and correlations between differences in average skill scores and across all variables were explored. The difference in each skill score was significantly higher in the high group in social skills and supportive communication skills (p<.05). There was no significant difference in critical thinking attitudes. In addition, performance assessment score showed a weak positive correlation with social skills and support communication skills (p<.05). The results suggest that nursing students who receive high scores on performance assessments also have good mastery of social and supportive communication skills.