Heat-induced histological changes were examined in mouse skin to search for safer surface temperature and duration for hot pack applications. Under a urethan anesthesia, mouse thigh was placed on a temperature-controlled copper tubing, and heated for varying periods of time. Microscopic changes in skin tissue were examined at various time points after heating. Heating at or over 43℃ induced irreversible pathological changes in skin histology, such as pyknosis and vacuolar degeneration of epidermal cells, subepidermal vesiculation, release of granules from mast cells, changes in collagen fiber arrangement, perivasocular infiltration of leukocytes. Heating at 42℃ for ５hr. resulted in the similar changes. The changes became increasingly evident as time elapsed after heating. Necrosis of entire dermis was observed on ７days after heating. In contrast, only a few, reversible changes were noted in skin heated at 42℃ for ２hr. Switching the material for heating from copper to aluminum, or covering a copper tubing with a flannel or polyester cloth slightly reduced the heating-induced damages and prevent necrosis in skin tissue. The results have demonstrated that care should be taken for the choice of temperature, duration and materials for hot pack applications to avoid the burns.

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This study attempted to elucidate factors contributing to nursing staff 's understanding of their liability in nursing practice and to determine the strength of the relation between these factors. From four general hospitals in the Tokyo Metropolitan area, 1361 nursing staff were surveyed using a self-reporting questionnaire composed of four sections: items concerning nurses' judgment of the degree of their liability in previous medical accidents; the "Scale of Nurses' Understanding of their Own Liability"; the scale of professional autonomy in nursing; and items regarding the supposed factors contributing to nurses' understanding of their liability". Multiple regression analyses based on these newly assumed relations between nurses' understanding of their liability and the related factors showed that understanding was directly related to, for example, professional autonomy, Locus of Control, frequency of section meetings to discuss the prevention of medical accidents, opportunity to learn about medical regulations and liability, and nursing educational background. Therefore, to promote further understanding of liability among nurses, the author suggests that they be offered sufficient opportunity to learn about medical accidents, liability, laws and regulations in and outside the clinical setting and that nursing students be instructed to show assertion and initiative within the nurse-doctor relationship.

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The purpose of the present study was to investigate the state of research utilization in clinical settings and statistically verify the relationships among factors that affect to research utilization.
Questionnaire investigation was carried out to the nursing staffs working at the university hospitals in Fukuoka prefecture. As a result, completed questionnaires were 306, 70% of them were found to utilize the research findings. Analyses of both chi-squared test and t-test in terms of such utilization revealed that four "personal factors" in association with the clinical research utilization were clinical experiences, abilities and knowledge in association with research, research experiences, and positive attitudes for research; three "environmental factors" were research communications, time, and job authorities. These findings suggest that it is necessary to make efforts both by individual and by organization as follows; participating in the academic activity, acquiring experience with distinct term as the individuals, and holding up distinct guideline for nursing research, providing the educational programs about literature search and review until ５ years after complete a course, providing the educational programs and opportunities for rousing positive behavior to research utilization until 10 years after complete a course, propelling selected research ,constructing the system to importation of new ideas, constructing the system of interchange among the personal, providing the learning opportunities based on the individual desires.

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This study aimed to clarify that how daughters-in-law accepted their responsibility as home caregivers to their elder parents-in-law, and what kind of conditions enhanced their continuous dedication. The study method was the semi-structured interview and three women participated to the study. They intended to obey to socially accepted role model that daughter-in-law should had taken care of her parents-in-law, which was a gender issue that her husband was excused from the responsibility. Reciprocal norm was also found: they also intended to recompense the parents-in-law because the parents-in-law took care of their husbands and children in the past. In addition to those, a perception that other people took similar responsibility was told by the interviewees. As to the conditions that enabled them to continue being caregivers, it was found that, attachment to the parents-in-law, being appreciated by others including the parents-in-law, having power of decision on care-giving and prospects how long they had to take the responsibility. I found that these factors and conditions were not always indispensable and some compensated lack of others factors and conditions. Although it has recently been said that social norm toward daughter-in-law became less strict than before, it still considerably influenced over them.

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The purpose of this research is to examine the effectiveness and validity of the ice mix water method for SMBG, which has been discovered to reduce the self monitoring of blood glucose (SMBG) puncture pain in a fingertip. This method involves dipping your finger into ice water for 15-20 seconds. We asked 50 diabetic patients and 20 healthy medical staff of a hospital to try the previous method and the new method. We then compared the two methods and we got the results as follows.
1) As for the ice mix water method, the sense of pain was diminished by the cooling action and the value of the pain threshold went up both with the patients (p<0.001) and the staff (p<0.01).
2) In the ice mix water method, we were able to acquire a regular amount of blood as much as with the conventional method and we could hardly see any error in the blood sugar level.
Therefore, from the above results, it can be concluded that the ice mix water method is a new SMBG method which can reduce puncture pain, leading to an improvement in QOL.

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Factors influencing reality shock and recovery were analyzed in this study. Subjects comprised 116 newly graduated nurses. Questionnaires were sent out in the first 3 and 6 months of the nurses' employment in hospitals. Shock responses were shown by 65.2% of subjects at 3 months, and by 46.4% at 6 months. Factor analysis yielded 6 factors. Significant positive correlations were shown between these factors and shock responses, with "Interpersonal relations in the workplace" exerting the most influence at 3 months, and "Working systems" exerting the most influence at 6 months. In the group displaying improved reality shock at 6 months compared to 3 months, "Nursing skill", "Dealing with patients and their families", and "Working systems" were reduced, and perception of social support was significantly increased. These results will prove useful for supporting recovery from reality shock.

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The purpose of this study was to investigate whether nurse managers had set standards about the exchange frequency of self-retaining urethral catheters and urine-accumulating bags in their units, and, if so, their relations to the actual exchange frequency.
Fifty three hospitals that had 200～300 beds in Tokyo metropolitan were investigated with the first set of questionnaires, and seven inpatient units of five hospitals were selected where inpatients who retained urethral catheters for more than a month occupied more than 20 % of all inpatients.
The second sets self-descriptive questionnaires for the nurse managers and the nurses were obtained through post-mail. As a result, all of the nurse managers answered that they had set standards about the exchange frequencies in their units, but there were marked differences in exchange frequencies among them. Furthermore, the shorter nurses' experience terms were, the more the nurses were affected by the standards in their units. The nurses answered that they took account of preventing urinary tract infection as a reason to decide exchange frequency of bags rather than catheters. From these results, it is suggested that a further study on the relation between exchange frequency and urinary tract infection should be conducted.

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We thought up the cause-and-effect model about HPN patients' quality of life (QOL) focusing on life satisfaction effected by their physical, psychological, sociological factors and their support network. The purpose of this study was to examine this model based on data, and to examine an affective system of nursing care. Data were collected through questionnaires, and subjects were 27 HPN patients who had benign diseases.
As a result, more subjective symptoms increased anxiety which decreased life satisfaction, and high level of activity raised self-esteem which urged to work again and which increased life satisfaction. But support network did not effect life satisfaction significantly.
The study has indicated that nursing care the first to lay stress on removing physical pain, the next to decrease anxiety and raise self-esteem, to urge to improve occupational functions finally may improve HPN patients' QOL.

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[in Japanese]

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[in Japanese]

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