The purpose of this study was to clarify the extent to which nurses' support contributes to patients' resilience, and identify the factors affecting the enhancement of resilience.
Subjects were 1,320 nurses with over three years' experience. Results were follows; We carried out a factor analysis and extracted three factors (cumulative contribution ration: 52.26%) . The first factor, defined as "I Can (α=0.922)", included the ability to resolve immediate problems. The second factor, defined as "I Am (α=0.911)", included a strong sense of responsibility. The third factor, defined as "I Have (α=0.880)", included having a reliable family　and friend. There were significant distinctions among personal elements (e.g, experience of hospitalization/bereavement) and occupational elements (e.g, presence of a specialized field, years of experience and occupational career score) for resilience score.
In addition, there was an transaction between years of experience and the recognition of occupational career. In the group with a high level of career recognition, those with longer experience provided more support to enhance resilience. On the contrary, a low level of career recognition, those with longer experience provided less support to promote resilience. These results demonstrate that both personal career and occupational career play important roles in strengthening the support nurses provide, that enhances patients' resilience.

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The purpose of this study was to clarify the process of decision-making and learning of esophageal speech from being informed of the necessity for laryngectomy in patients with laryngeal and phayngeal cancer.
Data were collected through interviews and observations for eighteen patients who underwent laryngectomy, being analyzed by the grounded theory approach.
The study revealed that the esophageal speech learning process could be summarized as "rehabilitation process involving continuous distress and efforts" based on the following 3 categories: 'experience of conflicts and abandonment in laryngectomy', 'experience of the promotion of the continuation of rehabilitation' , and 'experience of resistance to the continuation of rehabilitation'. The process to conversation by esophageal speech involved great difficulties, but the continuation of rehabilitation toward the acquisition of esophageal speech was possible by 'experience of the promotion of the continuation of rehabilitation'. For the continuation of rehabilitation, support that allows changes from rehabilitation resistance experience to promotion experience is necessary.

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Objective: This study was conducted for the purpose of developing a scale that enables nursing students to measure their self-efficacy during the course of clinical training in basic nursing education, and assessing the reliability and validity of a scale.
Study method: Mail survey covering those nursing students, who were in the third and the fourth grade at school, was conducted. Divided them into 3 groups. Study Group 1: 99 students, Study Group 2: 1,895 students, and Study Group 3: 1028 students. The survey content consisted of a preliminary scale for measuring self-efficacy during clinical training, a scale for measuring social skills and each student's fitness for their major field.
Results: In Study Group 1, the students were asked to reply those matters which they felt important in clinical training by using a sentence completion format. And a clinical training self-efficacy preliminary scale (73 items) was developed (N=99). In Study Group 2, a survey was conducted by using a preliminary scale (n=1895), and as a result of exploratory factor analysis, 3 were extracted, which were "Feeling of efficacy in understanding and assisting those surveyed", "Feeling of efficacy in maintaining relationship with friends" and "Feeling of efficacy in maintaining relationship with instructors". Selecting those items, which most closely matched each factor, from Stepwise Exploratory Factor Analysis, a scale of 16 items was developed. The correlation coefficients between the subscales and a scale for measuring social skills were .49, .45 and .50 respectively. The coefficients of reliability (α coefficient) ranged from .88 to .78 and the correlation coefficients between retests were .87, .49 and .70 respectively. Moreover, when a confirmatory factor analysis was done in Study Group 3, the results showed GFI = .95, CFI = .96 and RMSEA = .057 (n=1028).
Conclusion: A self-efficacy scale during clinical training, which consists of 16 items and 3 subscales, was developed, and construct validity and reliability were confirmed. By using this scale, it is possible to measure self-efficacy during clinical training easily.

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A questionnaire survey was conducted in order to understand the effect of the organizational climate of a ward on the turnover of nurses. This study verified the hypothesis that the organizational climate influences burnout by through work stressors and burnout influences turnover or the turnover intention. As a result of multiple regression analysis, sense of control, morale of the staff, and intimacy influenced the burnout in organizational climate dimensions. The effect of the organizational climate on the burnout was revealed in two ways, and the hypothesis was partly supported. Intimacy directly influenced personal accomplishment, and morale of the staff and sense of control of the ward directly influenced depersonalization and sense of control of the ward directly influenced emotional exhaustion. The morale of the staff influenced indirectly through ambiguity, emotional exhaustion, personal accomplishment and depersonalization. The turnover intention was significantly regulated by the recognition of emotional exhaustion, depersonalization, and consideration of the head nurse attitude to the staff; the description rate in three variables was very high at 21%.

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The aim of this research was to investigate and clarify the grief process in the mother who loses a child after long-term hospitalization. A total of eight mothers have now been followed for an average of 10 months since the death of a child and have been participating in a support group to share their grief. We have closely listened to the mothers in the group and in personal interviews. The findings were then analyzed using a modified grounded theory approach. Three categories emerged: -(1) process of change, in which the bond with the dead child gradually changes over time, (2) a process of starting over from scratch, and (3) the influence of sharing their grief on these two processes. We found that the process (1) of starting over was characterized by going forward generally but with some instances of going backwards. The other process (2) was characterized by change, from being side-by-side, to being inside or 'on top of one another'. Factors that helped the mother overcome her grief included the support of family or close relatives, reorganizing the mother's relationship with a surviving child, and participating in the self-help-group.

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The purpose of this study was to clarify how the patient with Spinal Cord Injuries (SCI) experienced in acute. The participants were 6 patients with SCI of entering or going one rehabilitation hospital. The methods were used for the semistructured interview, the data were analyzed qualitative and inductive. As a result, the patients with SCI had severe pain of body from damage. They also had pain that they cannot activity of living only pace of others, and groped their roles in families. While they felt thanks and trust in medical people, they had abhorrent thoughts that pain and disappointment with lack of understanding. Then, presence of their families and friends that were pleased about being of them, and of nurse admit the other of ability connected hope for live. These findings suggest that we understand patient's pain of body and they have to depend on others, that viewpoint of nursing intervention in relation that the patients with SCI can have will to live.

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The purpose of this study was to clarify the Suffering of long-Stay admitted patients of psychiatric hospitals. The subjects were 26 male and 8 female patients being in hospital for 5 years or more, from whom informed consent was obtained to be enrolled in this study. A qualitative and descriptive investigation was made through participating observation and semi-constructive interview. As the suffering that might appear in long-stay admitted patients in psychiatric hospital, the following five items were extracted; fear of loneliness, suffering of living with psychiatric disease, difficulty in daily living due to a lowering of social adaptability, anxiety for own existence to be threatened and suffering due to a lowering of self-acceptability. Generally, patients' suffering is closely related with their own cognitive factors as well as belief and sense of value in life. Therefore, to assess patients' suffering was thought as an important mental care to improve their QOL.

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The purpose of this study was to clarify the association between husband's support/peer support and childcare anxiety/ coping strategies in mothers with children who were experienced NICU care.
The subjects were 223 mothers with children who were experienced NICU care aged ≤ 6 years. A questionnaire consisting of the husband/peer social support scale, childcare anxiety scale, general self-efficacy scale, and coping strategy scale was sent, and replies were obtained by mail.
Emotional support by their husbands affected childcare anxiety via childcare satisfaction and was associated with "planning" in coping strategies. Peer support was associated with "avoidant conceptualization", and "childcare anxiety" was associated with all coping strategies of the "avoidance axes". husband's support and Participation in childcare support circles were associated with the coping strategies of the "approach axis". Approaches, focusing on these items, may be important in enhancing mothers' coping strategies.

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The purpose of this research is to clarify the effectiveness of TQM, and to obtain the suggestion in the TQM introduction in the future. The questionnaire survey of 11 attribute items, the organizational changes, and the influences was executed for the head of the nursing organization in the TQM introduction. As a result the following consequences in four points were obtained, 1.Neither a basic organization structure (attribute) nor the organizational change had the significance difference. 2.The top of the facilitate organization was doctor 51%, and the nurse 15%. 3.The organizational change structure was shown by three factors. 4.The TQM activity influenced changes in the tissues. As a result, three following points were suggested. 1) The change in the organization with TQM becomes innovation of the entire organization because "Common term" generation according to the activity of TQM makes construction each other efficiency and it makes string between the organization members strong. 2) The thought process of TQM becomes the training of the nursing process, and contributes to the nursing practice ability improvement and the quality improvement of the nursing organization. 3) The TQM activity is thought to be one of the means of the organizational change.

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The aim of this study is investigation into parenting stress and its relationship with the patterns of family stress by clarifying the particular stress experienced by mothers engaged in the rearing of very young children suffering from food allergies, (hereafter referred to as FA children), and to review the measures to be taken within the family and the nature of the professional support demanded in future.
The subjects were divided into two groups: A control group of 78 mothers of healthy children and 60 mothers of FA children. The investigation was conducted using the Japanese version of the Parenting Stress Index (PSI) together with a questionnaire concerning family stress measures. The following results were obtained:
1) When compared with the mothers of healthy children, the number of stressed mothers of FA children feeling that they had problems with their children, was significantly high (p<.001).
2) Within the group of mothers of FA children, these was a significant difference in levels of parental stress related to Atopic complications, awareness of worries, the number of products to be eliminated from the child's diet .
3) It is comparatively easier for the family of an FA child to adopt coping mechanism than in the case of other chronic ailments.
4) Most significantly families of FA children could readily adopt "integrated measures" of coping mechanism, resulting in a reduction in parental stress. their jobs.

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