This study of type 2 diabetes patients undergoing hemodialysis investigated qualitative factors related to the recognition of complications by patients and the clinical significance of complications they might experience. Data collected by interview from 12 subjects showed that patients with type 2 diabetes mellitus undergoing hemodialysis tend to become aware of their potential for developing complications only after they have experienced inconveniences in their daily lives due to the onset of such complications. However, the structure of what patients remember is not linked to the progression of complications following onset. Furthermore, patients tended to be self-critical for having developed diabetic complications, and were dealing with these feelings. ("Koukai Wo Osameru" in Japanese.) This study suggests that patients would not worry as much about diabetic complication if there were no chance of being aware of symptomatic onset of diabetic complication or facing inconvenience in daily life. It is thought that this issue should become an aspect of education regarding diabetic complications, i.e. coping with the process and progression of concrete symptoms and diabetic complications in daily life.

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The purpose of the this study was to conduct a comparative analysis of the traditional pamphlet-based guidance for gastrectomy patients with the Computer-Assisted Instruction (CAI) method, which was developed in order to improve dietary guidance for gastrectomy patients.
The subjects were 15 patients who had undergone gastrectomies at Hospital A in JAPAN. Nine patients who were in the hospital from August to September of 2002 were assigned to the pamphlet group, and the remaining 6 patients who were in the hospital from October to November of 2002 were assigned to the CAI group. Questionnaires were given to each group both during hospitalization and 1 to 2 months after discharge.
The scores for dietary knowledge were similar in the two groups during the hospitalization period, but were significantly higher in the CAI group than in the pamphlet-based group after discharge. During the period of hospitalization, patients in both groups were under the care of nurses and nutritionists. After discharge, subjects in the CAI group were able to practice self-learning on their own accord much better than were subjects in the pamphlet-based group.

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The objective of the present study was to determine whether the plateau phenomenon occurs with regard to the practical abilities of mid-career nurses, and to clarify factors related to the development of the practical abilities of mid-career nurses.
The questionnaire included practical ability based on Benner's seven domains of nursing in addition to items on individual autonomy, nursing autonomy, training, and education. Analysis was performed for 316 of 386 nurses.
The main results were as follows: 1) the correlation coefficient for the practical abilities of nurses with 5 to 20 years of clinical experience was r = -.109, and 2) nursing autonomy was identified as a factor related to the practical abilities of nurses with 5 to 20 years of clinical experience (multiple regression analysis: R²=0.140, β =0.233).
These findings indicate that the plateau phenomenon tends to occur with regard to the practical abilities of mid-career nurses, and that nursing autonomy is necessary in order to enable mid-career nurses to improve their practical abilities beyond this phenomenon.

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The purpose of the present study was to examine the change of learning experienced by nurse students between learning in classroom and adult nursing clinical course (perioperative) according to situated learning theory. Students' learning process in classroom and nursing clinical course was observed, and 9 students completed semi-structured interviews after perioperative nursing clinical course. Then the date was analyzed by Modified Grounded Theory Approach. The result revealed that students experienced the change that they could not really feel importance of practice based on theoretical ground in classroom but came to be able to feel one as they participated in nursing clinical course. And 3 categories was constructed as differences between the classroom and the nursing clinical course relate to this change: "the way of appearance of tasks and process solving ones", "the lowest needed action and free actions", "the success or failure premised by organization". These findings may provide systematic realization of the learning process of student nurses who are in transition from classrooms to nursing clinical course, and some clues to improve education circumstance.

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The purpose of this study is to clarify the change in caregivers' living activities (taking baths, washing clothes, eating and sleeping) due to children's hospitalization, the resulting burden, and the factors which influence this. The questionnaire was distributed in five hospitals, and the data, which was answered by mothers of hospitalized children, was analyzed. The changes in the living activities of mothers who stay with their children in hospital every night are bigger than mothers who do not. Also, the burden they feel is significantly higher. A logistic regression analysis specified "being able to use bathroom/ shower room inside the unit", "housework support", and "length of stay" as influencing factors.

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Objectives: The purpose of this paper is to identify public health nurses' attitudes, awareness and practice regarding patient support groups. Method: Questionnaires were mailed to 348 public health nurses, and a valid response was obtained from 149 nurses (42.8%). Results: The greatest nursing involvement by far was to initiate and set up support groups. Nurses referred clients to their own support groups because of their familiarity with these groups. In addition, they intended their support groups to grow into self-help groups. They did not know the original helping characteristics of self-help groups, but recognized many benefits of self-help groups and support groups. They thought that autonomy was important for such groups, but occasionally professional leadership and support were also necessary. Most nurses believed that they improved their professional practice through work with support groups and self-help groups. Conclusions: The definition of patient support groups should be made clear because Japanese public health nurses use inconsistent terms to refer to such groups. It seems a cause of confusion.

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The aim of this study is to evaluate correlation between Positive Coping and life style, physical state, and Health Locus of Control (HLC), in cancer patients before shifting to the stable stage after gastrectomy. Forty-seven patients from 6 months to 12 months after gastrectomy for cancer were interviewed at the outpatient clinic using questionnaires including food, drinking and smoking of life style and physical state as well as HLC. Positive Coping was associated with postoperative albumin, Health Locus of Control Supernatural, Health Locus of Control Family. In conclusion, it is important that medical stuff might control patients' albumin not to decline with their family in order to promote Positive Coping in cancer patients before shifting to the stable after gastrectomy.

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[in Japanese]

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