Journal of Japan Society of Nursing Research

Nurses Perception of Acceptance of Disability with the Convalescent Spinal Cord Injury Patients

Ryoko Hotta, Kumiko Ichimura

2011 Volume 34 Issue 2 Pages 2_21-2_30
Published: June 01, 2011
Released on J-STAGE: March 05, 2016

DOIhttps://doi.org/10.15065/jjsnr.20101021001

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The purpose of this study was to determine how nurses perceive acceptance of disability with the convalescent spinal cord injury patients. Semi-structured interviews were conducted with 22 nurses working at rehabilitation hospitals and other facilities and interview contents were analyzed. The following 13 categories were extracted from the analysis: acknowledging disability and its influence, expanding interest from self to surroundings, switching perspective from past to present, changing from negative to positive thinking, self-acceptance, rebuilding life, establishing new values, difficulty of evaluating acceptance, subjective nature of evaluating acceptance, difficulty of acceptance as a result of clinging to unrealistic hope, acceptance as an impossibility, recovery phase as a step in the acceptance process, and a process of continuing to struggle between anticipation and resignation. Participants perceived patients' acceptance of their disability from various angles. While participants presented a clear image of spinal cord injury patients in a state of accepting their disability, they also indicate the difficulty of evaluating whether a disability is accepted or not and a doubt of the very concept of accepting disability.

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Factors Affecting Acceptance of Disability in Hemodialysis Patients with Diabetic Nephroparhy and their Structure

Hiromi Onbe (Sanaki), Kaoru Takigawa, Michiyo Oka

2011 Volume 34 Issue 2 Pages 2_31-2_38
Published: June 01, 2011
Released on J-STAGE: March 05, 2016

DOIhttps://doi.org/10.15065/jjsnr.20101111002

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[Objective]
The purpose of this study was to identify factors affecting acceptance of disability in hemodialysis patients with diabetic nephropathy and their structure.
[Methods]
We selected 212 chronic maintenance hemodialysis outpatients with diabetic nephropathy as a primary disease, and conducted a diagnostic test for disability adjustment. Then, we performed an exploratory factor analysis of the results of the diagnostic test to identify factors, and carried out a confirmatory factor analysis to clarify the structure.
[Results]
Valid answers were obtained from 150 patients (70.7%), consisting of 105 males and 45 females with a mean age of 63.41 ±9.56 years. Exploratory factor analysis identified four factors: "feelings and behaviors derived from difficulty in facing the disability", "negative feelings attributed to the disability", "decrease in self-esteem", and " behaviors regarding relationships with others". Confirmatory factor analysis demonstrated a three-factor structure.
[Discussion]
Since a "decrease in self-esteem" strongly affects feelings towards the disability, it is important to provide care based on the social model of disability and enhance self-esteem.
[Conclusion]
Four factors were identified acceptance of disability in hemodialysis patients, whereas a three-factor structure was demonstrated.

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Changes in Autonomic Nerve Activity and Pleasure-Displeasure during Hot Compresses to the Posterior Region of the Neck

-- A Comparison between 40 and 60 Degrees Centigrade --

Kyori Kato

2011 Volume 34 Issue 2 Pages 2_39-2_48
Published: June 01, 2011
Released on J-STAGE: March 05, 2016

DOIhttps://doi.org/10.15065/jjsnr.20110308003

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For this study, we compared autonomic nerve activity changes and the pleasure-displeasure sensation during hot compresses to the posterior region of the neck (PRN) using two temperatures (40 and 60 degrees centigrade). In 12 postmenopausal women the PRN was warmed for 10 minutes. Each subject, experienced: 1) PRN warming with a hot towel of 60 degrees centigrade, 2) PRN warming with a heat and steam generating sheet of 40 degrees centigrade, and 3) no warming (control). We measured skin temperature (PRN, dorsalis pedis and palm), deep temperature (sole and forehead), heart rate variability (HRV) and skin conductance level (SCL). Subjects responded to the pleasure-displeasure scale and the degree of sleepiness scale.
The PRN skin temperature safely increased to a maximum of 41 degrees centigrade with the 40 and the 60 degree centigrade hot compresses. Both methods brought pleasurable drowsiness and maintained the foot temperature. Moreover, the 40 degree centigrade hot compress maintained SCL significantly less than the control. It was suggested that the 40 degree centigrade hot compresses relieved psychosomatic stress.

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The Relationships among Subjective Symptoms, Stress Cognition and Psychological Status in Inpatients

Yoko Hayashi, Michiko Morimoto, Chihiro Kanbara, Tamae Nakamura, Chika ...

2011 Volume 34 Issue 2 Pages 2_49-2_56
Published: June 01, 2011
Released on J-STAGE: March 05, 2016

DOIhttps://doi.org/10.15065/jjsnr.20101215004

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The purpose of this study was to clarify these relationships among subjective symptoms, stress cognition and psychological status in inpatients. The subjects were eighty one inpatients (age, >20 years). The data were collected using questionnaire based on the following scales: the Illness Perception Questionnaire (IPQ) and the Cornell Medical Index (CMI), the Cognition Scale of Illness-related Anxiety, and the Hospital Anxiety and Depression Scale (HADS). Collected questionnaire data were first used to confirm the reliability and factorial validity of subjective symptoms and identify correlations among subjective symptoms, stress cognition and psychological status. Subsequently, we applied a causality model that defined psychological status as the dependent variable and assumed subjective symptoms directly affect the dependent variable or have an indirect influence through stress cognition. As a result of our analysis, it was found that subjective symptoms affected both stress cognition and psychological status. Furthermore, it was discovered that stress cognition have greater effect on psychological status. Therefore, these findings indicated that nurse must not only manage　patients' subjective symptoms but also recognize their stress cognition in order to intervene with appropriate care that　maintains the psychological status of inpatients.

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Everyday Memory and its Related Factors in Community-dwelling People aged 65-74

Kiyomi Yamada, Kimiaki Nishida

2011 Volume 34 Issue 2 Pages 2_57-2_64
Published: June 01, 2011
Released on J-STAGE: March 05, 2016

DOIhttps://doi.org/10.15065/jjsnr.20110107005

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This study was designed to examine actual conditions of everyday memory and its related factors in community-dwelling people aged 65 to 74 years old. We conducted a survey of old people who had been randomly selected from an extract of the voter registration list for A Ward, Nagoya City. The survey items were sex, age, family structure, and highest attained educational level, as well as scores of ADL (Activity of Daily Living), GDS (Geriatric Depression Scale) 5, and the Everyday Memory Checklist (EMC).
We obtained valid responses from 804 people: 315 men and 489 women. The average EMC scores were 7.97±5.11 points for men and 7.29±4.36 points for women. To investigate factors related to EMC scores, we scrutinized the results using multiple linear regression analysis (stepwise method). Results showed that everyday memory in men was associated with age (β=0.128, p<0.05), although that in women was related to GDS5 (β=0.200, p<0.001) and "intellectual Activity" (β= –.122, p<0.01).

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Process by which Spousal Caregivers can Continue the Conjugal Relationship Through their Partner's Move to an Institutional Setting:

Determined Through Spouse Interviews

Yuko Harasawa, Kiyomi Yamada

2011 Volume 34 Issue 2 Pages 2_65-2_74
Published: June 01, 2011
Released on J-STAGE: March 05, 2016

DOIhttps://doi.org/10.15065/jjsnr.20110115006

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The purpose of this study was to clarify the process by which spousal caregivers can continue the conjugal relationship through their partner's move to an institutional setting. The participants were 9 former spousal caregivers, aged over 65 years, whose partners now resided in a geriatric health service facility. Data were collected by semi-structured interview, and were analyzed qualitatively and inductively. The findings revealed that the process is constructed of two steps. The first step is the decision-making process in which the spousal caregivers ask themselves what their motivation to care for their partner is and ultimately prepare to continue forward with their life by utilizing a care facility. The second step is a circular type process in which their preparation to continue forward circulates between two states: "sluggish preparation" owing to a factor which makes them 'disinclined to live', and "re-preparation" owing to a factor which 'motivates them to continue their conjugal life', A third factor affects both states. The spousal caregivers led an erratic life, but the option for their spouse to move into an institutional care setting enabled them to continue their conjugal life.

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Reliability and Validity of the Chinese Version of the Scale for Professional Autonomy in Nursing: Scale Development

Xiaodan Liu, Yoko Aso

2011 Volume 34 Issue 2 Pages 2_75-2_84
Published: June 01, 2011
Released on J-STAGE: March 05, 2016

DOIhttps://doi.org/10.15065/jjsnr.20110117007

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The present study examined the reliability and validity of the Chinese language version of the Scale for Professional Autonomy in Nursing aimed at 450 clinical nurses working in a Chinese university hospital, and clarified the relationship between autonomy and position and years of experience. Several differences in some factor structures associated with decision-making, clinical practice and recognition were noted between China and Japan. Although the scale score was significantly higher in the high duty position group, such as chief nurses, than in the low duty position group, such as staff nurses, the scale score increased with the number of years of experience.
Chinese nurses must renew their license every two years. In addition, those who wish to obtain a higher duty position are obligated to receive continuous education. This system contributes to development of professional autonomy. It should also be noted that Chinese social background supporting career might account for the increasing tendency of the scale score accompanied by years of experience.

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The Educational Significance of a Nursing Teacher Ttraining Program

-- From the Narratives about Learning Experiences in the Class (the First Report) --

Chiharu Yamada

2011 Volume 34 Issue 2 Pages 2_85-2_96
Published: June 01, 2011
Released on J-STAGE: March 05, 2016

DOIhttps://doi.org/10.15065/jjsnr.20110120008

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Objective: This study aimed to examine the educational significance in a nursing teacher training program. For this purpose the characteristic of "self-recognition as a nursing-teacher", which appeared in discussions about learning experiences in the class, was examined.
Methods: Data were gathered using a semi-structured interview with 15 class attendees. This was then analyzed by a qualitative study method that construes talk as a narrative by quoting the actual words.
Results: The data analyses showed 3 significances in the nursing-teacher training program. 1) The initial education to support the career as a nursing teacher. 2) Continued education to support growth as nurses. 3) Education to develop dignity through "self-recognition as a nursing teacher". These significances were found through 3 characteristics; deepened meaning of teaching nursing to students, reflecting on a career as a nurse, and confirming the value and faith of self-support. These characteristics appeared in their participants' narratives about how they came to recognize themselves as a nursing teacher. From results, the educational significance in a nursing teacher training program is the development of "self-recognition as a nursing teacher".

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A Qualitative Study of Spirituality of the Elderly Bereaved who have Lost their Spouse

Namika Ikuta

2011 Volume 34 Issue 2 Pages 2_97-2_107
Published: June 01, 2011
Released on J-STAGE: March 05, 2016

DOIhttps://doi.org/10.15065/jjsnr.20110202009

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The purpose of this study was to elucidate the spirituality of elderly people who were bereft of their husbands or wives. Semi-structured interviews were conducted for 13 bereaved (11 women and 2 men) and the verbatim records were analyzed qualitatively and inductively. Through analysis of the spiritual experience of the elders who had lost their spouse, 8 categories and 20 sub-categories were discerned. Sense of loss or the pain of the spouse's death put the bereaved into a category of 1) spiritual pain, which drove them to 2) search for the meaning of existence, and behavioral search of 3) living by oneself. Through searching for the meaning and the purpose of life, the bereaved have experienced 4) actual feelings of connection, 5) gratitude, 6) awareness of transcendent existence, and 7) allocation of the deceased to the transcendent existence. In the final phase, the bereaved found a harmony in relation to self, others, The transcendent and the deceased, and consequently acquired 8) consciousness of a new "self".

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Views of Public Health Nurses Held by other Profession in Inter-Professional Teams :

Improving Training for Public Health Nurses

Akiko Kanefuji, Yukiko Miyakoshi, Mitsu Ono

2011 Volume 34 Issue 2 Pages 2_109-2_118
Published: June 01, 2011
Released on J-STAGE: March 05, 2016

DOIhttps://doi.org/10.15065/jjsnr.20110203010

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[Purpose] To clarify other professions' views on public health nurses (PHNs) in order to improve professional training for PHNs.
[Methods] A semi-structured interview was conducted with 18 people from other professions who worked with PHNs. The results were subjected to content analysis.
[Results] The contents obtained from all subjects representing six professions were integrated and classified into 22 major categories. The subjects tended to think highly of conventional PHNs by expressing that their character includes "having a positive and receptive attitude", and that "they work closely with local residents", and that thus including PHNs "makes inter-professional teamwork smoother". However, they are concerned that PHNs "have lost sight of their goal, and their enthusiasm is misdirected", resulting in "a gap forming between them and local residents" and "making inter-professional teamwork more difficult". They want PHNs to "learn from tradition handed down by their senior PHNs and their own experiences at work".
[Conclusions] This survey clarified other professions' views of PHNs. A goal of PHN training should be developing PHNs who have good interpersonal skills and who can actively acquire extensive knowledge and develop a sense of responsibility. To achieve this goal, educational and administrative personnel must work together.

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Self Awareness of Elderly Living at Home who needs Nursing Care

Yumi Okinaka

2011 Volume 34 Issue 2 Pages 2_119-2_129
Published: June 01, 2011
Released on J-STAGE: March 05, 2016

DOIhttps://doi.org/10.15065/jjsnr.20110222011

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The purpose of this study was to clarify how elderly citizens in need of nursing care while living at home were self aware about aging. I used semi-structured interviews for thirteen elderly people (seven males and six females) who were receiving ambulatory rehabilitation. Data was analyzed using comparative analysis. The results showed three categories: "difficulties of old age presented new problems which needed to be solved," "power to fight against difficulties of old age," "the bond of family and community relationships." Elderly people in need of nursing care couldn't give up living for the future, while they were depressed because their bodies couldn't move like before and there was a limit to recovering. At the same time, they were challenging to get over their aging through making use of successful life experiences and by communicating with others who had experienced the same hardships and pain. I found they were living positively because of their home life as well as close relationships with family and community, but sometimes there were still problems.

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Changes in Awareness and Care Practices on the part of Public Health Nurses through Participation in an Action

Research-based Case Study Group on Child Abuse and Neglect

Keiko Kobayashi

2011 Volume 34 Issue 2 Pages 2_131-2_142
Published: June 01, 2011
Released on J-STAGE: March 05, 2016

DOIhttps://doi.org/10.15065/jjsnr.20110304012

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Purpose: To establish a case study group composed of public health nurses and describe changes in awareness and support on the part of the nurses participating in the group, with the aim of making public health nurses who deal with child abuse and neglect.
Method: Utilizing action research, the author established a case study group, described the changes noted in 11 public health nurses and analyzed the result.
Result: The study proceeded as follows:
1. Proposal to establish a case study group,
2. Pre-establishment publicity and implementation,
3. Evaluation and feedback.
In the course of expressing themselves in the case study group, participants became able to tackle their tasks in advanced ways. They changed their way of looking at the family and the content of their support by shifting the focus of their attention from "problems" to "strengths", thereby strengthening the prevention of abuse and neglect and promoting the spread of the support network.
Discussion: The above changes resulted from the author's role as facilitator, listening closely to each participant's thoughts, promoting interactions among the participants and supporting each individual participant by promoting the changes in their thinking so as to enable them to focus more closely on "strength".

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Issues and Present Status Concerning Multiple Cooling in Nursing Practice

Yukiko Kudoh

2011 Volume 34 Issue 2 Pages 2_143-2_149
Published: June 01, 2011
Released on J-STAGE: March 05, 2016

DOIhttps://doi.org/10.15065/jjsnr.20110215013

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Situation of Patients in a Multiple-Bed Ward and their Use of Privacy Curtains

Yoshiko Ishita, Chizuko Ishikawa, Teruko Abe

2011 Volume 34 Issue 2 Pages 2_151-2_161
Published: June 01, 2011
Released on J-STAGE: March 05, 2016

DOIhttps://doi.org/10.15065/jjsnr.20110113014

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The present study aimed to clarify the situation of patients in multiple-bed wards and their use of privacy curtains. An anonymous, self-completed questionnaire was administered to 278 patients staying in 4-person rooms in a general hospital ward. The questionnaire surveyed patients' individual situations, reasons for drawing the curtain around the bed, whether patients were able to open and close the curtain as they wished, and what patients required from nurses. Valid responses were obtained from 235 patients. The results revealed that 90% and 25% of patients closed the curtain at night and during the day, respectively. Whether patients closed the curtain at night depended on the position of the patient's bed in the ward. Among patients who kept the curtain closed all day, the extent to which the curtain was closed varied with the time of day.
Patients' reasons for closing the curtain were classified into six categories for use at night and five categories for use during the day. The most frequent reason was to maintain privacy: the curtain creates personal space within which patients can refuse intervention from outside and protect their individual dignity. The present results suggest that nursing care should take into consideration patients' personal space.

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Effects of Taste Stimuli on the Descending Pain Modulation System in Human Adults

Takahiro Kakeda

2011 Volume 34 Issue 2 Pages 2_163-2_170
Published: June 01, 2011
Released on J-STAGE: March 05, 2016

DOIhttps://doi.org/10.15065/jjsnr.20110411015

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This aim of study was to examine the analgesic effect of sucrose stimulus on pricking pain and examine the impact of sweet taste on the descending pain modulation system in adults. This study performed as a randomized control trial, single-masked, with crossover design. Subjects comprised 12 young adults. Prior to and during blood sampling, subjects held either 24% sucrose solution or distilled water as a control in the mouth. Reactivity was evaluated using blood level of 5-hydroxytryptamine, urine 5-hydroxyindole acetic acid, α-amylase in saliva, emotional evaluation from the profile of mood state and visual analogue scales of pain intensity and taste pleasantness. Blood level of 5-hydroxytryptamine values after taste stimuli did not differ between sucrose and distilled water conditions before taste stimuli. The level in urine 5-hydroxyindole acetic acid after taste stimuli were significantly decreased under both conditions. Each value of pain intensity and α-amylase under the sucrose condition was decreased, compared to the distilled water condition. Moreover, the score for taste pleasantness was higher in sucrose condition than in distilled water condition.
These findings show that sucrose stimulus might have no obvious influence on the descending pain modulation system. Additionally, sucrose administration might not induce analgesia on pricking pain in adults.

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Analysis of Published Papers in Journal of Japan Society of Nursing Research

Yuji L. Tanaka, Toku Ishii, Yoko Emori, Emiko Ogishi, Masataka Nakano, ...

2011 Volume 34 Issue 2 Pages 2_171-2_175
Published: June 01, 2011
Released on J-STAGE: March 05, 2016

DOIhttps://doi.org/10.15065/jjsnr.20110127016

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