The purpose of this study was to explore the psychosomatic symptoms, the difficulties of daily life, and the degree of QOL and anxiety of family members of patients with postoperative gastric cancers, and clarify the relationships among them. Twenty-nine pairs of patients who received outpatient treatment at a university hospital and their families were recruited and agreed to participate in the study. The patients responded to a questionnaire evaluating psychosomatic symptoms, and the families responded to two questionnaires on quality of life and anxiety. Relationships emerged between the gastric cancer patients' "physical and psychological symptoms" and families' "trait anxiety", and patients' "physical and psychological symptoms" and families' "physical domain" of QOL. Nurses need to offer information on relieving symptoms, listen to patients' anxieties or sufferings, coordinate family relationships, and assess families' physical conditions for family members to maintain health and be able to function as caregivers.

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The present study aimed to clarify nursing knowledge required of newly graduated nurses in intensive care units (ICUs). Data were collected by interviewing 12 specialists comprising doctors, nurses practicing in ICUs, and teachers at nursing schools. The interview transcripts were analyzed by text mining.
The results showed that the most frequently cited word regarding nursing knowledge required in ICUs was "patient", followed by "respirator", "drug", "breath", "basis", "somatic normal", "circulation", "heart", "blood pressure", "electrocardiogram", "somatic aberration", "dissection physiology", and "post-operation". Furthermore, a strong association was identified between the words "patient", "respirator", and "circulation". Using principal component analysis and cluster analysis (K-Means), these data were classified into the following five categories: "Basic knowledge required to detect early signs of somatic disorders through monitoring"; " Basic knowledge required to objectively assess patients based on their recovery processes"; "Basic knowledge about the mechanism of disease"; "Basic knowledge required to predict secondary complications from current information"; and "Basic knowledge about postoperative nursing care".
These categories reflect specific nursing knowledge required to care for patients in ICUs, who often require mechanical ventilation.

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The present study aimed to develop a Nursing Administrator's Competency Assessment Scale (NACAS) for nursing administrator in mid-size hospitals. Survey content validity was verified by skilled nurses, in order to confirm the competency elements required of nursing administrators. A further survey was subsequently conducted on 1,789 nursing administrators in order to construct the question items constituting the NACAS. Factor analysis of the resulting 25 items revealed the following 4 factors: 1) coping behavior, 2) human relationships, 3) goal-setting, and 4) information gathering. Cronbach's alpha for the 4 factors was .78-.92 and test-retest reliability was .58-.77 (p<.05), demonstrating internal consistency and stability of the scale. Furthermore, a significant positive correlation was observed between the scores obtained in the present study and employment position.

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The purpose of this paper is to develop a scale that measures the formation of a patient-nurse relationship in psychiatry and examine its reliability and validity. The scale was constructed by reviewing literature on Peplau's nursing theory and interviewing 8 nurses who had worked at psychiatric wards for at least 5 years. Then, We conducted a questionnaire survey of nurses who work on psychiatric wards in university hospitals in Japan and developed scale items by statistical methods.
The scale was composed of 24 items and 4 subscales - "cooperative and supportive intervention", "cognitive, analytical, and communicative skills", "receptive attitude", and "readiness for intervention". Statistical analysis showed that Cronbach's coefficient alpha was above .70, indicating high internal consistency. We also compared these results with results on the earlier study of involvement necessary for establishing the patient-nurse relationship. It showed that construct validity, and the emotional empathy scale and the opener scale on criterion-related validity were adequate, yet we consider that it is still necessary to enhance the validity for its practical application.

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A semi-structured questionnaire survey was administered to 14 mid-level nurse managers to elucidate the stages and factors associated with career development in mid-level nursing management. Qualitative inductive analysis extracted six factors as developmental stages: "accepting a mid-level management position with anxiety and anticipation", "learning business operations as a mid-level manager", "thinking and acting on issues to be addressed", "producing work results as a mid-level manager", "gaining self-confidence and a sense of satisfaction as a mid-level manager", and "being able to conduct business that affects the entire hospital".
Nine factors were associated with the career development of mid-level nurse managers. Mid-level nurse managers proactively engaged in their career development with "deeper awareness of the skills associated with the position" and "clarification of the roles of a mid-level nurse manager" through "experiences that promote growth as a mid-level manager", "mentoring by supervisors", "supports from colleagues", and "collaboration with other departments". These stages were supported by "meaning of nursing as a profession".

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We delivered our self-esteem recovery program (named "nurse-led group cognitive behavioral therapy for the recovery of self-esteem") involving 6 persons with psychiatric illnesses living in the community. A triangulation approach was used to identify changes associated with the program intervention. We quantitatively compared self-esteem, mood, Subjective Well-Being Inventory, and psychiatric symptoms before and after intervention. All study participants showed improvements in mental fatigue and its subscales, i.e., the sense of being in control and psychiatric symptoms. Significant improvements were noted for psychiatric symptoms and the sense of being in control. Self-esteem was also improved, but with no significant differences after intervention. A qualitative analysis showed that they benefited from "the effectiveness of group activities" and enhanced their metacognitive awareness through "facilitated understanding of the self", while experiencing "distress" facing up to themselves. This, in turn, enabled them to experience not only "the release" of their symptoms, but also "the internalization" of positive perception. Furthermore, the program served as an opportunity for them to learn and "put into practice" techniques used in the therapy. Changes after intervention identified in the quantitative analysis were explainable on the basis of the qualitative analysis.

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Purpose: This study was to clarify the process of change in nursing students' perceptions of terminal care during hospice nursing practicum.
Methods: The students were interviewed after their practicum and their responses were analyzed by Modified Grounded Theory Approach.
Results: Though students were "at a loss in front of the patients" initially, "their emotions approached those of the patients and/or families rapidly". Then they came to "be present beside the patients from the bottom of their heart" and were "impressed by nurses' skills" at the same time. Since students "could do nothing but be present, they felt regret". Then students were given "OK signs from the nurses" and "discovered that nursing can consist of merely being present". Through "the baton reception of life" from the patients and "permeation of ‘an uninfluenced view' of staff", the students' perceptions were transformed, and they realized they could share the patients' last moments.
Conclusion: When it was difficult for students to discover that their presence could obtain "a patient's relieved reaction", "OK signs from the nurses" were especially important. The students acquired confidence, a sense of accomplishment, and the values of terminal care nursing through nurses' affirmations.

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This study aimed to investigate the "reasons for living" of terminal cancer patients on general hospital wards. Interviews were conducted with eight terminal cancer patients, and the collected data were analyzed using qualitative and inductive research methods. The patients' reasons for living were categorized in the following three ways: 1; reasons for living that were obtained from the joys and comforts of everyday life, 2; reasons for living that could not be realized without having the experience of being a cancer patient; and 3; reasons for living that were gained by being able to live one's own way in a satisfying manner. Reasons for living obtained from the joys and comforts of everyday life were central among the various reasons for living among these terminal cancer patients.
The findings of this study reveal that essential care elements in support of terminal cancer patients' reasons for living are to understand the importance of helping patients make the best of their everyday lives, to make efforts to alleviate their symptoms so that they can better manage their disease, and to help them deepen their relationships with family members and significant others.

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Individuals who have suffered a stroke experience their illness from a different perspective than that of medical personnel. The current study sought to describe, from the perspective of those involved, how individuals who have suffered a stroke each experience their illness while recovering in a rehabilitation ward. Personal accounts of illness were not viewed in a framework as utilized by medical personnel but were instead described in light of a phenomenological approach.
This study described (analyzed) 3 participants' experiences. Participants were not aware of being confused during the acute stage of the stroke. Participants viewed the outside world as if in a daze and once lucid they heard about what had happened to them from others; participants' experiences during the stroke were shaped by the meshing of these two accounts. Later, participants sensed the significance of their illness through increasing interaction with medical personnel. Participants revised their accounts, which was evident in their actions during recovery. Nurses must be of a mindset to continually ask how patients are reacting to routine nursing practices.

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The purpose of this study was to investigate the nutritional status and PFC balance in Japanese pregnant women, by comparing weight gain during pregnancy.
Data were obtained from 111 postpartum women using a 141-item food-frequency questionnaire.
We categorized weight gain into 3 groups: less than 8.5 kg, 8.5-11.0 kg and more than 11.0 kg. All the groups with weight gain had a shortage of nutrient intake, especially energy intake, and the dietary items iron and folate were present at a lower level than the recommended dietary allowance. The groups with weight gain of less than 8.5 kg and more than 11.0 kg had significantly higher intakes of fat than the group with weight gain of 8.5-11.0 kg. Moreover, the group with weight gain of 8.5-11.0 kg had the ideal PFC balance possible with Japanese food consumption.
The pregnant women were classified according to their BMI prior to pregnancy, and their weight gain was managed during pregnancy. On the basis of our findings, we conclude that medical staff members should conduct not only weight management but also nutritional guidance on maintaining a balanced diet for patients.

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[in Japanese]

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Purpose: This study aims to comprehend difficult situations nursing students face when they communicate with patients and characteristics of their communication.
Method: A questionnaire survey was conducted on nursing students who completed all nursing practices. The survey included the following: situations in which nursing students find it difficult to communicate with patients, patient situations, the level of communication "difficulty", "decoding", "problem solving", and "affect".
Results: Statistical analysis was performed for a total of 192 valid responses (response rate=20.3% and valid response rate=86.9%). It found that nursing students tended to face difficulty in communicating with patients on the classes of third-year nursing practice and adult nursing clinical practice. The level of communication "difficulty" was also high on the classes of first-year nursing practice and pediatric nursing practice. Multiple regression analysis revealed that the level of communication "difficulty" was associated with "decoding", "problem solving", and "affect".
Conclusion: This study clarified difficult situations nursing students face when they communicate with patients and characteristics of their communication. It suggests that these findings are useful for refining communication education in a nursing school.

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