This study aimed to clarify the difficulties experienced by ward nurses when they provide home visiting services to people with mental disabilities to help them recuperate and improve their community life. Semi-structured interviews were conducted with 15 psychiatric ward nurses with more than 3 years of psychiatric ward experience, who provided psychiatric home visiting services. The data were analyzed by using Berelson's content analysis method.
The results showed that ward nurses experienced difficulties stemming from (a) the differences between ward nursing and home visiting, (b) an inadequate support system for home visiting nurses, (c) having to make many quick and independent decisions under time and space constraints, and (d) the effort required to improve the community life of people with mental disabilities.
To help nurses overcome these difficulties and to enable them to improve the community life of people with mental disabilities, nurses should be educated on how to support such people in the community. For this purpose, the nursing departments of the concerned hospitals should establish a support system for visiting nurses.

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We followed up 315 mothers from the time of issuance of the maternal and child health handbook until the three-yearold infant health checkup to determine the effects of maternal trait anxiety, depressive tendency, and attachment to their child on maternal tendency toward child abuse. Results indicated that trait anxiety at the time of issuance of the maternal and child health handbook had an effect on their attachment to their child or depressive tendency at the time of home visit guidance for newborns, and that maternal depressive tendency also had an effect on maternal attachment to the child. Mothers' tendency to be abusive at the three- to four-month-old infant health checkup affected their depressive tendency or attachment to their child at the 18-month-old infant health checkup, resulting in an effect on maternal tendency toward child abuse. Maternal tendency toward child abuse at the 18-month-old infant health checkup affected maternal depressive tendency or attachment to the child at the three-year-old infant health checkup, leading to an effect on maternal tendency toward child abuse. These results suggested that trait anxiety experienced by mothers at the time of issuance of the maternal and child health handbook had a continued effect on child abuse.

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In order to clarify the meaning of participating in the clinical trial, the decision-making process of the clinical trial participation and the factors and structure of the process, we carried out semi-constitutive interviews with 12 acute leukemia patients who participated in clinical trials and performed qualitative inductive analysis.
As a result, the decision-making process for participate in the clinical trials was comprised of 11 categories : "reactionto a shocking event", "action taken in response to a shocking event", "pursuit of hope of survival", "acknowledging of their leukemia", "having a life threatening feeling", "knowing that someone is devoted to you", "Insight into the decision-making process", "positive acknowledgement toward the clinical trial", "negative acknowledgement toward the clinical trial", "what motivated the decision", and "determination to participate in the clinical trial". In addition, the patients of this study had found out the meanings and the values which were accepted to be "the most excellent method", "only method to cure", and "for others it can contribute" in decision-making of the clinical trial participation.
These results were suggested it was important that the leukemia patients look at the situation has been placed in their own, and nursing support to shift value of clinical trial.

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Purpose: To show student nurses' level of motivation to start and maintain friendships based on self-determination theory, and to demonstrate the relationship between student nurses' need for autonomy, their desire become fully competent, and their motivation to learn, so as to gain ideas for educational methods that will stimulate their autonomous motivation.
Method: A self-report questionnaire survey was conducted among student nurses, and the results were analyzed and examined.
Conclusions:
1. Student nurses have more autonomous friendship motivation than university students other than student nurses.
2. Student nurses have more autonomous learning motivation than university students other than student nurses.
3. Autonomous friendship motivation is a factor in autonomous learning motivation.
4. A self-determined need for autonomy, with self-esteem as its antecedent, is a factor in autonomous learning motivation.
5. Autonomous friendship motivation among student nurses in not directly influenced by self-esteem or the need for autonomy.
6. Assumed competence is a factor in decreasing (controlling) both friendship motivation and learning motivation.
7. Assumed competence is an independent antecedent of the need for autonomy.

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The purpose of this study was to explore the relationships of stopping drug use to quality of life and self-esteem among patients with drug dependence and clarify their support needs. An anonymous self-administered questionnaire survey was conducted with 69 patients with drug dependence. Questionnaires were sent to participants and returned by mail. Two groups: the 3 years or more of drug stopping group and the less than 3 years of drug stopping group were compared.
As a result, it was found that continuing drug stopping was associated with older age, more hospitalization times and having a spouse or partner. However, it was not positively correlated with scores in WHO-QOL26. The 3 years or more of drug stopping group was higher in scores of the following subscales: "body image," "participation in leisure activities" and lower in "social aid". This implied that patients had hard times even after deciding to stop drug use to emerge from drug dependence. Findings suggest that patients with drug dependence need to be accepted as they are and social support, from an early stage of drug use.

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Objective: The purpose of this study was to clarify the components of resilience in nursing practicums for undergraduate nursing students.
Methods: We conducted a semi-structured interview for 12 undergraduate nursing students who had completed nursing practicums, and we analyzed the data by using a qualitative descriptive method.
Results: The following 3 components for resilience in undergraduate nursing students were extracted from the interview data: students receive support from another reliable person, students possess inner strength, and students perform their duties independently. These results were common to the 3 factors described by Grotberg: "I HAVE" factor that expresses external support; "I AM" that expresses inner strength; and "I CAN" that expresses problem-solving skills.
Conclusion: This study revealed that the undergraduate nursing students were supported by another reliable person, acted with a motivation or goal to learn, and solved problems independently by self-regulating their feelings and cooperating with another person; thus, they overcame difficulties in nursing practicums. We found that it was important to coordinate the learning environment in order to cultivate resilience in nursing undergraduate students.

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This study aimed to identify clues that nurses can use to exercise clinical judgment regarding when/whether to discontinue the observation-only approach for stroke patients in recovery during bed/wheelchair transfer and allow patients to care for themselves. A qualitative and inductive approach was employed to analyze data collected through focus group interviews of 17 proficient nurses on convalescent rehabilitation wards. As a result, clues for deciding whether to cease observation during bed and wheelchair transfer were classified into 4 categories: "cognitive abilities", "abilities to perform transfer activities", "willingness and feelings about transfer", and "the use of sleep medication". These nurses had difficulties with clinical judgment in relation to patients who either "became quite frustrated about being observed", "were likely to independently perform various activities including those other than bed/wheelchair transfer, once the observation had been discontinued", or those for whom "nursing staff were divided over the cessation of observation". These nurses, in principle, "continued with the observation-only approach when having difficulties with judgments", but they also "discontinued the observation-only approach while assuming the occurrence of falls". The findings revealed that nurses exercised clinical judgment from a unique standpoint as a professional providing rehabilitation care and services for real-life situations.

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The present study aimed to clarify the pain experienced by family members of advanced cancer patients, and examine what sort of nursing support is necessary. Data were collected through semi-structured interviews with 23 family members of patients with advanced lung cancer and malignant brain tumors. The data were subjected to qualitative inductive analysis using Krippendorff's method. We found that the pain of family members of advanced cancer patients consists of "pain arising from recognizing the reality that the patient has intractable cancer," "the pain of facing the patient's impending death," "pain arising from having to continue to face a patient who is suffering from cancer they cannot fight," and "pain accompanying disharmony within the family or social system." The pain of family members of advanced cancer patients comprises suffering that is difficult to deal with by cognitive coping, as it arises from an unacceptable reality and an inescapable environment. Given the above, nurses must form partnerships with family members early on and relieve their pain by listening adequately to them.

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This descriptive study aimed to elucidate the relationship between nurses' body movements, their method of using their hands when moving patients and patients' feeling of comfort when being repositioned from a supine to a lateral position. The subjects were 11 female nursing students. Measurements involved using pressure indicating sensor film to measure the pressure of the nurse's hands, and a measurement of the flexion angle of the nurse's elbow and trunk along with the proportion of their vertical movement. The subjective reactions of the patient role-player were also recorded and analyzed. The results showed that the students applied pressure primarily at the fingertip of the middle finger. Pressure distribution at the finger joints revealed three patterns: the fingertips, the base of the fingers, and the whole palm of the hand. The trunk flexion angle and the elbow angle were smallest for the fingertip pressure pattern compared to the others, but vertical movement was large. It may be that when changing the patient position, the student nurses extended their arms and applied pressure through their fingertips. The patients' subjective reaction exhibited more discomfort or anxiety for the fingertip pressure pattern. It was assumed that when a patient's position was changed with the nurse's elbow straightened, pressure was applied easily through the fingertips.

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The objective of this research was to clarify the relationship between certified nurse specialists (CNS) work environments and their job satisfaction.
A questionnaire survey was conducted on 102 CNSs who were working in hospitals in 2010. The questionnaire included questions on work environment, job satisfaction, and basic attributes.
Analysis of the answers collected on job position showed that the percentage of managers was 43.1%; the percentage of nurses who normally worked overtime for more than 50 hours a month was 19.6%. The average number of points for job satisfaction was 89.8 out of 125, with a range of plus or minus 10.5 points. Nurses with 5 years' or more experience after being CNS had significantly higher job satisfaction than those with less than 5 years of experience. Those nurses who were also hospital managers, were given time off in lieu, were expected to perform as CNS, or were given sufficient power to perform their duties had significantly higher job satisfaction than those without these characteristics.
These findings indicate that clarification of their position and roles within an organization, together with delegation of power and securing of time off in lieu, is essential for increasing job satisfaction among CNSs.

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The objective of this study was to clarify the actual activity of telephone consultation and pressing visits performed by visiting nurse stations offering around-the-clock services. Data from the 3-month records (applications for and instructions for in home-visit nursing, nursing plans and reports, and pressing visit records) of 2 visiting nurse stations were collected and analyzed. There were 119 cases of pressing visit in total. Seventy percent of the treated persons lived with their spouses or children and used nursing care insurance. The reason for the application was health consultation, and they were instructed in the medical treatments required. Emergency telephone consultations mainly concerned the daytime physical symptoms of the consulters themselves, and the conditions were stabilized by treatment during pressing visits. Family members of patients with cerebrovascular disorders and terminal cancer requiring medical treatment frequently had consultations concerning the patients' physical symptoms. The results suggested that it is necessary to predict problems and stressful situations that may occur and instruct family members in order to support their lives at home.

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Background: The purpose of this study was to examine the reliability and validity of the forward and back-translated final Japanese version of the Patient Assessment of Constipation and Quality of Life questionnaire (PAC-QOL), a diseasespecific scale for measuring the influence of constipation on QOL.
Methods: A total of 394 questionnaires were distributed at 17 Japanese hospitals and clinics, and 180 were returned by mail with valid responses from 140 participants. The 28-item PAC-QOL has four dimensions: worries and concerns, physical discomfort, psychosocial discomfort, and satisfaction. Data were analyzed to evaluate the internal consistency, test-retest reliability and validity.
Results: Cronbach's α was 0.92 in the overall scale. The kappa coefficient was over 0.41. Factor analysis indicated a Japanese version of the PAC-QOL had the different dimensions as the original version except the dimension of satisfaction. In addition, respondents commented that it was difficult to understand question items.
Conclusion: The Japanese version of the PAC-QOL while brief and reliable, is too difficult for participants to easily answer and lacks robust validity to measure the impact of constipation on QOL. Prior to using the Japanese version of the PACQOL, it is necessary to revise the questions.

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