This study aimed to develop an ethical dilemma scale in nursing practice for end-of-life cancer patients and examine its reliability and validity. The investigation targeted nurses at hospitals with a palliative care unit and national cancer medical treatment base hospitals.
The questionnaires comprised 80 items gauging nurses' reactions to ethical dilemmas. These were sent to 4,500 of nurses of end-of-life cancer patients; 1,337 responses were received. Twenty-two items were eliminated by the item-analysis and 58 items were used for the factor analysis. Seven dilemmas related to the nursing process were developed: (1) lack of informed consent for the patient and their family; (2) lack of support for nurses' decision-making; (3) nurses being unable to provide care in accordance with the needs of the patient; (4) having a differing opinion from the physician; (5) treatment being prioritized over the situation of the patient; (6) treatment advancing while the patient is left behind; (7) the opinions of patients and their family differing.
Reliability was confirmed (by Cronbach's α coefficient: .861). The validity of the items was verified from the correlations between two criteria: a job satisfaction measurement scale for nurses and the ethical dilemma scale (Pearson's product-moment correlation coefficient: -.260, p < .01).

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The objective of this study was to investigate clinical nurses' viewpoint of patients with consciousness disturbance. Semi-structured interviews were conducted with 22 nurses caring for patients who have lost spontaneous speech due to consciousness disturbance. Interview contents were analyzed using text mining software. Nurses' clinical viewpoints were then divided into the following 16 categories: [parts of the body]; [vital signs]; [comparison to usual condition]; [understanding the patient's intended meaning]; [action, reaction]; [level of consciousness]; [expression]; [pain]; [limb movement]; [skin condition]; [mouth movement, speech]; [eye movement]; [mentality]; [neurological signs]; [symptoms and pathology]; and [living environment]. Principal component analysis was performed to elucidate relationships between the categories. Five factors were extracted, and the first principal component was termed "movement involved both the body and mind". In order to find anomalies, nurses observed the deviation from a patient's usual mental and physical state.

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Aims: To clarify how stiffness and pain in the neck, shoulder, or back ("katakori") of Japanese female family caregivers affects their daily activity and to clarify the lifestyle and care situation factors affecting stiffness and pain in caregivers.
Methods: Japanese female family caregivers (n=156) completed a self-administered questionnaire regarding their lifestyle, health status, and care situation.
Results: Sixty-one participants (39.1%) reported that they always experience stiffness and pain in the neck, shoulder, or back. These symptoms had an overall negative effect on their daily activity. Female caregivers with these symptoms had a higher body mass index, perceived more stress, exercised less, and had a meal more irregularly than those who did not experience stiffness and pain. Concerning care situation factors, a multivariate analysis adjusting lifestyle factors demonstrated a significant positive correlation between nighttime care and all-day care.
Conclusion: This study demonstrated the possibility of improving one's lifestyle and reducing the care burden to prevent/reduce stiffness and pain in the neck, shoulders, or back, and by extension, improve the caregiver's quality of life. There is a need for medical workers in the nursing field, so as to direct attention to caregivers' lifestyles, health status, and care situation.

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We aimed to reveal differences in the self-care ability by employment status of cancer patients undergoing chemotherapy on an outpatient basis. Subjects included 34 cancer patients (breast, colon, cervical, endometrial, and ovarian cancers, excluding stage IV) who were regularly attending our outpatient chemotherapy center. A self-administered questionnaire survey was conducted to ascertain patients' attributes, employment status, and self-care ability (Self-Care Agency Questionnaire for Patients with Chronic Illness). Patients were divided into a continued employment group, a discontinued employment group, and an unemployed group, and the three groups were compared using the Kruskal-Wallis test, followed by the Bonferroni method. Results showed that the continued employment group exhibited superior ability to "be aware of needs in life" and "notice early exacerbation", and the discontinued employment group exhibited inferior ability to "get people to help them do things they could not do by themselves". These findings indicate that nurses involved in outpatient care should help patients to acquire the ability to perform necessary actions and self-manage symptoms, in addition to seeking help from others without trying very hard to do everything by themselves.

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Purpose: The present study aimed to examine the resilience of nurses involved in end-of-life care by integrating knowledge obtained from literature written in Japanese.
Method: We conducted a qualitative analysis of descriptions from 15 references obtained from Ichushi-Web.
Result: The following nine characteristics were extracted, including the abilities to: [increase their own value as nurses through interaction with end-of-life patients], [share pain and sadness due to end-of-life care with others and cope with them], [reflect on themselves to face their own immaturity and continue to exert efforts to fulfill their duties without limiting themselves], [develop the best solutions by reflecting on their care while receiving support from others], and [restore confidence based on their experiences acquired through the implementation of nursing care].
Conclusion: To enhance their resilience, nurses involved in end-of-life care should continue to exert efforts to: change their "values regarding death, its process, and the end-of-life phase", develop the habit of reflecting on themselves in relation to nursing practice, face their own immaturity and train themselves, enhance their ability to understand other people, and improve their skills to develop relationships in daily nursing practice.

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This study identifies the perceived aging experience of the elderly who resided alone and required support or long-term care. Data were collected by conducting semi-structured interviews with 13 elderly citizens and analyzed using a qualitative descriptive research method. Participants experienced 'freedom, loneliness, and tension of residing alone in this old age'. There was "a sense of loss and freedom after separating from their partners", "tension and anxiety in daily life", "losing the people they were familiar with in the past and now relying on their caring staff". and "preparing to leave home at any time depending on their children's wishes". As well as, they 'attempted to observe what they could do on their own accord as they grew older'. Thus, they "cared for their own weakening body and health", "conducted activities that were suitable for their situation", "had the strength of living through old age", and "accepted aging rather than confronting it". Therefore, it is important for support in old age to take cognizance of the social role of the elderly, who have gathered strength through experiences in life, and to evaluate their lives positively.

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We elucidated the behaviors associated with a high risk of fall by qualitatively and descriptively assessing the behaviors of hospitalized patients immediately before a fall. We used the medical accident search system established by the Japan Council for Quality Health Care to collect the data of fall cases. The 1,445 fall cases were categorized and described based on similarities in the behaviors of hospitalized patients immediately before a fall. Consequently, 18 sub-categories, and 4 categories were established. The behaviors of hospitalized patients at high risk of fall were characterized by habitual behaviors with unstable activities, erroneous perception of the capacity for the activity, use of a product unsafely with there not being enough knowledge and consideration, and ongoing behaviors in situations in which accurate judgment might be lacking.

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The purpose of this study is to clarify the changes of physical activities and health-related quality of life among patients who do not cardiac rehabilitation after percutaneous coronary intervention. A questionnaire survey of health-related QOL (SF-8) was conducted among 34 patients after percutaneous coronary intervention and the amount of their physical activity was measured immediately, one and six months after discharge from hospital. The number of steps taken as a physical activity (p = .008) and the intensity of physical activities (p = .026) increased at a significant level. On health-related quality of life general health (GH) improved at a significant level on "immediately - one month after discharge from hospital" (p = .019) and "immediately - six months after discharge from hospital" (p = .028), and social functioning (SF) also improved at a significant level on "immediately - six months after discharge from hospital" (p = .044) and "one month - six months after discharge from hospital" (p = .026). The results suggest that it is necessary to enhance health-related QOL by acquiring an ability to evaluate the association between the number of steps taken a day and their own symptoms and conducting physical activity in everyday life in order to increase the amount of physical activity.

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In this study, a questionnaire survey was conducted among 562 clinical nurses to clarify the physical data and practices for airway suctioning. Prior to airway suctioning, nurses collected physical data about the presence of secretions, increased work of breathing, and oxygenation, using inspection, auscultation, medical examination data, and observation of secretions. Regarding suctioning practices, the rates of performing "observation of secretions", "infection control", "explanation to patients and families", and "monitoring during suctioning" were high (≥ 80%); however, they were low for practices not included in the guidelines (< 50%). With regard to items of auscultation before aspiration, the rates of "identification of abnormal breath sounds" and "prolonged expiration" were 30%, which were lower than "diminished breath sounds" (78%) and "presence of abnormal breath sounds" (62%). Performing "identification of abnormal breath sounds" was related to "on-the-job training of nurses" in physical assessment. The data for oxygenation before suctioning (SpO₂ and blood gas) were related to oxygenation skill, and it served as indicators to assess the application of suctioning as well as oxygenation skill.

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[in Japanese]

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Purpose: This study aimed to clarify the relationship between personal background information and difficulties experienced by parents of children with eating disorders.
Method: The parents completed self-administered questionnaires about their personal background (5 items) and the Scale for Evaluating Difficulties in Daily Life (15 items).
Results: The relationship between the parents was significantly correlated with "financial burden" and "loss of the family fireside" (p < .05). Parents living with or apart from their children with eating disorders was significantly correlated with "concern about planning for the future" (p < .05). The average amount of time per day spent with their children with eating disorders was significantly correlated with the parents being "unable to work", "loss of the family fireside", "unable to go out freely", and "concern about planning for the future" (p < .05), and was also significantly correlated with "no personal time", and "physical and mental fatigue" (p < .001).
Conclusion: Personal background affects difficulties experienced by parents of children with eating disorders. Thus, such parents require support considering that their personal background affects how they feel about their children.

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