The purpose of this study was to identify the experiences of senior nursing students who acted as simulated patients (SP) in the practical exercise class of the third-year nursing course and to examine the educational effect of the experience connected with the senior students' reflection. A semi-structured group interview was conducted with 18 senior students who acted as SP regarding their experiences. The results found 4 main categories; [Noticed the involvement that values patients], [Realized patients' feelings], [Gave meaning to providing nursing care as a professional nurse], and [Observing junior students helping patients from the view of a senior student]. The SP experience for senior students gave them the opportunity to gain a multidirectional view; as a patient, as nursing personnel, and as a senior student, to look back at their own nursing acts. In particular, it can be considered that they deepened their self-awareness as a nursing professional and were reflective about nursing itself from actually experiencing a patient's feelings and objectively observing nurses' attitudes and behaviors. Therefore, it was indicated that senior students' SP experience has an educational effect that encourages reflection toward nursing.

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Purpose: This study aimed to clarify the conceptual structure of emotional labor in nursing university students, and examine its reliability and validity.
Methods: Based on a comprehensive literature review, a preliminary scale consisting of 38 items was prepared. A questionnaire survey was conducted with 386 nursing students from a four-year college. One hundred eighty-eight responses (valid response rate 48.7%) were analyzed.
Result: Four factors, with a total of 22 items were identified by the exploratory factor analysis: "Effort concerning the sensitive feelings toward a patient", "Expression of restraint toward the team", "Surface adjustment toward a patient", and "Expression of the self toward the team". The reliability of the scale was confirmed by a Cronbach's α internal consistency reliability coefficient of .83. The construct validity was assessed through the comparison of the construct-concept of explanatory factor analysis as the construct-creating items, and confirmatory factor analysis. The criterion-related validity was approximately confirmed by the correlation between the emotional intelligence scale and the emotional labor scale.
Conclusion: The results indicate that this emotional labor scale for nursing students with the four factors from 22 items predominantly possesses construct validity and high internal consistency reliability.

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Individuals in the nursing field are at the highest risk for needlestick injuries, and there are cases where nurses have experienced it repeatedly. This research is the first to empirically verify person approach factors influencing repeated needlestick injuries among nurses through a countrywide survey. Of 21,890 nurses, 3,114 (14.2%) had experienced repeated needlestick injuries. When nurses with ≥ 10 years of clinical experience were compared to those with < 10 years of experience, the odds ratio (OR) for repeated needlestick injuries was 2.798. "Maleness" (OR = 1.531), "not having taken a basic nursing education safety class" (OR = 1.346), "conducting recapping" (OR = 1.117), "not carrying a container to dispose of needles" (OR = 1.086), "recognizing that one is always pressed for time in their duties" (OR = 1.063), "giving a divided injection at the time of blood collection"(OR = 1.058), a "work mistake" on the error-type scale (OR = 1.051), and optimism "Kirakusa" (OR = 0.984) were factors influencing repeated needlestick injuries among nurses with ≥ 10 years of clinical experience. It was found that it is necessary to take measures focused on individual characteristics to prevent such injuries in hospitals.

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[Purpose] To clarify the challenges that nurses face in practicing terminal care in geriatric health service facilities (GHSF).
[Methods] 1) Participant: One nurse manager and one nurse from each of the six institutions from O Prefecture participated in the study. 2) Period: February 2015 to May 2015. 3) Analysis Method: We conducted an interview with each subject for approximately 40 minutes using a semi-structured questionnaire, and analysis was subsequently performed using qualitative synthesis (KJ method).
[Results] Seven symbol marks were extracted as follows: "Limitations of medical treatment and anxiety about drug use", "Challenges in determinations related to state change or gastrostomy", "Challenges concerning coexistence of life and death in multi-bed room", "Challenges in judging anxiety of nursing care staff and labor burden of staff member", "Challenges in building non-regrettable terminal care with family", "Quality assurance of terminal care through multidisciplinary consultation and accumulated experience", and "Natural caregiving leading to a sense of satisfaction and gratification".
[Discussion] Nurses are required to utilize relationship building function among the multidisciplinary team, create an environment for education, and in particular, create awareness of terminal care in day-to-day-care among care workers.

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[Purpose] The aim of this study was to examine the relationship between nurses' communication skills and their self-efficacy and professional autonomy.
[Methods] Nurses in Japan (N = 283) were administered four questionnaires that included questions on communication skills in nursing, general self-efficacy, and professional autonomy. The data were analyzed using structural equation modeling (SEM), clustering, and ANOVA.
[Results] The data from this sample were normally distributed. The results of the SEM showed that our model fitted the data well. Both nurses' communication skills with staff nurses and their professional autonomy were influenced by their com-munication skills with patients and their families. We found that to be professionally autonomous nurses need communica-tion skills, especially for communication with patients and their families. In addition, we classified the nurses' communication skills and self-efficacy into four levels.
[Conclusion] These results suggest that nurses' communication skills with patients and their families are highly significant core skills. Moreover, our findings have important implications in terms of nurses' communication skills and self-efficacy.

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Aims: This study aimed to determine what materials are used in the teaching of bioethics to undergraduate nursing students.
Methods: A questionnaire study was conducted between 2011 and 2015 on 1,281 students in a nursing department and non-nursing department (social welfare, rehabilitation, sports acupuncture and moxibustion, and oral health science) in one faculty at our university. The questionnaire included 11 items on "respect for life" and 7 items on "patient QOL", and was completed by students following education in bioethics. Data were analyzed by analysis of variance using IBM SPSS Statistics 19.
Results: Responses were received from 865 students. Respondents in both types of departments indicated being interested in ‘patients’ feelings' in "respect for life" and ‘respecting patients’ wishes' in "patient QOL". However, in "respect for life", nursing students were interested in ‘death’. Overall, 6 items were found to have been effectively learned by the students: ‘living my life’, ‘the birth of life’, and ‘existence of patients' families’ in "respect for life" and ‘support from surrounding people’, ‘respect for the patients' families' wishes', and ‘daily life that matches the patient’ in "patient QOL".
Conclusions: There were differences between nursing students and non-nursing students in their interest in bioethics.

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There is an expectation the healthcare system will provide comprehensive medical care for children during their transition to adulthood. To do so, however, necessitates understanding the respective family experience and dynamic. The purpose of this study is to describe the long-term self-reported experiences of both the father and mother while nurturing a child suffering from Intractable Central Nervous System Disease.
Data was collected in an unstructured interview style and analyzed using qualitative descriptions based on a life story study approach. The study focused on one family's experience. The paper considers a couple who shared and cooperated with nurturing duties for a long time, although there was a slight imbalance with the overall nurturing load. Experiences shared and results obtained suggest a need for the medical profession to review existing patient and family care practice. Reflective, careful thought should be given to better understanding the family dynamic.

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Objectives: To obtain implications for support of self-management of diabetes mellitus, based on results of the national survey on the current status of support for psychiatric day-care users with coexisting diabetes, and of management of diabetes mellitus.
Methods: We performed a survey by sending an anonymous, self-reporting questionnaire to psychiatric day-care facilities run by national psychiatric clinics about the outlines of the facilities and their users with coexisting diabetes.
Results: The prevalence of diabetes in patients with mental disorders was 8.7%. Based on the HbA1c values, the patients were divided into two groups, a group of patients whose diabetes was well-managed and another group whose diabetes was not well managed, to compare and analyze their collation to the basic attributes and others. As the results, significant differences were observed in age, treatment situation, BMI, and staff.
Conclusion: It is necessary to provide places that can offer support for diabetes control under the guidance of medical staff who have sufficient knowledge about mental disorders and who know how to deal with this situation. We believe the future role of psychiatric day-care facilities for the comprehensive support of patients with mental disorders and coexisting diabetes will be significant.

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