This study focuses on middle-aged patients with pre-adolescent onset Crohn's disease and aims to elucidate how they have rebuilt their lives and how they plan to live their life with this disease. We conducted semi-structured interviews of seven middle-aged patients with Crohn's disease and assessed the qualitatively obtained data. The results recognized the following seven categories: “incidences that prompt rebuilding lifestyle”, “having prolonged remission”, “self-control over health”, “having the strength to live prioritizing health”, “listening to one's own body”, “incorporating changes that have been previously beneficial into daily life”, and “uncertainty about future related to aging and possible development of new complications”. In addition, the following two core categories were recognized: “joy and confidence pertaining to having overcome past challenges” and “living a fulfilling life”. The rebuilding of life is repeated, and with the effects of illness and aging in mind, patients tried to live a life that was fulfilling and unique to each. Thus, it is essential to provide continuous support that encourages patients to implement, evaluate, and modify their lifestyle changes until they find what works for them.

We aimed to clarify the efforts of newly graduated nurses in dealing with more than one patient simultaneously. Data were collected from 7 newly graduated nurses using semi-structured interviews and analyzed using the KJ method. The newly graduated nurses were inspired to “learn new knowledge and skills through experience” through the novel experience of nursing more than one patient simultaneously based on “Obedience toward senior nurses” and “Reflection on each occasion”. In this situation, “struggle due to fear of ignorance” about the treatment was the driving force for newly graduatednurses. In this process, newly graduated nurses were performing both “efforts toward understanding pathology and gathering information” and “preparation of proactive business” with the support of senior nurses. Additionally, newly graduated nurses were performing “challenging, difficult nursing practices with the support of seniors nurses” while striving to “build human relations with seniors nurses” and derive “inventive ideas for reporting and consultation required for nursing professionals”. “Learning new knowledge and skills through experience” was strengthened with “independent and flexible work place learning”, leading to the acquirement and refinement of nursing competence. The results demonstrated the efforts to gain nursing competence by awareness of lack of expertise.

Purpose: The purpose of this study was to determine how nurses view and perform bed-bathing.
Methods: The study was conducted using ethnographic methods; participant observation and interviews were conducted in the surgical ward of a general hospital.
Results: It was found that nurses perform bed-bathing creatively using expert knowledge as a technique for [granting comfort to patients]. In addition, by sharing sensations with patients, nurses viewed bed-bathing as an opportunity to [better understand the patient] by closely associating with them. Nurses viewed bed-bathing as an essential practice in nursing, believing that [It isn’t nursing practice without bed baths].
Conclusions: Bed-bathing is the most effective measure available to nurses in the performance of their role of providing comfort to patients. Through bed-bathing, nurses can find confidence, worth, and pride in their chosen profession. Nurses can also integrate their values and conviction into bed-bathing, a technique that can be performed expertly, creatively, and autonomously. Furthermore, bed-bathing is a manifestation of nurses’ expertise and a foundation of nursing practice.

Objective: To elucidate the experience of patients with head and neck cancer who underwent chemoradiotherapy, from cancer onset to 1 month post- discharge.
Methods: Semistructured interviews were conducted at 1 month after discharge of 8 patients with head and neck cancer who had undergone chemoradiotherapy, and the results were analyzed using the grounded-theory approach.
Results: A core category, “endure the distress to live as before”, and 10 other categories were extracted. The results showed that, even though they had selected chemoradiotherapy, which does not cause voice loss, the patients expressed a desire to return to their pretherapy condition while they were experiencing distress over physical symptoms that were not limited to the throat, and they engaged in a process of continuous effort to cope with that distress.
Conclusion: The findings suggested the need for a system of continuous, long-term follow-up from before admission to after discharge that supports patients in coping with their distress and fulfilling their wishes.

Objective: The present study aimed to evaluate the effects of passive muscle relaxation (PMR) in cancer patients based on physiological and subjective assessments.
Methods: Eight cancer patients received PMR intervention for 3 days. Their systolic and diastolic blood pressure and pulse rate were measured before and after the intervention. Additionally, the patients were interviewed after the intervention and the data were analyzed using the Wilcoxon signed-rank test and content analysis.
Results: The analysis revealed a significant reduction in pulse rate (p<.05) on the first day of the intervention. In terms of the experience of performing PMR, 8 categories were reported on the first day and 11 on the third day, of which [The feeling of relaxation] and [Feeling refreshed] were reported most frequently. Categories such as [Improvement in sleep onset] and [Relaxation of tension] were reported only on the third day. Further, the recorded frequency decreased for [Difficulty of performing the technique] and it increased for [Ease of performing the technique] on the third day.
Conclusion: These results suggest that cancer patients' tension was relieved by performing PMR for 3 days.

Purpose: This study aimed to elucidate the process by which midwives at maternity clinics recognized “parents and children of concern” and decide to pass on the information on these case to prevent child abuse.
Methods: Data obtained from interviews of eight midwives were analyzed using the Modified Grounded Theory Approach (M-GTA).
Results: From the perspective that midwives are able to recognize potential child abuse, the processes by which midwives at maternity clinics identify parents and children of concern and decide to pass on this information involve “looking for risks during care” and “noticing signs for concern”. Then, “the anticipated long-term child rearing is determined” based on the “verifications, judgments, and support primarily by the individuals in charge”, i.e., midwife and head nurse. Decisions were made in accordance with “the guidance from the authority, i.e., the medical director”, and the next stage will be “overcoming the hurdle of gaining agreement from the mother and family”.
Conclusions: Individuals in charge provided support for “parents and children of concern” at maternity clinics; hence, a centralized service was established for cooperation with other institutions. We found that the medical director, who held an authoritative position, had great influence on our decision-making. This study also recognized environmental characteristics of maternity clinics, where detecting risks and confirming situations were difficult.

Purpose: This study aimed to investigate depression factors of home caregivers for people suffering from dementia.
Method•Results: A conceptual model based on Pearlin's caregiver stress model for people with dementia was used for this purpose. A questionnaire was conducted, and the responses of 103 males and 124 females were analyzed. Depressive conditions were seen in 64.8% of all caregivers surveyed, though no significant difference between the sexes was found. There were no differences between the sexes in the scores for caregivers' burden, self-efficacy and self-esteem. After descriptive analysis, factor analysis was conducted to extract latent factors from caregivers' backgrounds, after which such factors were introduced into the model. Multiple-group analysis owing to gender difference was performed, and good conformity was obtained. For caregivers, the background factors had a strong effect on the depressed state. Pass coefficients of caregivers' burden and self-efficacy of males were also larger than those of females. But self- esteem of females was larger than those of males.
Discussion: In addition to the background factors of the caregiver, it was suggested that proactively maintaining male's self-efficacy and female's self- esteem are an important factor in preventing depression.

Purpose: This study aimed to clarify the nature and effects of peer coaching for nurses during the initial career-development period.
Method: Focus group interviews on peer coaching experiences were conducted with 15 nurses in their third year after graduation. These data were analyzed using a qualitative descriptive method.
Results: According to nurses, the nature of peer coaching comprised the following: “strengthen the bond,” “set the peer as a short-term target,” “spontaneous behavior based on relationship with the peer,” “have the opportunity to learn together,” and “exploring care in my way with the peer.” The effects of peer coaching included “surge of motivation,” “acquisition of mental support from the peer,” “change to a mutually enhancing existence,” “transition to spontaneous behavior,” “expanding the scope of care,” and “successful experience by cooperating with the peer.”
Discussion: Peer coaching helped nurses obtain mental support, mature spontaneously, and expand their scope of care. It is therefore suggested that peer coaching be made available to nurses.

The present study aimed to clarify the factors related to care capacity required by family caregivers and determine how care capacity affects sense of care burden. Anonymous self-administered questionnaires were distributed to 1,200 family caregivers. A total of 661 valid questionnaires were returned (recovery rate of 55.1%). Analysis revealed six factors about care capacity and the following relevant factors associated with care capacity: level of care need, dementia, care expertise, age, sex, self-rated health, care period, care time, care assistants, care consultants, and desire to continue providing care. In the relationship between the six factors and sense of care burden, “capacity to see care positively” and “capacity to make a mental switch from caregiving” were associated with a low sense of care burden. In contrast, “practical care skills” and “capacity to express negative emotions about care” were associated with a higher sense of care burden. These results suggest that increasing the “capacity to see care positively” may help family caregivers increase the care capacity they need, and that family caregivers need emotional support, help learning appropriate caregiving methods, and assistance making a mental switch from caregiving.

We assessed the stress response of 139 disaster-relief workers who were affected by the Great East Japan Earthquake. The assessment was conducted in two phases—three months and one year after the earthquake—using the Impact of Event Scale-Revised (IES-R). We investigated the association between the subjects' stress response and the status of those who experienced damage as a result of the earthquake. The results indicated that the subjects who were at high-risk for posttraumatic stress disorder (PTSD) were over 40% in both phases. The IES-R score was significantly higher among subjects who were staff members at the nursing department; who experienced the loss of family, friends, or their home; and who mentioned “safety of family” as the stress-related issue. To conclude, our findings reveal that the disaster-relief workers who were affected by the earthquake need long-term mental health support. Furthermore, the findings suggest that regular psychological training before and an appropriate working environment after disaster strikes need to be provided for the subjects.