The purpose of this study is to clarify the characteristics of child rearing experienced by mothers who have autism spectrum disorder (ASD), but do not have intellectual disability, from the mother’s point of view. Semi-structured interviews were conducted with six mothers, and analysis was performed using the modified grounded theory approach. It was found that mothers who had not yet been diagnosed with ASD when their children were infants struggled with emotional distance and tended to put their own needs above those of the child. However, mothers who had been diagnosed with ASD and worked to live with it were able to move to a style of child rearing that valued both the children and themselves. Moreover, they were able to move toward living with ASD as a parent-and-child unit and joining society on their own terms. Thus, this study suggests that support for child care by mothers with ASD should focus on the importance of a concrete outlook on the mother’s lifestyle and parenting, and should foster relationship building based on the unique qualities of both the mother and the child.

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The purpose of this study was to elucidate the process by which nurses enhance the will of the elderly with declined ability to communicate and develop assistance. We conducted a semi-structured interview for 23 nurses with› 5-year nursing experience using the modified grounded theory approach─a qualitative research method. We obtained 2 core categories, 9 categories, and 32 concepts. Nurses have 《sharpened sensation》 by ‹underlying mission sense› and ‹motivation for will estimation›. This sense is further harnessed by ‹construct intimate relationship›, ‹understanding personal characteristics›, ‹intentional approach›, ‹promotion of contact with people›, and ‹field of view spread by cooperation› with other staff members, as well as 《detection of signs from living body》. From that, they ‹approach to the will› through ‹exploring the will›, have 《sharpened sensation》 again. By repeating the cycle over and over again, they enhance the will of the elderly, practice assistance for ‹the best everyday life› of the elderly.

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The purpose of this study was to clarify the relationships of role stress and labor load with burnout among nursing managers and among nursing staff with more than 15 years of nursing experience. A questionnaire survey distributed to nurses working in acute hospitals with more than 300 beds, and questionnaires were returned from 355 respondents. We found that there was no significant difference in the degree of burnout between the nursing managers and nursing staff (p ›.05). As for role stress, role conflict was associated with emotional exhaustion (β=.18) and depersonalization (β=.23) in the management position, and role ambiguity was associated with a decrease in personal accomplishment (β=.18). As for the labor load, it was shown that the load of the work was higher in the management position, and emotional exhaustion was strengthened (β =.19), and overtime work was slightly less (β=−.14) in nursing managers than in nursing staff.

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Purpose: The purpose of this study was to clarify the contents of the activities of Certified Nurses in Stroke Rehabilitation Nursing.
Method: The research design was a qualitative and descriptive study, and eight Certified Nurses participated. The data were collected using semi-structured interview methods and qualitatively analyzed the content.
Results: The actual situation was explained with eight categories and 30 subcategories, with 429 extracted codes. The eight categories were “self-reflection and leading nursing trainings to guarantee of quality of nursing,” “bedside care based on professional clinical judgment,” “cross-disciplinary nursing training activities to facilitate multi-job collaboration cooperation,” “educational activities to meet learning needs in and out of the hospital,” “expressing a view of nursing that respects the patients’ entire lives,” “promotion of continuing nursing activities for stroke patients,” “nursing managers’ and certified nurses’ management of activities associated with the granting of roles,” and “research and learning based on role consciousness as a certified nurse.”
Discussion: The extracted category reflects the disease characteristics of stroke, and is considered to be a multifaceted activity to life-behavioral function activity that looks at the whole process of medical treatment life.

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Objectives: This study is aimed at obtaining suggestions related to nursing practice by elucidating the process through which nurses’ reflections contribute to caregiving to children who require developmental support and their parents.
Methods: We conducted semi-structured interviews with nurses who tend to children requiring developmental support; the results were analyzed using a modified grounded theory approach.
Results: Nurses provided care by “understanding and supporting children based on their developmental characteristics” and “respecting parents and drawing out their strengths.” These practices were motivated by “the need to obtain knowledge for practices,” “visualizing the difficulty faced by parents,” and “focusing on children,” which stemmed from “reflections about the relationship between one’s personality or experience and ‘children and their parents” and “reflections based on one’s character.
Conclusion: Our findings suggest that reflections enabled nurses to acknowledge the common points shared between them and patients, note the tendencies that they are prone to, and understand their strengths and weaknesses. By accepting their own reflections, nurses were able to provide care by focusing on patients’ needs.

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[Aim] This study aimed to clarify problems associated with medical fees and ingenuity for the management of child-exclusive home visiting nursing stations’ manager, and to determine the appropriate medical fees for expanding and improving the medical care services for children.
[Method] We interviewed home visiting nursing stations that exclusively support children and conducted a qualitative analysis.
[Results] This study recognized seven categories of medical fee problems that home visit nursing stations’ managers caught: low levels of fees that do not reflect the complexity of care, the setting of long-term visiting nursing fees that do not reflect the needs, etc. As management measures for these problems, home visit nursing stations enacted five measures: preset fees for various services, cost reductions, the ingenuity to get the reward by combination with the welfare service, etc.
[Conclusion] The current system of medical fees for home care provided to children does not reflect the actual care given and required. The requests of the child-exclusive home visiting nursing stations’ managers need to be taken into account.

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Objective: To clarify care behaviors performed for terminal cancer patients and their families by visiting nurses in the final month before deathwatch and to classify the behaviors into the middle and late stages of end-of-life care.
Method: A researcher accompanied visiting nurses and took notes on the care and time involved through the participant observation method. The data were divided into middle- and late-stage end-of-life care and analyzed.
Results: Care behaviors involving physical assessment, lifestyle assessment, and communication/correction were seen significantly more often in middle-stage end-of-life care. Care behaviors including post-mortem procedures, deathwatch support for family members, and family support post-deathwatch were seen significantly more often in late-stage end-of-life care. The rate of family presence was significantly higher in the late-stage than in the middle stage (p<.05). Though the rate of presence was low in the middle-stage, over half of care time was spent on family care.

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This study, semi-structured interviews were conducted on 13 hemodialysis patients aged 65 years or older and analyzed using M-GTA. As a result, the process of how elderly hemodialysis patients use health information could be explained in accordance with seven categories consisting of 19 concepts along with 2 other concepts. Patients start by “recuperating while taking care of their weak bodies,” then select reliable information for themselves obtained via their preferred routes, and “make a self-determination that this convincing information is useful.” Upon evaluating the medical staff and considering the countermeasures depending on the strength of this self-determination, the process was divided into “embarrassed by the remaining data and their feelings” and “Transfer to your own.” From the above, it was suggested that elderly hemodialysis patients take independent action in order to obtain information on health, along with the issues regarding using this information and ways of supporting the use thereof.

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The primary objective of this study is to visualize the features of contents present in advance directives. A literature survey was conducted by employing the Japan Medical Abstracts Society database and using the keywords “older adults” and “advance directive.” Text mining was employed to perform content analysis of advance directives. Consequently, analysis of nineteen references dating from the year 2004 to 2018 resulted in the extraction of 2,556 words. During hierarchical cluster analysis, the resultant seven clusters were classified into two groups: 1) The associated advance directive specifying aspects such as when, to whom, and what. 2) The associated advance directive specifying the appropriate recuperation places and the type of medical and nursing care desired by an individual. By analyzing advance directives, the requirements of patients and their families can be comprehended, which can aid in improving the healthcare management system for patients and caregivers so that the highest degree of satisfaction with medical and nursing care support is achieved. Furthermore, aspects such as the duration and frequency of providing or receiving healthcare need to be carefully monitored and consensus building between patients and caregivers should be encouraged.

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