Objective: To report on the teaching design and educational practice of an online pediatric nursing practicum and present a strategy for effective online practices. Methods: From May to July 2020, the University of A offered online nursing practice courses to 30 fourth-year nursing students in three classes of ten students per class. At the end of the course, the students completed a questionnaire survey evaluating the course design and educational practice quality. Results: The average overall class rating was 4.72±0.46. The students’ opinions of the class included such positive comments as these: “I was able to learn through good communication with the instructors,” “I was able to think carefully,” “I had many opportunities to come into contact with other people’s ideas,” and “It was a learning experience similar to the actual clinical practice.” There were also some negative comments, such as “There were few opportunities to consult with the faculty individually” and “The time was too tight.” Conclusions: To ensure that online nursing courses effectively deliver the same high-quality education as in-person classes, the faculty designing the courses must consider the needs of the students and the technology’s limitations.

Objective: Schizophrenia patients are highly anxious about the future and tend to have difficulty finding meaning in life, which inhibits their discharge from the hospital. Based on the idea that hope and emotional support would help such patients find their life meaningful and lead to recovery, this study aimed to clarify the relationship between the meaningfulness of life, time perspective, and emotional support in schizophrenia patients. Methods: Forty-eight schizophrenia patients in the hospital responded to the Purpose in Life (PIL) test, which measures a person’s sense of purpose and meaning in life. The experiential time perspective scale and the emotional support network scale were also used. Correlations in the obtained data was calculated, and a path model was created using covariance structure analysis. Results: Time perspective was found to influence the meaning of life. Moreover, emotional support offered by a person appearing in a delusion provided support for having a goal. Conclusions: The necessity of emotionally supportive nursing assistance and the self-confidence to accept and associate with the disorder was indicated so that a sense of meaning can be nurtured while living with delusions, rather than regarding the delusions as obstacles.

Objective: To investigate gaze and procedures performed by experienced nurses during postoperative observation, using an eye tracker. Methods: Participants were 13 nurses with 5 or more years of experience in perioperative nursing, instructed to perform postoperative observations, assuming patients immediately after surgery under general anesthesia. We analyzed the gaze and procedures. Results: Twelve nurses were included in the analysis set. The order of subjective postoperative observations tended to correspond to the order of fixation during gaze latency. “Drip infusion check” and “PCA (patient-controlled analgesia) pump check” had a high concordance rate with fixation related to procedural content and procedures and a high rate of simultaneous procedures. “Blood pressure measurement,” “SpO₂ measurement,” and “body temperature measurement” had low concordance rates and a high rate of simultaneous procedures. “Foot pump check,” “abdominal drain check,” “breath sound auscultation,” and “intestinal sound auscultation” had low rates of simultaneous procedures. Conclusions: Subjective awareness of experienced nurses during postoperative observation tended to correspond with their gaze, suggesting that eye tracking may be effective in visualizing awareness and technique.

Objective: This study identifies the perceptions of people with early onset dementia regarding social participation. Methods: Semi-structured interviews with and participant observations of people with early onset dementia and their supporters were conducted. Results: The data on social participation among respondents could be classified into five categories. These included “exerting their power according to changing health conditions,” “remaining hopeful despite their symptoms,” “cooperating with others even when they become care recipients,” “encouraging each other through friendship,” and “communicating uniquely about dementia.” Conclusions: For people with early onset dementia, social participation encompasses expanding relationships with themselves, acquaintances (including supporters) and the population. In supporting them, it is necessary to suggest additional opportunities to communicate and interact with people and provide them with social participation opportunities that meet their characteristics or hopes.

Objective: The purpose of this study is to investigate the discourse surrounding attitudes toward breastfeeding by analyzing a nationwide database of academic journals on nursing in Japan. Methods: A discourse analysis was conducted on 92 articles on mothers and infants, excluding premature babies, who generally followed the normal breastfeeding routine. Results: The study identified “norms” and “uncertainties” as major discourses. “Norms” included considering breastfeeding as beneficial, meaning that breastfeeding is the optimum nutrition method for mothers and children: the mothers’ norm, which associates breastfeeding with good mothering; and the experts’ norm, where medical experts consider the promotion of breastfeeding as mandatory. Simultaneously, “uncertainties” included the risk that mothers may suffer a breakdown if they cannot breastfeed their babies successfully, as well as vagueness in both the perception behind what assures successful breastfeeding and the evidence for support methods. Among these norms and uncertainties, experts’ norm, risk, and mothers’ norm appeared at a frequency of 50 percent or more. Conclusions: Medical experts must reflect on whether their views of mothers are biased based on their beliefs about how mothers are expected to behave, and whether this influences their interaction with mothers. They should also develop knowledge for providing feeding support that transcends the simple dichotomy of breastfeeding vs. bottle-feeding by dealing directly with the uncertainties surrounding breastfeeding.

Objective: The objective of this study was to describe the experiences of Japanese female hospital nurses who were pregnant and feared suffering a miscarriage while working. Methods: This study employed secondary data analysis. Data were first collected through semi-structured interviews with 28 female hospital nurses in the highest and lowest TFR prefectures for scale development. Then, the interview transcripts were analyzed using a narrative approach. Results: Five themes were extracted from seven nurses’ transcripts: 1. I forced myself to work as if I was not pregnant, 2. My fetus and I were exposed to occupational hazards, 3. Despite being on medication and experiencing side effects, I continued working and feared suffering a miscarriage, 4. My requests for accommodation were disregarded, and 5. I considered resigning from work due to my supervisor’s attitude. Conclusions: In Japanese hospitals, nurses are expected to work full time and in rotating shifts. Several work styles do not fit the current system. Thus, as the results showed, the nurses did not want to cause trouble for their colleagues, and hence, tried to continue working as if they were not pregnant. Japanese work culture and the universal medical insurance system make it difficult for nurse managers to provide reasonable accommodation to pregnant nurses. Therefore, measures allowing diverse work styles for nurses are required.

Objective: This study examined home-visit nursing services for children who were not eligible for medical fee reimbursements and gained knowledge of practice managers’ countermeasures to stabilize the financial management. Methods: We conducted semi-structured interviews with managers of home-visit nursing stations for children and analyzed the findings from two perspectives. Results: The services and measures yielded the same as the results as a previous survey. This survey revealed that the managers were trying to obtain funding via means other than medical fees for services for the abovementioned children. Some managers considered providing services without compensation, but others thought they couldn’t provide services that would be a financial burden. Conclusions: In addition to request for expanding medical fee targets, managers of home-visit nursing stations must request funds from local governments to ensure stable financial management. Furthermore, managers must have the ability to judge the necessity of nursing and identify financial measures, while accumulating knowledge to support this ability.

Objective: The aim of this study was to examine the status of emotional labor among nursing school students in the end-of-life (EOL) nursing practicum and to provide support for them. We also clarified how the individual characteristics (empathy and sense of coherence [SOC]) of nursing school students are related to emotional labor. Methods: A questionnaire was administered to third-year nursing school students after the EOL nursing practicum. Results: The total score on the Emotional Labor Inventory for Nurses (ELIN) was 96.2±12.7 (n=81), indicating that the factors influencing emotional labor were related to empathy and SOC. Furthermore, SOC was determined to be the factor that reduced various other emotional labor factors, such as “surface adjustment” and “suppressed expression.” Conclusions: During the EOL care practicum, emotional labor among nursing school students was high. Moreover, high scores on empathy tended to influence nursing practice. However, low scores in the SOC suggested evidence of psychological burden and emotional suppression.

Objective: This systematic review aimed to clarify the effectiveness of interventions in reducing the use of physical restraint for older patients in hospitals. Methods: The following databases were searched on November 12, 2019: PubMed, CINAHL, the Cochrane Library, and PsycINFO. Results: A total of 330 studies were identified. Four studies (five articles) meeting the eligibility criteria were assessed for risk of bias. The interventions for reducing physical restraint were multicomponent non-pharmacologic nurse intervention and multicomponent interprofessional team intervention. One study had “some concerns,” and three studies had a “high” risk of bias. Conclusions: There is insufficient evidence on effective interventions that reduce the physical restraint for older patients in hospitals because of the small number of randomized control trials and high risk of bias. Thus, considering multicomponent intervention by an interprofessional team, including nurses, and conducting well-designed studies on this topic are warranted.

Objective: To understand care provided by nurses for patients with communication difficulties due to ventilator therapy in a tertiary emergency medical facility. Methods: Participant observation and semi-structured interviews were conducted with six emergency ICU nurses, and the data were analyzed qualitatively. Results: The analysis yielded seven care categories for patients by emergency ICU nurses. “Ensuring the survival of patients while keeping further course of treatment and the daily lives of the patients before hospitalization in mind, and maintaining their dignity in everyday life to refrain from dehumanizing them,” “Considering medical equipment as part of the patient’s bodies, managing the conditions to avoid trouble, and perceiving unspoken patient messages while providing medical treatment,” “Sensing slight changes in severely ill patients using own physical sensations,” “Providing security and comfort during care considering the physical position of patients” and others. Conclusions: While caring for patients who cannot respond to others, emergency ICU nurses must avoid dehumanizing them while showing concerns for them and imagining the future course of treatment and taking their daily lives before hospitalization into consideration. These attitudes are essential for nurses to be able to see the patient as a person, and should be the basis of emergency care provided by ICU nurses.