Objective: This study aimed to investigate the health behaviors and difficulties encountered in the daily lives of community-dwelling elderly people who were requested to refrain from leaving their homes to prevent COVID-19 infection. Methods: We conducted an inductive and qualitative analysis of free description through an anonymous self-administered questionnaire survey of 201 community-dwelling elderly individuals/older adults in Hokkaido, aged ≥65 years. Results: The survey identified the following health behaviors: “physical activity,” “health management behaviors,” “cognitive training,” “hobbies,” “stress relief and variety/diversity of activities,” and “implementation of infection control.” Daily problems that were encountered by the elderly were as follows: “unable to perform hobbies and recreational activities,” “decreased physical activity,” “restricted daily life,” “unable to participate in social activities,” “unable to obtain materials for hygiene control,” and “unable to receive medical examinations or visit a hospital.” Conclusions: While the elderly engage in health behaviors such as physical activity and infection prevention measures, they are concerned by their inability to participate in social activities as a result of the closure of public institutions and amenities/facilities.

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Objective: From the viewpoint of nursing managers, we study the factors leading to errors when newly graduated nurses multitask by simultaneously caring for more than one patient. Methods: Using semi-structured interviews, data were collected from seven nursing managers. The KJ method was employed for the analysis. Results: Newly graduated nurses “grow up in stages," but the reality of nursing practice, due to “the gap between basic nursing education and clinical practice," entails personal challenges prior to nursing practice, such as “surface learning that lacks independence," “weak interpersonal skills," and “selfishness." Surface learning especially invites the situation of “inability to connect medical knowledge to nursing practice" and causes “difficulty of individual guidance on reporting methods" and “lack of a flexible shift" at a practical level. Moreover, there have been negative effects of nursing more than one patient at the same time and simultaneously dealing with multiple tasks. This involves “weak interpersonal skill" and “selfishness," which develops into “limited education and guidance from senior nurses." Conclusions: It was considered necessary to refine the learning method of newly graduated nurses.

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Objective: This study aimed to clarify the concept of daily living care in acute nursing. Methods: Using a hybrid method consisting of theory, fieldwork, and integration phases, the concept was compared to previous studies. In the theoretical phase, the author examined the interpretation of living in nursing based on the literature and developed a working definition for daily living care. In the fieldwork (FW) phase, the use of concept in practice was established from field observations in which nurses provide daily living care for acute patients, as well as from interview data. The results were integrated in the integration phase. Results: In the theoretical phase, living in nursing was conceptualized into three activities: “vital activities of living,” “activities of daily living,” “personal living (kurashi in Japanese).” Through the FW phase, the author identified five categories of situations of patients in the acute phase, eight categories of daily living care processes in acute nursing, and five categories of the effects of living in acute nursing. In the integration phase, daily living care in acute nursing was defined. Conclusions: As a result of the integration of theoretical and fieldwork studies, the concept of daily living care in acute nursing was clarified.

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Objective: To elucidate the instructional process for pathophysiology education in the practical training of nurses. Methods: Semi-structured interviews were conducted with 12 teachers involved in the practical training of adult nursing students and analyzed using the modified grounded theory approach (M-GTA). Results: Encouraging the study of anatomy, physiology and pathophysiology prior to training, anticipating the nursing issues of the subjects that students will oversee, and “targeting the pathophysiology” [fully prepared instructors to teach pathophysiology]. Delving deep into explanations of pathophysiology and “focusing on the patient’s symptoms” expanded thinking and facilitated considering nursing care. When students’ understanding was insufficient, focusing on the pathophysiology and “revisiting the basics” helped to [deepen the understanding of pathophysiology and promote nursing concepts]. Furthermore, the description of pathophysiology in the rationale for the nursing plan was verified, and [nursing practice was substantiated through pathophysiology]. Conclusions: The instruction process constitutes practical training support that ties pathophysiological understanding to nursing care. Further, it requires an educational system that allows for the repetitive study of specialized nursing subjects in teaching pathophysiology.

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Objective: This study elucidated the current state of medical care for elderly patients with Crohn’s disease in accordance with the effects of aging, psychological changes, and needs. Methods: Participants included eight elderly patients aged ≥65 years. Data were obtained through semi-structured interviews and qualitatively analyzed. Results: Six categories were extracted from the effects of aging, eight from psychological changes, and six from needs. The patients’ mean age was 68.8 years. While the patients noticed their physical and cognitive function declining with age, it did not greatly impair their life or medical treatment. However, assuming that their physiological and psychological functions would continue to decline in the future, and thus, eventually affect their lives and medical treatment, countermeasures were adopted to maintain daily activities. Conclusions: While no formal support was necessary during periods of remission, the patients needed to obtain information about local specialized hospitals and the social security system. Furthermore, based on the effects of aging, it was suggested that patients need support to continue effective medical treatment.

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Objective: This study aimed to develop a reading strategy scale and a reading self- efficacy scale to assess article reading among nursing school teachers and to test the scales’ reliability and validity. Methods: A questionnaire survey was administered to 350 teachers and 147 valid responses were obtained. The original items of the scales were created from interviews and literature reviews. Results: As a result of factor analysis, the “reading strategy scale” consisted of 9 items under 3 factors (understanding strategy, cooperative strategy, and arranging strategy). The “reading self-efficacy scale” consisted of 12 items under 2 factors (confidence in searching and understanding article, and confidence in continuing and promoting article reading performance). Both the scales were found to have internal consistency, stability, construct validity, and criteria-related validity. Conclusions: The reading strategy scale and the reading self-efficacy scale for nursing school teachers with the reliability and the validity were developed.

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Objective: The purpose of this study was to spell out the factors influencing the career plateau of nurses and their relationship with career development. Methods: The participants were 776 nurses working at 194 general hospitals with more than 400 beds. The survey items included personal attributes, organizational attributes, career plateauing, content plateau, and career maturity scale for nurses. Multiple regression analysis was conducted for these associations. Results: Age was significantly associated with career plateaus and significantly suppressed satisfaction with promotions and opportunities. No item promoted a content plateau. Satisfaction with promotion opportunities, satisfaction with bosses, and the establishment of a career counseling department were negatively associated with content plateau. Scores on each subscale of the Occupational Career Maturity Scale were also negatively associated with career plateau scores. Conclusions: To control career plateau, it is important to consider the influence of age, provide fair promotion opportunities, and create a work environment where nurses can explore directions for their careers.

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Objective: To elucidate the difficulties encountered by nursing students when providing discharge instructions to chronic phase patients as perceived by clinical practicum instructors, and the steps taken by the instructors to alleviate such difficulties. Methods: Semi-structured interviews using an interview guide were conducted on 11 clinical practicum instructors working at eight general hospitals with a capacity of ≥ 300 beds. The interview data were then subjected to a qualitative descriptive analysis. Results: The instructors perceived students to be experiencing difficulties in visualizing patients’ post-discharge lives, tailoring instructions to their individual needs, and communicating with their patients. The steps taken by the instructors to alleviate these difficulties included asking questions that encouraged students to visualize patients’ post-discharge lives. Further, they provided opportunities for students to gather information and to learn from people in other professions. The instructors also demonstrated the actual provision of discharge instructions to enable students to tailor instructions to patients’ individual needs. Conclusions: Critical clinical practice measures for teaching discharge instructions to patients with chronic diseases include enabling students to gain early experience in interacting with patients living at home and in the community, focusing on patients’ perspective.

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Objective: This study aimed to explore and describe the competencies of clinical training practicum supervisors in basic nursing education. Methods: A qualitative description was used to analyze data collected by observing participants and semi-structured interviews were conducted with four practicum supervisors. Results: The analysis indicated that practicum supervisors in the clinical training had four competencies. First, they could train students as if they were actual members of the practice setting. Second, they could involve others in the clinical setting while building a student-centered network. Third, they could act as role models for nursing students. Fourth, they could turn students’ experiences into teachable moments. Conclusions: The characteristics shown to be fundamental in the competencies of practicum supervisors were the values and interpersonal skills that made them excellent practitioners. This study suggests that mastery through experience and receiving systematic on-the-job and on-site training is essential to acquire these four competencies.

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Objective: The purpose of this scoping review was to clarify nursing care in order to prevent and reduce the need for physical restraints for older patients in general hospitals throughout Japan. Methods: We made use of the Japan Medical Abstracts Society’s database, identifying 326 relevant studies. Ultimately, 18 studies met the criteria of this review and were included. Results: By reviewing the selected abstracts, we were able to create six categories: “involvement for hospitalized patients to comfortably spend time in,” “consideration of patients’ safety”, “assessment for the timely withdrawal of physical restraints,” “assessment of care based on daily life,” “the construction of a dementia care system,” and “decision-making support to consider physical and mental states.” Conclusions: Preventing and reducing the need for physical restraints for older patients requires thorough basic care by nurses and the development of relevant education and culture by administrators.

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