Thematic analysis is an often used qualitative research method, yet it is rarely utilized or acknowledged in Japan. This study provides an overview and procedure of reflexive thematic analysis by Braun and Clarke, which is widely used internationally. Braun and Clarke classify thematic analysis into three types, one of which refers to reflexive thematic analysis. Reflexive thematic analysis is utilized for systematically identifying, organizing, and offering insight into patterns of meaning (themes) across a data set. The analytic procedure used in reflexive thematic analysis consists of six phases and provides a checklist of criteria. Although such analysis is expected to be modified in the future, it remains useful in elaborating qualitative research in nursing.

Ethnographic research is “a methodology for describing phenomena and cultures occurring in the living world of subjects from emic and etic perspectives, performed through fieldwork that consists primarily of ethnographic interviews and participant observation.” This is conducted through a triangulation of methods: formal and informal interviews, participant observation, questionnaire surveys, collection of existing books, literatures, website materials, photography and video recording. Questions and hypotheses are refined through repeated data collection and analysis. Trustworthiness is ensured by criteria to evaluate qualitative research studies, including credibility, confirmability, meaning-in-context, recurrent patterning, saturation, transferability. All data are qualitatively described in fieldnotes, encoded, categorized in terms of similarities and differences in codes, after which it is summarized in a narrative report on stories in accordance with a theme.

This paper (1) presents an overview of Text Mining (TM), (2) describes trends in nursing research (academic papers) using TM, and (3) discusses typical methods of analysis in nursing research using TM. A subject search was performed with Igaku Chou Zasshi (Ichushi Web) using the keyword “text mining,” finding 57 academic papers in the nursing literature for analysis. Many academic papers using TM tended to be on “nursing education” and were by university researchers. Questionnaires (free description) were the most common data source, but the samples were small. TM is good for big-data analysis, but the possibility of analyzing a large amount of data was low. The most widely used TM software was KH Coder. The main methods of analysis using TM were reference frequency analysis, relationships between words, and multivariate analysis (especially principal component analysis and cluster analysis), which are core TM analytical methods. In particular, multivariate analysis frequently served as a method for extracting categories. Research on “nursing education” and “nursing management” was considered highly compatible with TM.

Objective: This article aimed to provide readers with information regarding the usage status of Computer-Assisted Qualitative Data Analysis Software (CAQDAS) and the experience of researchers with this software. Methods: Papers regarding the usage status of CAQDAS were extracted from Ichushi Web and J-STAGR. Then, the year of publication and research fields were analyzed. Additionally, two researchers with different years of CAQDAS usage reported their experiences. Results: A total of 95 papers using CAQDAS were extracted from qualitative studies published from 2010 to 2021. There were 15 research articles each pertaining to medicine/health science, business administration, and nursing. “NVivo” was the most used CAQDAS. Researchers with more experience in qualitative research stated that the ability to note and store analytical processes (the core function of CAQDAS) enabled efficient reanalysis, thereby increasing the reliability and accuracy of the results. Researchers with less experience also felt that the smooth analysis promoted and improved work efficiency. Conclusions: CAQDAS has been used in various research fields. Its utilization is expected to increase the efficiency and reliability of analytical works in the qualitative research field.

Objective: The objective of this study is to investigate the experiences of a family that found its purpose in caring for an elderly family member suffering from cancer, after the patient’s involuntary transfer from an acute care hospital to home care. Methods: Semi-structured interviews were conducted with 13 family members. The data were analyzed using continual comparative analysis, a modified grounded theory approach. Results: The family’s “Unintentional wish to care” changed to them ‘Reflecting on caregiving at home’ due to the “Declaration of transfer to place of recuperation” by the doctor. Such reflection developed into their “Determination to care” due to the “Backing of supportive family” and the ‘Support from professional staff.’ A family with “Switch on care” have ‘Found a caregiving pace that does not involve them working too hard,’ and finally obtained a ‘Sense of happiness in the difficulty’ with the ‘Backing of a supportive family’ and the ‘Co-operation of professionals.’ ‘The family bond” was based on this process. Conclusions: The findings of this study suggest that it is necessary for nurses to understand the apprehensiveness exhibited by family members in providing home care to elderly cancer patients, and discuss it with professional staff to provide the families with reassurance.

Objective: This study aims to clarify the process by which male nurses working in a general hospital develop their work styles after being sexually harassed. Methods: We conducted semi-structured interviews with 14 male nurses, who were victims of sexual harassment. The data obtained were transcribed verbatim and analyzed using a modified grounded theory approach. Results: The analysis presented 21 concepts, explaining the process by which sexually harassed nurses dealt with abuse at the workplace. When male nurses came to understand the nature of sexual victimization and perpetration through their own experiences, they gained insights into the situation encountered by female nurses, who out of necessity were compelled to act as figures of authority, thus enabling them to understand the implications of sexual harassment occurring in the workplace. Conclusions: Male nurses who experienced sexual harassment developed coping mechanisms in their social interaction with the perpetrator, and recognized the power dynamics and relationships in the workplace. Thus, their working style was developed through defense mechanisms that identified the power structure in a female-dominated work environment. This understanding was applied to their lives and experiences, to allow for personal growth in the face of abuse.

Objective: To classify, analyze, and reveal features of sexual harassment (SH) experienced by male nurses who worked at general hospitals and their SH coping behaviors. Methods: Data obtained from semi-structured interviews with nine male general hospital nurses who belonged to Organization A were qualitatively analyzed. Results: SH experienced by male nurses were classified into four categories: caused by performing nursing duties, triggered by awareness of masculinity, their body was treated frivolously, and the number of harassers increases over time. SH coping behaviors were classified into two categories: coping behaviors performed by the individual and coping behaviors mediated by others. Conclusions: SH was found to occur due to the unique characteristics of nurses’ work and power structure. This suggests the need for ethics education in the nursing work environment that gives nurses an understanding of both sides and multiple perspectives, rather than unequivocal victim-perpetrator or male-female perspectives.

Objective: This study aims to clarify the status of the broad autism phenotype (BAP) and its relationship to communication and nursing practice skills among female nursing university students. Methods: The study comprised female nursing students at two universities. A total of 199 fourth-year students participated (valid response rate: 78.0%) by completing a questionnaire survey that included attributes, a BAP questionnaire -- Japanese version (BAPQ-J), an index of communication skills (ENDCOREs), and practical skills that are used in nursing practice. A hierarchical cluster analysis was conducted using the scores of all items in the BAPQ-J. Receiver operating characteristic curves were used, with mean scores of all items and subscales of the BAPQ-J. The scores of ENDCOREs and practical skills were compared by clusters. These clusters were formed based on the BAPQ-J. Results: First, the participants were classified into normal, borderline, and high BAP tendency types. Those of a high BAP tendency were further classified into low and high aloof types. They demonstrated significantly lower ENDCORE scores. Those of the high aloof type had significantly lower practical skill scores. Conclusions: Students with high BAP tendencies tend to have lower communication skills. Those of high aloof types tend to have difficulties in acquiring nursing practice skills. These results suggest that teachers at nursing universities should provide support to students of high aloof types.

Objective: The objective of this study is to demonstrate how nurses who visited patients to care for foot lesions interacted with and supported those who did not believe they needed care. Methods: Data were collected in interviews with nine nurses with at least five years of home nursing experience. The analysis used a modified grounded theory approach. Results: Home visiting nurses support patients who do not believe that they need care for foot lesions using three approaches. First, they encourage the individual to experience the benefits of care. Second, they suggest specific self-care strategies. Third, they create and use opportunities for change. In all these approaches, they ensure that they do not alter the person’s lifestyle. Nurses use a direct approach with patients, and also attempt to increase individuals’ interest in self-care by encouraging them to notice that those around them are interested and concerned about their health. Conclusions: This is an approach that can be best implemented by home visiting nurses who understand potential patients and their lives holistically, and provide care in collaboration with multiple organizations and professionals.

Objective: To define “staying power,” conceptualized as the set of skills veteran nurses acquire as they continue working that empower them to remain in the profession. Methods: Semi-structured interviews were conducted with nine veteran nurses who had worked continuously at a local university hospital in Japan for 20 years or more. Interview contents were analyzed using Kinoshita’s Modified Grounded Theory Approach (M-GTA). Results: Staying power was defined in terms of 22 concepts in nine categories: determination to keep up with one’s peers, determination not to repeat the same mistakes, positive mindset, emotional self-control, good maintenance of physical and mental health using a compatible approach, sociability to build good personal relationships, resolution to fulfill one’s responsibilities as a nurse, drive to improve and discover one’s full potential as a nurse, and choosing a compatible work style. Career nurses acquire the determination to keep up with their peers prior to employment: this ability is a core strength, which influences the acquisition of all other component strengths, and is maintained and reinforced as they continue in the profession. Conclusions: Establishing a supportive workplace culture that sustains and reinforces nurses’ determination to keep up with their peers should be an essential aspect of turnover prevention and nurse retention strategies.

Objective: This study aimed to develop a risk assessment sheet for Philippine-born patients with tuberculosis receiving directly observed treatment short-course. Methods: Based on previous studies, we prepared a draft of the risk assessment sheet for Philippine-born patients with tuberculosis and mailed it to public health nurses in 323 public health centers. Based on the results, four researchers, including a Filipino studying tuberculosis, conducted an expert meeting to examine default risk items. Results: In total, 126 public health nurses responded to our survey. According to survey results, among 166 Philippine-born patients with tuberculosis (number of effective responders, 137) who received care from the respondents, 127 patients (92.7%) completed the treatment, whereas 10 (7.3%) did not. An χ² test involving 32 risk items, classified into eight classes in the risk assessment sheet, identified five items that showed significant differences between the two groups. In the expert meeting, the researchers evaluated the risk items based on the results of assessments performed by the public health nurses and decided to add another item to the default risk items. Conclusions: The expert meeting validated the content of a risk assessment sheet, consisting of 33 items in eight classes, for Philippine-born patients with tuberculosis.

Objective: This study aimed to clarify trends in post-stroke apathy research, the reality of apathy, and intervention methods that can prevent and improve apathy. Methods: Seventy-five papers sampled from PubMed and Igaku Chuo Zasshi were categorized according to their similarities; their contents were then summarized and described. Results: The categories for research content were: “review” (9 papers), “mechanism of onset” (14 papers), “treatment” (14 papers), “rating scale” (7 papers), “reality” (12 papers), “relevant factors” (15 papers), “meta-analysis” (2 papers), and “intervention study” (2 papers). Although high-quality research has been conducted in recent years, the scientific evidence on the reality of and the intervention methods concerning post-stroke apathy has remained insufficient. The incidence rate of post-stroke apathy has remained a little below 40%, and “the frequency of stroke onset,” “depression,” and “cognitive impairment” have been associated with the onset of apathy. Findings on the associations between post-stroke apathy and types of stroke, age, time, and severity of clinical outcomes have not been consistent. Cognitive behavioral therapy, the promotion of the problem-solving process, behavioral activation, and the prevention of stroke recurrence have been identified as intervention methods that can prevent and improve post-stroke apathy. Conclusions: The reality of post-stroke apathy needs to be clarified and its intervention methods need to be established.

Objective: This study aims to elucidate the process by which students with continuous school attendance refusal decide to return to school while attending Free School (an alternative school). Methods: Semi-structured interviews were conducted with six children who resumed school after a school attendance refusal, and interview data were analyzed using a modified grounded theory approach. Results: Children with continuous school attendance refusal felt that “it was not optimal to maintain their refusal” while “finding a place in their home,” regained self-confidence, and decided to “prepare attending an alternative school and breaking with” the school attendance refusal. When they began attending the school, they felt “the weight of onlookers’ gaze,” a “difference between them and classmates” and that “the alternative school was not appropriate for them,” but “changes in family relationships” occurred. With “the awareness of taking small steps,” they “decided to go back to school” being “encouraged to resume school or advance to a higher school year” searching for “the meaning of their school attendance refusal.” Conclusions: The findings suggest the importance of understanding the situations in which children gradually gain experience and self-confidence, and assisting them in finding opportunities for personal growth and development.

Objective: This study aimed to investigate opioid analgesic medication guidance and nursing care for outpatients with cancer pain and determined differences between cancer hospitals and general hospitals. Methods: We conducted an internet questionnaire survey of outpatient nurses. Results: The respondents worked at 145 designated cancer hospitals and 236 general hospitals. The frequency of issuing the first prescription of opioid analgesics (p‹.001), the frequency of requests for medication guidance from prescribing physicians (p‹.001), and nurses performing “cross-field” activities (p‹.001) were significantly higher in designated cancer hospitals. Nursing care for outpatients with cancer pain was statistically significantly different for all items. Conclusions: Designated cancer hospitals more commonly provide medication guidance to outpatients who are prescribed the first opioid analgesics and provide nursing care for outpatients with cancer pain, than general hospitals. In nursing care for outpatients with cancer pain, some issues need to be addressed. These are support for consultation on problems in cancer pain nursing care, development of education arrangements for nurses, and development of inter-professional work.