Objective: The study examines how nurses develop professionalism and abilities through work experience. Methods: To collect data on nurses’ work experience, semi-structured interviews were conducted with 17 nurses who worked in the COVID-19 ward of a hospital. The grounded theory approach was used to analyze the interview data. Results: (1) The nurses developed “professional identification: infection control” professionalism by “combating infection risk” work experience; (2) they developed “professional identification: professional commitment and workplace commitment” through interactions between “boundaryless cooperation” and “seeking ways to promote caring” work experiences; and (3) they developed “combating infection risk,” “boundaryless cooperation,” and “knowledge and skills of caring” through professionalism. Conclusions: Nurses developed professionalism and abilities through their work experience, in a step-by-step process.

Objective: To clarify the contents of and changes in reproductive institutions’ medical care, older infertility patients’ treatment status, and the coronavirus disease 2019 (COVID-19) pandemics’ impact on visits to reproductive medical institutions. Methods: A questionnaire survey was conducted at a fertility treatment agency and analyzed quantitatively and qualitatively. Results: Of the respondents, 90.5% reported a change in their practices, while 67.9% had restricted access to their husbands and family members because of infection control. Moreover, 12.2% had a restricted number of appointments. Changes in the medical treatment system included the increase of online medical treatment and information sessions. Although a high percentage of medical professionals thought that the treatment status of elderly infertility patients and the conditions of their visits to the clinic “remained the same,” free comments indicated that “treatment continues despite the conflict with anxiety about infection.” Conclusions: With countermeasures against infection, direct support opportunities for patients were limited and alleviating patients’ anxiety proved difficult. Hopefully, information and communication technology (ICT) and other methods will be used to support elderly infertility patients during the pandemic.

Objective: This study aimed to determine whether acupuncture treatment can regulate the autonomic nervous system activity and relieve menopausal symptoms. Methods: Forty-eight menopausal women, with symptoms such as hot flushes, were categorized into four groups, based on their symptom levels and whether they had undertaken acupuncture treatment before. The participants also received nursing interventions during the study. Acupuncture treatment was performed four times at a frequency of once per week for 10 min at seven acupuncture points. The sham treatment was performed at the same points using only the acupuncture tube. The autonomic nerve activity was measured for 24 h and analyzed using power spectrum analysis. Symptoms of hot flashes, excessive sweating, and cold sensation were evaluated using the visual analog scale. Results: In the acupuncture-moderate group, parasympathetic nerve activity increased while sympathetic nerve activity decreased at night. In addition, hot flashes were significantly reduced after four treatments. In contrast, moderate sweating and cold sensation were significantly reduced after receiving four treatments, with or without acupuncture. Conclusions: Collaboration of nursing, with acupuncture treatment, might improve the autonomic nervous system activity in menopausal women at night and resolve their menopausal symptoms, such as hot flashes, excessive sweating, and cold sensation.

Objective: This study aims to show relationships between concepts related to daily living care and attempts to develop a theoretical model for daily living care in acute nursing. Methods: A hybrid method of theory construction is used to develop a model based on concepts clarified in previous studies. First, a tentative model is created by diagramming the nursing perspectives of daily life, the relationship between the situations of acute patients, and the content of daily living care practices. Second, the responses and effects of daily living care were explained using fieldwork examples. The results are then integrated to develop the model. Results: The model for daily living care in acute care nursing is presented as a three-layered structure consisting of “vital activities of living,” “activities of daily living,” and “personal living.” The model shows that nurses identify the properties of the “situation of the patients in an acute phase” from a three-layered perspective, then practice several “art of daily living care in acute nursing” to promote the “recovery of the integrity of the person.” Conclusions: This model demonstrates the value of daily living care in acute nursing by showing the multilayered structure of daily living care, and between daily living care and its effects.

Objective: This study aimed to determine whether satisfaction in a marital relationship has an impact on feelings of parenting difficulty in response to a child crying. Methods: A self-administered questionnaire was distributed to mothers and fathers of children aged three to six months in Prefecture A, Japan. The questionnaire included questions on the following attributes: feelings of parenting difficulty in response to a child crying, parents’ feelings toward their children (feelings of closeness and avoidance), and satisfaction in their marital relationship. Multiple regression and mediation analyses were conducted on the data. Results: Valid responses were obtained from 100 individual respondents (50 fathers and 50 mothers). Marital relationship satisfaction mediated fathers’ feelings of closeness toward their child and influenced feelings of parenting difficulty in response to their child crying. Feelings of avoidance was the strongest factor that influenced mothers’ feelings of parenting difficulty in response to their child crying, followed by feelings of closeness, and satisfaction in their marital relationship. Conclusions: Marital relationship satisfaction had an impact on parenting difficulties in response to a child crying in both fathers and mothers, suggesting that improving marital relationship satisfaction could reduce parenting difficulties in such situations.

Objective: This study aimed to clarify the current situation and issues related to the in-service training of nurses and reasonable accommodation for nurses with noticeable developmental disabilities based on a fact-finding survey. Methods: An anonymous, self-administered questionnaire survey was conducted among nursing administrators, including head nurses. The questionnaire included questions about educational considerations and respondents’ thoughts on reasonable accommodation for nurses with diagnosed developmental disabilities and those suspected of having developmental disabilities. Results: Some of the challenges recognized by nurse administrators were related to difficulties in communicating with nurses, the need to become aware of nurses’ distinct characteristics, relationships with other nursing staff, and a thorough understanding of reasonable accommodation. Conclusions: To resolve challenges related to in-service education, a system needs to be constructed that facilitates the following: a declaration of reasonable accommodation, avoids an excessive focus on emotions in retrospective interviews, increases nurse administrators and nursing staff’s knowledge of developmental disorders, seeks collaborative solutions, identifies concrete objectives, and coordinates job and environmental conditions.

Objective: This study aimed to clarify the current status and factors related to nursing practice in acute care hospitals for older adults with dementia. Methods: Self-administered questionnaires were distributed to 614 nurses working in acute care hospitals. A multiple regression analysis using the forced entry method was conducted with related factors as the independent variables and all the subscale scores of the self-assessment scale for nursing practice as the dependent variables. Results: A total of 471 questionnaires were returned (recovery rate, 76.7%). The subscale items for I and II were below the average score of 4.3 and those for III and IV were above the average score. All the subscale scores of the self-assessment scale for nursing practice were significantly associated with attending conferences on dementia nursing when difficulties were encountered. In addition, the presence or absence of adequate manpower, the number of training events related to dementia attended outside the hospital, experience in working with dementia patients during nursing education, and conflict between the treatment of dementia patients and nursing practice that respects older adults with dementia were related to the subscales’ scores. Conclusions: These results suggest that an improvement in the work environment and greater involvement with older adults with dementia in nursing education are important.

Objective: Research evidence demonstrating the effect of Partnership Nursing System (PNS) on nurses is limited because it has only recently been developed. Therefore, this study aimed to clarify the effect of PNS on nurses’ autonomy and nursing practical ability. Methods: A questionnaire survey was conducted among nurses with less than three years of experience working in general wards at six facilities with and without the PNS. We compared the scores of autonomy and practical nursing ability of 192 nurses with only PNS experience (PNS group) and 121 nurses without PNS experience (non-PNS group). Results: Scores on autonomous clinical judgment and control over working conditions were lower in the PNS group than in the non-PNS group. However, job-related independence was similar among the two groups. The PNS group showed significantly larger dispersion in scores on autonomous clinical judgment than the non-PNS group, indicating that nurses in the PNS group had particularly low autonomy. Scores on all factors of practical nursing ability did not differ significantly between the two groups. Conclusions: Results suggest that PNS may interfere with the development of nurses’ autonomy and that nurses with low autonomy may choose facilities that implement PNS.

Objective: This study aimed to clarify the actual situation and need for home-visit nursing services for children ineligible for medical fee reimbursements at nationwide home-visit nursing stations in Japan and to consider the content of medical fee that should be requested for these services in the future. Methods: A questionnaire survey was conducted on the implementation status and necessity of home-visit nursing services for children ineligible for medical fee reimbursements. We evaluated the descriptive statistics and performed content analysis of free description at 455 home-visit nursing stations. Results: The implementation rate of home-visit nursing services for children ineligible for medical fee reimbursements was 78.7%. The advantages of providing these services included avoiding risk of health deterioration of a child with poor physical condition, promoting the child’s growth and development according to changes in their situation, providing stability of life through medical care for the child and the family, and constructing a support system for the child and the family. Conclusions: Many home-visit nursing stations provided services even if the service-seekers were ineligible for medical fee reimbursements, considering the benefits children received from their services; additionally, necessity of reviewing the content of medical fee that should be requested for the services in the future was also considered.

Objective: This study aimed to verify the efficacy and validity of foot care programs in elderly facilities. Methods: We requested the assistance of three staff members at elderly facilities with a foot care program. Results: There were five male and nine female subjects. Before-and-after comparisons after the intervention of the foot care programs revealed the following results: 1) Blood circulation–related problems such as “coldness” in feet and “hanging” feet improved, while calluses, keratinization, and skin peeling disappeared. 2) Tactile sensation on the soles of the feet was significantly reduced at five thresholds (p‹.05). 3) The skin surface temperature decreased for both feet. 4) The subjects could stand longer on one leg with their eyes open (p‹.05) and their scores on the Functional Reach Test increased significantly (p‹.01). 5) The maximum speed when walking 10 m increased (p‹.05) and the time taken on the Time Up and Go Test decreased significantly (p‹.01). 6) Toe grasp power improved significantly in both feet (p‹.05). Conclusions: Although the interventions were performed by assistants with different occupations, the programs were judged as appropriate since the outcomes (the progress and effect of care) were the same.

Objective: To prepare a standard risk assessment form to be used for community directly observed treatment short-course (DOTS) individual patient support plan. Methods: A tuberculosis expert panel examined the risk assessment form based on statistical analysis (470 subjects) of the result of assessing tuberculosis patients’ risk of discontinuing their medications at each public health center in four Tokai prefectures. Results: The 15 risk items common to all public health centers were scored by assigning two weighing points to three items that showed significant differences: “there are side effects,” “there is no understanding of side effects,” and “there is a history of discontinuing treatment”; and one weighing point to the remaining 12 items. Referring to existing papers, we added “irregular lifestyle,” “foreign nationals,” and “patients with recurrence” as well as “latent tuberculosis” as additional risk items as they showed significant differences in attributes. Scores were categorized as ≥6 and 3–5. Ranks A to C were classified by adding discretionary points through interviews. We prepared a risk assessment form comprising 19 items. Conclusions: Items weighted in the standard risk assessment form have a high risk of interruption. In community DOTS, it is necessary to respond flexibly based on risk items.

Objective: This study aimed to clarify regional differences among background, difficulties in cooperating with other facilities and multiple professions, and implementation status of services for which medical fees cannot be calculated at pediatric home nursing stations. Methods: A random sampling of home nursing stations for special chronic pediatric disease support was employed to conduct mail survey. Results: For comparison, the 455 questionnaires used were divided into three groups: urban area (31.4%), middle area (31.4%), and county area (36.3%). In comparison with urban areas, the score for “more than 15 kms one way” was 73.9% higher in county areas. The number of pediatric users was as low as 4.8±7.0 in the county areas. There was no difference in the number of children who received medical care. When it came to the difficulty of cooperating with other facilities and multiple professions, the score for “I feel difficulty in cooperating at the discharge coordination meeting” was significantly higher in county areas than in urban areas. When it came to the implementation status of services for which medical fees could not be calculated, the number of “visiting nurses present at the time of consultation” was significantly higher in county areas than in urban areas. Conclusions: Based on the results of this study, it appears that a system that facilitates the functioning of home nursing stations in all regions is required.

Objective: The purpose of this study was to investigate the sense of coherence (SOC), occupational stress, organizational climate, identity, and mental health of new graduate nurses working in specialized hospitals. It examined mental health factors and the Generalized Resistance Resources (GRRs) related to SOC. Methods: The self-completion questionnaire on SOC (29 items), identity scale (20 items), job content questionnaire (JCQ; 22 items), organizational climate scale (OCS; 12 items), and general health questionnaire (GHQ; 12 items) were employed among 105 new graduate nurses in specialized hospitals. A multiple regression analysis was performed with each subscale of the GHQ-12 and SOC-29 as dependent variables. Results: The mental health of new graduate nurses was strongly associated with SOC. In addition, the organizational environment and basis of identity contributed to a sense of comprehensibility, which is a factor of SOC. A sense of manageability and a sense of meaningfulness also affected basis of identity and established identity. Conclusions: It is integral to raise SOC as a mental health measure for new graduate nurses. Creating an organizational environment may strengthen SOC to enable this.