Objective: This study aimed to clarify palliative care practiced by certified nurses in palliative care and certified nurses in chronic heart failure nursing for later-stage elderly patients hospitalized for end-stage heart failure. Methods: Semi-structured interviews were conducted with four certified nurses, and the interview data were analyzed qualitatively. Results: Regarding care provided by certified nurses, eight categories were extracted: [adjust patients’ oxygen consumption in daily activities], [use a non-pharmacological approach to ease patients’ difficulty in breathing], [create a time that allows patients to get relief from their chronic pain and feel comfortable], [involve other people to mitigate patients’ pain], [get support from people around the patient so that he/she can lead his/her daily life without excess treatment burden], [recognize patients who keep fighting despite feeling depressed due to prolonged restrictions on daily life], [relax prolonged restrictions on daily life little by little], and [provide support to make patients’ wishes come true while taking into account their remaining lifetime]. Conclusions: It was suggested that in caring for patients approaching the end of life, it is necessary to provide care while striking a balance between the degree of psychological burden and restrictions on daily life.

Objective: This study aimed to reveal the actual situation and the relationship between factors affecting the career design of midwives in hospitals with multiple clinical departments, including obstetrics. Methods: A survey was conducted on 844 midwives at 63 hospitals. An ordinal logistic regression was conducted on the relationship between factors affecting career design. Results: Responses were obtained from 436 midwives. About 90% engaged in career design. According to the results of the ordinal logistic regression analysis, work satisfaction, motivation for work, acceptance of past experiences, and goal-directedness were positively related to career design. Conclusions: Regarding midwifery career design, it is important to have a sense of satisfaction and motivation for work, to accept one's past experiences, establish goals, and plan the future.

Objective: To clarify the conditions that lead home healthcare nurses to determine whether clients with schizophrenia living in the community need respite hospitalization, the involvement of nurses in the admission process, and the changes in clients caused by hospitalization. Methods: Semi-structured interviews involved 11 nurses with at least 3 years of experience each in psychiatric wards and psychiatric home healthcare and in guiding clients to respite hospitalization. Eight cases were analyzed qualitatively. Results: Home healthcare nurses evaluated the need for respite hospitalization based on changes in clients’ sleep, living space, and activities of daily living, in addition to physical symptoms. Furthermore, comprehensive decisions were made through a consultation system led by home healthcare nurses and involving other supporters, while support for family caregiving of clients led to medical consultations and respite hospitalization on their own volition. During hospitalization, home healthcare nurses continued to be involved with clients preparing to resume community life, resulting in improvement of clients’ mental symptoms and a better understanding of their illness. Conclusions: Characteristic categories, including decision indicators for respite hospitalization, collaboration with other supporters, and interventions, including those by family members living with the patient, were extracted.

Objective: This study aimed to evaluate sleep quality improvement using a breathing technique, in primary caregivers of older adults with dementia who are undergoing home care, through subjective indicators. Methods: The primary caregivers were intervened with three days of breathing technique and three days of the control period. The evaluation items were the Pittsburg Sleep Quality Index Japanese version (PSQI), the OSA Sleep Inventory MA version (OSA), and interviews. Analysis was performed using the Friedman test, the Mann-Whitney test, and the content analysis method. Results: Six subjects were analyzed. The median total PSQI score of the primary caregivers was 7. There was a significant difference in the score between days 1–3 of sleep onset and sleep maintenance between the day when the breathing technique was implemented and the control day (p‹.001). Furthermore, as a result of content analysis of the effect of the breathing technique on sleep, five categories were extracted: “improves sleep quality,” “feeling of relaxation,” “feeling that the breathing technique affects sleep,” “recognize the importance of resting myself,” and “there was no change felt in my sleep.” Conclusions: It was suggested that implementing the breathing technique might promote sleep onset and sleep maintenance of primary caregivers.

Objective: The objective of this study is to organize information from Japanese literature on the thoughts and concepts of support in the process of accepting impairment in the fetal anomaly found after prenatal diagnosis. Methods: A search was conducted with the Ichushi Web, using the keywords “prenatal/AL,” “(“acceptance (psychology)”/TH or Impairment Acceptance/AL)” to identify twelve original articles in the nursing field as analysis subjects. Our search specifically excluded literature examinations. Results: It was elucidated that the subjects experienced a range of emotions from shock to grief, as well as conflict and distress over the destroyed connection to people. They ultimately accepted the fact through revival by selective abortion or an affirmative experience from giving birth, and eventually succeeded in reconstructing their love by deciding in favor of the child’s best interest and recovering their daily life. Providing sufficient information, securing enough time to address the issue, and continuous support to achieve the best for the child with the consideration for the family ties were essential. Conclusions: In the process of accepting impairment in fetal abnormality found during prenatal diagnosis, the relationship with family and society has major relevance, and the importance of continually providing nursing to support the child for the best was indicated, considering the fact that there will be acceptance when sufficient information and ample time are provided.

Objective: To review international literature on pathophysiology teaching activities among nursing faculty and obtain indications for teaching methods that would effectively facilitate student understanding of pathophysiology. Methods: The research databases Cumulative Index to Nursing and Allied Health Literature, MEDLINE, and PubMed were searched for the keywords “pathophysiology,” “nursing faculty,” “teaching,” and “education.” All years of publication were included. Results: A total of 13 pieces of eligible literature were analyzed, and it was found that pathophysiology subjects included tuberculosis, diabetes, gestational hypertension, and circulatory shock. Furthermore, the following four major themes were identified: “active learning practice for students,” “support for learning after the class,” “integration of pathophysiology and nursing,” and “class readiness.” Conclusions: Teaching activities that incorporate active learning and media as well as teaching methods that lead to learning outcomes should be considered. Furthermore, curriculum and subjects should be reconsidered with an awareness of the connection between pathophysiology and nursing, and an educational system that would strengthen pathophysiology teaching activities among nursing faculty is necessary.

Objective: This study on the current status of infection nursing education at nursing universities in Japan clarified the position of infection nursing in the existing curricula and identified the issues to be addressed. Methods: A questionnaire survey was conducted among faculty members in charge of infection nursing lectures and seminars at 283 nursing universities in Japan. Descriptive statistics were calculated and a qualitative inductive analysis of open-answer content was done. Results: The collection rate was 38.9%. Thirty percent of the universities had independent courses on infection nursing, and the extent of teaching time devoted to the subject unit varied by institution. Many respondents acknowledged the necessity of studying nursing care and ethical issues of infectious disease patients by the time of graduation. Educational issues related to infection nursing were classified as “issues related to students’ achievement level,” “issues in the curriculum,” and “issues of the instructors themselves.” Issues such as “lack of understanding of basic knowledge about microorganisms,” “lack of coordination among related subjects,” and “lack of practical nursing skills for infection nursing” were extracted. Conclusions: The results suggest the need for cooperation among subjects for the implementation of a systematic approach to infection education.

Objective: To capture the transition and overview of research articles and commentaries on “dialogue” in the field of interpersonal support, such as health and medical care welfare, and to clarify the achievements and challenges in dialogue. Methods: We searched for and analyzed material using the Central Journal of Medical Science web (Ver. 5) and CiNii Articles. Results: Five research articles were case studies in the field of psychiatry, and 34 articles were commentaries describing the practice. The results were as follows: “Respect for and discovery of the health and independence of the person concerned,” “Change in the relationship, to connect as equals,” “Change in the perspective of supporters,” and “Fostering resources to protect health and life in clinical and community settings,” “Creation of a system to encourage practice,” “Search for a position in the practice and research,” “Efforts to prevent health issues from an early stage,” and “Changes in the way of thinking about health from the perspective of the person concerned.” The challenges were: building a system to encourage practice, finding a position in practice and research, preventive approaches to health issues from an early stage, and verifying the usefulness of dialogue. The usefulness of dialogue was considered to be the creation of “relationships” between people in need of support and their supporters. Conclusions: Training in dialogue theory and techniques, the creation of a system to encourage practice, and the enrichment of research and practice through the accumulation of case studies are desirable.

Objective: We reviewed previous studies on lower back pain (LBP) among nurses, clarified future nursing research issues for the prevention and relief of LBP among nurses, and obtained suggestions for nursing practice. Methods: We searched the literature on “Nurse/Lower back pain” over the past 20 years from the Ichushi-Web and analyzed 90 documents. To calculate the percentage of those reporting symptoms of LBP, these papers were inductively classified based on the theme, keywords, and content. Results: The papers were categorized into six categories: “Facts on LBP/factors for LBP (lumbar burden)”, “LBP prevention/ relief (education)”, “Use of assistive equipment, clothing/equipment for LBP prevention”, “LBP prevention/relief (treatment/care)”, “Physical, mental, and social impact of LBP” and “Thoughts on LBP and its recognition”. The median percentage of those reporting to have symptoms of LBP was 62.5% (32.0-100%). Conclusions: The percentage of nurses reporting to have symptoms of LBP has not fluctuated significantly over the past 20 years and is consistently exceeding 60%. Previous studies examined the effects of interventions through fact-finding surveys, LBP education, and exercise. Regarding exercise interventions, a few studies used subjective and objective assessments to evaluate LBP, but the majority used only subjective assessments. In the future, it will be necessary to establish physical care methods for LBP evaluation, prevention and relief of LBP, incorporating objective evaluation by physiological indices.