The purpose of this study was to determine the degree of care necessary for wheelchair-bound individuals with spinal cord injury（SCI）by extracting factors related to the depth of pressure ulcers from the concept of health-related behavior. We interviewed subjects with SCI and experience of pressure ulcers to clarify their health-related behavior, and also subjects with SCI who had not experienced pressure ulcers. The qualitative data were analyzed regarding factors related to SCI, pressure ulcers, and health-related countermeasures using a Health Action Process Approach（HAPA）model. Subjects with SCI who had experience of deep ulcers conceded that they had not taken sufficient preventive action against external forces and infection during the process of wound formation, or to promote wound healing, and therefore had a poor risk awareness of ulcer formation. Subjects with SCI who had not experienced pressure ulcers were worried that they might not recognize these risks, and so be unsure if/when to take appropriate action. However, there appeared to be some reluctance in recognizing that preventive action was necessary. In addition, as all the subjects were fully active socially, and participated in sports, it was considered that their state of mind and physical condition were good.

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　Aim：To investigate colostomates’ satisfaction levels and their need for stoma care education provided by Registered Nurses（RN）or Enterostomal Therapist/Wound, Ostomy and Continence Nurses（ET/WOCN）.
　Subject：One thousand colostomates who were enrolled in the ConvaTec information support group, were randomly selected. They underwent colorectal surgery and received permanent colostomy between April 1st and August 31st, 2006.
　Methods：A researcher-designed questionnaire comprising 65 questions was sent by mail. The questionnaire was designed to assess the quality of education at four stages：pre-operative（pre-OP）, post-operative（post-OP）, before discharge（BD）, and at outpatient clinic in the post-operative stage（OC）. The Likert Scale was used to evaluate ostomates satisfaction level, and multiple-choice questions were employed to assess the specifics of their dissatisfaction.
　Results：One hundred and ninety eight ostomates responded to the survey. Throughout the four stages of evaluation（pre-OP, post-OP, BD, and OC）, 70％ or more of the ostomates were satisfied with the explanation and feedback they received from RN or ET/WOCN. At the pre-OP stage, 28％ of the ostomates complained about not receiving enough information on life with a stoma, stoma appliances, and stoma site marking. At the post-OP stage, 7％ of the ostomates complained of being given insufficient information about stoma appliances. At the BD stage, 13％ of the ostomates complained about not receiving enough information on odor control, the way to use a public toilet and finding suitable consultants. At the OC stage, 12％ of the ostomates complained of not receiving enough information about new products, odor control, and potential skin problems. Ostomates who were dissatisfied with care felt that their inquiries to RN or ET/WOCN did not alleviate their concerns and anxiety. Ostomates receiving education from ET/WOCN showed higher scores for satisfaction than ostomates receiving education from RN at the post-OP stage（P=0.0087：Mann-Whitney U test）.
　Discussion：Although ostomates received detailed explanations on stoma care at the pre-OP stage, they tended to have a difficult time picturing their life with stoma. At the post-OP stage, ostomates showed reduced anxiety over stoma care by receiving frequent support from RN or ET/WOCN. ET/WOCN provided sufficient information and care techniques which improved ostomates satisfaction levels regarding stoma care. Much more effort needs to be made by RN or ET/WOCN to improve the quality of ostomates lives. Further detailed investigations are needed to provide ostomates with adequate care information and appropriate care procedures.

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　１．Aim：To identify the process of self adjustment for a person with colostomy.
　２．Subjects：Fifteen cancer patients who had undergone colostomy surgery less than three years earlier.
　３．Method：The study design was quantitative and qualitative. The questionnaire was composed of demographic data, type of colostomy and Ostomate’s Self Adjustment Scale ver. 2（OSAS23）. We also serially interviewed the colostomate to determine their state of mind pre-, post-operation and after discharge.
　４．Results：Ten categories and one concept were extracted from the qualitative data about the process of self adjustment. The process of self adjustment consisted of “Acceptance of the therapeutic method of colostomy”, “Imaging of postoperative colostomy life”, “Anxiety regarding daily life and stoma management by his/her selves”, “Experience of daily life and stoma management, and acquisition of a new pattern”, “Confidence in colostomy life”, “Rebuilding daily life as a colostomate”, “Making an effort toward positive thinking about colostomy”, “Compromise with him/herself as a colostomate”. These patterns varied during the following stages；“Anxiety regarding daily life and stoma management by his/her selves”, “Experience of daily life and stoma management, and acquisition of a new pattern” and “Confidence in colostomy life”. Total score on OSAS 23 was significantly lower among colostomates who had to limit daily life activities due to experiences of stool leakage.

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