We conducted a survey of ostomates to determine whether they require Japanese society to have correct knowledge and understanding about stoma and to clarify the influence of professional care on their requirements.
　A qualitative analysis was performed to clarify the reasons for their requirements regarding the understanding of stoma among Japanese society. The questionnaire was formulated based on the results of qualitative analysis and was distributed to 1000 ostomates. The response data were estimated by stratified analysis with regard to whether or not the subjects had received WOCN care.
　Eighty percent of participants required society, family members and health care workers to understand about stoma correctly. The WOCN care that the subject received was related to their individual requirements. It was realized, however, there were issues that could not be resolved by WOC Nursing care only.

　Aim：To identify the relation between the ostomate’s self adjustment and mutual interactions between the ostomate and nurses.
　Subjects：Fifteen subjects who underwent colostomy due to cancer less than three years after surgery.
　Method：Study design was qualitative. We also interviewed the colostomate to determine state of mind preand post-operatively and after discharge.
　Results：Categories were extracted from qualitative data about mutual interactions between ostomates and nurse; information and technique about stoma care received from nurses, stoma management, relations with the nurse, ostomate’s response to care. Colostomates having“Perceptibly sufficient information from nurses”,“Stable stoma management”,“Relationships of mutual trust between colostomates and nurses”and“Independent participation in care”showed a positive self-adjustment pattern.

　To investigate the current practices of Enterostomal Therapist / Wound, Ostomy, Continence（ET/WOC）nurses regarding sexuality-related consultations with people who have a stoma, a mailed self-administered survey was conducted among 560 ET/WOC nurses in 2008. Of the surveyed sample, 204（36.4%）responded（mean age 39.1 y.o.）. Of these respondents, 121（59.3%）had been consulted about sexual issues. The consultations were mostly from adult patients, and the numbers of consultations by partners or family members were extremely small. The contents of consultations included physical changes such as erectile dysfunction, ejaculation disorder, and dyspareunia, as well as the possibility of recovery and treatment for those changes. The respondents were also consulted about practical advice when having sex, psychosocial problems such as changes in body image and partnership issues, and issues relating to pregnancy. Regarding the advice or support about sexual issues that the respondents usually provide in clinical practice, 97（47.5%）indicated at least one item of advice or support. These included giving practical tips when having sex, facilitation of patient-doctor communication, encouragement of consultation about sexual issues, active exploration of sexual problems by raising the topic occasionally, and so on. Those with a history of consultation had a greater tendency to suggest at least one item of advice or support（P=.004）. This study indicated that ET/WOC nurses have been consulted about various sexual issues in clinical practice. There is an urgent need to prepare educational materials and training opportunities for ET/WOC nurses so that the nurses can provide support for people with a stoma and their families in achieving more satisfactory sexual relationships after the creation of a stoma.

　Although nutritional screening is important for the early detection of older residents at risk of undernutrition, the availability of nutritional screening tools is limited, depending on their physical characteristics or the setting. We focused on skin conditions evaluated by engineering measures, and investigated their associations with nutritional status. A cross-sectional study was conducted in a long-term care hospital in Japan. Ninety elderly residents without dermatologic disorders were included. Mean age was 82.5 years（standard deviation, 8.0）and 70（77.8%）were female. The nutritional status of the residents was assessed by body mass index（BMI）and serum albumin levels. Leg skin condition at lateral and medial sites of the tibia was evaluated by: 1）functional factors including pH, hydration and transepidermal water loss; 2）skin color including L*, a*, b* and individual typology angle（ITA°）using a tristimulus colorimetric instrument; and 3）skin morphology. Among the skin conditions, b* was significantly correlated with BMI at both sites（medial siteρ=－0.28, p=0.008; lateral siteρ=－0.30, p=0.004）. When residents were categorized by the risk of malnutrition, b* was significantly higher in residents with BMI<18.5 than those with BMI < 18.5（medial site p=0.006; lateral site p=0.004）. Also, b* was significantly higher in residents with serum albumin level < 3.5g/dl than those with > 3.6g/dl（medial site p=0.016; lateral site p=0.006）. Residents at risk of malnutrition demonstrated a more yellow skin color. In the future, skin color could be used as a simple screening tool to evaluate the chronic nutritional status of older people.