With the objective of elucidating the subjective influence of wound, ostomy, and continence nurses（WOCN） on pressure ulcer management systems at their institutions, as well as the structural requirements and effective measures in pressure ulcer management that relate to the incidence of pressure ulcers, a questionnaire survey was conducted at 425 hospitals that provided consent. The final subjects of analysis were 166 hospitals with over 200 beds that replied.
　As requirements related to “perception of influence” on pressure ulcer management systems, the personal attribute among WOCN of “having 21 years of clinical experience” was strongly related. Involvement of administrators, such as “inter-departmental adjustments by the hospital director”, “WOCN’s superiors were certified as nurse administrators”, and “evaluation of WOCN”, was also related, suggesting its importance. “The ability of WOCN to transmit information” promoted the perception of influence of the WOCN, which in turn was thought to promote the awareness of “medical device-related pressure ulcers” and “cooperation with professional team”.
　Measures related to incidence were as follows: “awareness of deaths of patients with pressure ulcers among WOCN”, “a sufficient number of WOCN”, “confidence in pressure ulcer care techniques among WOCN”, “recognition of medical device-related pressure ulcers among ward nurses”, and “relationships of trust with practitioners in the community”. Relationships with “involvement of occupational therapists/physical therapists（OT/PT）” were also suggested.
　These findings indicate that using the perception of influence as a measure of achievements enables assessment of the quality of pressure ulcer management, which is not reflected in the incidence.

　This study aimed to clarify the resilience of partners of patients with temporary stoma, by conducting semi-structured interviews with five partners and selecting the resilience frameworks from Grotberg: individual internal strengths（I am）, support from others（I have）, and strength to cope（I can）. The results produced five categories for I have: “I have family that gives me support”, “I have someone who supports me who has experience of stomas”, “I have a doctor who gives me support”, “I have a place where I can go to talk when I have a problem”, and “I am helped by the existence of the patient”. There were eight categories for I am: “I accept it as it is”, “I accept it optimistically”, “I look on the bright side”, “I don’t hide the illness from the people around me”, “I am honest about my feelings”, “I can believe in myself”, “My experience up until now is a strong point”, and “I have other things to do apart from look after the patient”. There were six categories for I can: “I can obtain the information that I require”, “I can deal with the patient proactively”, “I can participate in the care required for the stoma”, “I can control my own emotions”, “I can perceive my own life positively”, and “I can work on the illness with the patient”. This study suggested that the resilience of partners who participate proactively in stoma care for patients is enhanced in response to the need of the partner for stoma care.

　The purpose of this study was to develop a process model for disseminating and implementing advanced wound management skills as specified medical practices in clinical settings. Data were collected through semi-structured focus group interviews with wound, ostomy, and continence nurses（WOCNs）who had received advanced wound management education in our previous studies, and the process of introducing and disseminating skills in clinical settings was conceptualized. We found that “the process of effective dissemination and implementation of advanced skills involves building cooperative systems and continuous practice that allows for the understanding of specified medical practices.” WOCNs gained advanced competency through the development of safe practices. Moreover, WOCNs demonstrated the scientific competence required to provide safe and effective dissemination and implementation of new skills in clinical settings.