Purpose : To identify factors necessary for continued self-care in the health care of patients with NAFLD.
Methods : Semi-constructive interviews were conducted patients with NAFLD who were able to continue selfcare. Conducted a qualitative inductive analysis. Factors necessary for the continuation of self-care in the health management of patients with NAFLD and extracted codes, subcategories, and categories.
Results : We interviewed 12 patients visiting a city clinic, 6 categories : ［Viewing the lack of health care as a problem］［Convince them that health care is meaningful］［Have a good response to health care］［Become aware of ways to manage your health that work for you］［Create relationships for health care］［Health care for own behavior change can become a habit］, 14 subcategories were extracted.
Conclusion : The results suggest that the continuation of self-care in patients with NAFLD is related to supportive relationships, which are necessary for them to recognize the current state of their health care, to find it meaningful, and to recognize the appropriate ways to manage their health care.

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Objective：To evaluate the effectiveness of our team's mouth-care program to ameliorate dry mouth in outpatients who are undergoing hemodialysis using factors related to dry mouth, nutritional status, and bacterial count.
Methods：The mouth-care program we developed was conducted over a three-month period on hemodialysis patients receiving outpatient dialysis therapy. All participants in this study were over 18 years of age, cognitively normal, and had undertaken outpatient hemodialysis for more than three months. The Wilcoxon signed rank sum test was used for oral and nutritional related data, and the test results prior and post intervention were compared. A content analysis method was also performed following an interview survey conducted with the participants, regarding their awareness of any changes in their dry-mouth symptoms, following the mouth-care program.
Results：26 hemodialysis patients participated in this study. The mean age was 65.3（±13.7）years. The mean dialysis vintage was 12（±11.0）years. Participant oral bacterial count decreased and total protein value increased significantly. Furthermore, the participants were aware of an amelioration in their oral hygiene state, mouth hemorrhage, oral cavity inflammation, and dry mouth. The participants also noted a decrease in the overall fluid intake per day required and ease in chewing and swallowing increased when they were eating.
Conclusion：The results demonstrate that this mouth-care program for people receiving outpatient dialysis has a positive effect on ameliorating dry mouth, decreasing oral bacterial count and improving the total protein value in hemodialysis patients.

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Objective：Scale items were examined for the development of a severity feeling scale in patients with chronic kidney disease.
Method：A 14-items initial scale of severity feeling was created and a preliminary survey was conducted. The 11-item severity feeling scale was then modified and the main survey was administered to 270 patients with chronic kidney disease. The reliability and validity of the scale were examined.
Results：Three items were deleted from the preliminary results. The response rate for this survey was 77.7％, and 178 valid responses were received. The alpha coefficient was .847, and the reliability coefficient by the retest method was .602. Two components were extracted by principal component analysis. The loadings of the first principal component ranged from .792 to .432, and the second principal component overlapped. In factor analysis, two factors were extracted and the factor loadings were .843 to .415 for the 7 items of the first factor and .794 to .314 for the 4 items of the second factor. The correlation coefficient between the sense of ill-being scale and the severity feeling scale was .697（p＜ .001）. Comparison of the severity feeling scale according to the chronic kidney disease severity showed a significant difference only between stages G1 and G5（p= .045）.
Conclusion：The 11-item severity feeling scale had two overlapping components extracted by principal component analysis and two factors extracted by factor analysis, and could be interpreted as a one-dimensional scale divided into items expressing perception of severity feeling as severe and items expressing perception of mild severity feeling. Also, the validity of this scale was supported by its correlation with sense of ill-being scale. Reliability was supported by internal consistency, and stability was acceptable.

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Objective：This study aimed to examine the status of nurses' decision-making support for patients with pre-dialysis chronic kidney disease and to provide suggestions for nursing practices to promote support.
Method：Articles published in CINAHL, MEDLINE, and Japan Medical Abstracts Society Database（the ICHUSHI Web）（Ver. 5）were reviewed for the study.
Results：A total of 11 papers were selected and examined. The following characteristics of nurses' decision-making support for patients under conservative management for chronic kidney disease were identified:［information provision in consideration of appropriate content and timing］,［taking time to provide continuous support］, ［support for creating opportunities for patients to interact with one another］, and［support from nurses with specialized knowledge］.
Conclusion：It was found that the intervention program by specialist nurses was effective in providing decision-making support for the patients and support that focusing on the mental aspect was evalu

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Purpose：To identify the self-management methods practiced by young old persons to prevent the progression of angina pectoris.
Methods：Semi-structured interviews were conducted with such adults with angina pectoris and making outpatient visits, and the data were analyzed qualitatively and descriptively.
Results：A total of five categories were generated as self-management methods: “Utilize guidance from health professionals and information from the media for selfmanagement,” “Adjust life accordingly with awareness of one’s chest symptoms and laboratory data,” “Feel burdened by the treatment management but come to terms with it in one’s own way,” and two other categories.
Conclusion：Each of the older adults took the initiative to practice self-management with adjustments to their life. Additionally, awareness of one’s role in the family and the hope of achieving one’s goal of contributing to society were linked to continuous self-management.

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Objective: To clarify patient/family support and multidisciplinary collaboration by nurses during the transition from outpatient care to home care for patients who have difficulty coming to the hospital.
Methods: Semi-structured interviews were conducted with nurses at outpatient care and discharge planning department. The data obtained were recorded verbatim, and analyzed qualitatively inductively into codes, subcategories, and categories.
Results: Six categories were extracted from nine participants: （1）grasp with life changes associated with the progression of the disease and support continued outpatient care, （2）supporting patient and family decision-making through dialogue for the introduction of home care, （3）consult with community care professional regarding the introduction of home care and make adjustment to continue home care, （4）coordinate support system in consideration of patient/family anxiety about leaving the hospital, （5）person in charge of coordination office at home care and hospital serve as a bridge during the transitional care, and （6）share information among supporters at hospital and home care to ensure consistency in support goals.
Conclusion: In collaboration among physicians, person in charge of coordination office at home care and hospital played an important bridge role during the transitional care. Outpatient and discharge planning nurses supported decision-making by interacting with patients and their families to address their wavering and anxious about changing primary physicians.

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[in Japanese]

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