Objective: This study aimed to clarify self-management support that leads to glycemic control in people with type 2 diabetes from regretful experiences of diabetic nursing specialists.
Method: Semi-structured interviews using interview guides were conducted with nurses with certified qualifications in diabetes care or who were certified educators in diabetes nursing who had taken care of multiple patients every month for the past year. Data analysis was then conducted using qualitative analytic methods.
Results: The narratives of six nurses were analyzed. The self-management support that diabetic nursing specialists consider to leads to glycemic control in people with type 2 diabetes was composed of the following eight categories: “ A method of communication that enhances the value of medical treatment and impresses patients”, “ A link between blood sugar levels, internal conditions, and daily life”, “Encouragement of patient participation in the selection of behaviors”, “Enabling patients to act without increasing their negative emotions”, “Conversations and considerations to build an equal relationship with each other”,“ Seeking ways to make patients’［can］ and［wish］ coexist”, “Deep attention to how patients view treatment” and “Care provision with the idea of supporting a patient’s life”.
Discussion: Approaching patients from a holistic human perspective and supporting their active behavior are elements of how to interact with them. The present findings suggest that along with these two elements, continuous motivation for action support is necessary a type of self-management support that leads to glycemic control among people with type 2 diabetes.

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[in Japanese]

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Purpose: This study aimed to clarify the support older family members provide to older adults with heart failure, an essential factor in self-management and daily care, as well as their emotional experiences regarding this care.
Methods: In this study, data collected through semi-structured interviews were analyzed based on a qualitative inductive approach.
Results: Support was classified as follows: “Developing practical and sustainable methods for managing sodium and water intake in a way that is feasible for older adults”, “Understanding changes in heart failure symptoms and monitoring and comprehending daily care behaviors”, “Supporting care behaviors while negotiating with patients resistant to change due to long-standing habits”, “Responding to worsening symptoms based on severity”, “Supporting older adults so they can maintain their daily lives” and “Joining forces to sustain desirable medical treatment”. Furthermore, emotions related to support were classified as follows: “Strain caused by aging and prolonged caregiving responsibilities”, “Challenges in modifying support while navigating long-standing relationships and past experiences”, “Staying positive to continue support” and “Commitment to spending the rest of their lives together with the patient”.
Conclusion: Despite experiencing both positive and negative emotions, older family members consistently supported patients with heart failure, adapting their approaches to sustain their shared aging journey and ensure continuity in both self-management and overall daily care, including medical support.

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[in Japanese]

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Objectives: To clarify care provided by certified nurses specialist in chronic care（CNS）for chronic disease patients before changes occur in their self-care behavior, and to identify the content of changes resulting from the care.
Methods: Semi-structured focus group interviews were conducted with 15 participants.
Results: Interventions by CNS included “behave in a way that conveys to the patient that the CNS is someone who understands,” “deepen interest in the patient’s physical condition,” “ask about how the patient lives and precious aspects of the patient’s life,” “support the patient’s feelings and efforts,” “prepare the treatment environment,” “work together with medical professionals surrounding the patient,” “gauge the timing of intervention while standing by,” “search for self-care that the patient would not feel to be a burden,” and “promote motivation for self-care based on the patient’s interest.” Changes in patients as perceived by CNS were“ recognize the CNS as someone who understands,” “convey thoughts in response to interaction with CNS,” “build good relationships with medical professionals,” “understand their physical condition and become increasingly considerate.”
Conclusion: Our findings suggest that, in addition to CNS, nurses can provide hints regarding care for patient self-care behavior.

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Objective: To develop a resilience scale for individuals diagnosed with type 1 diabetes mellitus in or after adolescence and to examine its reliability and validity.
Methods: Semi-structured interviews were conducted with 21 people with type 1 diabetes that developed in adolescence or later, and based on the draft of the scale, anonymous self-administered questionnaire surveys and web-based questionnaire surveys were conducted with 272 people with type 1 diabetes that developed in adolescence or later, and factor analysis was performed using maximum likelihood promax rotation.
Results: A 50-item, 6-factor resilience scale for people with type 1 diabetes that developed in adolescence or later was developed. The overall Cronbach’s alpha coefficient was .875. There was a significant positive correlation between this scale and the resilience scale for adult-onset type 2 diabetes patients undergoing treatment, and reliability and validity were confirmed.
Conclusion: The developed scale comprises six factors: （1）ability to think flexibly,（2）ability to have hope for one’s future,（3）ability to recognize support from family and friends,（4）ability to accept type 1 diabetes, （5）ability to maintain good glycemic control, and（6）motivation derived from others with the same condition.

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Objective: To determine the proportion of patients with frailty, and the current status, to facilitate outpatient nursing of older, chronically ill patients attending cardiology and respiratory medicine departments.
Methods: Over 5 consecutive days, a questionnaire survey was conducted at one medium-sized general hospital on patients aged ≥ 65 years attending the cardiology and respiratory medicine departments. Frailty was determined using the Kihon Checlist total score and categorized as frail, pre-frail, and healthy. Correlations between the Kihon Checlist total score and various sociodemographic factors were calculated to examine factors associated with frailty.
Results: Of 211 patients assessed, 50.2% were categorized as frail. Sociodemographic factors that were associated with frailty were being female, older age, taking more than six medications, having transportation to attend medical appointments, and experience of having physical changes pointed out by a support person.
Conclusions: The observed frailty rate was higher than in previous studies in Japan. The association between frailty and having transportation to attend medical appointments and having physical changes pointed out by support staff suggest that these factors could be used to determine the progression of frailty in outpatient nursing.

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[in Japanese]

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The purpose of this study is to describe balancing work and medical treatment in patients with heart disease from the perspective of the elements of the International Classification of Functioning, Disability and Health（ICF）, and considered the support provided by nurses for balancing work and medical treatment in patients with heart disease. A semi-constructive interview was conducted with a patient, who had left his job after the onset of heart failure, and then reemployed and was continuing to work. As a result, aspects of work and employment were described from four periods: leaving work, resuming work after leaving work, immediately after resuming work, and continuing to work. Cardiac rehabilitation played a role as a place of education and consultation that worked on the patients’ “body functions and body structures” to maintain and improve physical strength, and as a place of community“participation”that connected them with others. As support by nurses for balancing work and medical treatment in patients with heart disease, it was suggested that it is necessary to understand the subject’s life situation, including employment, according to the period, to provide support in cooperation with multiple professions, and to develop evaluation indicators for self-management behavior for balancing work and medical treatment that can be used for such support.

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