Purpose : This study was intended to clarify nursing care that imparts comfort, as well as reactions and effects occurring in patients and their measurement indicators. 　
　Methods : We conducted an integrative literature review of 52 pieces of literature found on the Japan Medical Abstracts Society website using Cooper's methodology and the key search terms “comfortable” and “comfort”. 　
　Results : The timing of efficacy measurements was classified into four periods : during care, immediately after care, after care, and the day after care or later. We extracted three categories of efficacy factors related to mood and psychological behavioral aspects from basic research papers : comfort, alleviation of symptoms, and increased vitality. In addition, six categories were extracted from clinical research papers : comfort, alleviation of symptoms, increased vitality, broadening of relationships, broadening of activities of daily living, and stable daily rhythm. The qualitative measurement indices used were speech and behavior, facial expressions, and conversation ; and the quantitative indices used were scales that were independently created by each researcher. Efficacy factors related to physiological aspects were increased body temperature, stable autonomic nervous activity, and stable circulatory dynamics. 　
　Discussion : It was found for the spread and value of the possibility of nursing care that imparts comfort when shifting the perspective to change after care. It is important to focus on trends in the subsequent efficacy of comfort.

　Induration of the injection site caused by an oil-based solution has been reported to be a problem. However, the current status of occurrence of induration induced by fulvestrant is unknown. The purpose of this study was to understand the current status of occurrence of induration induced by fulvestrant, nurse injection techniques and nursing care with intramuscular injection of fulvestrant. We performed a descriptive study using a questionnaire survey sent to 169 nurses who had used fulvestrant at a hospital in Japan. Fifty-four nurses replied to our survey. The results were analyzed using descriptive statistics and Fisher's exact test. This study was approved by the institutional review board at the University of Human Environments. Thirty hospitals (55. 6％) reported the occurrence of induration by fulvestrant. Induration tended to occur regardless of weight or complications of the patients, and it occurred in patients with continual injection for more than three months. Nurses chose “the site of Clark” (66. 7％) as the most common primary site of injection. The most common primary site of injection was significantly associated with the occurrence of induration (P＜0. 01). These findings showed that nurses choosing “the site of Clark” were likely to experience induration, but induration cannot be prevented by changing the injection site alone. The nurses in only three hospitals performed massage during their normal nursing care in order to prevent the onset of induration.

　In the present study, we developed a sphygmomanometer for nursing students and evaluated how it affected their technique acquisition related to blood pressure measurement as a teaching material. The subjects in this study comprised a total of 138 nursing students at the nursing department of University A. The first group was the “improved sphygmomanometer group” and consisted of 58 students who entered the program in 2015 and practiced using the improved sphygmomanometer. The control group was the “normal sphygmomanometer group” and consisted of 61 students who entered the program in the previous year (2013) and practiced using the normal sphygmomanometer. Instructors assessed the effects, which were grouped under the three categories of “cuff placement (three items) ”, “cuff deflation”, and “listening to the sounds”. No differences were found between the two groups in terms of “cuff placement” and “listening to the sounds”. However, the improved sphygmomanometer group performed “cuff deflation” more accurately than the normal sphygmomanometer group (P＜0. 01). The improved sphygmomanometer allowed visualization of the deflation rate, making it possible for students to evaluate their own deflation rates more objectively, which, therefore, appeared to lead to accurate technique acquisition. In the future, we will explore new methods for students to practice “cuff placement” and “listening to the sounds” more effectively.

　Intramuscular injections are often administered into the deltoid muscle for reasons of the clinical convenience, despite the risk of axillary nerve damage. Although previous studies have attempted to use morphological data obtained from axillary nerve dissections to identify safe sites for intramuscular injections in deltoid muscles, they have not been able to validate the application of data from dissections in live subjects. This study compared measurements taken from 44 dissections performed up to the present using magnetic resonance imaging to measure the distance between the acromion and posterior humeral circumflex artery running along the axillary nerve in live subjects in order to investigate the applicability of the dissection body. Measurements taken from five live subjects were similar to measurements from dissections, suggesting that dissection data can be utilized as a means for determining safe injection sites.

　To adequately secure vascular access, the vein must be sufficiently distended so that a puncture site for short peripheral catheter placement can be determined. Techniques to induce venous distention are provided in the related literature and their use in healthy individuals has been verified, but methods differ between individuals and no methods have been established as a standardized nursing technique. In the present study, in a clinical setting, we video recorded a total of 143 punctures by 42 nurses to secure vascular access and analyzed the time required for avascularization, stroking, and tapping, and whether a hot compress was used at the puncture site. We found that avascularization time tended to increase with age, that the time required for avascularization and tapping increased when determining the site for securing vascular access was difficult, and that hot compresses were used when administering anticancer drugs. These results indicate that more time is required for vasodilation with advanced age due to changes in blood vessel characteristics and circulation, that more time is required for avascularization and tapping when determining the placement site for a short peripheral catheter is difficult, and that hot compresses are used when anticancer drugs are administered.

　In order to clarify impact of Amazake ingestion on constipation, 18 female university students (Amazake group : 11, control group : 7) ingested Amazake by 150 ml for two weeks in the study. The experiment was initiated by approval of Ethical Committee upon obtaining consent of the subjects.
　Using Japanese version of constipation assessment scale (hereinafter MT-CAS), frequency of bowel movement and degree of discomfort of constipation, Wilcoxson's signed rank test was conducted for their scores to assess the impact comparing the results between Amazake and control groups. Frequency of bowel movement was significantly improved in Amazake ingestion group (P＝0.046) as well as total score (P＝0.009), “frequency of bowel movement” (P＝0.025) in MT-CAS were also significantly improved, while no significant difference was observed in degree of discomfort of constipation between the both groups.
　From the results above, ingestion of Amazake once a day was suggested to be useful for improvement of constipation.

　The effects of stretcher transport on the autonomic nervous system and psychological index of passengers were investigated by transporting 40 healthy men and women (average age : 22.1 years old) over a 50 m straight course at two transport speeds (5 and 7 km/hour). Salivary amylase activity, heart rate, low frequency/high frequency of the heart rate variability, amount of palm sweat, electrodermal activity [skin potential level, skin potential response (SPR) ] and respiratory rate were measured as indices of the autonomic nervous system. The tension and anxiety felt by passengers were also measured using a visual analog scale (VAS). Significant changes were observed in SPR, respiration rate, and VAS due to transport, and the VAS was higher at 7 km/h than at 5 km/h. The changes in VAS due to transport also showed a positive correlation with the changes in respiratory rate. These observations suggest that the mechanical stresses occurring during transport, such as acceleration and vibration, induced passenger tension and anxiety, which eventually affected respiration. The respiratory rate increased even in healthy adults ; therefore, patients with advanced illnesses should be transported slowly to avoid excessive mechanical stress, and precautions should be taken to reduce tension and anxiety in these patients.

　The purpose of this study was to examine the saliva cortisol concentration, autonomic nervous system response, and subjective evaluation on the application of a hot compress to the eyes in the elderly and the nonelderly. There were significant differences in SDNN, rMSSD, and LogL×T between the elderly and the non-elderly in both the control and hot compress conditions. However, no significant differences observed in the other measurements. With regard to the time course in the hot compress condition, rMSSD increased during recovery and L/T decreased during the application of a hot compress in the elderly but not in the nonelderly. In the elderly, the comfortable-uncomfortable feeling score in the hot compress condition was lower than in the control condition ; in other words, the elderly felt comfortable in the hot compress condition. Although the core body temperature tended to be lower in the elderly than in the nonelderly, there were no differences in the thermal sensation of local and whole body regions between the two groups in the hot compress condition. Our results suggest that the application of a hot compress does not induce stress in the elderly but rather has a relaxing effect.

　This study investigates low back loads experienced by nurses working at clinical sites and assesses the relationship between the working environment and low back loads experienced by nurses at convalescent wards by using the transferring art movement assessment (TAMA) tool. Researchers observed 187 repositionings during the research period and calculated the TAMA tool total score, which refers to low back loads, and analyzed the relations to the working environment. The factor corresponding to the “number of nurses performing repositioning” were 63.1% the most, while “using equipment” were only 1.6% the least. Stepwise multiple regression showed the partial regression coefficient of the “number of nurses performing repositioning” to be 1.61, which was the highest value, and 1.22 for the “height of the bed.” Nurses have to know that their working environment are most time not in good order, and equipping working environments where more than two nurses can perform repositioning and can easily adjust bed heights will effectively reduce low back loads.