To understand the relationship between negative feelings toward service users in geriatric healthcare facilities and burnout among care workers, a questionnaire survey was conducted with 1,283 care workers in geriatric healthcare facilities in the Kanto region. The Negative Feelings toward Patients Scale (NFPF) was used as the negative feelings scale, and the Japanese version of the MBI-HSS scale was used as the burnout scale. A total of 710 valid responses were included in the analysis, and the mean age was 36.67±11.03 years (Mean±SD). The mean burnout score among care workers and for negative feelings were 11.97±3.03 and 2.94±2.42. The negative feelings subscales “negative feelings that care workers have for users” and “negative feelings passively developed by care workers” were related to burnout. Care workers who were more likely to have negative emotions were more likely to experience burnout. It is necessary to develop and implement coping strategies such as expressing and controlling negative emotions in care workers.

This study aimed to clarify the difficulties faced by older adult home care patients and their families regarding oral care and targeted those who provided oral care to the patients who used visiting nursing services. A self-reported questionnaire survey, based on previous studies, was conducted with the users of a visiting nursing station. A total of 129 older adult home care patients were asked to participate and 67 responded (51.9% acceptance rate). In the breakdown, 46 (68.7%) provided oral care for themselves and 21 (31.3%) received it from their families. The survey results showed that when the older adult home care recipients received oral care from their families, the overall feeling of difficulty was significantly higher than when they performed it themselves (p＝0.04). An analysis of all subjects found a moderate correlation between “oral care methods”, “tongue coating”, “difficulty opening”, and overall difficulty (Spearman’s ρ＝0.45, 0.54, 0.47, respectively). Among them, when the oral care performer was a family member, a moderate correlation was found between “oral care methods,” “dry oral cavity,” “tongue coating,” “difficulty opening,” “physical difficulty of the performer,” “preference,” “refusal of care” and the overall difficulty (Spearman’s ρ＝0.45, 0.44, 0.61, 0.64, 0.51, 0.40, 0.67, respectively). The findings suggest the need to provide support for oral care to older adult home care patients, especially to reduce the sense of difficulty among family members who provide the oral care. Not only the correct oral care methods and symptom-specific responses, but also methods that consider the decline in cognitive function of such patients should be provided.

This study aimed to determine the proportion of locomotive syndrome (LS) occurrence in residents in a Japanese community. The subjects of this study were 426 residents aged 21 to 89 years with no specific mobility disorders. The participants were required to take the LS risk tests proposed by the Japanese Orthopedic Association. The chi-square test was used in each age group for comparing the LS risk and the non-LS in both males and females, respectively. The results revealed a tendency of declining movement ability in approximately 47% of the participants, including some in their 20s. In this study, LS risk was observed in more than 12% of participants in their 20s. This result indicates an important finding since only a few previous investigations have included subjects younger than 60 years old. Surprisingly, LS risk in males in their 20s to 40s was determined by the presence of pain and mobility difficulties in the 25-question Geriatric Locomotive Function Scale instead of showing declining mobility by the stand-up test and the two-step test. The findings suggest that sex- and age-appropriate interventions are essential for the prevention of LS.

The purpose of this study was to clarify the actual condition and associated factors of palliative care for older patients with heart failure in acute hospitals. The participants were nurses (n=175) who provided nursing care for heart failure in acute hospitals for the above-mentioned population. The participants’ characteristics, daily nursing practice, and palliative care for older patients with heart failure were investigated using a questionnaire.

The care with the highest implementation rate in palliative care for older patients with heart failure was dealing with physical problems such as “assessment of dyspnea” (91.4%) and “care for dyspnea” (90.9%). The care with the lowest implementation rate was psychosocial problems and multidisciplinary cooperation, such as “consultation with multiple professions outside the hospital” (4.6%) and “intervention for economic issues” (9.7%). Regarding the 25 items of palliative care for older patients with heart failure (dealing with physical problems, dealing with psychosocial problems, dealing with spiritual problems, decision support, and multidisciplinary cooperation), “experience in end-of-life care for older patients with heart failure” and “experience in palliative care training” led to significant implementation in 24 and 23 items, respectively. In addition, daily nursing practice such as “communication to know the patient’s wishes,” “nursing practice to prioritize the patient’s wishes,” “reflecting the patient’s life history in hospital life,” and “gathering information for the relationship between the patient and family” were significantly correlated with the items of dealing with spiritual problems.

Therefore, improving practical skills for palliative care for older patients with heart failure requires educational support, such as conducting palliative care training for heart failure patients and improving nursing care skills, to ensure that respect for the patient’s wishes is maintained.

We have located few systematic studies that use existing scales for shift leader nurses who are responsible for nursing in a team while receiving instructions from physicians, coordinating and directing team members during specific shifts. The present study uses a development method different from existing scales to reduce the number of items. This study aims to develop a scale for nurses to assess their own shift leadership behavior, and establish the reliability and validity of the scale. A 37-item draft scale was created based on the results of an anonymous open-ended questionnaire administered to shift leader nurses working in hospitals in metropolitan areas in Japan and a literature review. Using the draft scale, an anonymous self-rating questionnaire survey was conducted with 631 shift leader nurses working in hospitals in metropolitan areas in Japan. As there was a statistically significant difference between male and female nurses in the mean total scores of the draft scale, we decided to analyze only the 336 female nurses. Based on principal factor analysis and promax rotation, a scale for nurses to assess their own shift leadership behavior that contains 25 items in 6 factors was developed. The six factors are “task coordination behavior”, “human relationship building behavior”, “effecting collaboration through information transmission”, “confirmation of the performance of the nursing practice”, “information sharing behavior in teams”, and “development of nursing skills”. The goodness of fit of the hypothetical model obtained by an exploratory factor analysis was confirmed by a confirmatory factor analysis, and we obtained following results : GFI＝0.880, AGFI＝0.850, RMSEA＝0.053. The correlation coefficient with the Self-evaluation Scale on Role Performance of Shift Leader Nurse was 0.786, a value which has shown criterion-related validity. Cronbach alpha coefficients were 0.94 for the whole scale, and 0.78-0.88 for subscales. The intraclass correlation coefficient by the test-retest method was 0.88. We decided that these results support the reliability. The findings show that the reliability and validity of the scale comprised of 25 items in 6 factors were largely established.

In this study we developed an original scale comprised of 29 items to assess hospital ward nurse team collaboration including collaboration with physicians, based on previous qualitative studies and a literature review conducted by the authors. Using the 29-item original scale, we conducted a questionnaire survey with 1,285 ward nurses working in university hospitals with 400 beds or more in the Kanto region of Japan. We included 617 (48.0%) responses in the analysis. An exploratory factor analysis using a generalized least-squares Promax rotation extracted 17 items for the four factors from the 29-item original scale: “communication in the ward,” “support among team members,” “collaboration with doctors,” and “ethical behavior in the team.” Using these items as required items, we completed a Ward Nurse Team Collaboration (WNTC) scale that assesses hospital ward nurse team collaboration. Confirmatory factor analysis indicated goodness of fit of the completed scale. In the examination of reliability, the Cronbach alpha coefficients were 0.91 for the whole scale of 17 items, and 0.86 --0.91 for the subscales. The intraclass correlation coefficient by the test-retest method was 0.82 and the correlation coefficient with the “team process scale” as an external criterion was 0.65. Based on these statistical criteria we determined that the WNTC scale comprised on 17 items developed in this study has sufficient reliability and validity to assess hospital ward nurse team collaboration.

With the aim of clarifying factors associated with burnout among female nurses working in a specialized hospital, a self-administered questionnaire survey was conducted from June to July 2019 among all nurses, except for those in the position of head nurse or higher at the National Centers for Advanced Nursing Care, who cooperated with the survey, The burnout measurement scale was the Japanese version of MBI-HSS (Maslach Burnout Inventory-Human Services Survey). The mean of the Japanese version of the MBI-HSS showed differences among occupations for the 174 female nurses included in the analysis. The mean age of the participants was 32.8±9.5 years, and the mean MBI-HSS score was 11.44±2.80. The results of a multiple regression analysis showed relationships between burnout and the following items : “health status” (β＝－0.26), “work is harder than I thought before I started working”(β＝0.21), “raising children” (β＝－0.20), “satisfaction in nursing” (β＝－0.18), “exhaustion by patients who keep complaining even after repeated explanations” (β＝0.17), “relationship with patient families” (β＝－0.16), “workload” (β＝0.15), “ability to accept opinions and feelings of others” (β＝－0.12), and “work-life balance” (β＝0.11). The adjusted R2-value was 0.64% giving a 64.0% explanation rate. Among female nurses working in specialized hospitals, those who were not in good health, those who felt that their current job was harder than they had expected before they started working, those who were not raising children, those who did not feel satisfaction in nursing, those who felt tired from patients who continued to complain even after repeated explanations, those who did not have a good relationship with patient families, those who think they have a heavy workload, those who do not think they are capable of accepting the opinions and feelings of others, and those who have difficulty balancing work and life were found to be more likely to suffer from burnout.

In recent years, it has been said that motivational involvement is effective for subjects of health guidance to change their behavior in order to maintain their health and prevent diseases. Satisfaction of basic psychological needs promotes this motivation. This study tried to clarify the composition and definition of the concept by conducting a conceptual analysis of autonomy, the key to basic psychological needs in health behavior. We searched mainly for articles in the medical field, such as nursing, and examined them based on the Walker & Avant method. As attributes of autonomy in healthy behavior, “having a free will,” “confidence in behavioral change,” and “voluntary behavioral adjustment” were extracted. In addition, as mediators, “sense of choosing one’s actions” and “perception or recognition of receiving autonomous support” were extracted. As moderators, “relationships and communication methods between patients (health guidance subjects) and others, including medical staff,” “education,” and “environment where individual support can be received” were extracted. Autonomy in health behavior was defined as “to self-regulate behavior and management of health, with confidence in strengthening and correcting health behavior under free choice.” It was suggested that using this concept in the field of health guidance will also lead to clarifying the ways of involvement and necessary resources to enhance the autonomy of health guidance subjects.

This study was designed to examine the effects of working environment and rationalization (justifying reason why they could not do) as defense mechanism on HbA1c and dietary habits of workers with diabetes mellitus. The participants were 303 workers with type 2 diabetes. A two-factor analysis of variance was conducted with working environment (good group vs poor group) and rationalization (low group vs high group) as independent variables and HbA1c and eating habits (dietary balance and irregular diet) as dependent variables. The results were as follows. HbA1c and dietary balance tended to be worse in the high rationalization group. Moreover, poor working environment led to irregular diet. Accordingly, workers with type 2 diabetes showed that poor work environment aggravated their eating habits, and that rationalizing the inability to self-care worsened eating habits and glycemic control.

Using a web-based questionnaire, influence of experience of participating in dinner party on future intention to participate was evaluated in nursing university students. Valid responses were obtained from 169 (69.8%) of the 242 subjects. The most common part of the dinner community was the university sports and cultural arts club (111 people, 86.7%). The most common feeling about eating together was “delicious and enjoyable” (146 people, 86.4%). The most common feeling about loneliness was “I don’t care because I want to cherish my time” (98 people, 58.0%). Of the 129 people who feel that there is a difference in deliciousness between eating alone and eating together, 91 (70.5%) are willing to participate in the dinner party in the future, and of the 40 people who say that there is no difference, they will participate, there were 21 people (52.5%) who were willing ; the ratio was significantly (p＝0.035) higher in the former. Of the 128 people who have participated in the dinner party in the past, 101 people (78.9%) are willing to participate in the future dinner party, which is significantly (p<0.001) higher than 11 people (26.8%) who are willing to participate in the 41 people who have not participated. In order to motivate nursing college students to participate in the dinner party, it is effective to use the words “fun and delicious” mainly for those who have participated in the dinner party in the past and wish to participate in the future.

Objective : To determine awareness of the actions of sodium and potassium on blood pressure in pregnant women.

Methods : An anonymous self-administered questionnaire survey was conducted in 230 pregnant women who underwent a maternity examination at a research cooperation facility.

Results : Responses were obtained from 116 pregnant women and valid responses were obtained from 110 pregnant women. Sixty-one (55.6%) pregnant women knew about the actions of sodium and 16 (14.5%) knew about the actions of potassium. More pregnant women knew about the actions of sodium than those who knew about the actions of potassium, with a significant difference in perceptions of sodium and potassium (p=0.009). Many pregnant women recognized that the effects of sodium are occurrence of hypertension and edema. Additionally, many pregnant women knew that the effects of potassium are a burden on the kidneys, a burden on the heart, and a reduction in edema.

Discussion : Fewer pregnant women are aware of the actions of potassium compared with the actions of sodium. This finding suggests that teaching methods that can recognize the effects of potassium as a preventive measure against hypertension should be considered.