To identify factors associated with excellence in nursing practices among nurses, a self-rated questionnaire consisting of the Excellence in the Nursing Excellence Scale in Clinical Practice (NES), Japanese version of Blau’s Career Commitment Scale (JCCS), affective organizational commitment Scale, personal Factors, and workplace environment factors was administered to 661 nurses working in public hospitals in the Tohoku and Kanto regions of Japan. Responses were obtained from 453 participants with no deficits or duplications in age, gender, or NES (valid response rate: 68.5%). The mean age and length of nursing experience of these respondents were 38.0±9.5 and 16.2±9.1 years, respectively. The mean total scores for the NES, the JCCS, and the affective organizational commitment scale were 121.3±19.2, 2.74±0.8, and 3.01±0.7, respectively. The results of multiple regression analysis (adjusted R²=0.495) showed that those who had compassion for their patients (β=0.221), those who reflected on their nursing practice (β=0.179), those who were confident in their clinical decisions (β=0.136), those who were considering using research findings (β=0.129), and those who had approval from their colleagues (β=0.128), those who participate in conferences and trainings to obtain the latest information (β=0.115), and those who have mentored new graduate nurses for one year (β=0.100) were found to have high excellence in nursing practice. To improve the quality of nursing practice, it is necessary to provide support based on these results.

As of September 10, 2020, outbreaks of novel coronavirus infection (COVID-19) clusters had been announced in 10 single-department psychiatric hospitals in Japan. To clarify the status of infection control measures in single-department psychiatric hospitals as of July 2020, we conducted a questionnaire survey of four items: source control, route control, host control, and COVID-19-specific infection prevention measures, limited to single-department psychiatric hospitals in Osaka Prefecture. As a result, 70% of the facilities answered “Yes” to the questionnaire, meaning that they were taking sufficient measures to prevent infection. In the case of infection control, 62% of the respondents answered “Yes”, but only a request was made to restrict the behavior of staff. In 6 of the 10 facilities where clusters occurred, the first patient with COVID-19 was a medical staff member. This survey suggested that behavioral restrictions on health care workers in psychiatric hospitals, in addition to behavioral and visitation restrictions on patients, are important measures for preventing clusters.

To clarify women’s health problems in the evacuation shelters provided after occurrence of the disaster, semi-structured interviews were conducted with 10 mature women between July and November in 2014 (three years after the disaster). The interviews covered all sorts of hardships of life in evacuation shelters that prevented them from keeping their own health. The Berelson method was used to definitely analyze the proportions of physical, psychological and social women’s health problems. The results produced seven categories. There were one physical problem : [difficulty and relief in the problems peculiar to women such as care of menstruation] ; two psychological problems : [pain resulting from difficulty in being attentive to personal appearance as a woman] and [pressure and pain due to having no choice but to stay in the evacuation shelter not always safe] ; and four social problems : [life of evacuation shelter with fear of sexual assault on daughters], [worry about the effect of the disaster experience on daughters’ health], [desire to ensure an ordinary life for daughters although the disaster destroyed the foundations of livelihood], and [endeavors to play the maternal role and the conflicts]. In the life of evacuation shelters, nursing care for coping with menstruation and modifying the environment to keep women’s spirit of self-respect is needed. From the social aspect of women’s health in the evacuation shelters, it is necessary to support the women’ conflict as mothers. In consideration of the fear of sexual assault on daughters, health education concerning the risk of sexual assault should be provided at ordinary times.

The Depression Anxiety Stress Scales (DASS-21) is a well-established questionnaire for measuring depression, anxiety, and stress with good reliability and validity in English-speaking countries. DASS-21 is translated in several languages, such as German, French, and Japanese and used in various countries. However, the lack of appropriate reliability and validation among the Japanese population continues to pose concerns over the use of DASS-21 in Japan. We retranslated the original DASS-21 according to the translation and cultural adaptation process and evaluated the reliability and validity within the Japanese population. We also assessed the factor structure of the DASS-21.

Undergraduate students (141 women) filled out the DASS-21, Beck Depression Inventory-I (BDI-I), State-Trait Anxiety Inventory (STAI), and Public Health Research Foundation stress check list short form (PHRF-SCL). Cronbach’s alpha coefficients showed the high internal consistency of DASS-21 and its subscales. The correlation analysis for item-total score (I-T correlation) demonstrated a significant positive relationship between total score of each subscale and score of each criterion. These results suggested DASS-21 has a high reliability. The correlation analysis showed a significant positive relationship between DASS-21 and established questionnaires, such as BDI-I, STAI, and PHRF-SCL. This result demonstrated the validation of DASS-21. The multi-group exploratory factor analysis revealed that the DASS-21 has three factors as shown in original version, however, this showed that DASS-21 has a different structure, compared to original version. Further investigations of the reconstructed structure and psychometric properties of the DASS-21 are needed to discriminant validity.

The content and face validity of the draft Career Plateau Measurement Scale for Mid-career Nurses consisting of 104 items created based on previous studies is examined and the items required are selected. To examine the content validity of the draft scale, a self-administered questionnaire survey was conducted on five nursing managers. In the draft scale, 91 out of 104 items showed a content validity index (I-CVI) of ≥0.8. Based on the I-VCI and free-text comments, duplicate items were deleted, integrated and revised to constitute a total of 40 items. Next, to examine the face validity, a self-administered questionnaire survey was conducted on five mid-career nurses regarding the comprehension of expressions used in the 40 items of the draft scale. Based on the free-text comments, among the 40 items of the Career Plateau Measurement Scale for Mid-career nurses, 39 were selected by deleting one item and modifying the phrasing to ensure content and face validity.