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Hierarchy and power characterize health‐care relationships around the world, constituting a barrier to assertive communication and a risk to patient safety. This issue is more problematic and complex in countries such as Japan, where deep‐seated cultural values related to hierarchy and power persist. The current paper is the second of two that present the findings from a study exploring Japanese nurses' views and experiences of how cultural values impact assertive communication for health‐care professionals. We conducted semistructured interviews with 23 registered nurses, following which data were analyzed using directed content analysis. Two overarching themes emerged from the analysis: hierarchy/power and collectivism. In the present study, we focus on cultural values related to hierarchy and power, including differences in professional status, gender imbalance, seniority/generation gap, bullying, and humility/modesty. The findings from our research provide meaningful insights into how Japanese cultural values influence and constrain nurses' communication and speaking up behaviors, and can be used to inform educational programs designed to teach assertiveness skills. [ABSTRACT FROM AUTHOR]

In the UK and Japan, midwives provide health services for women with concerns about a genetic condition or who are considering antenatal screening. In both countries, competences related to genetic health care have been devised but there is little evidence about midwifery competence in practice. A systematic literature review was undertaken to determine the extent to which midwives are achieving the genetic competences that are prescribed for their practice. English and Japanese literature from January 1999 to March 2009 was retrieved. Original studies or reviews, in which an aspect of midwifery practice was related to genetic competences, were eligible for inclusion. After a critical appraisal, six UK and five Japanese papers were eligible for inclusion. The findings indicated that midwives are not achieving the competences, nor are they confident about their genetics knowledge. Moreover, women are not being supported to make informed decisions regarding antenatal screening. We have confirmed that little research is being undertaken in both countries regarding competency achievement in practice. Changes to midwifery curricula and further continuing education are required to ensure that midwives are able to provide effective care regarding genetics. [ABSTRACT FROM AUTHOR]

Culture influences the way health‐care professionals communicate with each other and their ability to relate to colleagues in an assertive manner. Cultural barriers can also make it difficult for nurses to speak up even when they have concerns about patient safety. An understanding of the potential impact of cultural factors is therefore needed when developing assertiveness communication training programs. This paper presents the findings from a study that explored Japanese nurses' perceptions of how culture and values impact assertive communication in health care. Semistructured interviews with 23 registered nurses were undertaken, and data were analyzed using directed content analysis. Two major themes were identified: collectivism and hierarchy/power. In the present study, we discuss the cultural values related to collectivism that included four categories of "wa" (harmony), "uchi to soto" (inside and outside), implicit communication/ambiguity, and "nemawashi" (groundwork). The findings highlight the impact of culture on nurses' assertive communication behaviors and can be used to inform the design of culturally‐appropriate assertiveness communication training programs for Japanese nurses working both within their own country or internationally. [ABSTRACT FROM AUTHOR]

This paper presents the initial translation process and follow-up psychometric evaluation of the Japanese version of the Primary Communication Inventory (J-PCI). The J-PCI was developed using the committee approach to translation and then used in a study exploring Japanese couples' communication satisfaction while separated during Satogaeri Bunben - a Japanese perinatal tradition. The committee approach attends to cultural nuance and context and is especially useful when languages have dissimilar linguistic roots and cultures, such as Japanese and English. The translation process and evaluation included five steps; (i) selection of the original PCI for research; (ii) selection of translators; (iii) development of the J-PCI using a committee approach; (iv) an initial small pilot study; and (v) a larger follow-up study. The J-PCI has good initial validity and reliability, although some nuances were observed in scoring. [ABSTRACT FROM AUTHOR]

In 2011 the east coast of Japan experienced a massive earthquake which triggered a devastating tsunami destroying many towns and killing over 15 000 people. The work presented in this paper is a personal account that outlines the relief efforts of the Humanitarian Medical Assistance team and describes the efforts to provide medical assistance to evacuees. The towns most affected had a large proportion of older people who were more likely to have chronic conditions and required medication to sustain their health. Since personal property was destroyed in the tsunami many older people were left without medication and also did not remember which type of medication they were taking. Some evacuees had brought a list of their medication with them, this assisted relief teams in obtaining the required medication for these people. The more successful evacuation centers had small numbers of evacuees who were given tasks to administer the center that kept them occupied and active. [ABSTRACT FROM AUTHOR]

Following the Great East Japan earthquake (the Big Quake) that hit the northeastern parts of Japan on March 11, 2011, aid was dispatched from multiple levels of organizations including the Japanese Nurses Association ( JNA). Evidence indicates that the JNA did not play an effective role in the aid efforts, since the professional organization had pulled out and stopped sending nursing personnel from the end of April 2011. In view of the way that things were handled in terms of aid efforts immediately, a year, or two years after the Big Quake occurred, the authors of this paper have identified issues related to nurse's role at the time of the disaster. By looking back at what happened, we have gained insights into how to prepare for future disasters. [ABSTRACT FROM AUTHOR]

Recovery from disaster can take a lifetime, and people looking in from outside might not appreciate the stages of recovery. Little talked about is the stigma, which might attach to the survivors of a disaster, especially if it is a man-made disaster. This paper documents the account of a Japanese nursing student who visited the area 18 months after the Great East Japan earthquake and tsunami, talked to the people there, and shared her reflections. The experiences of the Fukushima survivors are linked to those of victims of other disasters, whose recovery was impeded by being discriminated against and stigmatized. [ABSTRACT FROM AUTHOR]

Over the last 30 years in Japan, there has been a 10% increase in the number of people suffering from sick house syndrome due to toxic chemicals released from construction materials and wallpaper. This syndrome can develop into the more complex and disabling, chemical sensitivity syndrome, so preventing early exposure to toxins at home is critical in reducing the likelihood of health problems in the community. A qualitative study was undertaken using ethnographic methods to identify the psychosocial aggravating factors of sick house syndrome. As a result, the participants identified three aggravating factors that extended the period of exposure of the participant to toxic chemicals: a lack of knowledge about the disorder; the difficulty in establishing a diagnosis; and the difficulty of taking radical measures to improve the home environment. Public awareness of sick house syndrome and the dangers of toxicity from construction materials is vital to eliminate these aggravating factors and to prevent illness. [ABSTRACT FROM AUTHOR]

Social support for Japanese elderly people living in small towns is the focus of this paper. Specifically, it explores the relationship between selected aspects of self-reported social support, religion, end-of-life issues, and death anxiety. A total of the 1956 men and women responded to a questionnaire including a scale of social support they received in their home. The major findings showed that an increased level of perceived social support is not a predictor of decreased death anxiety but correlated with image of death and coping style of death anxiety, for which those who reported greater support tend to use more human relationships and fewer religious beliefs. Early in the next century 25% of Japan's population will be 65 years of age or older. Elderly Japanese have benefited from the traditional values of family care giving which historically provided great social support. How do these elderly respond to questions about the end of their lives when their reported social support varies? [ABSTRACT FROM AUTHOR]

This paper examines reliability and validity of an instrument measuring the quality of life of elderly Japanese people with dementia. The instrument is a translation of an American instrument. The instrument has 48 items with binary answer format over five domains: 'social interaction', 'awareness of self', 'enjoyment of activities', 'feelings and mood', and 'response to surroundings'. Altogether, 321 elderly in various facilities/services in Japan were evaluated by their formal caregivers. Factor analysis supported the domain of 'enjoyment of activities', but the domains of 'awareness of self' and 'response to surroundings' were statistically overlapped. The domains of 'social interaction' and 'feeling and mood' were not supported. Test-retest reliability was generally satisfactory except for the domain of 'response to surroundings'. Interrater reliability was relatively low for domain scores but the total score was acceptable. Thus, the instrument showed moderate reliability and validity and further improvement is needed. [ABSTRACT FROM AUTHOR]

AbstractInformation disclosure at the end of life is one of the most debated ethical issues in Japan. This paper, using data from a larger questionnaire survey in which 147 Japanese nurses participated, describes nurses’ perceptions about this issue. The nurses perceived that non-disclosure of impending death information to patients was the norm in Japan due to its traditional values. This non-disclosure of information has various impacts on clinical nurses. Tension was evident between the Japanese traditional concepts supported by some nurses and the shift toward Western cultural and ethical values supported by other nurses. The nurses confronted uninformed patients who became suspicious, isolated, angry, or died unprepared for their life’s ending. The nurses were placed in the middle between the patient and the family, as nurses became keepers of family secrets, or between nurses’ ethical obligations to the patient and those of the institution. The nurses had the belief that at the patient’s end of life, it is important to change health professionals’ attitude from curing to caring. [ABSTRACT FROM AUTHOR]

This paper describes the responses of undergraduate nursing students to an ethical clinical case study. Students in a baccalaureate program were given a case study before a lecture on ethical principles and the same case study after this lecture. These responses raise questions about the content of nursing ethics classes in Japan. The place of individual patient rights and the role of the family in a situation of non-disclosure about diagnosis and prognosis were major issues for the students. The responses reveal the problem of the ‘nurse-in-the-middle’ between the patient and others whose values differ. Students’ post-lecture responses emphasized communication among the people involved. [ABSTRACT FROM AUTHOR]

Over the last decade, the importance of Advanced Care Planning has been recognized in Japan. However, it is still difficult for healthcare providers and patients to verbalize how they want to spend the last days of their lives and what unfinished business they have left to accomplish. This study aimed to clarify how nurses intervened to assist patients with cancer at the end of life to express their thoughts and concerns. Twenty‐four nurses were interviewed regarding how they intervened for patients' thoughts and concerns, and data were analyzed qualitatively using a modified grounded theory approach. A 25‐item scale was selected, and the questionnaires, which included the scale, were distributed to nurses in general wards, palliative care units, and home visiting nurse services. A total of 1864 responses were analyzed. Factor analysis and structural equation model analysis were used, and three factors were identified: "assessment and intervention," "basic care," and "knowledge and communication," which led to the formulation of an intervention structure model for uncovering thoughts and concerns. These results indicate the importance of basic care and communication during interventions for patients. [ABSTRACT FROM AUTHOR]

This study examined the association between adding nurse aides and patient mortality in acute care settings. We conducted a retrospective cohort study using a national healthcare administrative claims database. We identified patients who underwent planned surgery for six types of cancer from 2010 to 2017. Multivariable logistic analyses were used to examine the association between the nurse aide staffing level and patient outcomes. The primary outcomes were failure to rescue and 30‐day hospital mortality. We examined 330 666 in‐hospital patients. The median number of nurse aides per 100 occupied beds was 6.60 (interquartile range, 4.61–8.43). In the multivariable analysis, nurse aide staffing level was not significantly associated with failure to rescue or 30‐day hospital mortality. The Japanese government provides economic incentives to hospitals that hire more nurse aides, expecting that a higher nurse aide staffing level will help licensed nurses concentrate on the tasks that need their specialties. However, our findings suggest that adding nurse aides may not be associated with lower rates of failure to rescue or 30‐day hospital mortality in acute care settings. [ABSTRACT FROM AUTHOR]

This study investigated the association between maternal smartphone use during breastfeeding and the quality of mother–infant interactions and maternal visual responsiveness to the infant's bids for attention. We observed 13 mother–infant dyads and video‐recorded breastfeeding under the experimental (smartphone use) and control (no smartphone use) conditions on separate days. To evaluate the quality of mother–infant interactions between the two conditions, we used the Japanese revised version of the Assessment of Mother–Infant Sensitivity (AMIS) scale. The mothers' visual responses to their infants' bids for attention were categorized into two groups. In this study, although smartphone use clearly increased distracted feeding times, we found no significant associations between maternal smartphone use and the quality of mother–infant interactions or bonding during breastfeeding. However, smartphone use during breastfeeding was found to interfere with the mother's ability to respond visually to the infant's bid for her attention. The results of this study can be applied while developing resources regarding smartphone use for nursing mothers. [ABSTRACT FROM AUTHOR]

Approximately 20% of Japanese women in their reproductive years are smokers. Therefore, in the present study, we report the behavioral changes of woman who undertook a 3 month stop-smoking program. Sixty-six pregnant smokers in the first trimester of pregnancy participated in this study from two hospitals and an obstetric clinic in Japan. Our newly-developed e-learning program uses a cell phone Internet connection service to support pregnant women who want to quit smoking. Using this, service participants were given guidance concerning smoking, and were breath tested for their carbon monoxide levels every 4 weeks for 3 months. An e-learning cessation smoking-support program was maintained throughout the same period. Consequently, 52 of 66 pregnant smokers from three settings began the program, and 48 of 52 eventually completed it. The achievement rate of non-smoking was 71.1% (37/48), and their carbon monoxide exhalation levels significantly decreased from 6.43 ± 4.5 ppm at the beginning to 0.7 ± 1.0 ppm in 1 month, to 0.29 ± 1.08 in 3 months ( P < 0.001). These results suggest the effectiveness of our e-leaning program. This paper reports the results of the study. [ABSTRACT FROM AUTHOR]

This descriptive study used a qualitative inductive approach to investigate the subjective experiences and perceptions of people with schizophrenia living in the community during times of difficulty and how they coped. We conducted semi‐structured interviews with nine community‐dwelling people with schizophrenia and used the KJ method developed by Kawakita Jiro to structure the data obtained. We identified 10 symbols with his method: bewilderment at the onset; helplessness and longing for death; solitude linked to death; precarious daily life; relationships at risk; fear of being stigmatized; pillars of emotional support; will to overcome; hope to never give up; and living with the illness. The results suggest that community mental health nurses should provide support so their patients can continue to have pillars of emotional support and the will to overcome difficulties, as well as continue to use their coping methods, even when experiencing many difficulties. It is important that nurses understand and share in their patients' difficult experiences and hopes when providing support toward their recovery. [ABSTRACT FROM AUTHOR]

The purpose of this cross‐sectional study was to examine factors associated with nurses' resilience during the COVID‐19 pandemic. Data were collected in the latter half of 2020 from 904 nurses across Japan, Republic of Korea, Republic of Turkey, and the United States. The questionnaire included the Connor‐Davidson Resilience Scale 10, plus demographics and 20 questions about practice environment, workplace safety concerning infection control, COVID‐related experience, and organizational support. Fear of becoming infected, intention to leave nursing, and having had a positive COVID‐19 test were inversely associated with resilience (p < 0.05). Regression analysis indicated that U.S. nurses had significantly greater resilience than nurses in the other countries examined (p < 0.001). Nurses reporting organization support and those who participated in policy and procedure development had higher resilience scores (p < 0.01). Organizational support, involving nurses in policy development, and country of practice were found to be important resilience factors in our research, which aligns with other findings. Further research is recommended to determine the optimal practice environment to support nurse resilience. [ABSTRACT FROM AUTHOR]

The most significant influence on nurses' professional growth is through work under direct guidance in clinical settings. Associate nurse unit managers perform direct patient care with the staff, as well as assist management work of nurse unit managers. They can be excellent role models for the staff. We examined their behaviors that help promote staff development, aimed to identify effective behaviors, and created a self‐checklist to evaluate them. We created 53 items to assess staff development behaviors, which were evaluated via a Delphi survey with 252 experts and a questionnaire survey with 124 associate nurse unit managers in Japan to evaluate whether the created item was appropriate. The results of the Delphi survey showed an agreement rate of over 90%, and associate nurse unit managers showed an acceptance rate of 82.6–99.2% for 40 of 53 items. Consequently, we created 40‐item self‐checklist of staff development behaviors for associate nurse unit managers with adequate validity. This checklist would be helpful for them to promote staff development while working in clinical settings and would contribute to enhancing the quality of nursing. [ABSTRACT FROM AUTHOR]

Empathy is an important characteristic for healthcare students and professionals that may improve the quality of healthcare interactions. Empathy has predominantly been studied within medicine, but also among various allied health personnel. Within paramedicine, empathy has previously been examined internationally, but not within Japan. This study used a descriptive, cross‐sectional methodology which aimed to examine self‐reported empathy in Japanese paramedic students using the Jefferson Scale of Empathy, and compare results with similar international cohorts. Empathy levels in the Japanese cohort were higher among females compared to males. In addition, there was a decrease in empathy with each subsequent year of the paramedic program, and a general decrease as age increased. This contrasts with comparable Australian cohorts which demonstrate no significant change in empathy levels during the undergraduate program. Empathy levels measured in the Japanese paramedic cohort were generally lower than for Australian cohorts. The reasons for the differences are unclear at present and thus further research in this area is required to fully determine and describe the contributing factors. [ABSTRACT FROM AUTHOR]

High graduation of nurses and limited job opportunities in Indonesia may lead to the emigration of nurses particularly through facilitated migration. This study aimed at identifying the prevalence of Indonesian nursing students with intention to work in Japan and predictors of their intention to migrate as well as having a definite plan to work in Japan. The study adopted cross‐sectional design with a sample of 1,407 Indonesian nursing students. Factors associated with having migration intention, as well as a definite plan to work in Japan, were age, residence, and overseas experience. Other factors related to a definite plan to work abroad were family income, mastering a foreign language, knowledge about the nurse migration related to Indonesia‐Japan cooperation, and their motivations to migrate to Japan. Sustainability of this international recruitment of nurses is possible by understanding the context of both source and destination countries. Maximizing benefits of migration of nurses for Indonesia and Japan requires structured policies targeting the educational sector and addressing the sustainability issues. [ABSTRACT FROM AUTHOR]

Nurses need to be appropriately trained in genetics to provide clinical care based on best practice for patients and families. This exploratory study describes an educational intervention using authentic stimulus material centered on a clinical case study of a family with a baby with Down syndrome. Quantitative and qualitative data were collected from a sample of 15 nurses and 27 students from three universities in Japan before and after completing an entry‐level workshop on competency‐based genetics nursing. Participants reported increased perceived genetics knowledge and clinical confidence. Despite more than 90% of the participants reporting that they understood the underlying genetics knowledge, their confidence and the ethical aspects of genetics nursing had not been promoted after the seminar. In contrast, the reflections, coded into three categories, showed they recognized families' needs for psychological support, family decision making, and protection and privacy and suggested that nurses had undergone a profound shift in understanding about these issues. Although indicating that a single seminar was insufficient, the study findings will be useful to develop educational materials on genetics for both students and nurses. [ABSTRACT FROM AUTHOR]

During pregnancy, women re‐evaluate their body image based on their increasing body weight. They are usually concerned about their body size, which leads to body dissatisfaction. In this study, we investigated body dissatisfaction among Japanese women during the second trimester, when they are recommended to gain adequate weight. A cross‐sectional survey of body dissatisfaction among pregnant women was conducted using a new figure rating scale corresponding to body mass index with real‐life photographs of women in their sixth month of gestation. Pregnant Japanese women expressed body dissatisfaction and preferred to be thinner by 1.6 kg/m2 of their body mass index. They perceived their body size as larger than their real size, and those with a higher body mass index had more body dissatisfaction, although they were of normal weight or underweight. The results indicated that the new figure rating scale could be a useful tool to identify pregnant women with higher body dissatisfaction during the second trimester, providing an opportunity to discuss adequate gestational weight gain with pregnant women. [ABSTRACT FROM AUTHOR]

Antenatal fear of childbirth (FOC) is associated with negative effects, such as postnatal traumatic symptoms. As the birth‐related culture of East Asian countries differs from that in Western countries, the aim of the present qualitative, descriptive study was to explore FOC, perceptions for Caesarean section (CS), and obstetric analgesia (OA) among Japanese primiparas. The qualitative, descriptive study included focus group interviews with 11 primiparous women, which were conducted in a birth house and a maternity hospital in a metropolitan area of Japan in 2013. As a result, seven categories emerged from the analysis: Maternal and child risk, pain, losing control, uncertainty, prolonged labor, poor family support and loneliness before hospitalization. All participants denied having a preference for CS birth due to fear. Opposing values of OA were identified in women who chose OA and those who did not. In conclusion, it is necessary to increase clinical awareness that the objects of fear are diverse. Furthermore, diverse values regarding OA should be understood and equally respected by health‐care professionals. [ABSTRACT FROM AUTHOR]

The 'Skippu-Mama' peer support program was developed to improve quality of life and reduce parental stress in mothers of children with autism spectrum disorders. The program was designed to improve these variables by refreshing and healing participants' minds and bodies. Twenty-four mothers of 26 children diagnosed with ASD in Japan were included in the study and completed measures of quality of life and parental stress before, during, and after participation in the Skippu-Mama program. Our results demonstrated that time was a significant main effect. Further, multiple comparisons with Bonferroni corrections indicated a significant increase in World Health Organization Quality of Life 26 scores three months into the program and at its conclusion six months after commencement. Overall, the Skippu-Mama program improved the quality of life of mothers of children with ASD, and we believe that the intervention's focus on both individual and family variables may be especially effective in this population. [ABSTRACT FROM AUTHOR]

An interview with Dr. Nobuko Tokuda, a researcher in anatomy and immunology is presented wherein she gave her perspective on Japanese women in academia. Topics covered include how she sees the place of women researchers in universities in Japan, the situation for women researchers in nursing and health sciences in Japan and what she thinks are the broad societal influences for women in Japan.

Interprofessional communication and teamwork are essential for medication safety; however, limited educational opportunities for health professionals and students to develop these skills exist in Japan. This study evaluated the impact of an interprofessional multimedia learning resource on registered nurses' and nursing students' intention to practice in a manner promoting medication safety. Using a quasi-experimental design, Japanese registered nurses and nursing students (n = 203) were allocated to an experimental (n = 109) or control group (n = 94). Behavioral intentions of medication safety and the predictor variables of attitudes, perceived behavioral control, and subjective norms were measured using a Japanese version of the Theory of Planned Behavior Medication Safety Questionnaire. Registered nurses in the experimental group demonstrated a greater intention to collaborate and practice in a manner that enhanced medication safety, evidenced by higher scores than the control group on all predictor variables. The results demonstrate the potential for interprofessional multimedia learning resources to positively impact the behaviors of Japanese registered nurses in relation to safe medication practices. Further research in other contexts and with other cohorts is warranted. [ABSTRACT FROM AUTHOR]

A high total homocysteine (t Hcy) level during pregnancy is a risk factor for adverse perinatal outcomes, such as fetal growth restriction and preeclampsia. Caffeine is assumed to increase t Hcy levels by acting as a vitamin B6 antagonist. The objective of this study was to examine a relationship between circulating t Hcy levels and dietary caffeine and vitamin B6 intakes in pregnant Japanese women. A total of 321 healthy women with singleton pregnancies were recruited in metropolitan Tokyo, from June to December 2008, resulting in the final number included in the study as 254. Dietary caffeine intakes did not correlate with plasma t Hcy levels. When we analyzed the data according to caffeinated beverages, caffeinated tea consumption was positively associated with plasma t Hcy levels only among the women with a high intake of vitamin B6, after controlling for confounding factors ( P = 0.029). No correlation between coffee consumption and plasma t Hcy levels was found. Pregnant Japanese women might need to cut down the consumption of caffeinated tea as well as take sufficient vitamin B6 in order to prevent the t Hcy levels from increasing. [ABSTRACT FROM AUTHOR]

This study aimed to develop a reliable and valid measure of functional health literacy in a Japanese clinical setting. Test development consisted of three phases: generation of an item pool, consultation with experts to assess content validity, and comparison with external criteria (the Japanese Health Knowledge Test) to assess criterion validity. A trial version of the test was administered to 535 Japanese outpatients. Internal consistency reliability, calculated by Cronbach's alpha, was 0.81, and concurrent validity was moderate. Receiver Operating Characteristics and Item Response Theory were used to classify patients as having adequate, marginal, or inadequate functional health literacy. Both inadequate and marginal functional health literacy were associated with older age, lower income, lower educational attainment, and poor health knowledge. The time required to complete the test was 10-15 min. This test should enable health workers to better identify patients with inadequate health literacy. [ABSTRACT FROM AUTHOR]

In Japan, where older people already make up more than 23% of the population and the proportion is still growing, the burden on those caring for people with dementia is an increasing problem. This burden is magnified by wandering behavior, a peripheral symptom. Thus, there is a need for an objective measure of wandering behavior to determine what constitutes effective care. In this study, we translated the Algase Wandering Scale - Version 2 into Japanese, and examined its reliability and validity. Ambulatory residents with dementia were selected from two nursing homes and two wards specializing in dementia care in hospitals in Japan. Nurses and care workers taking care of these residents answered questionnaires regarding the residents. From the results, the Algase Wandering Scale - Version 2, Japanese version, was examined for inter-rater reliability, stability, internal consistency, and concurrent validity. The results of the analysis in the present study demonstrated that the Algase Wandering Scale - Version 2, Japanese version, has reliability and validity, and that it can measure the presence or absence of wandering and its severity. Surveys of residents with various wandering patterns in many facilities and verification of construct validity are warranted in the future. [ABSTRACT FROM AUTHOR]

Early child development and the impact of parenting on later life are of global concern. The rise in child abuse and maltreatment in Japan suggests that measures to increase self-efficacy and reduce stress would benefit Japanese parents. In this study, we explored if Japanese parents attending a 123 Magic parenting program reported reduced stress and enhanced self-efficacy. Questionnaire data were collected from 49 mothers attending a parenting program conducted in public nursery schools in one prefecture in Japan. There were significant changes in parenting self-efficacy scores ( P < 0.001) and parenting stress scores ( P < 0.01). Focus groups with 16 parents also found that there were benefits to parents in terms of increased confidence and less stress. The findings provide support for the role of public health nurses in delivering group-based parenting support in Japan. [ABSTRACT FROM AUTHOR]

The aim of this study was to obtain basic data about the support for life adjustment in lung cancer patients in Japan. We identified factors that affect life adjustment in people with lung cancer, developed a model for life adjustment support of lung cancer patients, and investigated its validity. A survey was conducted using self-completed questionnaires, and responses were received by 203 individuals. Analysis of the responses revealed that life adjustment was regulated by six factors associated with positive self-evaluation: stress dissipation, fighting spirit, helplessness/hopelessness, full discussion with doctor about treatment, clarity of thought, and support network size. A model search with covariance structure analysis was conducted. The resulting model was revealed to have a goodness-of-fit index of 0.963, an adjusted goodness-of-fit index of 0.930, a comparative fit index of 0.974, and a root mean square error of approximation of 0.040. The findings suggest that improvements in quality of life can be expected by combining a positive self-evaluation in lung cancer patients and interventions to raise self-adjustment ability with the use of this Model, although it requires further testing. [ABSTRACT FROM AUTHOR]

The practices required by community and public health nurses to establish community networks mainly involve communicative competencies. Assessment through development and testing of such competencies is necessary for community and public health nurse educators and practitioners around the world to create and maintain a mutual support network. The purpose of this study was to develop and test a scale for community and public health nurse practices to establish and maintain community networks, and to then determine construct validity in a factorial structure model. The participants were 3970 community and public health nurses in Japan. A 43-item list was developed from a literature review, individual interviews, and repeated examinations. The secondary structural model consisted of four factors with 21 items. The internal consistency of the 21 items was highly reliable ( Cronbach's α = 0.915). Confirmatory factor analysis by structural equation modeling showed the fit criteria to be statistically significant. Attributes of the community and public health nurses (age, years of experience, work municipalities, work positions, and educational institutions) showed significant relationships with the scale scores. The findings validated the efficacy of the Network Establishment Practices Scale to assess community and public health nurse practices to establish community networks. [ABSTRACT FROM AUTHOR]

This study aimed to explore how pregnant Japanese women interpret maternal serum screening test results presented as probabilities and to consider the possible methods to improve women's understanding of the results. Semi-structured interviews were conducted with 15 women. Data collection and analysis were performed concurrently, based on the grounded theory approach. We showed that the participants interpreted the test results using various criteria, including information from obstetricians, previously experienced risk probabilities, subjective interpretations, and comparisons with other women. The explanations given by health-care professionals affected the participants' interpretation of the probability of risk and their recognition of false-negative results. Therefore, health-care professionals should explain the meaning of the probability test results and confirm how women interpret them. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine social support as a predictor of health status among older adults living alone, based on a 2-year longitudinal study in a rural area of Japan. The self-reported questionnaires were distributed to 624 older adults living alone and were collected during home visits by welfare commissioners as baseline survey. After the follow-up survey of 493 respondents as the baseline survey, we analyzed 340 persons who lived alone over the last 2 years. Women had significantly higher emotional and instrumental support scores than men. Receiving positive support from the neighborhood had a significant effect on retaining activities of daily living for older women living alone. Our results suggest that receiving social support from the neighborhood brought an improvement in the health status of older adults, particularly women living alone. [ABSTRACT FROM AUTHOR]

28–29 March 2000 Yamaguchi University School of Medicine, Ube, Japan (Local Organizers: Junko Yoneda and Susumu Tomonaga, Yamaguchi University). [ABSTRACT FROM AUTHOR]

28–29 March 2000 Yamaguchi University School of Medicine, Ube, Japan (Local Organizers: Junko Yoneda and Susumu Tomonaga, Yamaguchi University). [ABSTRACT FROM AUTHOR]

The aim of the present study was to explore the relationship between work environment and moral sensitivity among Japanese (n = 138) and Norwegian nurses (n = 71), and to compare the results from a sociocultural perspective using a descriptive-correlational design. Data were analyzed using descriptive and inferential statistics. The results point to a significant relationship between work environment and moral sensitivity for both groups of nurses. In comparison, the Japanese nurses were more focused on 'patient centered oriented care', reported 'work engagement', seeking 'meaning in difficult caring situations' and 'following rules'. In addition, they ranked the factor 'values in action of patient care' as significant and 'relation to superior and colleagues' and 'job stress and anxiety' ranked significant to 'moral conflicts'. The Norwegian nurses were more independent, which was correlated with moderate significance with 'job stress and anxiety'. A significant correlation was found between 'physical and mental symptoms' and 'moral conflicts' among Norwegian nurses. [ABSTRACT FROM AUTHOR]

The main aim of the present study was to explore the midlife experience for women living in Australia and Japan. The specific objectives of the study included: (i) comparing menopausal symptoms between the two groups; and (ii) comparing the factor structure of symptoms and exploring their relationship to menopausal status. Postal questionnaires were distributed to two structured, random population based samples of midlife women aged 45–60 years; consisting of 712 women living in Australia and 1502 women living in Japan. Analysis showed significant differences in menopausal symptoms related to psychological symptoms ( P < 0.001), including anxiety ( P < 0.001) and depression ( P < 0.001), somatic symptoms ( P < 0.001), and vasomotor symptoms ( P < 0.01). The analysis, which excluded hormone replacement therapy (HRT) users, found that there were significant differences seen across menopausal status in the following symptoms: difficulty in sleeping ( P < 0.01), difficulty in concentrating ( P < 0.01), feeling dizzy or faint ( P < 0.001), loss of interest in most things ( P < 0.01) and loss of feeling in hands or feet ( P < 0.001). In the postmenopausal stage specifically, significant differences were seen in the areas of feeling tense or nervous ( P < 0.01), feeling unhappy or depressed ( P < 0.01), parts of body feeling numb or tingling ( P < 0.05), headaches ( P < 0.01), and sweating at night ( P < 0.05). Our analysis revealed that the experience of menopause for women is different between Australian and Japanese women. [ABSTRACT FROM AUTHOR]

A health education program for nurses was conducted to address the complex problem of child abuse, which has reached epidemic proportions. In Japan, the number of consultations has risen 23-fold over the past 11 years. Maltreatment of children is a public health problem as perilous as any contagious disease. The International Council of Nurses asks for nurses' leadership to strengthen measures to combat abuse throughout the world. The Japanese Nursing Association has published statements for prevention, detection and support. Yet, few community-based education programs with a multidisciplinary perspective have been reported that focus on nurses, the largest group of health providers. More than 200 nurse educators, clinicians and managers met for a one-day program designed to improve understanding of the nurses' role in combatting the abuse and neglect of children and to formulate action plans. This significant health problem is addressed in the context of a health education program's needs, objectives, content and evaluation. [ABSTRACT FROM AUTHOR]

Presents abstracts from the International Symposium on Genetic Nursing held at Yamaguchi University, Japan on September 14-15, 2002. 'Chance, Challenge and Change: Nursing and Genetic Health Care'; 'Genetic Content in Japanese Language Nursing Textbooks'; 'Genetic Discoveries and Nursing Implications for Complex Disease Management.'

The purpose of this study was to examine how the use of medical/social services by elderly persons changes over time as they approach death. This research was conducted at a public visiting nursing office in Tokyo. Nursing records of all elderly persons, those who died at home or died within 1 week of hospital admission between April 1993 and June 1997 were reviewed. The percent of patients using each type of medical or social service was calculated for three time periods before death: more than 6 months, 1-6 months and within 1 month. This retrospective examination clearly demonstrates a shift in specific service usage by elderly persons during the months prior to death. As terminal illness becomes more advanced, the use of medical services increases more remarkably than the use of social services. The increase in nurse visits is far greater than that of home aid visits. Visiting nurses should demonstrate their skills of care appropriate to the changeable conditions of the elderly and their families in the terminal stage. [ABSTRACT FROM AUTHOR]

Abstract The purpose of the present study was to identify the characteristics of patients from a geriatric ward who were referred for discharge planning support, a service provided by the first multidisciplinary department for discharge planning among the national university hospitals in Japan. From October 1997 to May 1999, 335 patients were discharged; 23 patients (6.9%) were referred. The referred patients were older and more frequently diagnosed with malignancy, dementia and respiratory infection. In addition, they had lower activities of daily living (ADL) and instrumental ADL scores. Those characteristics, which may be related to the longer hospital stay and lower rate of returning home of the referred patients, can be assessed early in hospitalization to identify patients at risk for difficult discharge planning. It is important to identify patients who need earlier intervention by formalized discharge planning so that the current situation of overly long hospitalization in Japan will improve. [ABSTRACT FROM AUTHOR]

Abstract This case study describes the strategies and activities of public health nurses to increase the availability of services in a municipality of 36 000 and to transform community attitudes so that those needing services would feel free to use them. Strategies and activities are seen in the context of Japan, Minakuchi Town and the leadership of the chief public health nurse. Practicing in partnership with members of the community, strategies of public health nurses include technical activities (conducting needs assessment and framing program alternatives) and information sharing and health education (e.g. 75 meetings organized with health promoters for residents in the districts of the town). On the basis of the results of Minakuchi Town, viewed as an example of expert public health nursing practice, a general model for public health nursing practice is presented. [ABSTRACT FROM AUTHOR]

As part of a community health assessment, variations in maternal and child health-related vital statistics data in Ishikawa Prefecture, Japan, from 1984 to 1993 were studied. Annual vital statistics reports published by the Prefectural government were used for the analysis. The following rates by public health district were calculated: abortion rate, early fetal mortality rate, late fetal mortality rate, perinatal mortality rate, neonatal mortality rate, and infant mortality rate. Maternal mortality rates were calculated for the Prefecture because of the small number of events. A few northern public health districts had relatively high perinatal mortality and infant mortality rates throughout the study period. Cause-specific infant mortality rates showed that the northern region had higher infant mortality rates related to the level of perinatal care, injury, and poisoning. Inconsistencies in the pattern of mortality were found in one of the 10 public health districts. No indirect maternal deaths were reported for the 10-year study period. This study identified potential problems for perinatal care in some districts. Results also suggest the potential misclassification of vital events, such as fetal deaths, induced abortions, and maternal deaths. [ABSTRACT FROM AUTHOR]

The article mentions the anniversary of the journal "Nursing and Health Sciences" (NHS), which have been in business for 20 years.