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Spinal fixation surgery has been increasingly performed in patients with osteoporosis. Romosozumab, a drug that was introduced in Japan recently, is known to possibly promote bone healing. However, few studies have reported the therapeutic effects of romosozumab in clinical practice in Japan. Therefore, here, we investigated the effects of romosozumab dosage on bone fusion promotion using an ovariectomized rat spinal fusion model. Eight-week-old female Sprague-Dawley rats were matched by body weight and divided into three groups: 1.0 romosozumab (R) group (Evenity®, 25 mg/kg), 1/10R group (Evenity®, 2.5 mg/kg), and control (C) group (saline). Subcutaneous injections were administered twice a week for 8 weeks postoperatively. Computed tomography scans were performed every 2 weeks from the time of surgery till 8 weeks postoperatively. The mean fusion rates in terms of volume were significantly higher in the R groups [1/10R, 1.0R] than in the C group from 4 weeks postoperatively. The rate of increase was significantly higher in the 1.0R group from 4 weeks postoperatively and in the 1/10R group from 6 weeks postoperatively, than in the C group. The proportion of trabecular bone area was approximately 1.5 times higher in the R groups than in the C group. No significant differences were observed between the R groups. Our results suggest that romosozumab stimulates bone growth at the graft site, and similar effects were achieved at 1/10 of the standard dosage., (© 2024 Orthopaedic Research Society.)

Objectives: Work engagement is an essential factor in improving employee performance. However, no reviews on the work engagement of psychiatric nurses have been conducted to date. This study aimed to examine the current status of research on the work engagement of psychiatric nurses and identify salient factors., Design: A scoping review., Methods: This review adhered to the established scoping review methodological guidelines and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews checklist. The inclusion criteria were based on nurses, work engagement and psychiatric settings without language or date restrictions. Regardless of the methodology or study design, research studies related to the work engagement of psychiatric nurses have been included. A systematic search was conducted in MEDLINE, CINAHL and PsycINFO from the inception of each database, with the search strategies being set by an information specialist. The deadline for the search was 15 February 2023., Results: The study included 12 studies. All studies have been published since 2013. The study designs included cross-sectional (n=10), longitudinal (n=1) and intervention (n=1) studies. The impacts of work engagement were classified into (1) attitudes towards patients, (2) attitudes towards work, (3) mental health and (4) quality of care. Factors influencing work engagement were classified into (1) demographics, (2) workplace factors, (3) individual factors and (4) patient factors., Conclusion: Work engagement of psychiatric nurses has lately gained attention, although data are limited because most studies used a cross-sectional design. Psychiatric nurses with higher work engagement showed positive outcomes. Workplace and individual factors can potentially improve their work engagement. The findings can assist nursing managers in enhancing psychiatric nurses' work engagement and, consequently, their performance., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Obejective: To perform a magnetic resonance imaging T2-mapping of the ligamentum flavum in healthy individuals and patients with lumbar spinal stenosis scheduled for surgery and compare the T2 relaxation times., Subjects and Methods: The T2 relaxation time of the ligamentum flavum was compared among 3 groups, healthy young individuals (H group (age< 50)), healthy middle-aged and older individuals (H group (age≥50)), and patients with lumbar spinal stenosis (L group). Additionally, the thickness of the ligament was measured in the axial image plane, and the occupied area ratio of each fiber was measured by staining the surgically obtained ligament, and each was correlated with the T2 relaxation time. We also evaluated the adhesion of the ligamentum flavum with the dura mater during the surgery., Results: The T2 relaxation times were significantly prolonged in H group (age ≥50) and L group (P < 0.001) compared to H group (age<50). The relationship between collagen fiber and T2 relaxation times was significantly positive (r = 0.720, P < 0.001). Moreover, the relaxation times were significantly prolonged in those with adhesion of the ligamentum flavum with the dura mater (P < 0.05). The cut-off for the relaxation time was 50 ms (sensitivity: 62.50%, false positive rate: 10.8%)., Conclusion: Healthy middle-aged and older individuals and patients with lumbar spinal stenosis and adhesion of the ligamentum flavum with the dura mater have prolonged T2 relaxation times. Hence, the adhesion between the ligamentum flavum and dura mater should be considered in cases with a relaxation time ≥50 ms., (Copyright © 2023 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.)

Platelet-rich plasma (PRP) promotes bone union through osteoinduction. We investigated whether adding demineralized bone matrix (DBM), derived naturally from biomaterial and with various growth factors, for osteoconductivity and bone marrow fluid for osteogenesis results in different bone unions. Eight-week-old male Sprague-Dawley rats were divided into four groups of five based on transplantation material: sham control (C group); DBM alone (D group); DBM + PRP (DP group); and DBM + PRP + bone marrow fluid (DPB group). After posterolateral fusion at L3-5, postoperative weekly CT imaging determined average number of bone union in facet joints (4 joints × 5 animals = 20 joints) and bone formation. Pathological evaluation and bone strength were assessed using 3-point bending two weeks postoperatively. Facet joint bone union at four weeks postoperatively was 4/20 (20%, DP group) and 8/20 (40%, DPB group) joints. Six weeks postoperatively, it was 7/20 (35%, D group), 12/20 (60%, DP group), and 16/20 (80%, DPB group). Eight weeks postoperatively, it was 13/20 (65%, D group), 17/20 (85%, DP group), and 20/20 (100%, DPB group), suggesting that DPB > DP > D > C. Bone formation and bone strength showed a similar DPB > DP > D > C group trend. Adding PRP and bone marrow fluid to DBM promotes bone union and strength., (© 2023. Springer Nature Limited.)

Study Design: A retrospective analysis of magnetic resonance imaging (MRI)., Objective: The study aimed to evaluate the performance of a convolutional neural network (CNN) to differentiate spinal pyogenic spondylitis from Modic change on MRI. We compared the performance of CNN to that of four clinicians., Summary of Background Data: Discrimination between pyogenic spondylitis and spinal Modic change is crucial in clinical practice. CNN deep-learning approaches for medical imaging are being increasingly utilized., Methods: We retrospectively reviewed MRIs from pyogenic spondylitis and spinal Modic change patients. There were 50 patients per group. Sagittal T1-weighted (T1WI), sagittal T2-weighted (T2WI), and short TI inversion recovery (STIR) MRIs were used for CNN training and validation. The deep learning framework Tensorflow was used to construct the CNN architecture. To evaluate CNN performance, we plotted the receiver operating characteristic curve and calculated the area under the curve. We compared the accuracy, sensitivity, and specificity of CNN diagnosis to that of a radiologist, spine surgeon, and two orthopedic surgeons., Results: The CNN-based area under the curves of the receiver operating characteristic curve from the T1WI, T2WI, and STIR were 0.95, 0.94, and 0.95, respectively. The accuracy of the CNN was significantly greater than that of the four clinicians on T1WI and STIR (P<0.05), and better than a radiologist and one orthopedic surgeon on the T2WI (P<0.05). The sensitivity was significantly better than that of the four clincians on T1WI and STIR (P<0.05), and better than a radiologist and one orthopedic surgeon on the T2WI (P<0.05). The specificity was significantly better than one orthopedic surgeon on T1WI and T2WI (P<0.05) and better than both orthopedic surgeons on STIR (P<0.05)., Conclusion: We differentiated between Modic changes and pyogenic spondylitis using a CNN that interprets MRI. The performance of the CNN was comparable to, or better than, that of the four clinicians., Competing Interests: The authors report no conflicts of interest., (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Diclofenac etalhyaluronate (DF-HA) is a recently developed analgesic conjugate of diclofenac and hyaluronic acid that has analgesic and anti-inflammatory effects on acute arthritis. In this study, we investigated its analgesic effect on osteoarthritis, using a rat model of monoiodoacetate (MIA)., Methods: We injected MIA into the right knees of eight 6-weeks-old male Sprague-Dawley rats. Four weeks later, rats were randomly injected with DF-HA or vehicle into the right knee. Seven weeks after the MIA injection, fluorogold (FG) and sterile saline were injected into the right knees of all the rats. We assessed hyperalgesia with weekly von Frey tests for 8 weeks after MIA administration. We took the right knee computed tomography (CT) as radiographical evaluation every 2 weeks. All rats were sacrificed 8 weeks after administration of MIA for histological evaluation of the right knee and immunohistochemical evaluation of the DRG and spinal cord. We also evaluated the number of FG-labeled calcitonin gene-related peptide (CGRP)-immunoreactive(ir) neurons in the dorsal root ganglion (DRG) and ionized calcium-binding adapter molecule 1 (Iba1)-ir microglia in the spinal cord., Results: Administration of DF-HA significantly improved pain sensitivity and reduced CGRP and Iba1 expression in the DRG and spinal cord, respectively. However, computed tomography and histological evaluation of the right knee showed similar levels of joint deformity, despite DF-HA administration., Conclusion: DF-HA exerted analgesic effects on osteoarthritic pain, but did not affect joint deformity., (© 2022. The Author(s).)

This study investigated the effect of romosozumab on bone union in a rat posterolateral lumbar fixation model. Posterolateral lumbar fixation was performed on 8-week-old male Sprague Dawley rats (n = 20). For bone grafting, autogenous bone (40 mg) was harvested from the spinous processes of the 10th thoracic vertebra until the 2nd lumbar vertebra and implanted between the intervertebral joints and transverse processes of the 4th and 5th lumbar vertebrae on both sides. Rats were matched by body weight and equally divided into two groups: R group (Evenity®, 25 mg/kg) and control (C) group (saline). Subcutaneous injections were administered twice a week until 8 weeks after surgery. Computed tomography was performed at surgery and week 8 after surgery. The area and percentage of bone trabeculae in the total area of bone fusion were calculated. Statistical analysis was performed using an unpaired t test (p < 0.05). We found that the R group rats had significantly higher mean bone union rate and volume than did the C group rats at all time courses starting week 4 after surgery. The R group had significantly higher increase rates than did the C group at weeks 4 and 6 after surgery. The percentage of bone trabeculae area in the R group was approximately 1.7 times larger than that in the C group. Thus, we demonstrated that romosozumab administration has stimulatory effects on bony outgrowth at bone graft sites. We attribute this to the modeling effect of romosozumab., (© 2022 Orthopaedic Research Society. Published by Wiley Periodicals LLC.)

Aim: Psychiatric home-visit nursing is key for providing medical services to community-living individuals with mental illness in Japan. However, little is known about factors associated with encountering violent incidents among psychiatric home-visit nursing staff during visits. This cross-sectional study examined associations between staff's exposure to violence and their visit conditions reflecting characteristics of individuals with mental illness., Methods: Psychiatric home-visit nursing staff members completed a questionnaire regarding their exposure to violence during the past 12 months and their visits to individuals with 23 characteristics, comprising static (13 items; e.g., psychiatric diagnosis) and dynamic factors (10 items; e.g., hostility/anger)., Results: Forty (16.3%) of the 246 participants had experienced violence. Visits to individuals with four static factors (psychiatric diagnoses, i.e., Disorders of Adult Personality and Behavior or Mental Retardation, alcohol/drug abuse with psychiatric diagnoses, and history of violent behavior), and nine dynamic factors were significantly and positively associated with participants' violent experiences. In addition, regarding the static factors of Disorders of Adult Personality and Behavior and history of violent behavior, it was found that overlapping of specific dynamic factors (e.g. hostility/anger) were significantly associated with violent experiences., Conclusions: For visits with limited information on individuals (e.g., initial visits), having information on their static factors could help prevent violence. Additionally, it is important to create educational programs for psychiatric home-visit nursing staff to detect the status of individuals' dynamic factors, and a system to share any related changes in timely fashion., (© 2022 Japan Academy of Nursing Science.)

Introduction: Psychiatric nurses face various stressors related to nurse-patient relationships, workplace interpersonal relationships and organisational problems, and are required to perform excellent work under stressful situations. As work engagement (a counterconcept of burnout) is a key factor that improves the performance of nurses, clarifying how to improve work engagement is an essential topic among researchers. Although some knowledge has been accumulated on the subject, no reviews have been conducted on the work engagement of psychiatric nurses. To fill the gap, this scoping review will examine the status of research activity on the work engagement of psychiatric nurses and identify related factors, consequently mapping the available research in this area., Methods and Analysis: The review will be conducted according to established scoping review methodological guidelines. The inclusion criteria will be based on nurses (participants), work engagement (concept), and psychiatric settings (context) without language or date restrictions. Regardless of the methodology or study design, research related to the work engagement of psychiatric nurses will be included. A systematic search will be conducted for MEDLINE, CINAHL and PsycINFO, with the searches being arranged by an information specialist through discussion. The first author will screen all potentially relevant publications, and the second author will independently screen a random sample comprising 10% of the manuscripts. Any disagreement will be resolved by a review team. Data will be extracted using a standardised extraction form, subsequently summarised through quantitative (frequencies) and qualitative analyses (narrative synthesis), and reported in the results of the review., Ethics and Dissemination: As the data will be collected from existing literature, ethical approval is not required. The findings will be disseminated through conference presentations and publication in a peer-reviewed journal. They are expected to help researchers enhance psychiatric nurses' work engagement, consequently contributing to improving their performance., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Aims: To test the relationship between patient-related stressor, psychological distress, work engagement and outcomes (job satisfaction and recovery attitude) among psychiatric nurses in Japan. Specifically, we tested the following hypotheses: psychological distress mediates the relationship between patient-related stressor and outcomes and work engagement moderates the direct and indirect effects of patient-related stressor on outcomes., Design: Cross-sectional study., Methods: In total, 446 psychiatric nurses in Japan responded to a self-reported questionnaire between August and October 2018. Data on demographics, patient-related stressor, job satisfaction, recovery attitude, psychological distress and work engagement were collected, followed by a moderated mediation analysis using hierarchical regression and structural equation modeling (SEM)., Results: Regression analysis indicated that psychological distress mediated the negative relationship between patient-related stressor and job satisfaction and that work engagement moderated the direct and indirect effects of patient-related stressor on job satisfaction. In particular, the higher the work engagement, the higher the indirect effect, but the lower the direct effect. Additionally, no mediation of psychological distress and moderation of work engagement was observed in the relationship between patient-related stressor and recovery attitude; however, work engagement directly increased recovery attitude. Results of the SEM test showed a satisfactory fit of the final model., Conclusions: Work engagement facilitates recovery attitude and increases the indirect effect of patient-related stressor on job satisfaction through psychological distress. However, work engagement decreases the direct effect not mediated by psychological distress., Impact: This study addresses an essential topic, that is, psychiatric nurse job outcomes (job satisfaction and recovery attitude) are negatively influenced by patient-related stressor. Work engagement has multiple beneficial effects on outcomes as both a facilitator and moderator; thus, programs that improve work engagement are useful for psychiatric nurses. Furthermore, programs may be enhanced considering that work engagement decreases the direct effect of patient-related stressor on job satisfaction., (© 2021 John Wiley & Sons Ltd.)

Study Design: Prospective cohort study (open-label, single-arm, and non-blinded)., Purpose: This study aims to determine the effects of systemic administration of tocilizumab, an anti-interleukin-6 (IL-6) receptor antibody on refractory low back pain and leg symptoms., Overview of Literature: IL-6 overexpression is associated with neuropathic pain pathogenesis, which is potentially followed by chronic low back pain, including leg pain and numbness. This finding suggest that inhibition of IL-6 at the site of pain or in the transmission pathway could provide novel therapeutic targets for chronic low back pain., Methods: This prospective, single-arm study included 11 patients (eight men; mean age, 62.7 years) with ≥3-months' chronic pain history due to lumbar disease. Subcutaneous TCZ injections were administered twice, at a 2-week interval. We evaluated low back pain, leg pain, and leg numbness using numeric rating scales and the Oswestry Disability Index (ODI; baseline and 6 months postinjection); serum IL-6 and tumor necrosis factor-α levels (baseline and 1 month postinjection); and clinical adverse events., Results: Intractable symptoms reduced after TCZ administration. Low back pain improved for 6 months. Improvements in leg pain and numbness peaked at 4 and 1 month, respectively. Improvements in ODI were significant at 1 month and peaked at 4 months. Serum IL-6 was increased at 1 month. IL-6 responders (i.e., patients with IL-6 increases >10 pg/mL) showed particularly significant improvements in leg pain at 2 weeks, 1 month, and 2 months compared with nonresponders. We observed no apparent adverse events., Conclusions: Systemic TCZ administration improved symptoms effectively for 6 months, with peak improvements at 1-4 months and no adverse events. Changing serum IL-6 levels correlated with leg pain improvements; further studies are warranted to elucidate the mechanistic connections between lumbar disorders and inflammatory cytokines.

Purpose: In this multicenter retrospective observational study, we examined the early effects of romosozumab in patients with severe osteoporosis in terms of time-course changes in bone metabolism marker, improvement in bone density, and adverse effects., Materials and Methods: Patients with severe osteoporosis were included. We investigated the progress of TRACP 5b and P1NP before and 1-2 months after the administration of romosozumab. We also investigated the bone density of lumbar spine, femoral neck, and the entire femur, measured by the DXA method, before and 5-7 months after the administration of romosozumab., Results: A total of 70 patients (7 males and 63 females, age 75.0±3.6 years) participated in this study. Significant improvements in TRACP 5b and P1NP levels were observed before and 1-2 months after romosozumab administration. The average bone density of lumbar spine, femoral neck, and the entire femur were measured before and 5-7 months after romosozumab administration; and a significant increase only observed in the lumbar spine., Conclusion: Consistent with the findings of previous clinical studies, romosozumab has both bone formation-enhancing and bone resorption effects (dual effect). In addition, romosozumab also demonstrated improvement in bone density from the early phase after the administration, though the result was only seen in the lumbar spine., Competing Interests: The authors have no potential conflicts of interest to disclose., (© Copyright: Yonsei University College of Medicine 2021.)

This study aimed to perform a comparative analysis of postoperative results between lumbar degenerative spondylolisthesis (LDS) treated with oblique lateral interbody fusion (OLIF) and transforaminal lumbar interbody fusion (TLIF) from the Chiba spine surgery registry database. Sixty-five patients who underwent single-level OLIF (O group) for LDS with ≥ 3 years' follow-up were retrospectively reviewed. The control group comprised 78 patients who underwent single-level TLIF (T group). The analyzed variables included global alignment, radiological parameters of fused segments, asymptomatic and symptomatic ASD incidence, clinical outcomes at 3 years postoperatively using the Japanese Orthopedic Association Back Pain Evaluation Questionnaire data, visual analogue scale scores for low back pain, lower extremity pain, and lower extremity numbness. There was no significant change in global alignment between the two groups. The rate of improvement in anterior intervertebral disc height was not significantly different between the groups at 1-month postoperatively. However, at the final evaluation, the anterior intervertebral disc height and incidence of asymptomatic ASD were significantly higher in the O group. There was no significant difference in symptomatic ASD, reoperation cases, or clinical results between groups. Thus, single-level OLIF can maintain the corrected disc height, but as it has no effect on global alignment, its benefit is limited., (© 2021. The Author(s).)

Objective: In recent years, there has been an increase in research on the therapeutic effects of exergaming, but there have been few studies on these types of interventions for chronic low back pain. In this study, we hypothesized that the Nintendo Ring Fit Adventure (RFA) exergame would be effective for patients with chronic low back pain, and we conducted a randomized prospective longitudinal study. Materials and Methods: Patients with chronic low back pain were included in this study. Twenty randomly selected patients (9 males and 11 females, mean age 49.3 years) were included in the RFA group, and RFA exergaming was performed once a week for 40 minutes for 8 weeks. Twenty patients (12 males and 8 females, mean age 55.60 years) served as the control group and received oral treatment for 8 weeks. Pain and psychological scores (pain self-efficacy, pain catastrophizing, and kinesiophobia) were measured and analyzed before and after 8 weeks of treatment in both groups. Results: In the RFA group, low back pain, buttock pain, and pain self-efficacy were significantly improved after 8 weeks of RFA exergaming, but there was no significant improvement in lower limb numbness, pain catastrophizing, or kinesiophobia. In the control group, no significant improvement was observed after 8 weeks of oral treatment. Conclusion: RFA exergaming increased pain self-efficacy and reduced pain in patients with chronic low back pain. Future treatment protocols should be developed to improve pain self-efficacy. Approval code: 2894, School of Medicine, Chiba University.

This study examined the factors that inhibit the therapeutic effects of cognitive behavioral therapy (CBT) and clarify the adaptation judgment criteria of CBT. We included patients with chronic low back pain and allocated them to the adaptation (with visual analog scale [VAS] improvement) or non-adaptation group (without VAS improvement). The patients were analyzed using various psychological tests. CBT improved depressive symptoms and catastrophic thinking; however, they were not correlated with the VAS and did not directly affect low back pain improvement. The non-adaptation group showed an unexplainable/vague sense of anxiety; an excessive focus on searching for pain; a strong intimacy desire; a strong tendency of medical dependency; and fantasy or distortion of the actual experience, especially self-image. Moreover, the patients showed a low ability to objectively express or attribute meaning to pain due to poor language skills, attention-deficit hyperactivity disorder, and emotional value judgment. Individuals with the aforementioned characteristics of pre-CBT psychological tests should select a different treatment approach given the high poor-adaption possibility. Even patients with depressive or anxious symptoms are not necessarily adaptable for CBT. Therefore, pre-CBT tests for treatment suitability are necessary. Future studies should establish a protocol for psychotherapy suitable for the non-adaptation group.

Introduction: Mirogabalin should be equivalent to pregabalin, but with fewer incidences of adverse drug reactions (ADRs). To verify these benefits in actual clinical trials, our study investigated the frequency of ADRs and mirogabalin's analgesic effects during treatment of peripheral neuropathic pain., Methods: This study included 74 patients with lower limb pain. We surveyed patient reports of ADRs during the follow-up period as the primary endpoint and examined the visual analog scale (VAS) reported for lower limb pain as the secondary endpoint (before administration, and two and four weeks after administration)., Results: The occurrence of ADR was 27.0%, like the frequency of ADRs in the clinical trials for other disorders. However, the discontinuation rate of administration was 10.8%, which was significantly lower than the frequency of ADR occurrences. When the analgesic effect was assessed, a significant decrease in the temporal change of VAS for lower limb pain was observed before administration, and two and four weeks after administration., Conclusions: In this study, the occurrence of ADRs reported by the patients was like the frequency of ADRs reported in the clinical trials for other disorders. When assessing the analgesic effect, the temporal change of VAS for lower limb pain was found to decrease significantly before administration, and two and four weeks after administration., Competing Interests: Conflicts of Interest: The authors declare that there are no relevant conflicts of interest., (Copyright © 2020 by The Japanese Society for Spine Surgery and Related Research.)

Aim: To identify the factors influencing work engagement among psychiatric nurses., Background: Work engagement is an essential outcome that promotes nurses' performance, but studies investigating its influencing factors remain limited in psychiatric settings. We hypothesized that job resources and personal resources positively predict psychiatric nurses' work engagement and have a particularly positive impact on engagement when job demand is high., Methods: This cross-sectional study included 425 Japanese psychiatric nurses. Data regarding demographics, job resources, personal resources (emotional intelligence), job demand (patients' attitude towards nurses) and work engagement were collected followed by data analysis using hierarchical multiple regression., Results: Reward, supervisor support, nurse-physician collaboration, other-emotion appraisal and use of emotions were positively related to work engagement. Patients' unpleasant attitude towards nurses boosted the association of reward and supervisor support with work engagement., Conclusions: Certain job resources, empathic ability and self-motivation ability may enhance work engagement. Furthermore, reward and supervisor support may be particularly useful when psychiatric nurses face patients' unpleasant attitude., Implications for Nursing Management: For enhancing psychiatric nurses' work engagement, nursing leaders should educate nurses' skills related to empathy and self-motivation, consider whether nurses are confronted with patients' unpleasant attitude, and improve the job resources., (© 2019 John Wiley & Sons Ltd.)

Objective: For nursing students, career maturity -an individual's readiness to cope with career development tasks and make age-appropriate career decisions- is an essential factor influencing their desire to continue the job after qualifying as a nurse. Although job security as motivation to become a nurse might influence the career maturity of nursing students, it has not been demonstrated. In this study I aimed to elucidate the correlation between job security as motivation and career maturity among Japanese nursing students. Patients and Methods: This study was conducted in 2012, through an anonymous, self-administered questionnaire, on 237 Japanese nursing students. Data on career maturity, job security as motivation, and personal characteristics were collected followed by data analysis using multiple regression. Results: Job security as motivation ("A nursing job is not affected by the economic climate") was significantly correlated with career maturity ( β = -0.29; p < 0.001). Conclusion: This study demonstrated that being motivated by job security negatively affects career maturity. Hence, at an early stage, basic nursing educators should identify nursing students with low career maturity by assessing whether they are motivated by job security, and if so, efficiently providing support to improve their career maturity.