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Background: With the needs of patients and families who wish for quality, assuring, and safe medical care, and the diversity of medical tasks due to advances in and the complexity of medical care, medical practices has currently been changing from conventional models to team medical care in Japan. Because nurses are engaged in a wide range of tasks in medical settings, from medical checkup and treatment to the assistance of patients in the medical treatment they engage in, they are expected to collaborate with patients, physicians, and other medical staff as the “key person for team medical care” [1]. The roles that nurses are required to play in promoting team medical care are also extremely various, and it is important for team medical care to improve the awareness and skills of individual nurses to enable and effect collaboration. Previous studies reported that there are difficulties in collaboration between nurses and staff in other medical professions due to barriers including the differences in values specific to different medical professionals and the hierarchy comprising physicians [2, 3]. The authors previous study found that physicians give instructions only to nurses they trust and consider reliable, and do not share information with nurses they consider less reliable [4]. In this study, we define team collaboration as the cooperation between nurses and physicians in wards as the key persons, and aim to develop an original scale to evaluate ward team collaboration by examining the elements of the concept hypothesized as factors related to team collaboration by reviewing qualitative studies on team collaboration by the present authors and as reported in previous studies. Methods: We examined hypothesized elements of the concept from a previous study related to team collaboration reported by the authors [4] as well as from the clinical experience of the authors, and from existing scales and qualitative studies, created an item pool of 153 items, and developed an original scale to evaluate ward team collaboration by conducting brainstorming repeatedly with 20 to 25 nursing administration researchers. Finally, we created an original scale to evaluate ward team collaboration comprised of 29 items. [ABSTRACT FROM AUTHOR]

Aim: This study aims to identify the characteristics of factors related to assertiveness of preceptors of novice nurses. Methods: An anonymous self-rating questionnaire survey was administered to 1292 preceptors working in participating city and university hospitals across Japan. The survey had question items from the Japanese version of the Rathus Assertiveness Schedule (J-RAS, 30 items), and included demographic details, evaluation of the novice nurses, instruction framework, self-evaluation of the preceptors, workplace environment, and a burnout inventory (Japanese version of the Maslach Burnout Inventory-Human Services Survey, 22 items). Bivariate analyses were conducted using assertiveness as the objective variable, and other surveyed items as explanatory variables. Selecting variables with p values smaller than 0.2 obtained in the bivariate analysis as explanatory variables, a multiple linear regression analysis was performed. For the analyses, we used a statistics analysis software package, SPSS Statistic 22. Approval to conduct the study was obtained from the Ethics Committee of University A. Results: Excluding nurse administrators, responses from 836 participants 79.4%) were analyzed. Results of the multiple regression analysis showed that the factor most strongly related to the improvement of assertiveness of preceptors were ‘making rapid decisions’. The characteristics of the factor were having ‘longer clinical experience’, thinking that ‘novice nurses are mentally weak’, ‘with poor skills’, the preceptors ‘themselves to be as valuable as others’, and ‘having confidence in their nursing in the present workplace’, and with the ‘Total burnout score significantly low’. Discussion: The characteristics of preceptors who evaluated themselves to be able to ‘make rapid decisions’, which is most strongly related to the improvement in the assertiveness of the preceptors, include longer clinical experience, seeing novice nurses as they are, and the preceptors evaluating themselves positively. Previous studies have also reported that these are important factors for preceptors to interact with novice nurses in an assertive manner. [ABSTRACT FROM AUTHOR]

Aim: This study aims to describe situations where “preceptors wanted to convey matters to novice nurses but felt unable to, or wanted to say no but felt they could not” in situations where preceptors were unable to be adequately assertive to novice nurses in the workplace. Methods: We administered a self-rating anonymous questionnaire survey to 101 preceptors, focusing on “situations where preceptors wanted to be assertive to novice nurses in the workplace but felt they were unable to, during the last one year”. Data were classified based on the content analysis method by Krippendorff. Results: The analysis suggested the following eight situations: (1) at assigned duties, (2) for ways of speaking, (3) submission of study assignments, (4) making requests to perform tasks, (5) attitudes toward work, (6) manners, (7) coming to work late, and (8) private talking while on duty. Conclusion: The findings show that there are a variety of situations where preceptors feel unable to tell novice nurses what they really want to say. Further, it is suggested that preceptors regard the relationship with novice nurses as important, and worry about the novice nurses resigning due to poor mutual relationships. [ABSTRACT FROM AUTHOR]

A questionnaire survey was conducted of 1283 nursing care staff in geriatric health service facilities in the Kanto district of Japan to identify the relationship between negative feelings towards elderly patients in the facilities and nursing care staff. We collected and analyzed data from 710 responses with the mean age of respondents 36.67 ± 11.03 years (Mean ± SD). The mean score of burnout of these nursing care staff was 11.97 ± 3.03 (p < .01), and the mean scores of negative feelings was 2.94 ± 2.42. The results suggest that the subscale of negative emotions, “negative feelings nursing care staff develop towards elderly patients” and “negative feelings passively developed by nursing care staff due to elderly patients” are related to burnout. It is necessary to develop measures to control negative feelings of nursing care staff. [ABSTRACT FROM AUTHOR]

This study aims to identify levels of assertiveness among preceptors of novice nurses one year after the commencement of employment and determine factors related to their assertiveness. An anonymous self-rating questionnaire survey was administered to 1292 preceptors working in participating city and university hospitals across Japan. The survey had question items from the Japanese version of the Rathus Assertiveness Schedule (J-RAS, 30 items) characteristics for the participants (demographic details), evaluation of the novice nurses, instruction framework, self-evaluation of the preceptors, working environment, and a burnout inventory (Japanese version of the Maslach Burnout Inventory-Human Services Survey, 22 items). Bivariate analyses (T-tests and oneway analysis of variance) were conducted using assertiveness as the objective variable, and other surveyed items as explanatory variables. Bivariate analyses (t-tests and one-way analysis of variance) were conducted using assertiveness as the objective variable, and other surveyed items as explanatory variables. Selecting variables with p values smaller than 0.2 obtained in the bivariate analysis as explanatory variables, and also a multiple linear regression analysis (Stepwise method). For the analyses, we used a statistics analysis software, SPSS Statistic 22. Excluding administrative nurses, responses from 885 participants (83.7%) were analyzed. Factors related to higher levels of the assertiveness of preceptors were 'Making rapid decisions', 'Having confidence in the nursing at the present workplace', and 'Having persons outside workplace to consult with', and a factor related to lower levels of the assertiveness was 'High total burnout score' (adjusted R2, 22.4%). Factors related to higher levels of the assertiveness of preceptors of novice nurses one year after the commencement of employment were having positive self-evaluations and having persons outside workplace to consult with. The factor related to lower assertiveness was a high total burnout score. It was found that a positive self-evaluation was associated with higher assertiveness and lower likelihood of burnout regardless of when the instruction of novice nurses takes place. It is necessary for supervisors to promote the assertiveness of preceptors by improving the working environment to ensure assertiveness and prevent burnout. Such conditions will make it possible for preceptors to build an assertive relationship with novice nurses. [ABSTRACT FROM AUTHOR]

This study aims to identify differences in the health conditions and social contributions of the elderly in relation to the degree of volunteer activity participation, and determine what effective support can be provided for these elderly persons. The participants are elderly persons participating in volunteer activities, living in municipal housing owned by the Kumamoto prefecture in Japan. We classified the participants into an active group who contributed to the raising of funds for activities, and a non-active group. We conducted group interviews with the volunteers, organized interview data on the thoughts of the two groups according to the five perspectives of the balanced score card (BSC): (1) learning and development, (2) participants, (3) financial matters, (4) process of the activities, and (5) social contributions, and conducted a Strength-Weakness-Opportunity-Threat (SWOT) analysis. When comparing the strengths of the two groups, the active group showed the following characteristics in the information collecting: more variety in the collected information (perspective of learning and development), ease of obtaining information of potential volunteers (perspective of participants), knowledge of how to raise funds (perspective of financial matters), and physically more active and knowledge of the local community (perspective of social contributions). From the perspective of the process of activities, both groups place importance on the relations among people. For weaknesses, and from the perspective of learning and development, the active group had difficulty in maintaining their motivation, and from the perspective of financial matters this group had difficulties in securing funds. From the perspective of social contributions, the non-active group depended on the active members. From the perspective of participants, both groups experienced a decline in physical function with age, and from the perspective of the individual circumstances make it difficult to participate in all activities. Participants in this study are members of a volunteer group of elderly persons voluntarily formed in a regional city in Kumamoto prefecture where the elderly population accounts for 25.7% and is expected to increase. It appears that there is a selfand mutual-help relationship between active and non-active members where non-active members rely on the active members who assist the non-active members to be in harmony with the volunteer activities led by the active members, and that this relationship helps maintain independent lives. For the strengths, active members were able to collect more information from the perspective of learning and development, and contributed more through physical activity from the perspective of social contributions. It can be inferred that physically more active elderly persons are in a situation where they remain able to use their cognitive functions to collect information. For the weaknesses, the active members experienced loss of motivation. This may be due to the possibility that active members feel it a burden to assist non-active members. We wish to conduct further studies to understand how to maintain and improve motivation. The results of the SWOT analysis with the perspectives of the BSC showed that there are differences in health conditions and social contributions of the elderly depending on the participation in volunteer activities, and what types of support from health services can be expected to be effective. [ABSTRACT FROM AUTHOR]

In December 2012 a norovirus infection outbreak occurred in the Orthopedic Surgery Ward of Hospital A in Japan. This study aims to establish details of coping behaviors used by nurses and physicians of the facility, and examine the issues involved in infection control as well as the ways employed to deal with the infections. Participants in this study were twenty-two nurses and four physicians who were working in the facility at the time the infection outbreak occurred, and who were still working there when the interviews were conducted. Interviews were conducted from January to April 2015, and the data from the interviews were analyzed using the "Trend Search 2008" text mining software. As a result of the analysis it was found that the nurses primarily communicated information by passing messages to the nurses who took over the duty at shift changes, but did not pass on the information to other staff or to the ward as a whole. The nurses clearly remembered that the ward was closed and it was a difficult experience, but did not remember details of the patients they were in charge of. The physicians clearly remembered individual patients they were in charge of, but they were not aware of the situation and state throughout the ward. The findings suggest that this difference is due to the differences in the occupational nature and sense of values of the staff involved. [ABSTRACT FROM AUTHOR]

This study aims to identify factors related to the administrative abilities of nurses, and contribute to the improvements in education programs and arrangements for nurse administrators. We distributed a self-rating questionnaire survey to 1291 head nurses and administrative staff in positions equivalent to head nurse in 69 participating hospitals among the 172 hospitals with 300 beds or more in the Kanto and Tokai regions of Japan. The surveyed items are ability in nurse administration, demographic characteristics, support from superiors, and workplace environment. We received 984 (76.2%) responses. Excluding responses that included two or more choices to a question and where there was no response to questions of gender and administrative abilities, this left 880 (68.2%) responses which were considered valid and these were included in the further analysis. As a result of a multiple regression analysis for factors related to the administrative abilities of nurses, administrative abilities are better for head nurses who reported that "My judgment in nursing is appropriate", "I am decisive", "I can demonstrate my ability in this job", and "I fulfill my responsibilities to achieve goals in accordance with my beliefs", as well as those who participate in workshops for nurse administrators. Head nurses who showed poorer administrative abilities reported that "I am satisfied with the rewards earned", and "I became less kind to people since I became a nurse". The findings suggest that head nurses who are confident in their decision making abilities may have better administrative abilities. In addition, head nurses with low cynicism (only little of negative attitude) scores, a subscale of the burnout score, appear to have better administrative abilities. The head nurses with better administrative abilities tend to feel that they are not sufficiently rewarded for fulfilling their duties. Education programs for nurse administrators need to include measures that enable administrative staff to work with self-confidence while preventing them from developing cynical attitudes. [ABSTRACT FROM AUTHOR]

The aim of this study is to identify relationships between striving for Work-life balance (S-WLB), Sense of coherence (SOC), and intention to leave among nurses. In August of 2017, we conducted a self-administered questionnaire survey to 2239 nurses at nine public hospitals. The questionnaire included demographic environmental factors, striving for work-life balance, a 13-item SOC, the Maslach Burnout Inventory, and intention to leave. We carried out a multiple regression analysis with intention to leave as the dependent variable and others as independent variables. We obtained valid responses from 1368 full-time employed nurses (61.1%). The mean age of respondents was 36.38 ± 10.18 years, and the length of clinical experience 13.4 ± 9.65 years. The mean total score of the intention to leave was 14.58 ± 5.09. As a result of the multiple regression analysis, the S-WLB and the SOC were found to be statistically related to the intention to leave even after controlling for the confounding factor of burnout. In addition, in the satisfaction of desire level for the actual working assignment at the workplace was a significant independent factor. In this study, the full-time nursing staff had a low intention to leave score when they had high score in the S-WLB and the SOC. It was also found that the level of satisfaction with appointment to a desired assignment is a significant factor in the intention to leave. In establishing an attractive workplace for nursing staff, it is important to create a workplace environment and supports to be able to properly evaluate workplace satisfaction after assignments are made while taking into account individual SWLB and SOC functions. [ABSTRACT FROM AUTHOR]