Journal of Japan Academy of Nursing Science

Factors that Influence Psychological Adjustment to Haemodialysis

Ryoko Sherriff-Tadano, Akihide Ohta

2003 Volume 23 Issue 1 Pages 1-13
Published: March 28, 2003
Released on J-STAGE: October 29, 2012

DOIhttps://njjn-jsjc-gov-cn-s-1416.res.gxlib.org.cn:443/rwt/1416/https/MSYXTLUQPJUB/10.5630/jans1981.23.1_1

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This study examined various factors that influence psychological adjustment to haemodialysis. It included examining the influence of 1) patients' understanding of the need for treatment-“Informed consent” and 2) patients' satisfaction with the way they were treated by dialysis staff. A questionnaire survey was conducted on 196 patients who had been on haemodialysis for 1-5 years.
Stepwise multiple-regression analysis revealed that “perception of stress”(β=- 0.389) was the most influencing factor, followed by “support from friends”(β= 0.236), “age”(β=- 0.230),“mental state” and “giving initial sufficient consent to starting haemodialysis”. These variables explained 46.8% of variance in psychological adjustment to haemodialysis in these patients. In addition, patients who were working had significantly better psychological adjustment than those who were not.
The study found that psychological adjustment to haemodialysis improved when, a) medical staff have a thorough understanding of patients' mental states and help them to cope with stress, b) when they encourage patients to maintain contact with friends and get their support, and c) when they make great effort to get patients to understand the need for haemodialysis at the outset.

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The Process of Empathy

-In the Relationship between Patients and Nurses-

Yukiko Ito

2003 Volume 23 Issue 1 Pages 14-25
Published: March 28, 2003
Released on J-STAGE: October 29, 2012

DOIhttps://njjn-jsjc-gov-cn-s-1416.res.gxlib.org.cn:443/rwt/1416/https/MSYXTLUQPJUB/10.5630/jans1981.23.1_14

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The purpose of this qualitative study was to clarify the process of empathy which occurs in relationships between patients and nurses in the clinical setting. The participants in this study were 5 nurses and 9 patients on an internal medicine unit of a general hospital in S city. The data was collected using a participant observation and a semi-structured interview.
The findings of this study showed that the process of empathy in the patient-nurse relationship was found to consist of three different phases. The first phase:“the initial condition of empathy.” It consists of the concern in the mind of nurses and patients. The second phase:“a stepwise development of the interrelationship” which consists of five stages. These five stages are: 1) preparations for committing to the concern, 2) groping for the concern, 3) focusing on the concern, 4) mutual action for understanding the content of the concern, 5) identifying and presenting the content from each person's viewpoint. The third phase:“the result of a process” is divided into two components. These components are nursing care based on mutual understanding about the concern and sharing the effect of the empathy process.
Based on the results of this study, it is recommended that following a step-by-step process is essential for understanding the meaning of empathy. Further, it's suggested that nursing care for the patient be delivered by following these three phases.

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A Study of Physical Environmental Characteristics and Safety in the Field of Nursing Care

The Influence of Lighting Conditions on Discrimination of Colors

Michiru Uemura

2003 Volume 23 Issue 1 Pages 26-35
Published: March 28, 2003
Released on J-STAGE: October 29, 2012

DOIhttps://njjn-jsjc-gov-cn-s-1416.res.gxlib.org.cn:443/rwt/1416/https/MSYXTLUQPJUB/10.5630/jans1981.23.1_26

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The purpose of this study was to identify which factors in lighting conditions affect discrimination of color in a clinical context. The subjects were 25 females (mean age 24.2 years old, SD 3.2) with visual acuity of 0.8 or higher. The experimental conditions comprised two light sources, a D65 color fluorescent lamp and an incandescent lamp, used at light levels of 1,000, 500, 200, 100, 50, 30, and 10 lx. Colored Landolt's rings placed against colored backgrounds were used to test color discrimination at these different light levels. As seen in the presentation color tables, the colors used were “RED-white”,“RED-orange”, and “RED-blue”, plus the standard “BLACK-white”. RED is the color of blood, and the background colors are the colors of clinically used linens. The results showed a significant increase in the rate of incorrect answers when an incandescent lamp was used to illuminate the “RED-orange” presentation color table at 100, 50, 30, and 10 lx, compared with the recommended 1000 lx level of illumination (p<0.05, p<0.001, p<0.001, p<0.001). The experimental results suggest that when observing patients, the use of a portable auxiliary light providing illumination of 200-1,000 lx or a light source with a higher color temperature would lead to fewer errors in color discrimination.

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The Effects of Music and the Stress Responses of Healthy Female Students who were in a State of Complete Rest

Akiyo Morishita

2003 Volume 23 Issue 1 Pages 36-45
Published: March 28, 2003
Released on J-STAGE: October 29, 2012

DOIhttps://njjn-jsjc-gov-cn-s-1416.res.gxlib.org.cn:443/rwt/1416/https/MSYXTLUQPJUB/10.5630/jans1981.23.1_36

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This study examined the effectiveness of reducing stress by using classical music on resting females. Twenty females, 23.25±0.68 years old, with normal hearing (experimental group N=10, control group N=10) participated in this study. The subjects in the experimental group were instructed to stay in supine position and listen to music whereas the subjects in the control group were instructed to stay in the same position and exposed to silence for about one and a half hours.The effectiveness of reducing stress was measured using STAI, POMS, diastolic and systolic blood pressure, heart rate variability, and plasma adrenaline concentrations. The differences between the pre-test and the post-test were compared. There were significant differences statistically between the experimental group and the control group in the scores of“Depression-Dejection”,“Fatigue”and“confusion”in POMS (p<0.05). The values of plasma adrenaline concentrations had an interaction effect of the two groups by two-way layout ANOVA. These results indicated that the experimental group experienced reduced stress as a result of listening to classical music as compared to the control group. These findings suggest that classical music has the potential to be used with clinical patients suffering from stress.

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Women's Experiences of Subsequent Pregnancy and Childbirth Following Delivery of a Child with Down's Syndrome

Keiko Tsuji

2003 Volume 23 Issue 1 Pages 46-56
Published: March 28, 2003
Released on J-STAGE: October 29, 2012

DOIhttps://njjn-jsjc-gov-cn-s-1416.res.gxlib.org.cn:443/rwt/1416/https/MSYXTLUQPJUB/10.5630/jans1981.23.1_46

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The purpose of this study was to describe the meaning of women's experiences of subsequent pregnancy and childbirth following delivery of a child with a congenital anomaly. Five women participated in unstructured interviews, after subsequent childbirth following delivery of a child with Down's syndrome. All data were analyzed qualitatively based on phenomenology. The results were as follows: After the delivery of a child with Down's syndrome, each woman experienced not only“not being able to raise a normal child”but also“lowered self-esteem”. They perceived subsequent pregnancy as a chance to: a) regaining their own self-worth, b) raise a normal child, and c) give a sibling to the Down's child. Prior to the subsequent pregnancy, these women had already made their own decisions regarding amniocentesis. However, all women reported in the interviews that they experienced emotional conflict and wavered when they became subsequently pregnancy, and faced anew the issue of amniocentesis. They also reported that they found emotional strength through: “a) their own resolution to accept the child with or without a congenital anomaly, b) their trust in God, and c) the existence of their husband.”After the subsequent childbirth following delivery of a child with Down's syndrome, each woman gained “the joy of caring for a normal child”,“a new perspective on raising the child with Down's syndrome”and“a new outlook on life”.

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The Parental Intervening Process to Children's Participation in Decision Making Concerning a High Risk Treatment Plan

-In Case of Hematopoiesis Stem Cell Transplantation-

Kayo Nomura, Keiko Murata

2003 Volume 23 Issue 1 Pages 57-66
Published: March 28, 2003
Released on J-STAGE: October 29, 2012

DOIhttps://njjn-jsjc-gov-cn-s-1416.res.gxlib.org.cn:443/rwt/1416/https/MSYXTLUQPJUB/10.5630/jans1981.23.1_57

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Concerning hematopoietic stem cell transplantation as a high-risk treatment, children's participation in decision making is important to respect their rights and obtain their cooperation in treatment. It is, however, difficult to achieve such cooperative relationships, because children's cogni-tive abilities are inadequate and parents have options for their children's participation.
The purpose of this study is to clarify processes that parents, who were deeply involved with the accomplishment of such cooperation, intervened to children.
Thus, in this research, we conducted semi-structured interviews with parents of 14 pediatric cases of hematopoietic stem cell transplantation performed within the past 2 years, and data were analyzed qualitatively.
The processes of parents' interventions in decision making by children regarding hematopoiet-ic stem cell transplantation began with invitation to participation on the basis of parents' decisions, that is,“approach to participation-”conveyance of parents' wish”, “inviting”,“guidance to consent”and“trust””, and reached to verification of the results, namely “confirmation for participation-”confirmation for assent”and“confirmation for acceptation””.
To enhance the coping abilities of parents and to gain children's cooperation, nurses are required to understand and support such processes.

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Telling People How Nursing Makes a Diffarence through Researches

Michiko Hishinuma

2003 Volume 23 Issue 1 Pages 67-73
Published: March 28, 2003
Released on J-STAGE: October 29, 2012

DOIhttps://njjn-jsjc-gov-cn-s-1416.res.gxlib.org.cn:443/rwt/1416/https/MSYXTLUQPJUB/10.5630/jans1981.23.1_67

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Translating Nursing Research to Practice

William L. Holzemer

2003 Volume 23 Issue 1 Pages 74-82
Published: March 28, 2003
Released on J-STAGE: October 29, 2012

DOIhttps://njjn-jsjc-gov-cn-s-1416.res.gxlib.org.cn:443/rwt/1416/https/MSYXTLUQPJUB/10.5630/jans1981.23.1_74

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[title in Japanese]

[in Japanese]

2003 Volume 23 Issue 1 Pages 83-88
Published: March 28, 2003
Released on J-STAGE: October 29, 2012

DOIhttps://njjn-jsjc-gov-cn-s-1416.res.gxlib.org.cn:443/rwt/1416/https/MSYXTLUQPJUB/10.5630/jans1981.23.1_83

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