Children's participation in decision making in high risk treatment is strongly affected by parents, and we confirmed in our previous study that parents' approaches were “encouragement to accept treatment” and “confirmation”. Therefore, in this study, we aimed to clarify parental encouragement to accept treatment, we prospectively examined parents whose child would undergo hematopoiesis stem cell transplantation, and data were analyzed using Grounded Theory Approach.
The results demonstrated that parents' encouragement to “the child's acceptance of treatment” required to set “acceptance of change”, “acceptance of needs” and “subjective acceptance” as objectives of “the child's acceptance which meets parents' expectations”; “notification of transplantation”, “uplifting motivation”, “presentation of benefits”, “intervention in the child's information collection”, “handling of refusal” and “encouragement of subjective acceptance” as “how to encourage” child to achieve objectives;and considerations of “appropriate person” and “timing” as “measures to conduct the encouragement effectively”. This meant that “parental strategies for encouraging the child to accept treatment”.

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The purpose of this study is to clarify patient bowel movements after hysterectomy or myomectomy. The subjects were 16 patients that had undergone a hysterectomy or myomectomy. Methodological triangulation was used. A quantitative and a qualitative approach to the method were used concurrently and continuously.
It was not only at postoperative days (POD) 3–4 with the risk of bowel dysfunction after surgery, but also at POD7 that they experienced difficulty in defecation. When POD7 passed, the score on the constipation assessment scale (CAS) was improved to the same state as it was before hospitalization in 75% of the patients, but it was not improved in 25% of the patients. The group of patients who did not have any appetite on POD2 were those who had a low defecation rate (without taking a laxative) on POD5 and POD6. Therefore, when the patient does not have any appetite at POD2, we should intervene in natural bowel movement for such patients.

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Today, health care facilities are expected to innovate in their organizations. It is said that success of the innovation depends on understanding organizational culture. But, in fact, the concept is not yet fully understood. Here, I tried to identify a concept of organizational culture in nursing organization.
I used Hybrid Model in this work. In the first phase, I reviewed articles on anthropology, business and nursing. In the second phase, I did field work at two general hospitals for six months. And then, I integrated the results from the two phases.
As the result, it has been found that the organizational culture is composed of three levels: artifacts, values/norms, and basic underlying assumptions, which is the essence. And nursing organizational culture has three aspects:basic underlying assumptions on the groups, basic underlying assumptions on the jobs, and basic underlying assumptions on the nurse, and those three aspects are overlapping.

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To understand nurses' perception of the wishes and feelings of children with progressive muscular dystrophy, the Leininger ethnonursing method was used. The participants in the study were eight nurses as key informants and sixteen general informants, who consisted of nurses, family members, a teacher at school for handicapped children, a physician and four children with muscular dystrophy.
The major theme was that although it was painful for nurses to be aware of children's frustration over loss of movement, nurses should notice the children's signs and become involved. The results indicate that it is important for nurses to approach and listen carefully to children when they notice any irritation in the children if the nurses are concerned about the children's expressions or voices.

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Aims: This study aimed to examine the effects of health evaluation to Health-Related Quality of Life (HRQOL) in diabetic outpatients by using SF-36. Diabetics were compared with no disease people.
Methods: The Time Trade-Off method and the SF-36 questionnaire (Japanese ver. 1.2) were used. Eighty five outpatients with diabetics participated in this study after giving written informed consent. Then they were divided into three groups (diabetic-high health evaluation G., middle health evaluation G., and low health evaluation G.) by the range of time trade off value. Eighty four persons with no disease (no disease G.) also participated in this study.
Results: a) Mean scores of six subscales without role physical functioning and bodily pain were significantly lower in diabetic-low health evaluation G. in comparison with those in diabetic-high health evaluation G. (p<.05). b) Mean score of the general health subscale in diabetic-high health evaluation G. were significantly lower than those in no disease G. (p<.01), but mean scores of vitality and role emotional functioning health subscale in diabetic-high health evaluation G. were significantly higher than those in no disease G. (p<.05). c) Mean scores of seven subscales without bodily pain were significantly lower in diabetic-low health evaluation G. in comparison with those in no disease G. (p<.05).
Conclusions: These results show that it is clearly necessary to provide more supportive physical and mental care for diabetic-low health evaluation G. It is the next problem why mean scores in diabetic-high health evaluation G. were significantly higher than those in no disease G. on vitality and role emotional functioning health subscale of SF-36 (p<.05).

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This study examined various factors that influence perception of stress in patients undergoing hemodialysis. A questionnaire survey was conducted on 196 patients who had been on hemodialysis for 1~5 years.
The most stressful factor for those patients was “restriction of water,” followed by “length of treatment.” Stepwise multiple-regression analysis revealed that “mental state” (β=0.591) was the most influencing factor, followed by “support from family (β=−0.168),” “malignant neoplasm (β=−0.165),” “satisfaction with dialysis staff (β=−0.163),” and “the quality of explanation received by family at the outset (β=−0.126).” These variables explained 40.5% of variance in perception of stress in these patients.
The study suggests that perception of stress in patients undergoing hemodialysis may be reduced when: a) dialysis staff have a thorough understanding of patients' mental states; b) patients get sufficient support from their families; c) dialysis staff give patients comfortable treatment sessions and talk to patients sufficiently; d) dialysis staff make great efforts to get patients' families to understand the need for hemodialysis at the outset.

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This study identified threats to hope in severe chronic obstructive pulmonary disease (COPD) people. Data were collected from semi-structured interviews with a convenience sample of 10 patients with COPD. The responses from the interviews were analyzed using an inductive qualitative method.
As a result, four categories were identified from interview responses to elaborate on threats to hope. The four categories were: (1) ‘Continuance of suffocative suffering,’ (2) ‘The evidence of decline and the worse,’ (3) ‘Disturbance to performance of activities,’ (4) ‘Unconcern attitude with value as a being and identity.’
Nurses should show a concern with suffering and distress caused by such experiences, and be with severe COPD people. Nurses can use the categorical themes identified in this study to help COPD people to maintain hope and avoid hopelessness through minimizing or eliminating hoping inhibitors, palliating unavoidable suffering and distress.

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The purpose of this study was to clarify how preclinical lessons with Simulated Patient (SP) participation link with clinical training. The subjects were five A Nursing University second year students who agreed to participate in this study. Using the qualitative reductive method, we made tape recordings of the subjects talking freely about their activities and emotional responses, from prior to the commencement of clinical training until after its completion. Transcriptions of the recordings were categorized and encoded. Seven categories were identified according to the passage of time and learning methods: “Through the SP participation I experienced something close to clinical practice,” “From the classroom role-playing, I could envisage patient types before the clinical training,” “Through the SP participation classes I could imagine myself interacting with patients,” “Putting into action techniques I derived from the SP participation classes, I felt that patients accepted me,” “In my own way, I tried to do my best for the patients, providing care (assistance) to patients through trial and error,” “Through a process of repeated practice, failures and corrections, I worked out a way of providing care (assistance) suited to each patient,” and “I gained understanding of real patients through clinical training.” These results suggest that students put their experiences with SP participation classes to good use, and soon developed good relationships with their patients when they commenced clinical training.

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The purpose of this study is to determine the relationship among the control of self-expression activities, patterns of interpersonal attitudes and burnout. A mail survey questionnaire was distributed to nurses working at 76 different palliative care units (N=782).
The questionnaire consists of 5 scales: Japanese version the Maslach Burnout Inventory (MBI), Self-Monitoring Scale, Other-Consciousness Scale, Emotional Empathy Scale, and Internal Working Model Scale.
Overall, nurse with higher scores on the MBI were likely to be more unstable interpersonal relationships, more concerned about the outward appearance of others, and more susceptible to emotion. This tendency was stronger among young and less experienced nurses who lived alone.

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