Purpose: The objective of this study is to test the reliability and validity of the 9 factors Chinese version of MCEM.
Method: The study objects were 249 main caregivers who delivered care to the aged people admitted into hospitals twice and in need of care-giving in China. Data were collected by post or placement methods, and analyzed with correlation coefficient. The application of measures such as Cronbach's α coefficient and factor analysis testified the reliability and validity of MCEM.
Results: Based on analysis of internal consistency and designated factors, the number of Chinese MCEM version items was reduced from 64 to 51. Results from the reliability and validity test of the new 51-item version proved that there is no significant relationship between reliability and the “Social Desirability Scale” and no responding biases were observed. Cronbach's α coefficient at 0.88 indicated a high internal consistency measurement and test-retest Abs function (absolute value) for all items was within range 0.08~0.18, a figure far below the absolute value of 1. The coefficient of stability amounted to a high of 0.82 proving that there is a relationship between validity and “Care-givers' Self-efficacy Scale” (r=0.33, p<0.01) supporting further the criterion-related validity. Results of factor analysis showed that the 9 factors on which the final 51-item version was based provide a cumulative contribution rate of 54.8%, a value which supports the construct validity of MCEM.
Conclusion: Though a few issues remain that need to be resolved, the current MCEM version can be well applied resulting in high value assessment of main care-givers' empowerment in China.

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The purpose of this study was to describe nursing care related to the sharing of information with preschoolers undergoing painful procedures and/or treatment using grounded theory. Interactions were observed among 22 preschoolers aged 3 to 6 years. In addition, 36 nurses underwent semi-structured interviews. As a result, the phenomenon of a child feeling anshin was shown to be derived from “a process involving sympathy.” “A process involving sympathy” includes the “sharing of anshin (security)” as a part of the content of assistance. Five categories of aspects related to children for nurses to consider in order to effectively share anshin formed the basis of a process for relating to a child involving a constellation of nine categories of aspects related to supporting assistance. To help a child through a painful procedure and/or treatment, the “sharing of anshin (security)” is a process whereby the child, the child's parents, and the nurse together assume a common point of view in order for all parties to contribute to the formation of an atmosphere of anshin.

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Purpose: This study aimed to investigate emergency care needs of terminally elderly in home care.
Method: The subjects were terminally elderly who died in the 2003 and 2004 calendar years. We divided elderly into two groups, elderly with cancer (Group A, 112) and elderly with diseases other than cancer (Group B, 119), and investigated the reason for each emergency call and emergency visit by a visiting nurse, analyzing interventions according to the terminal home care stage (Introductory, Stability, and Near-death phases) and service needs involved.
Result: The average age at death and duration of care were 79 years (SD 8.4) and 34 days in Group A, 86.6 years (SD 7.9) and 185 days in Group B. Emergency calls and visits were made 3.3 times and 2.2 times per elderly in Group A and 3.5 times and 2.7 times in Group B. In both A and B Groups, adverse changes in elderly's physical symptoms were the most frequent reason for these interventions and the family's psychological care was consistently needed throughout the care process. Distinctive needs were found for pain control in Group A and for care techniques by family in Group B.
Conclusion: From the above, the care, prevention and care system for emergency needs by stages are considered to be required in terminal care of the home-care elderly.

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The majority of mothers with a child with autism are conflicted as to whether their care actually alleviates their child's behavioral disorder. Although knowledge of the effectiveness of daily care in relation to her child will encourage activism by the mother, an appropriate evaluation method also plays an important role in the treatment of such developmental disorders. In this study, we propose a new multidimensional inventory for determining the severity of the behavioral disorder, one that does not require any specific skill. Our inventory covers the social, emotional, cognitive, stereotypical, abnormal sensory, and autism-specific behavioral dimensions (ten questions each). The mother scores the severity of each item using a five-point scale. The subjects were 162 mothers who had a child with autism. We determined the dimensional structure statistically using confirmatory factor analysis. The hypothesized six-factor model appeared to fit the data in all samples tested (RMSEA=0.066) and had good internal consistency, with an average Cronbach's alpha coefficient of 0.930. We determined a possible correlation between the severity of the behavioral disorder in the autistic child and the positive or negative affect of their mother, using the SUBI. A canonical correlation analysis revealed that there exist a significant correlation between the severity of behavioral disorder and the mental health (positive/negative affect) of mothers with an autistic child. These findings suggest that our questionnaire offers a useful tool for evaluating the efficacy of education/training at home or in school. Following up on these findings, we hope to establish a support system for children with autism and their mothers.

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During menopause, women experiences major physical changes. There are concurrent psychosocial changes. Both can be stressful. It is thought that a woman's flexibility can help her cope. To better understand the concept of flexibility a concept analysis following the methods of Rodgers was conducted. Thirty publications from nursing, psychology, sociology and feminism during the years 2000 through 2005 were reviewed. Attributes of flexibility were extracted:smooth movement, differentiation and integration, adaptive and sensitive response, adjustment, and efficiency. Antecedents of flexibility were also extracted:constantly changing environments, multiple conflicting demands, uncertainty, and a tendency to support change and diversity. Consequences of flexibility were extracted:extending range of control, resilience to external shock, improving the spirit of cooperation, becoming thoughtful, and maintaining emotional stability. Flexibility is a property concept because it expresses a state. Being flexible can require the capacity of analyze situations and be adaptable to circumstances. Developing these capacities can mitigate the problems of menopause. The results of this analysis will be used to devise nursing interventions to promote healthful flexibility among menopausal women.

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This study investigated the experiences of patients with cancer to draw a hypothesis of emotional distress. We asked questions of 10 men who were undergoing different treatments from March 16 to September 3, 2004. Participants performed a semi-structured interview about their experiences and analysis of their responses was done. As a result, we identified the 26 concepts (ex. invalidism, uncertainty, spirituality, awareness of self-efficacy). The 26 concepts were classified to establish a hypothesis about distress based on a model of psychological stress. The distress that requires intervention by nursing specialists is considered to develop from the following factors: ‘events influencing cognitive appraisal,’ ‘events influencing emotional responses,’ ‘coping strategy,’ and ‘cognitive-behavioral responses.’ In conclusion, nurses engaged in caring for cancer patients need to understand the processes as a whole and employ these concepts in practice.

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Purpose: In accordance with the method of disease management, a 6-month educational program was developed with a view to acquiring self-management skills for patients with type 2 diabetes. The effects and operational potential of the program were examined.
Method: The subjects were 36 outpatients at two institutions. A randomized clinical trial was conducted. The newly developed structured program was applied to the intervention group, while the current treatment was given to the control group. A nurse and a registered dietitian conducted a 30-minute interview once a month and also telephone monitoring in accordance with the program.
Results: Four subjects dropped out of the program due to time constraints, while the remaining 32 continued the program through to the end (completion rate: 81.0%). The sense of self-efficacy improved in the intervention group. The achievement rate for the dietary and exercise therapies increased significantly; however, there was no statistically significant improvement in the physiological data. The HbA_1c and QOL scores, which were the final outcomes, improved; however, there was no significant difference between the two groups. The overall evaluation of the program was favorable.
Discussion: It was suggested that there is room for improvement in terms of criteria for choosing a target population, goal-setting and guidance, the period of implementation, and data collection methods for the control group. In terms of effective operation, utilization of electronic media and the importance of hospital-clinics collaboration were suggested.

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This research evaluated a restoration process of muscular activity of rectus abdominis in the puerperal period by measuring surface electromyographic activity, and investigated the relation with the state of childbirth. Twenty nine primipara women (age: 29.0±2.9 years, height: 158.7±4.7cm, body mass: 49.9±4.2kg) participated in this study. The number of measurement for each woman was ten times. The first measurement period was between 15 weeks and 25 weeks of gestation. Follow-on measurements were made every days during 5 days after delivery, and then at the 2nd week, 1st month, 2nd month and 3rd month. The surface electromyographic signals were recorded from the upper right portion rectus abdominis the subject was in an abdominal curl position. The recorded data were first rectified, and then calculated for 200 ms continuously using the trapezium rule, and finally standardized with averaged value of each woman's data. The results of this study indicate that it takes two months to restore muscular activity in the rectus abdominal muscle from delivery. This result should help set the expectations and reduce the uneasiness associated with postpartum body image. A remarkable negative correlation was observed between the amount of intrapartum hemorrhage and muscular activity of the rectus abdominal muscle (r=−0.424). This result provides women during the postpartum period with health guidance according to amount of intrapartum hemorrhage. Moreover, the breastfeeding women had significantly more powerful abdominal muscles than the others at the 1st month postpartum (p<0.05), this result can be recommended as one of the advantages of breastfeeding.

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