The Development of a Reflection Program for Practical Implementation of End-of-Life Care

The purpose of this research was to develop a reflection program to support the practice of end-of-life care for nurses and to examine its effectiveness and feasibility. We developed and examined the effectiveness of a facilitator-based reflection program (FRP) and card-based reflection program (CRP). Average scores for both the FRP and CRP were measured using a Knowledge, Attitude and Difficulty Scale for palliative care and Self-education Ability Scale implemented before, immediately after, and 3 months after the program. The changes in scores were compared. This research was conducted with approval from the ethics review committee. Nine people participated in the FRP, and 15 in the CRP. FRP significantly reduced difficulty concerning palliative care compared to CRP. FRP significantly increased knowledge compared to CRP. Similar results were obtained within the FRP group. Both FRP and CRP were considered highly feasible because the program evaluation was high. In the future, it is necessary to clarify the effect of the reflection program by reviewing the research design.

Mental Health Conditions of Nurses in Acute Care Hospitals / 日本農村医学会雑誌

　　This study sought to analyze the conditions of nurses in acute care hospitals struggling with mental health issues. We administered a questionnaire survey to 204 nurses and analyzed 163 valid responses. A total of 81 conditions related to the working environment and 35 conditions related to interpersonal relations were identified. Conditions related to the working environment included working overtime beyond regular workhours, feelings of stress due to assignments, frequency of night shifts, stress in new environments, mistakes made on the job, worries about assigned positions, worries about work procedures, inability to take public and paid holidays, balance between work and raising children, heavy burden of responsibility, loss of confidence, flashbacks to occasions of past stress, trauma, and poor quality of nursing care. Conditions related to interpersonal relations included stress due to pressure from superiors and co-workers, attitude of senior colleagues, stress from senior colleagues, verbal abuse from superiors, behavior of doctors, negative feelings toward patients, changes in department assignments after maternity leave, verbal abuse from co-workers, verbal abuse from senior colleagues, neglect of duties by chief nurses, attitude of juniors, cooperation with other departments, and training of juniors. There were more statements about conditions related to the working environment than to interpersonal relations.