Cultural characteristics of nursing practice in Japan.

The population of Japan has become multi-cultural, and there is more demand for culturally competent nursing care. The purpose of this study was to explore cultural characteristics of nursing practice in Japan focusing on behaviour. We interviewed 25 professionals with experience in or knowledge of nursing practice both in Japan and either the United States, the United Kingdom, Sweden, Thailand or South Korea. Qualitative content analysis has yielded three themes for cultural characteristics of nursing practice in Japan: practice expectations, communication and relationships with patients. Practice expectations for nurses in Japan involved various aspects; nurses conducted a wide range of basic nursing tasks, including bed baths and toileting. They often relied on non-verbal communication to deliver thoughtfulness and perceptiveness. They typically show deference to doctors and colleagues, emphasizing building and maintaining harmony with them. This emphasis on a multifaceted, non-verbal, and harmonious approach seemed characteristic of practice among Japanese nurses.

Recreational drug use and related social factors among HIV-positive men in Japan.

This study aims to determine the relationship between recreational drug use in HIV-positive males in the past year and socio-economic factors and/or social support networks in Japan. A national online survey in a cross-sectional study was conducted by HIV Futures Japan project from July 2013 to February 2014. Of the 1095 HIV-positive individuals who responded, 913 responses were determined to be valid; responses from the 875 males were analysed. A total of 282 participants used addictive drugs (32.2%) in past year. New psychoactive substances were used by 121 participants (13.8%), methamphetamine or amphetamine by 47 (5.4%), air dusters/sprays/gas by 31 (3.5%), 5-methoxy-N,N-diisopropyltryptamine (5MeO-DIPT) by 16 (1.8%) and cannabis (1.0%) by 9. Multiple logistic regression analysis was performed with the use of alkyl nitrites, addictive drugs, air dusters and thinners, which are low illegality, as dependent variables. We found that the odds ratio (95% confidence interval) for use among participants with full-time and temp/contracted/part-time employees compared to management/administration professions were 2.59 (0.99-6.77) and 2.61 (0.91-7.51). Also, a correlation was observed between alkyl nitrites and new psychoactive substances and usage rates in people engaged in few HIV-positive networks. It is necessary to develop targeted policies for drug use prevention and user support among HIV-positive men and to support and provide care for drug users who are isolated or have a narrow HIV/AIDS support network.

Psychological and physical self-management of people with schizophrenia in community psychiatric rehabilitation settings: a qualitative study.

This study had three objectives: to explore the psychological and physical self-management behaviours of people with mental illness; to identify their motivations for their self-management behaviours; and to develop a framework to understand the generative processes of healthy vs. unhealthy conditions. The participants were eight persons with schizophrenia who were attending psychiatric rehabilitation centres. We conducted semi-structured interviews with the participants on their observations regarding public health nurses' counselling with them. The data were analysed qualitatively. Six categories of health self-management behaviours were identified. The primary motivations that led to the participants' behaviours were 'getting a job in the near future' or 'maintaining my current level of living'. The use of their own methods caused unhealthy conditions when health management was excessively strict or there was a discrepancy between their and care providers' recognition of the appropriate level of self-management.

Evaluating pressure ulcer care by home healthcare nurses.

AIM: To field test an objective evaluation tool consisting of process-oriented quality indicators for pressure ulcer care, using nursing charts of homecare nurses. These quality indicators were developed by the authors. BACKGROUND: Most Japanese homecare nursing agencies are small and to use much of their human and economic resources to improve the care quality is not realistic. A simple and effective system for quality assurance/improvement needs to be considered. DESIGN: Descriptive study design, using the chart reviews of 34 homecare nursing clients from two homecare nursing agencies. METHODS: Nursing charts were evaluated using our quality indicators for pressure ulcer care, and whether the charts pass or not in terms of the practices described in the quality indicator was rated. The pass rates by chart and nurses' self-evaluation were compared, and pass rates by charts were examined. Results. The evaluation by chart review generally matched with self-evaluations. The pass rates by charts were higher for indicators related to wound treatment than those related to preventive care. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Home healthcare nurses could give more attention to pressure ulcer prevention. Regular self-checks of quality indicators may remind the nurses of the importance of prevention.

Home-visit nurses' attitudes for providing effective assistance to clients with schizophrenia.

There were two objectives of this study. The first was to identify the attitudes of home-visit nurses towards clients with schizophrenia that lead to the provisions of effective care and positive client outcomes for clients with schizophrenia. The second was to develop a framework to understand how nurses acquire nursing attitudes that lead to such provisions. Seven expert home-visit nurses who had successfully prevented rehospitalization of clients with schizophrenia for more than 2 years were interviewed. In the semistructured interviews, the nurses described their experiences in assisting one or two clients. Data were analyzed qualitatively. The central theme was having equal footing with the client. An effective nursing attitude was acquired through recognizing one's own preconceptions of clients with schizophrenia through two steps: encountering unexpected client behaviours and becoming aware of one's problematic care. For these clients, it was essential that the nurses reflect on their preconceptions towards clients with schizophrenia and alter these preconceptions by working with the clients and believing in their innate ability to live in the community. The findings suggest that the field of mental health home-visit nursing might benefit from adding these educational components in order to cultivate effective nursing attitudes for assisting clients with schizophrenia.

[A study on the influence of daily life habits on people's health symptoms].

PURPOSE: The purpose of this study was to understand the relation between daily life habits and subjective symptoms and to gather basic data about improvement of the quality of life and its influence on a person's health. METHOD: The subjects were middle-aged (including all residents, males and female, all between the ages of 20 and 59. n = 2,520) in an agricultural village near a large urban center on the main island of Japan. A total of 1,834 villagers who responded to the survey in 1995 could be followed until 1998. The contents of the questionnaire covered age, sex, past history, daily life habits, mental condition, and activities of daily living. Using the method chi 2 verification and multiplex logistic analysis the village residents daily life habits their relation with subjective symptoms after 3 years were investigated. RESULTS: According to the analysis focusing on factors which had effects on subjective symptoms, the odds ratio were as follow: people who often skip breakfast-shortness of breath: 3.37 people who often eat between meals-toothache: 2.06 smokers-headache: 0.39, nausea: 18.89, urination problem: 0.03 people with insufficient sleep-eye fatigue: 1.76, diarrhea: 4.07 people with a BMI value less then 18.5-dizziness: 1.82 The results showed a significant relationship between people's daily life habits and their health condition. (all P < 0.05). CONCLUSION: From the results of this study, we can clearly see the tendency to minimize the subjective symptoms by desirable daily habits and that there is a possibility to prevent some of the through even slight improvement of habits. The study also indicates that it is necessary to stimulation a more diverse life style to maintain good health.

[Study on the effects of telephone counseling for family caregivers of demented patients].

PURPOSE: The purposes of this study were to clarify the impact of telephone counseling on the actual state of family caregivers of demented patients, and to investigate strategies of public health care for such caregivers. METHODS: We classified 206 counseling cases, including 103 cases in 1999 and 103 cases through mid-2000, using several checklists, and analyzed date with the chi 2 test. RESULTS: 1) The most common symptom of demented patients was "forgetfulness." (106 cases) 2) 87 caregivers (42.2%) lived separately from demented patients, and in 60 cases the caregivers were daughters. 3) 104 caregivers suffered from stress because of caregiving difficulties, 89 (43.2%) having "emotional difficulties in caregiving," 33 (16.0%) "social difficulties with caregiving," 28 (13.6%) "physical difficulties with caregiving," and 8 (3.9%) "financial difficulties." While 102 caregivers (49.5%) reported no caregiving difficulties. 42 (40.4%) belonged to more than two of the listed categories. 4) The greatest concern of caregivers was "how to care for senile patients' mental symptoms." followed by "whether suffering from dementia" in 36 cases, "how to use welfare services" in 35, "whether the doctor should be consulted" in 30, and "expression of emotion" in 30 cases. The caregivers for whom "expression of emotion was an issue" had emotional, social and physical caregiving difficulties, prompting the contact for telephone counseling. 5) Public health nurses who had been working for more than 10 years tended to deal with the caregivers' "emotional caregiving difficulties" (P = 0.05). There were no differences regarding other items. CONCLUSIONS: 1) The results suggest that living apart, especially for daughters, has an effect on caregiving with senile patients if the number of family caregivers is reduced. In the future, we should consider ways to support families living apart from senile patients. 2) The results also reveal that caregivers of senile patients have emotional, social and physical caregiving difficulties. Therefore, a necessity for support of caregivers' emotional and physical health maintenance, and provision of community education is indicated. 3) Caregivers can talk more freely on the telephone than face-to-face, and get help when senile patients' symptoms are in the early stages. Therefore, it is possible to mitigate caregiving difficulties by intervening in their problems before these become serious and entrenched. 4) Telephone counseling gives caregivers the opportunity to express their emotions. Therefore, it can be expected to mitigate caregiving difficulties through appropriate targets of their expressed concerns.