Japan Journal of Nursing Science最新文献

Aims

Diabetes-related stigma poses challenges for individuals with diabetes, including impaired self-care. Understanding its relationship with healthcare professional support is essential to clarify strategies for reducing stigma. This study aimed to examine the association between diabetes stigma and the support provided by physicians and nurses.

Methods

A cross-sectional survey was conducted from October 2022 to May 2023 in Osaka, Japan, among outpatients attending hospitals and clinics with diabetes specialists. Participants were aged ≥18 years with type 1 or type 2 diabetes; those with gestational diabetes or unable to complete the questionnaire were excluded. Diabetes-related stigma was assessed using the Kanden Institute Stigma Scale, whereas support from physicians and nurses was evaluated using the doctors' and nurses' support scale. Data were analyzed using multivariate logistic regression. Ethical approval was obtained prior to study initiation.

Results

Diabetes-related stigma was inversely associated with physicians' support and nurse's support. Social and self-stigma were associated with physicians and nurses' support among participants aged <65 years but not among those ≥65 years. By contrast, discordant stigma was associated with physicians' support in the younger group and with both physicians' and nurses' support—particularly in health information subscales—among older participants.

Conclusions

Support from physicians and nurses may reduce diabetes-related stigma. Younger adults may benefit from advocacy and personalized care, whereas older adults require enhanced emotional and informational support. Healthcare professionals should address stigma to improve self-management and quality of life among people with diabetes.

Aims

To develop a clinical scenario-based educational program incorporating five evidence-based practice (EBP) steps and evaluate its effects on EBP knowledge and skills and EBP implementation among hospital nurses.

Methods

This study employed a randomized controlled trial design. Eighty-seven registered nurses were recruited from 22 hospitals across Japan and randomly assigned to either the Intervention group (n = 44) or the Control group (n = 43). The Intervention group received a clinical scenario-based education program incorporating the five EBP steps, utilizing the Prevention of Delirium in Elderly Hospitalized Patients scenario. EBP knowledge and skills and EBP implementation were measured at baseline (T1), immediately post-intervention (T2), and 2 months later (T3). Linear mixed models were used to assess the between-group differences in EBP knowledge and skills, as well as EBP implementation.

Results

No significant differences were found between groups at T1 in EBP knowledge and skills (25.4 [22.6–28.1] vs. 27.9 [25.0–30.7], p = .219) and implementation scores (14.8 [12.7–16.9] vs. 15.0 [12.8–17.3], p = .882). At T2 and T3, the Intervention group had significantly higher knowledge and skills (T2: 33.8 [31.4–36.3] vs. 27.6 [25.1–30.2], p = .001; T3: 36.8 [34.3–39.3] vs. 27.2 [24.7–29.7], p < .001) and higher implementation scores at T3 (21.5 [19.5–23.5] vs. 14.5 [12.5–16.5], p < .001).

Conclusions

A clinical scenario-based educational program incorporating the five steps of EBP effectively enhanced EBP knowledge and skills as well as promoted EBP implementation among hospital nurses.

Trial Registration: Trial registration number UMIN000053457 (1/27/2024).

Aim

Sense of Coherence (SOC) reflects an individual's ability to overcome challenges under stressful conditions. This study examined the relationship between SOC and the research activities of nursing researchers, alongside factors associated with SOC during the prolonged coronavirus pandemic.

Methods

The study analyzed secondary data from a 2022 survey conducted by the Japan Academy of Nursing Science, which included responses from 616 nursing researchers. The survey assessed SOC using a 3-item version of a SOC scale (SOC-3-UTHS) developed by the University of Tokyo Health Sociology team. Multiple logistic regression analysis was performed, with research activity-related outcomes in the context of the pandemic as dependent variables and SOC-3-UTHS scores, along with individual and professional attributes (selected based on previous studies), as independent variables. The relationship between SOC-3-UTHS scores and researcher attributes or environmental characteristics was also examined.

Results

The study found that higher SOC-UTHS scores were significantly associated with sustained or increased research time (odds ratio [OR] = 1.07, 95% confidence interval [CI] [1.02, 1.13]) and motivation (OR = 1.08, 95% CI [1.03, 1.14]), and lower negative impact on research (OR = 0.94, 95% CI [0.90, 0.99]). Older age, managerial position, and possessing a doctoral degree were significantly associated with higher SOC-UTHS scores (p < .05).

Conclusions

The findings revealed a significant association between SOC and age, position, and academic degree. SOC may play an essential role in enabling nursing researchers to sustain research activities during prolonged crises. However, given the potential sample bias, further research is needed.

Aim

To evaluate the feasibility of a breast stimulation program using a breast pump shortly after cesarean section (CS) to enhance the onset of lactogenesis II.

Methods

We used a convergent mixed-methods design. It provided an overall picture through quantitative results, which were complemented by qualitative findings. The results were presented using a joint display. Participants were full-term women who underwent CS at a regional perinatal hospital and nurse-midwives from January to March 2025. The program included: (1) providing information about breastfeeding after CS; and (2) providing breast pump–mediated nipple stimulation, starting within 6 h postpartum and continuing until day 2, at least four times daily under researcher supervision. Main outcomes focused on the feasibility of the program, including acceptability, practicality, and implementation. An eight-item questionnaire and open-ended questions were administered. Quantitative data were analyzed using descriptive statistics; qualitative data were analyzed using content analysis.

Results

Seven full-term women with planned CS and 29 nurse-midwives. Most used a breast pump four times within the first 24 h after CS. Women were satisfied with painless nipple stimulation and early milk expression. Both designs complemented each other, and the program was deemed acceptable based on early postpartum breast milk volume data. Identified challenges included pump operability, individual adaptation, and preparation time.

Conclusion

The breast stimulation program initiated shortly after CS was feasible, well accepted, and aspects of breast milk volume. A future randomized controlled trial should consider individual differences and adjustments in the frequency of breast pump usage.

Aim

Nursing-related intraoperative incidents, such as specimen loss and retained surgical items, pose serious risks to patient safety. These events may be influenced by surgical complexity, team structure, and nursing experience. However, data on the specific impact of these factors, particularly in Japan, remain limited. This study aimed to determine the incidence of nursing-related intraoperative incidents and identify clinical and procedural factors associated with their occurrence.

Methods

We conducted a retrospective observational study of all surgeries performed at a tertiary care hospital between April 1, 2018, and March 31, 2023. Data were extracted from anesthetic records, perioperative nursing notes, and an electronic incident reporting system. The primary outcome was the incidence of nursing-related intraoperative incidents. Secondary outcomes included associations with surgical specialty, instrument delivery personnel (nurse vs. physician), duration of surgery (<2 vs. ≥2 h), timing of surgery (daytime vs. night shift), surgical approach (endoscopic vs. non-endoscopic), and nurse experience (<6 vs. ≥6 years). Logistic regression was used for statistical analysis.

Results

Of 37,265 surgical cases, 85 cases (0.23%) of nursing-related intraoperative incidents were identified. Incident rates were highest in neurosurgery and emergency department surgery. Univariate analysis identified instrument delivery personnel (nurse), longer duration of surgery, night shift surgery, and limited nursing experience as associated factors. In multivariate analysis, limited nursing experience (odds ratio: 1.810) and longer duration of surgery (odds ratio: 4.008) remained significant predictors.

Conclusions

Nursing-related intraoperative incidents, though rare, were more likely to occur during longer surgeries and when performed by less experienced nurses.

Aim

This study aimed to investigate the incidence of near-miss events related to medical device use errors (MUEs) in intensive care units (ICUs) and to identify their root causes using the Ishikawa diagram.

Methods

This observational study was conducted in a referral hospital ICU in South Korea between August and September 2023, involving 60 nurses (29 MICU, 31 SICU) who completed anonymized questionnaires on near-miss events related to five commonly used medical devices. Root causes were analyzed with a modified Ishikawa diagram. Data were processed using SPSS software. Independent t-tests, ANOVA, and Pearson correlation were used for continuous variables, while chi-square and Fisher's exact tests were applied to categorical data. One-way ANOVA identified major contributing factors.

Results

Each participant experienced an average of 2.11 ± 12.53 near-miss events per device per year, with the highest incidence in IV line sets. A positive correlation was found between near-miss frequency and years of work experience. Root cause analysis (RCA) showed that the most common contributing factors were work environment factors, especially high patient load. The main contributing factors included chronic fatigue (personal factors), frequent device malfunctions (medical device usability factors), and insufficient education programs (unit communication and culture/education factors).

Conclusions

The study highlights the importance of improving working conditions, updating outdated equipment, and strengthening educational programs to reduce MUEs and improve patient safety in ICUs.

Aim

This study aimed to clarify the factors affecting the information and communication technology skills of nurses involved in home-visit nursing services based on their attributes, computer self-efficacy, and attitudes and perceptions regarding information security risks.

Methods

A web-based survey was administered to 2000 visiting nursing stations. The survey items included nurses' information and communication technology skills acquisition status, basic attributes, computer self-efficacy, and attitudes and perceptions regarding information security. A multiple regression analysis (stepwise method) was performed with the dependent variable being information and communication technology skills acquisition status, and the independent variables being computer self-efficacy, as well as attitudes and perceptions regarding information security.

Results

In total, 205 responses were collected and analyzed. The factors affecting the acquisition status of information and communication technology skills were educational background, computer self-efficacy, and two scales regarding attitudes toward perceptions of information security risks (one scale regarding computer security education experience and another regarding perceived security cost).

Conclusion

The results of this study suggest that to improve the information and communication technology skills of nurses involved in home-visit nursing services, security-related measures must be considered, such as improving self-efficacy with computers, providing opportunities for information security education, and ensuring appropriate management of passwords, which are often neglected. However, the conceptual structure of an important element, computer self-efficacy, has only been clarified for other occupations. Therefore, clarifying nurses' conceptual structure is necessary in developing teaching methods to improve information and communication technology skills.

Aim

We aimed to assess the impact of birth preparedness interventions among pregnant women on the improvement of their maternal and neonatal outcomes in low- and middle-income countries.

Methods

Randomized controlled trials from 2007 to 2023 that assessed birth preparedness interventions for pregnant women living in such countries were reviewed after searching on PubMed, CENTRAL, Embase, and CINAHL databases. This systematic review followed the Preferred Reporting Items for the Systematic Reviews and Meta-Analysis standards. The database searches yielded 7405 articles. Nine trials were eligible for inclusion.

Results

The meta-analysis revealed a statistically significant variation in perinatal mortality (participants = 3573; studies = 2; risk ratio = 0.58; 95% confidence interval = [0.47, 0.73]; I² = 0%, moderate certainty of evidence) and a significant difference in the initiation of breastfeeding (participants = 8743; studies = 3; risk ratio = 1.89; 95% confidence interval [CI] = [1.50, 2.39]; I² = 96%, low certainty of evidence).

Conclusion

Our systematic review showed that birth preparedness interventions significantly reduced perinatal mortality and increased breastfeeding initiation, as well as produced a positive impact on infant birth weight (grams) and age of gestation at birth (weeks). Future randomized controlled trials on birth preparedness interventions should be conducted and effectively promoted to enhance the health of mothers and neonates in low- and middle-income countries.

Aim

To clarify the nursing difficulties faced by Chinese migrant nurses, this study developed a scale to measure those experienced by nurses working in Japan.

Methods

The questionnaire was developed and scaled based on the results of a literature review and interview survey. Participants were Chinese migrant nurses working in Japan. The initial 24 questionnaire items were refined through experts' evaluation and pretesting. Exploratory and confirmatory factor analyses were conducted to identify the underlying factors of the scale. Reliability was assessed using Cronbach's alpha, while criterion-related validity was evaluated using external measures.

Results

A three-factor scale with 20 items was identified, comprising “language difficulties in daily nursing task,” “considerate of patients' feelings in nursing practice,” and “smooth relationships with colleagues.” Confirmatory factor analyses indicated an adequate model fit. Construct and criterion-related validity were confirmed, and Cronbach's alpha coefficients ranged from 0.84 to 0.88 for each factor.

Conclusions

The scale was confirmed to be valid and reliable; thereby making it suitable for measuring the nursing difficulties experienced by Chinese migrant nurses in Japan.

Background

Lack of family readiness to care for stroke patients can negatively impact the health of family members who serve as primary caregivers, often leading to prolonged stress and depression.

Aim

This study aimed to develop a valid and reliable family readiness instrument based on a transition model to assess preparedness for caring for stroke patients at home.

Methods

A mixed-methods approach was employed in this research, consisting of four phases: Delphi Study, face validity, content validity, and testing for structural validity and reliability. A total of 153 participants were included in this study. In the first phase, a Delphi Study was conducted in three rounds to reach consensus on the instrument items, involving eight experts. The second phase involved 30 family members of stroke patients to test face validity. In the third phase, content validity was assessed by five experts using the “judgment by expert” method. The final phase involved testing structural validity and reliability with 110 families of caregivers of patients with stroke.

Results

The results of the exploratory factor analysis (EFA) identified three main factors: awareness (12 items), involvement (6 items), and changes in internal and external processes (2 items). The instrument demonstrated good reliability with a Cronbach's alpha value of .811.

Conclusion

Twenty items from the family readiness instrument based on the transition model were valid and reliable for the Indonesian family population, making it suitable for assessing family readiness in caring for stroke patients at home.