Tsukamoto Naoko

For the past few years, the author has seen cases where a psychological approach has been applied to children, and has noted that a significant amount of importance is placed on the continuation of the relationship between husband and wife over children's symptoms, for example, the husband (father) takes the child out to help his wife, and due to his worry over his partner's health, scolds the child rather than caring for its physical symptoms. Then, to place emphasis on providing psychological interview and educational guidance to parents, the author assumed that it is important to comprehend the level of intimacy between husband and wife, and attempted to develop an "intimacy scale of relationship between husband and wife". Subjects: 1. Study 1: A preliminary questionnaire, called the "Draft questionnaire for creating intimacy scale between husband and wife," was given to 100 parents of undergraduate students of T women's university and 100 parents of undergraduate students of M university. The collection rate was 30 percent for each university. "A total of 97 items from 56 parent-related items and 41 child-related items" was created according to the results of study 1. 2. Study 2: Another questionnaire was given to 1000 parents of undergraduate students of T women's university and M university, 100 parents of private-school kindergarten children, 50 parents of outpatient children of Y clinic, 100 parents working at hospitals, 30 parents of public junior high school students, 30 parents of private high school students, 30 parents of outpatient children of H clinic, and 30 parents of pediatric outpatients of a university hospital. The questionnaire was handed out to 1370 parents and the collection rate was 77.4 percent. Among the 1037 returned questionnaires, 650 were valid. More than half were returned blank and discarded. The breakdown of people who provided valid responses was male : 285 male, female : 365. Method: A Promax rotation was performed on the valid 650 responses for "a total of 97 items from 56 parent-relationship items and 41 child-related items". Factors with an eigenvalue of 1 or more, and factor loadings of 0.35 or more were adopted. Four factors were extracted from parent-related items (hereinafter referred to as "P scale") and child-related items (hereinafter referred to as "C scale"), and 31 items from P scale and 25 items from C sale were selected. Results: Factor I of P scale is defined as "dependant couple", factor II "stable couple", factor III "discontent couple", and factor IV "respect couple". Factor I of C scale is defined as "child-oriented couple", the factor II "child-noninterference couple", factor III "child-denying couple", and factor IV "child-distrust couple". The reliability and validity of each factor have been confirmed. Conclusion: From the correlation with the "family function", it is inferred that conventional family functions have changed, and the study suggests that the change can lead to confusion in children.

The purpose of this study was to construct an organizational climate scale for use in the nursing setting and examine the relationship between the organizational climate, burnout, and job situation. Staff nurses (n=151) employed at a hospital were administered the Japanese version of the Maslach Burnout Inventory for measuring burnout, a scale for measuring organizational climate and a scale for measuring job situations. Factor analysis identified five factors in the organizational climate scale: Positive climate, Authoritative climate, Support from matron, Burden on business, and Good communication. These factors, with the exception of the Authoritative climate, had fixed reliability levels. The correlation analysis between the organizational climate scores and job situation scores revealed that there were significant correlations among all the job situation variables and the Burden on business. In addition, multiple regression analysis revealed that emotional exhaustion could be explained by Good communication, Burden on business, and role ambiguity. Depersonalization could be explained by Positive climate and the Burden on business. However, accomplishments could not be explained by either organizational climate or job situation.

The aim of this study was to clarify the relationship of nursing autonomy and other factors related to attitudes toward caring for dying patients. A cross-sectional survey of nurses was conducted in November 2003 using a self-administered questionnaire. We collected demographic data from 178 (75%) participants and used the Frommelt Attitude Toward Care of the Dying scale, Form B, Japanese version (FATCOD-Form B-J), the Pankratz Nursing Questionnaire (PNQ), and the Death Attitude Inventory (DAI). FATCOD-Form B-J measures nurse's attitude toward caring for dying patients. It includes two subscales: positive attitude toward caring for the dying patient and perception of patient- and family-centered care. The PNQ measures nursing autonomy of individual nurses and has three subscales: nursing autonomy and advocacy, patients' rights, and rejection of traditional role limitations. The DAI measures attitudes toward death in context of Japanese cultural characteristics. It includes seven subscales: afterlife beliefs, death anxiety, death relief, death avoidance, life purpose, death concern, and supernatural beliefs. We investigated the factors associated with the FATCOD-Form B-J. Support of a mentor regarding end-of-life issues ( =.19, P =.001), death avoidance domain of the DAI ( = .14, P = 0.03), life purpose domain of the DAI ( =.23, P =.001), and rejection of traditional role limitations domain of the PNQ ( =.51, P =.001) were selected as significant independent variables by multivariate analysis to evaluate nurses' positive attitudes toward caring for dying patients. Death anxiety domain of the DAI ( = .17, P =.02), patients' rights domain of the PNQ ( =.46, P =.001), and rejection of traditional role limitations domain of the PNQ ( =.34, P =.001) were selected as significant independent variables by multivariate analysis to evaluate the nurses' perception of patient-and family-centered care. In conclusion, nursing autonomy plays an important role in the attitudes of Japanese nurses who care for dying patients. Educational and administrative efforts to strengthen nursing autonomy are necessary. © 2007 Sage Publications.

The purpose of this study was to identify the need for certified nurse specialists as felt by nurses and further to collect basic data in preparation for CNS graduate programs at Tokyo Metropolitan Goverment. A questionnaire survey was conducted with a sample of 60 experienced nurses undergoing a training course to become nursing instructers in T-Universiy. 37 out of 60 questionnaires were returned (return rate: 61.7 %) . The questionnaire consisted of 26 items concerning 5 key conceptualized functions identified as the essentials of CNS such as "patient care", "consultation", "education", "research" and "co-ordination". The findings were as follows: (1)25% of nurses expressed thier strong wishes to introduce CNS to their hospitals while 69.4 % of them wished if the situation permits. (2)They had high expectations of the CNS as providers of quality "patient care", and "research". (3)The nurses who wished to introduce CNS to their hospitals seemed to put emphasis on "humanity", "knowledge and technique" and "cooperation" in the order of importance. (4)They feel that CNS program assist in their career development and it is their wish to take CNS programs without quiting their job. The above findings provided some evidence to justify the need for the development of a suitable curriculum related to CNS program in T-University.

The purpose of the present study was to investigate the relationship between preparatory information about pain stimuli and differences in cold pressor pain sensation, as well as to clarify the interaction between preparatory information and characteristics of individual participants. Seventy-two participants were divided into two groups, according to the type of preparatory information provided. In one group, participants were provided with information about the pain sensation that they were going to receive. In the other group, participants were provided with information about the overall experimental procedure. The results indicated that the two groups of participants experienced different pain sensations. Also, there was a significant correlation between coping and preparatory information, suggesting that different people experience sensory information differently.

The purpose of this study was to identify the need for certified nurse specialists as felt by nurse administrators and further to gather basic data in preparation for a curriculum of CNS graduate programs. A postal questionnaire survey was conducted on a sample of 300 nurse administrators in the Kanto Region.185 out of 300 questionnaires were returned(return rate:61.7%). The questionnaire consisted of 26 items concerning 5 key functions identified as essentials of CNS such as"patient care", "consultation", "education", "research"and"co-ordination". The findings were as follows:46.5% of nurse administrators expressed thier strong wish-es to introduce CNS to their hospitals while 45.9% of them wanted to do so if possible. They had high expectations of the CNS as providers of such functions as"patient care", "education"and"research". The nurse administrators who wished to introduce CNS to their hospitals seemed to have greater considerations for"humanity", "knowledge and technique"and"leadership". The above findings provided enough evidence to justify the need for the development of a suitable curriculum related to CNS programs.

The study investigated the effects of Health Locus or Control beliefs as an individual difference variables and cancer stage as medical variables on cancer patients' psychological adaptation. Although some studies suggested that HLC beliefs were effective to account for psychological adaptation of cancer patients, but their studies did not include medical variables, which were important factors for psychological adaptation of cancer patients. Another purpose of this study was to examine the relationship between HLC in cancer patients and social support to them.<br> Two-hundred and seventeen subjects, who were undergone an operation on the cancer and already discharged, responded to questionnaires, which included HLC (Health Locus of Control). STAI (State-Trait Anxiety Inventory). THI (Todai Health Index) and social support scales. Medical variables were collected from doctor charts by researchers.<br> Multiple regression indicated that HLC and cancer stage accounted for 33% and 27%, respectively, of the variance in cancer patients' anxiety and depression. This results suggested that HLC was as useful as the stage to explain anxiety and depression on cancer patients. ANOVA revealed the interaction of self-control × emotional support by doctor was significant. When received many emotional supports by doctor, high self-control beliefs were high anxiety, but low self-control were not. And the interaction of self-control × emmotional support from family showed that patients with high self-control beliefs were high depression when they did not received any emotional supports by family. This inconsistent results, were discussed, suggested the same support was not necessary to all of patients.

The purpose of this study was to review the teaching methods for nursing ethics in a basic nursing program. Data were collected by means of two different questionnaires. The questionnaires were administered to 81 sophomore nursing students and 75 junior nursing students in an associate degree nursing program. The results revealed that the development level for moral judgment in five dilemma situations was slightly higher in junior nursing students than sophomore nursing students. Concerning role taking opportunities there was also a difference between the two groups. Sophomore students had more relations withbrothers and friends. However, junior students had more relations with faculty. Personal relations with peers was concidered in the development level of moral judgment. It is assumed that a solution concerning moral judgment in handling nursing dilemma cannot be realized untill the content of the dilemma becomes realistic for nursing students. To develop the moral judgement in handling a nursing dilemma, it isnecessary for nursing students to receive concrete teaching methods and experience in dealing with conflicts in the early part of a nursing program.

In recent years, bone marrow transplant has been widely deployed as a radical form of therapy against leukemia, a disease that had been considered to be fatal. This study was conducted on five female and two male bone marrow transplant patients that participated in a meeting of blood disease patients in order to obtain suggestions for methods of assistance with respect to "sex life" and "return to society", which were indicated as being problems that can occur at high frequency in a previous survey of QOL associated with bone marrow transplant. The subjects were interviewed regarding specific problems relating to "sex life" and "return to society" following their discharge from the hospital, the findings from which are reported below. 1. With respect to infertility and sex, a lack of accommodation by the practitioner before and after transplant had an effect on psychological problems encountered by bone marrow transplant patients following their discharge from the hospital. 2. Infertility was not limited to just being a somatic problem, but also had an effect on the desire and awareness of later feelings of love and affection on the part of the bone marrow transplant patient. 3. Somatic, psychological and social problems affected the amount of time required until the patient was able to return to society as well as the workload of the patient following that return.

The bereavement of spouses is the most serious trial in one's lifetime. We conducted a survey on the bereavement of people sixty five and over in rural areas in Japan from October '94 to September '95. Findings from this survey are as follows. 1. Elderly bereaved persons in Japan's rural society experience a mild grief process. 2. However, the following cases need social supports; 1) in the case that the elderly bereaved became alone and get little support from their friends and relatives, 2) in the case that they had no time for preparation psychologically because their spouses' death happened suddenly, 3) in the case that they have great difficulty in everyday life, 4) in the case that they are sickly and also have economical anxiety, 5) in the case that they have a strong anger and blame physicians for their spouses'death, 6) in the case that even though they live with their family, their personal relationships are not good. 3. We should start with the present system of visiting nursing as a social support for the elderly bereaved and add a counselling system to it. Still more, some kind of volunteer groups to care for the elderly bereaved and other support groups for them are now needed.