Decision making regarding the place of EOL care was recalled as burdensome for family decision makers. An early decision-making process that incorporates sharing patients' and family members' values that are relevant to the desired place of EOL care is important.

Many families have unfinished business. Health care professionals should coordinate the appropriate timing for what the family wishes to do, with consideration of family dynamics, including the family's preparedness, communication pattern, and relationships.

PURPOSE. To examine the validity of the nursing diagnosis body image disturbance and to specify its major and minor defining characteristics in Japanese culture. METHODS. A qualified sample of 149 RNs with an average of 10 years of clinical experience and knowledge of nursing diagnosis was given a questionnaire consisting of 21 defining characteristics from NANDA, 8 additional items from the literature, and 2 distracting characteristics. FINDINGS. Four major diagnostic content validation (DCV) scores of 0.75 and higher and 15 minor defining characteristics with DCV scores from 0.60 to 0.74 were identified. CONCLUSIONS. This study provides a foundation for further study of culturally appropriate defining characteristics for use in Japan.

Shift work is the popular working pattern in many fields in industrialized nations. However, the shift worker does not pay much attention to his (her) own health. It is known that shift work has strong associations with various diseases. The aim of this study was to investigate the relationship between food intake and chronotype in Japanese nurses working an irregular rotation of shifts. This questionnaire-based study used a cross-sectional design. Participants were nurses working in several hospitals, data from 159 respondents being analyzed. The questionnaire covered demographics, the Diurnal Type Scale (DTS) and a Food Intake Questionnaire (FIQ). The DTS scores were classified into three chronotype groups: modified Morning-type (M-type), modified Evening-type (E-type) and modified Intermediate-type (I-type). For food intake behavior, meal habits of the M-types were compared with the E-types before / after day-and night-work. In the morning, just after the night-shift, the M-types chose cold food more frequently (p = .016) and felt less satiated after the meal (p = .016) than the E-types. Furthermore, the E-types chose significantly larger meals (p = .023) than the M-types, the M-types snacking more frequently. Chronotype was associated with the food intake behavior both in day-and night-shift. These results suggest that the Morning-type person suffered more inconvenience with regard to food intake behavior during night-work.

While more women with breast cancer survive because of advances in cancer treatment including hormonal therapy, they are at a risk of menopausal symptoms, which can threaten their psychological wellbeing. We examined the effect of menopausal symptoms on women's psychological wellbeing during three different phases of breast cancer: short-term (0-1 years since diagnosis), medium-term (2-5 years), and long-term (more than 5 years). In this cross-sectional study, 425 survivors treated with hormonal therapy were recruited from a convenience sample in Japan and completed an anonymous self-administered questionnaire. Multiple regression analysis revealed that menopausal symptoms significantly contributed to psychological wellbeing in all phases. In long-term survivors, menopausal symptoms were significantly milder; however, the negative effect was prolonged. One in three to four survivors was suspected to have poor psychological wellbeing, irrespective of time. Although the effect of menopausal symptoms on psychological wellbeing has been described in short-term survivors, little is known about the long-term effect. This study examines the effect of menopausal symptoms on psychological wellbeing, thereby providing useful information regarding long-term quality of life.