The continuation of in-home caregiving among caregivers of patients with dementia was affected by both positive appraisal and caregiver burden. In addition, the present study revealed that behavioral and psychological symptoms of dementia score indirectly affects the continuation of caregiving by directly affecting caregiver burden.

The current study examined the relationship between home visiting nurses’ job stress and error incidents to provide a better understanding of risk management for home visiting nursing services. Home visiting nurses often perform patient care alone, under great mental and physical stress, increasing the risk of human error when executing tasks. A mail survey was distributed to 437 home visiting nurses working at agencies in 71 locations in Japan. The questionnaires were anonymously completed and included items on career history, experiences of job stress, and experiences of incidents. Answers were collected from 230 participants. After eliminating incomplete responses, 146 questionnaires were included in the analyses. Participants’ average age was 48.5 ± 9.3 years, and they had an average of 7.2 ± 5.6 years of experience in home visiting nursing services. In total, 21 (14.4%) were administrators, and 125 (85.6%) were staff nurses. Administrators experienced more no-harm incidents in which an error occurred but did not result in client injury than did staff nurses ( p < .05) and scored higher on three items of job stress (quantitative overload, fit to the job, and supervisor support) ( p < .05). Harmful incidents were positively associated with quantitative overload ( p < .05) and work environment ( p < .01). These results suggest that there is a limit to the extent to which an administrator can offer safe care. A less stressful working environment and active information exchange rooted in a culture of medical safety should reduce the number of incidents.

Objectives To clarify factors associated with professional confidence in Japanese public health nurses (PHNs) and to examine the relationship between professional confidence and professional competency. Design A cross‐sectional study. Sample Public health nurses (N = 1,512) working in local government agencies. Measurements An anonymous, self‐administered questionnaire with questions on demographic characteristics (sex, age, experience as a PHN, educational background, affiliation, and position) and 34 items on professional confidence developed by the researchers based on a literature review was administered. Factors associated with the professional confidence were extracted through an exploratory factor analysis, and construct validity of the confidence was verified through a confirmatory factor analysis. Results In total, 883 responses (response rate, 58.4%) were received; only 467 (30.9%) of them were valid. On the basis of the exploratory factor analysis results, professional confidence included 17 items, with the following four factors: “technical practice,” “effortful learning,” “exploring the evidence,” and “educators in workplace.” The goodness‐of‐fit model in the confirmatory factor analysis proved the construct validity of professional confidence. Conclusions Professional confidence was gained by self‐improvement that reflects on public health practice. Professional confidence underpinned the generalist level of professional competency among PHNs.

The purpose of the present study was to identify which factors in care management affect client outcomes. We performed path analysis using care management processes as independent variables, and client outcomes measures as dependent variables. Client outcomes were measured by improvement in care items and Functional Independence Measure (FIM) scores in 170 clients, and client satisfaction in 97 clients. Improvement in care items was significantly related to the amount of service. Deterioration of the functional independence level was significantly related to the amount of service and lower implementation of monitoring. Higher implementation of evaluation raised client satisfaction. It is important for care managers to develop a care plan based on the necessary amount of service and to perform monitoring. A sufficient amount of service in the care plan and higher implementation of monitoring and evaluation are the three factors in care management affecting client outcomes.

Background In situations of home care, patients and their family members must address problems and emergencies themselves. For this reason, home-visiting nurses (HVNs) must practice risk management to ensure that patients can continue receiving care in the comfort of their homes. The purpose of this study was to examine HVNs’ attitudes toward risk management. Methods This study adopted a qualitative description approach. Semi-structured interviews were conducted to collect information on HVNs’ risk management behavior and their attitudes toward it. Participants comprised 11 HVNs working at home-visiting nursing agencies in a prefecture of Japan. Transcribed interviews were analyzed using content analysis. Results Nurses’ attitudes toward risk management comprised the following themes: (i) predicting and avoiding risks, (ii) ensuring medical safety in home settings, (iii) coping with incidents, and (iv) playing the role of administrators in medical safety, which was answered only by administrators. Conclusions When practicing risk management, home-visiting nurses should first assess the level of understanding of the patient and family, followed by developing safety measures tailored to their everyday needs. These results further suggest that administrators should take actions to foster a working environment conducive to risk management. These actions include coordinating duties to mitigate risk and improve the process of reporting risks. This study provides a baseline for future researchers to assist patients and families requiring medical care services of this nature.

Background: Public health nurses in Japan are nationally licensed professionals who act as members of local governments and provide services to local community residents. Public health nurses must establish their professional identity early on in order to deliver high quality public health services. However, the structure of their professional identity is not fully understood. Objectives: Our purpose was to investigate structures of professional identity of public health nurses working for governmental agencies, and to clarify characteristics of their professional identity. Methods: Questionnaire surveys were conducted on 670 PHNs working for local governmental agencies. The investigation items included measurement indices for professional identity of PHNs, basic attributes, and scales which reflect aspects of self-respect. After analyzing the investigated items, we conducted exploratory factor analysis. Also we named extracted factors, and investigated reliability and appropriateness. Relationships with the attributes or self-respect aspects were also analyzed. Results: Of 350 respondents (52.2%), 309 effective answers (effective answer ratio: 88.2%) were analyzed. Item and factor analyses identified 12 items, which were categorized into 3 factors: "intention to develop professionally", "confidence in own abilities", and "occupational affinity". Scales of self-respect aspects and the index for professional identity showed positive correlation. The coefficient for all 12 items was 0.89. Significant difference with the attributes were noted for "age", "years of experience as PHNs", and "number of PHN in the workplace". Conclusion: Professional identity of PHNs is found to be consisted of 3 factors.

Background: Patients with hemiplegia often suffer from malnutrition and security threat due to disabilities and inadequate supports. This study aims to explore nursing perceptions regarding problems, necessary nursing supports, and nursing competencies required for the provision of oral feeding assistance to hospitalized hemiplegic patients.Methods: A qualitative study was conducted in Taian City, China in 2016. A purposive sampling method was used, and data were gathered using semi-structured interviews. Totally, 5 faculty members and 10 ward nurses in China were interviewed. In relation to the nursing status regarding oral feeding assistance in the case of hemiplegic patients, background and improvement measures in nursing practice were assessed. Data were analyzed using the content analysis method.Results: Four problems in providing oral feeding assistance to hemiplegic patients were identified: 1) insufficient cognition of nursing roles, 2) insufficient consideration of psychological aspects of the patients, 3) lack of related theoretical and practical education, 4) lack of nutritional support during hospitalization. Twenty-five items of nursing competencies, the knowledge and skills required for oral feeding assistance to hospitalized hemiplegic patients were identified.Conclusions: The nursing competency identified by this study can provide evidence for reviewing the related nursing practice and continuous education in China.

Infants need sufficient nutrients even during disasters. Only qualitative descriptive analysis has been reported regarding nutritional problems of mothers and children after the Kumamoto earthquake, and non-subjective analysis is required. This study examined issues concerning maternal and child health, food and nutrition after the Kumamoto earthquake using automatic computer quantitative analysis from focus group interviews (FGIs). Study participants (n = 13) consisted of dietitians in charge of nutrition assistance of infants in affected areas. The content of the interviews was converted into text, nouns were extracted, and co-occurrence network diagram analysis was performed. In the severely damaged area, there were hygienic problems not only in the acute phase but also in the mid-to-long-term phase. “Allergy” was extracted in the surrounding area in the acute and the mid-to-long-term phase, but not in the severely damaged area as the acute phase issue. In the surrounding area, problems have shifted to health and the quality of diet in the mid-to-long-term phase. This objective analysis suggested that dietary problems for mothers and children after disaster occurred also in the mid-to-long-term phase. It will be necessary to combine the overall trends obtained in this study with the results of qualitative descriptive analysis.