Column Editor: Lauren Clark Scientific Inquiry provides a forum to facilitate the ongoing process of questioning and evaluating practice, presents informed practice based on available data, and innovates new practices through research and experimental learning.

Joan K. Magilvy and Eileen Thomas
Column Editor: Anne Marie Kotzer Scientific Inquiry provides a forum to facilitate the ongoing process of questioning and evaluating practice, presents informed practice based on available data, and innovates new practices through research and experimental learning.

The purpose of this study was to explore the process of establishing the professional identity of Japanese nurses. Following a grounded theory design, data were generated by interviews, multisite participant observations and theoretical memos. Eighteen Japanese nurses who were selected by theoretical sampling were formally interviewed. Data were analyzed using methods of constant comparative analysis. Six categories emerged from the data: (i) learning from working experiences; (ii) recognizing the value of nursing; (iii) establishing one's own philosophy of nursing; (iv) gaining influence from education; (v) having a commitment to nursing and (vi) integrating a nurse into self. The core category, 'bonding into nursing', incorporated the relationship between and among all categories and explained the process of establishing the professional identity of Japanese nurses. 'Bonding into nursing' was described as an initial substantive theory, which is defined as the process by which each nurse established her/his professional identity as a nurse.

Home care in Japan has developed over the past 30 years. Nurses have taken leadership in promoting home care and at the same time have expanded their roles. The roles of Japanese nurses in the field of home care are presented in the context of the historical perspective and view for the future. Home care nurses have performed care management for their community as well as for individual older clients living in their community. Currently, nurses work as high-tech and personal care providers and are developing a new role in health care enterprises. The number of nurses working as clinical nurse specialists will increase consistently with the rapid increase of master's programs. In the future, nurses should take a lead in developing health policy. The purpose of the article is to describe the current situation of home care clients and home care nursing in Japan. In addition, four issues of home care in Japan are described related to home care for older persons, high-tech home care, terminal care, and home care for psychiatric patients.

The complex health, socioeconomic, and environmental problems experienced by many American elders often place them at high risk for disease and disability. Over time, acutely or chronically ill older persons experience numerous transitions across various health care settings. Although availability of health services is improving in rural areas, barriers such as distance, geography, and poor distribution often limit access to health care. In a longitudinal rural ethnography, the health care transition experiences of older adults, families, and health care providers were examined. A major ethnographic theme emerged from analysis data from interviews, participant observations, and photographs: the crisis nature of health care transitions experienced by rural older adults and their families and observed by rural nurses and other health care providers. Several patterns were observed including the crisis was compounded by surprise; limited knowledge of local resources exacerbated the crisis; inconsistent discharge planning disrupted transitions; changing family support necessitated admission to nursing homes; continuity of care in nursing home discharge lessened transition crisis; and rural home health care was identified as a strength. Recommendations were made for community-based interventions to improve the transition experience. Comprehensive care management services provided by public health nurses (PHNs) in the local rural community were recommended.