The construct validity and internal consistency reliability were supported. Further research is needed to refine this scale to increase the generalizability.

The construct validity and internal consistency reliability of the Moral Competence Questionnaire for Public Health Nurses were supported. This questionnaire reflected the characteristics of Japan's public health nursing practice and it may be used to assess current moral practice and need for continuing education. However, this questionnaire needs additional internal validity testing and possible item development. Additional research is needed to refine this scale and increase the possibility of generalizability.

Systematic continuing ethics education programs for PHNs need developing, tailored to the specific characteristics associated with PHNs' ethical concerns, such as nurses' working experience and the type of employing local government.

Aim: The purposes of this study were to identify specific components and frequencies of ethical issues that home-visiting nurses encountered in their practice, relationships between ethical issues and demographic data, and experience of ethics education and workplace environment. Methods: A self-administered questionnaire was distributed to home-visiting nurses in Japan. Usable data (1961) were analyzed. Results: Item and exploratory factor analysis for the frequency of encountering ethical issues revealed: (i) concern about respecting client or relationships with relevant professionals; (ii) differences in treatment or care-taking views among home-visiting nurse and client and family, or relevant professionals; and (iii) discrepancy of intention between family and client or home-visiting nurse. All factors were significantly positively related to the current position, duration of working experience as a home-visiting nurse, and type of nursing education; age was significantly negatively related. Home-visiting nurses noted that programmed continuing education systems and staff-training programs were not sufficiently available. Conclusion:The findings of this study indicated the characteristics of ethical issues that home-visiting nurses encountered in their practice and insufficient continuing education system including ethics education. Ethics education programs tailored to home-visiting nurses ethical concerns and traits and continuing education systems are needed.

The purpose of this study was to clarify inductively-derived concepts comprising grief care provided by visiting nurses nurses perspectives of family caregivers outcomes and nurses outcomes. Data was generated from a mail survey using an original researcher developed self-administered questionnaire to visiting nurses employed at the visiting nurse stations throughout Japan, which were established by the Long-term Care Insurance Law.