Makoto Tsukuda

We organized a family nursing seminar employing virtual simulation for home visiting nurses. The seminar utilized gamification and a digitally simulated family to enhance family nursing competence. This study aims to evaluate the effectiveness of a seminar by conducting a β test of a virtual simulation. This study employed a descriptive design. Study period was from November of 2022 to January of 2023. Study participants were seven home visiting nurses at four Home-Visit Nursing Agencies in Japan. In the virtual simulation, participants communicated with the digitally simulated family created with Unreal Engine 5.0.0. Before and after the seminar, participants were asked to complete the Family Nursing Competency Scale and data were gathered through an open-ended questionnaire. The total scores on the Family Nursing Practice Competence Scale all increased after the seminar. In feedback, the instructor commented that the simulation scenarios and level of difficulty were appropriate but that the time schedule needed to be revised. Participants also commented on the reality and tension in the digitally simulated family and the lack of discussion. The integration of gamification and the digitally simulated family was positively accepted and increased the sense of reality and tension of the participants. However, there were problems with the recognition of achievement, time management of the debriefing sessions. Further modifications to this seminar design are needed.

The essential skills required for nursing practice for patients on ventilator support include knowledge of ventilators, invasive techniques for preventing complications, and risk prediction for safe management. Therefore, management in the intensive care area is generally recommended for patients on ventilator support. In addition, the coronavirus disease 2019 pandemic has rapidly increased ventilator-related patients. Nursing practice for ventilator-associated patients is complex and requires advanced knowledge and skill. Therefore, this study aimed to develop a nursing practice self-assessment scale for clinical nurses and evaluate its reliability and validity. A survey of 629 nurses found that the scale could be classified into the machine and patient management. The management of the ventilator comprised the following 31 items with six factors: “initial confirmation,” “artificial airway,” “alarm management,” “humidification management,” “emergency management,” and “airway fixation.” For patient management, 27 items of five factors, including “complication prevention,” “prevent VAP,” “transfer safely,” “skin management,” and “assessment post transferred” were extracted. Finally, we believe that our study contributes significantly to the literature because it provides relevant evidence-based findings, which indicate that this scale can help in the safe practice of ventilator care.

There exists an international consensus on the importance of family-centered care (FCC) in intensive care settings and the evaluation of collaboration between nurses and families; however, FCC is currently practiced blindly in Japan. In this study, we developed a Japanese version of the questionnaire, Factors that Influence Family Engagement (QFIFE-J) and examined its reliability and validity. A web-based survey was conducted with 250 nurses working in the intensive care unit (ICU). Exploratory and validatory factor analyses were used to ascertain factor validity. Criterion-related validity was tested using correlation analysis with the ICU Nurses’ Family Assistance Practice Scale. Internal consistency and reproducibility were verified for reliability. Following exploratory and confirmatory factor analyses, a 15-item measure emerged comprising four factors: “ICU environment”, “nurses’ attitudes”, “nurses’ workflow”, and “patient acuity”. Confirmatory factor analyses showed a generally good fit. Cronbach’s α for the overall scale was 0.78, indicating acceptable internal consistency. The intraclass coefficient for test–retest reliability was 0.80. It was found that the QFIFE-J was reliable and valid and may help determine the factors that promote or inhibit FCC. Additionally, this study has also clarified the current status and family support related issues in ICUs in Japan.

BACKGROUND: Healthcare workers caring for patients with Coronavirus Disease 2019 (COVID-19) have been a primary target of stigmatization and discrimination during the COVID-19 outbreak. Thus, there is an urgent need to develop a support system for Asian healthcare workers who care for patients with COVID-19. PURPOSE: This study was designed to understand the characteristics of COVID-19-related stigma experienced by nurses caring for patients with COVID-19. METHODS: A qualitative content analysis methodology was used. This study was conducted between April 2020 and March 2021. The participants were 10 female registered nurses working at three medical facilities that accepted patients with COVID-19. The data included specific narratives on the instances of stigma experienced when caring for patients with COVID-19, including connected situations and ideas. The data were collected using focus group interviews with three or four participants in each group. Data analysis was conducted based on the inductive qualitative analysis approach of Krippendorff. RESULTS: The content analysis identified two categories and seven subcategories of stigma experienced by clinical nurses. The category "directly experienced prejudice and discrimination" included the subcategories "being avoided," "being treated as dirty," "discrimination toward family members," and "others prying." The category "self-imposed coping behavior" included the subcategories "keeping oneself apart," "feeling guilty," and "nondisclosure." CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The participants internalized their experiences of stigma, as Japanese culture emphasizes keeping such things to oneself. Therefore, there is an urgent need to strengthen the support system for nurses who care for patients with COVID-19. This study addressed the problem of the stigmatization of these nurses and their families by others as well as their colleagues. The main findings were that stigma was directly experienced as discrimination and prejudice and often resulted in self-imposed coping behavior. The major implication of these findings is the need to establish systematic, active, and ongoing organizational support programs for nurses who are discriminated against because of COVID-19-related stigma.

Stigma among healthcare workers during the coronavirus disease 2019 (COVID-19) pandemic is an issue that requires immediate attention, as it may otherwise lead to the collapse of healthcare systems. In this study, we developed the COVID-19-related stigma scale for healthcare workers (CSS-HCWs) and assessed its reliability and validity. Data were collected online from 500 participants, including physicians and nurses involved in COVID-19 care. The first item of the draft scale was developed based on a literature review and qualitative study. The draft scale consisted of 24 items, which were rated on a six-point Likert scale. Descriptive statistics were calculated and the data distribution was analyzed. To assess the scale’s validity and reliability, structural validity was evaluated through an exploratory factor analysis. Criterion-related validity was examined through a correlation analysis using the E16-COVID19-S, a COVID-19 scale developed for physicians in Egypt. Reliability was evaluated by examining the scale’s stability and internal consistency. The findings revealed that the stigma scale was a valid and reliable instrument. The final scale consisted of 18 items across three domains: personal stigma, concerns of disclosure and others, and family stigma. In conclusion, the scale is a valid and reliable instrument that can measure COVID-19-related stigma among healthcare workers.

To evaluate edema, the depth of surface imprint is measured. The depth is influenced by the amount of the counterforce generated by the body. We devised a method to quantify the presence of the interstitial fluid using the counterforce generated from the body surface during compression. This study used a pressure sensor to detect the counterforce. The “elderly group” comprised 27 elderly people, and the “young group” comprised 12 young people. The pressure sensor was strapped on the legs with a cuff. Air was gradually pumped into the cuff, and the counterforce received by the pressure sensor was output. The increase in the counterforce at lower pressures was 2.15 N in the elderly group and 1.09 N in the young group (P<0.01). The increase in the counterforce at medium pressures was 1.92 N in the elderly group and 1.38 N in the young group (P<0.01). The increase in the counterforce at higher pressures was 1.91 N in the elderly group and 1.61 N in the young group (P=0.14). All values are average values. Our findings indicate that it is possible to quantify the presence of the interstitial fluid by observing the counterforce generated from the body surface during compression. Key words: edema, body composition, quantification, elderly people

Aim: To develop the Questionnaire for Reflective Practice of Nursing Involving Invasive Mechanical Ventilation (Q-RPN-IMV), a Japanese self-evaluation instrument for ward nurses' IMV practices. Design: Cross-sectional survey. Methods: Participants were 305 ward nurses from five hospitals in Japan with nursing involving invasive mechanical ventilation. Items concerning the process of nursing practice, including the thought process related to ventilator care, were collected from the literature and observation and interviews with five IMV specialists. Construct validity, concurrent validity, internal consistency and test-retest reliability were tested. Results: Initially, 141 items were collected and classified into three domains (i.e., observation, assessment and practice). Examination of exploratory factor analysis yielded five factors in the observation domain, six factors in the assessment domain and six factors in the practice domain. The data exhibited internal consistency, stability and concurrent validity. Items of practical content, including thoughts on ventilator care, are useful for preparing educational programmes.

&amp;emsp;The aim of this study was to investigate the physiological and psychological effectiveness of hand massages on female university students. We compared the difference in effectiveness of hand massages of short durations, such as 5 and 10 minutes. We randomly assigned 23 students each to receive a 5-minute and 10-minute massage, respectively.&lt;br&gt; Additionally, we investigat