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Intensive care unit (ICU) nurses' professional autonomy is a critical factor affecting their ability to sustainably provide high-quality care to patients who are critically ill and to their families. However, in the absence of a systematic or scoping review of ICU nurses' professional autonomy, limited information and evidence are available on this topic. The aim of this scoping review was to clarify the extent and type of evidence on ICU nurses' professional autonomy. This scoping review was conducted in accordance with the Joanna Briggs Institute methodology for scoping reviews. The following research questions were addressed: (1) Which areas of interest and trends regarding ICU nurses' professional autonomy have been explored in studies published in scientific journals? And (2) What is known about ICU nurses' professional autonomy? The data sources included MEDLINE, CINAHL Ultimate, PsycINFO, Cochrane Library, and Ichushi-Web of the Japan Medical Abstracts Society databases. Identified studies were mapped based on their aim, design, methodology, and key findings and categorized according to their focus areas. Of the 734 identified studies, 16 were analyzed. The identified categories were as follows: "relationship between professional autonomy and mental issues," "experiences and processes of exercising professional autonomy," "relationship between professional autonomy and nurse-physician collaboration," "relationship between professional autonomy and demographic characteristics," "concept of professional autonomy," "barriers to professional autonomy," and "team approach to improve professional autonomy." Most studies have focused on the relationship between professional autonomy and mental health issues and nurse-physician collaboration and few included interventions to enable or promote the exercise of professional autonomy, highlighting a research gap. Future research should identify factors that inhibit the professional autonomy of ICU nurses and that can be changed through interventions and should develop educational and organizational change-based interventions to modify the factors.

Purpose: This study aimed to develop an autonomy scale for emergency nurses and verify its reliability and validity. Method: Upon confirming the face and content validity of the initial draft of the autonomy scale for emergency nurses, an anonymous self-report questionnaire of the 77-item draft scale was administered to 3408 emergency nurses. The scale’s reliability and validity were examined thereafter. Results: A total of 434 valid responses were obtained. Following an exploratory factor analysis of these responses, 33 items were extracted across three factors within the draft scale. For reliability, internal consistency was confirmed by Cronbach’s alpha coefficient, and stability was confirmed by the test-retest method. For validity, criterion-related validity was confirmed using the Professional Autonomy Scale, Dempster Practice Behavior Scale, and Job Satisfaction Scale. Discussion: The autonomy scale for emergency nurses encompasses items that evaluate independent thinking and actions aimed at advocating for, treatment of, and support for the recovery of emergency patients and their families. Conclusion: The reliability and validity of the autonomy scale for emergency nurses is confirmed in this study.

【目的】集中治療の効果がなく死にゆく患者の家族の悲嘆への看護実践の内容を明らかにする。 / 【方法】ICUの看護師11名に半構造化面接を行った。逐語録の内容からコードを抽出し、カテゴリへ高次化した。 / 【結果】本研究の参加者は、…… [Purpose] This study aimed to analyze the content of nursing practice for grief of families of patients dying after unsuccessful intensive care, and clarify the specific nursing practice. / [Methods] A semi-structured interview was conducted with 11 nurses who worked in the ICU. The code was extracted from the contents of the verbatim, and it was made higher in the category. / [Results] The Research Participants were ......

BACKGROUND: We aimed to clarify usefulness of the modified Frailty Index 11 (mFI-11) for assessing risk of postoperative complications (POCs) and effectiveness of perioperative management team (POMT) intervention for improving postoperative status of frail aged patients requiring colorectal cancer (CRC) surgery. METHODS: We compared, retrospectively, surgical outcomes among 151 consecutive CRC surgery patients aged ≥80 years. Patients were grouped by mFI-11 scores and by POMT intervention (vs. no POMT intervention). RESULTS: POCs were more prevalent, postoperative stays were longer, and discharge status was poorer among high-risk (mFI-11 ≥ 3/11) patients without POMT intervention than among low-risk (mFI-11 ≤ 2/11) patients (p = 0.04, p = 0.02, p < 0.01). Multiple POCs occurred less frequently and performance of activities of daily living was better for high-risk patients with (vs. those without) POMT intervention (p = 0.04, p = 0.03). CONCLUSION: POMT intervention appears beneficial for frail aged patients scheduled for CRC surgery.