Factors related to hospital nurse intention to leave: Does striving for work-life balance and sense of coherence affect wishes to stay in the organization?

The aim of this study is to identify relationships between striving for work-life balance (S-WLB), sense of coherence (SOC), and intention to leave among hospital nurses. In August of 2017, we conducted a self-administered questionnaire survey to 2239 nurses at nine public hospitals. The questionnaire included demographic factors, work environmental factors, organizational factors, striving for worklife balance, a 13-item SOC, the Maslach Burnout Inventory, and intention to leave. We carried out a multiple regression analysis with intention to leave as the dependent variable and others as independent variables. We obtained valid responses from 1368 full-time employed nurses (61.1%). The mean age of respondents was 36.38 ± 10.18 years, and the length of clinical experience 13.4 ± 9.65 years. The mean total score of the intention to leave was 14.58 ± 5.09. As a result of the multiple regression analysis, the SWLB and the SOC were found to be statistically related to the intention to leave even after controlling for the confounding factor of burnout. In addition, the satisfaction of desire level for the actual working assignment at the workplace was a significant independent factor. In this study, the full-time nursing staff had a low intention to leave score when they had a high score in the SWLB and the SOC. It was also found that the level of satisfaction with appointment to a desired assignment is a significant factor in the intention to leave. In establishing an attractive workplace for nursing staff, it is important to create a workplace environment and supports to be able to properly evaluate workplace satisfaction after assignments are made while taking into account individual S-WLB and SOC functions

Factors related to administrative abilities of nurse administrators – focusing on confidence in nursing

Purpose: This study aims to identify factors related to the administrative abilities of nurses in education programs for nurse administrators. Methods: We distributed a selfrating questionnaire survey to 1291 nurse administrators in positions equivalent to head nurse in 69 participating hospitals among the 172 hospitals with 300 beds or more in the Kanto and Tokai regions of Japan. The surveyed items are ability in nurse administration, demographic characteristics, and workplace environment. Results: We received 984 (76.2%) responses. Excluding responses that included two or more choices to a question and where there was no response to questions of gender and administrative abilities, this left 880 (68.2%) responses which were considered valid and these were included in the further analysis. We performed a multiple regression analysis with the focus on confidence in nursing. Here, the nurse administrators who showed better administrative abilities reported that ‘I am decisive’, ‘My judgment in nursing is appropriate’, ‘I read books about new nursing and medical care developments’, ‘I can demonstrate my ability in this job’, ‘I fulfill my responsibilities to achieve goals in accordance with my beliefs’, ‘The present ward (department) has an active atmosphere that makes work enjoyable’, and ‘I work with an awareness of work-life balance (WLB)’. Nurse administrators who showed poorer administrative abilities reported that ‘I became less kind to people since I became a nurse’. Conclusion: The findings suggest that nurse administrators who are confident in themselves and their decision making abilities, who fulfill their responsibilities in accordance with their beliefs, who think their workplace culture is good, and who work with an awareness of WLB may have better administrative abilities. In addition, nurse administrators with low cynicism (developing negative attitudes) scores, a subscale of the burnout score, appear to have better administrative abilities. Education programs for nurse administrators need to Vol.4 No.1, May-2019include support that enables nurse administrators to work reliably with an awareness of WLB, in the efforts to improve the workplace environment, and ensure that they are prevented from developing cynical attitude

Causal Model of Work Engagement among Registered Nurses and Licensed Practical Nurses Working in Long-Term Care Contexts in Japan

The objective of this study was to determine a causal process underlying work engagement, in which individual resources (i.e., resilience) and job resources influence work performance, mediated by work engagement in different types of nurses working in long-term care contexts. We investigated a work engagement causal model in which individual and job resources were set as antecedent factors, work engagement as a mediating factor, and work performance as the outcome, to clarify differences between registered nurses (RNs) and licensed practical nurses (LPNs) working in long-term care contexts. We conducted a questionnaire-based survey with 1,786 Japanese nurses working in long-term care contexts in the Tohoku region. Using 1,269 respondents, we examined the causal model using structural equation modeling (SEM) and multiple population analysis to compare between RNs and LPNs. The results revealed a process whereby individual and job resources influenced work performance, mediated by work engagement, in RNs. In other words, greater individual and job resources enhance pride in work and positive emotion (i.e., work engagement), and greater positive emotion improves work performance. This process was not equivalent in LPNs. In LPNs, the most significant factor affecting work performance was the direct effect of job resources; moreover, the mediating effect of work engagement was not supported. The results demonstrated that in order to improve performance among LPNs working in long-term care contexts, it is important to provide job resource support, as well as to facilitate positive emotion through pride in one’s work

Management of Volunteer Activities among Elderly Persons

Purpose: Volunteer activities in Japan may be expected to result in a variety of effects on health conditions and social contributions of the elderly depending on the degree of their activity participation. This study aims to identify differences in the health conditions and social contributions of the elderly in relation to the degree of volunteer activity participation, and determine what effective support can be provided for these elderly persons. Further, focusing on the differences in the level of activity of the elderly persons in volunteer activities, we discuss the effect of management through SWOT analysis from the perspectives suggested by the Balanced Scorecard (BSC), which is a performance management tool. Participants and Methods: The participants are elderly persons participating in volunteer activities, living in municipal housing owned by the Kumamoto prefecture in Japan. We classified the participants into an active group who contributed to the raising of funds for activities, and a non-active group. We conducted group interviews with the volunteers, organized interview data on the thoughts of the two groups according to the five perspectives of the balanced score card (BSC) management tool: (1) learning and development, (2) participants, (3) financial matters, (4) process of conducting activities, and (5) social contributions, and conducted a Strength-Weakness-OpportunityThreat (SWOT) analysis. In the SWOT analysis internal factors are distinguished into strengths and weaknesses, and external factors into opportunities and threats. Combining the internal and external factors, problems were extracted from the perspective of a positive strategy (S+O: strength + opportunity), a differentiation strategy (S+T: strength L threat), a stepwise strategy (W+O: weakness + opportunity), and a defensive strategy (W+T: weakness + threat). Then, we confirmed the main results by identifying the major factors in success to achieve salient aims, activity goals, and specific measures from the five perspectives provided by the BSC. Results: When comparing thestrengths of the two groups, the active group showed the following characteristics in the information collecting: more variety in the collected information (perspective of learning and development), ease of obtaining information of potential volunteers (perspective of participants), knowledge of how to raise funds (perspective of financial matters), and being physically more active and knowledgeable of the local community (perspective of social contributions).From the perspective of the process of conducting activities, both groups place importance on the relations among people. For weaknesses, and from the perspective of learning and development, the active group had difficulty in maintaining their motivation, and from the perspective of financial matters this group had difficulties in securing funds. From the perspective of social contributions, the non-active group depended on the active members. From the perspective of participants, both groups experienced a decline in physical function with age, and from the perspective of the process of activities there was a possibility that family or individual circumstances make it difficult to participate in all activities. In the SWOT analysis, combining the internal and external factors, we evaluated the directionality of volunteer activities from the five perspectives of the BSC. From the perspective of learning and development, regardless of the differences in the level of activity of the elderly persons in the volunteer activities, the volunteer members conducted a signature-collecting campaign to call for continuing volunteer activities for residents among those in their surroundings, and this made it possible to continue volunteer activities. From the perspective of the process of conducting activities, regardless of the differences in the level of activity of the elderly persons in the volunteer activities, the volunteer members became active in making remarks, and started to assume roles voluntarily. From the perspective of financial matters, the volunteer members were able to obtain donations for volunteer activities from neighboring establishments, as well as financial support from the social welfare council, by applying for subsidies for activities. From the perspective of participants, the number of new members increased through word of mouth spread by the existing membership. From the perspective of social cost, there was a remark that “I would like my schedule to be full of enjoyable events so that I become too busy to go to the hospital”, and in fact some members did reduce the frequency of hospital visitsDiscussion: Participants in this study are members of a volunteer group of elderly persons voluntarily formed in a regional city in Kumamoto prefecture where the elderly population accounts for 25.7% and is expected to increase. It appears that there is a self- and mutual- help relationship between active and non-active members where non-active members rely on the active members who assist the non-active members to be in harmony with the volunteer activities led by the active members, and that this relationship helps maintain independent lives. For the strengths, active members were able to collect more information from the perspective of learning and development, and contributed more through physical activity from the perspective of social contributions. It can be inferred that physically more active elderly persons are in a situation where they remain able to use their cognitive functions to collect information. For the weaknesses, the active members experienced loss of motivation. This may be due to the possibility that active members feel it a burden to assist non-active members. We wish to conduct further studies to understand how to maintain and improve motivation. The results of the SWOT analysis from the perspectives suggested by the BSC showed that there are differences in health conditions and social contributions of the elderly depending on the participation in volunteer activities, and what types of support from health services can be expected to be effective. This study evaluated the achievements of the volunteer activity goals of elderly persons by identifying the details of volunteer activities and quantifying the goals. The elderly members began to seek for new ideas to achieve better results when they were convinced that there were favorable results of their activities. This suggests that the PDCA cycle in volunteer activities may work by effecting empowerment in the process of BSC.

The Process of Identity Adaptation （ Oriai ） in Community-Dwelling People with Schizophrenia － Results from Content Analyses and Text Mining －

This study aimed to further elucidate the process of identity adaptation in people with schizophrenia by talking to them about their illness. Semi-structured interviews were conducted with nine community-dwelling people with schizophrenia. Analysis was performed using Krippendorf’s approach, and Text Mining. Eleven content categories were derived: “illness acceptance”, “self-control”, “help from family”, “help from friends”, “help from doctors or nurses”, “modifying thinking”, “social roles and activities”, “worthwhile work”, “enjoyment of life”, “being happy”, and “being free”. Participants with schizophrenia were found to attain “illness acceptance” based on “help from family”, “help from friends”, and “help from doctors and nurses”. Text mining results is 400 keywords were identified. The top 5 in order of importance and frequency were: “omou” (feel/think), “naru” (become), “iu” (say), “suru” (do), and “kusuri” (medication).As a result of an interactive process surrounding the concepts of “illness acceptance”, “self-control” and “modifying thinking” the participants sought out “social roles and activities” and “worthwhile work” to acquire a social identity. Thus, it was found that the participants felt they “enjoyed life and were happy” and “they were free”, because they were productive members of society

Longitudinal study on factors affecting assertiveness among preceptors of novice nurses

Purpose: This study aims to understand the assertiveness of preceptors of novice nurses and factors affecting the assertiveness through a longitudinal perspective. Methods: Anonymous self-rating questionnaire surveys were administered to 1292 preceptors working in participating city and university hospitals across Japan (August, 2013 (baseline) and March, 2014 (second survey)). The surveys had question items from the Japanese version of the Rathus Assertiveness Schedule (J-RAS, 30 items), demographic details of the participants, evaluation of novice nurses by preceptors, instruction framework, selfevaluation of preceptors, working environment, and a burnout inventory (Japanese version of the Maslach Burnout InventoryHuman Services Survey, 22 items). Bivariate analyses (T-tests and one-way analysis of variance) were conducted using assertiveness of the second survey as the objective variable, and other items of the baseline survey as explanatory variables. Selecting variables with p values smaller than 0.2 obtained in the bivariate analysis as explanatory variables, a multiple linear regression analysis (Stepwise method) was conducted. For the analyses, we used a statistics analysis software, SPSS Statistic 22. Results: Choosing 836 valid respondents of the baseline survey as a cohort group, we repeated the survey 8 months after the baseline survey to identify the factors affecting the assertiveness of preceptors of novice nurses. Excluding 62 who had missing values in the question items for assertiveness, 472 participants who were followed were included in analyses. As the results, following factors were found to affect the assertiveness: thinking that ‘they make rapid decisions’, and that ‘they are valuable as others’. Further, participants who have higher total burnout scores had lower assertiveness. Adjusted coefficient of determination was 0.153. Discussion: It can be inferred that the assertiveness of preceptors is higher than that of novice nurses measured by the J-RAS used in this study, and lower than that of administrative nurses. The assertiveness of preceptors was higher among participants who evaluated themselves positively, thinking that ‘they make rapid decisions’, and that ‘they are valuable as others’. It was also found that higher ‘total burnout scores’ was a factor that lowers the assertiveness. These findings suggest that a positive self-evaluation improves assertiveness and helps to prevent burnou

日本の統合失調症をもつ人の生活機能の評価に関する研究の動向と課題

目的:本研究は日本の統合失調症をもつ人の生活機能の評価に関する研究を概観し,その動向および課題を明らかにする.方法:医学中央雑誌Web版Ver.5を用いて1986年から2015年の論文を検索し,その中で2001年にWHOがICFモデルを発表した前後の尺度を用いた研究に注目し,その動向と課題を明らかにした.文献検索のキーワードは「統合失調症」「生活機能」「尺度」「ICF」とした.結果:統合失調症をもつ人の生活機能を評価する尺度は,12件認められた.これらのうちICFモデルの発表後,尺度の開発や日本語版の作成および尺度活用の文献は6件であった.これらの尺度は,医学モデルの障害や疾病の評価のみならず広く生活の機能を評価していた.統合失調症患者の生活機能の評価の視点が,「出来ないこと」の評価から「できることへの評価」に移行し,社会モデルとして患者を前向きにとらえることができるようになった.しかし,医学モデルの尺度研究と比較して社会モデルで開発された尺度は数が少なく,その活用は乏しい現状であった.結論:今後は統合失調症をもつ人の生活機能を評価するために「社会モデル」の尺度開発および活用が求められる.Aim : This study was a literature review to elucidate research trends and issues related to the assessment of functioning in individuals with schizophrenia in Japan. Methods : We searched the Ichushi Web Database (ver.5) for literature published between 1986 and 2015 using the keywords "schizophrenia", "functioning", "scale", and "ICF". We focused on studies that evaluated scales developed based on the ICF model published by the World Health Organization and investigated the research trends and issues related to developing rating scales. Results : Twelve research papers focusing on rating scales for functioning in individuals with schizophrenia were identified, and of these, six papers assessed scales systematically developed after the ICF model was published. These scales assessed a wide range of deficiencies in functioning in the medical models and assessments of illnesses. The focus of the issues assessing functioning in individuals with schizophrenia has undergone a change from emphasizing "what cannot be done" to "what can be done". This has enabled positive assessments of patients based on social models. However, compared to scales based on medical models, scales based on social models are still rare and not widely used. Conclusion : The findings suggest the need for further development and use of systematic rating scales based on "social models" to assess functioning in individuals with schizophrenia.総

Training cessation and subsequent retraining of a world-class female Olympic sailor after Tokyo 2020: A case study

Olympic sailing is a complex sport where sailors are required to predict and interpret weather conditions while facing high physical and physiological demands. While it is essential for sailors to develop physical and physiological capabilities toward major competition, monitoring training status following the competition is equally important to minimize the magnitude of detraining and facilitate retraining. Despite its long history in the modern Olympics, reports on world-class sailors' training status and performance characteristics across different periodization phases are currently lacking. This case study aimed to determine the influence of training cessation and subsequent retraining on performance parameters in a world-class female sailor. A 31-year old female sailor, seventh in the Women's Sailing 470 medal race in Tokyo 2020, completely stopped training for 4 weeks following the Olympics, and resumed low-intensity training for 3 weeks. Over these 7 weeks, 12.7 and 5.3% reductions were observed in 6 s peak cycling power output and jump height, respectively, with a 4.7% decrease in maximal aerobic power output. Seven weeks of training cessation-retraining period induced clear reductions in explosive power production capacities but less prominent decreases in aerobic capacity. The current findings are likely attributed to the sailor's training characteristics during the retraining period.This study was part of Functional Development Project for Resilient Athlete Support commissioned by Japan Sports Agency

Measuring effective orifice area of bileaflet mechanical valves in patients after aortic valve replacement using phase-contrast cine MR imaging

POSTER PRESENTATION2011 SCMR/Euro CMR Joint Scientific Sessions / Nice, France / 3-6 February 201

Coping Behaviors and Collaboration among Staff of Multiple Occupation Classifications during Norovirus

In December 2012 a norovirus infection outbreak occurred in the Orthopedic Surgery Ward of Hospital A in Japan. This study aims to establish details of coping behaviors used by nurses, physicians, physiotherapists, and pharmacists of the facility, and examine the issues involved in infection control by team collaboration as well as the ways employed to deal with the infections. Participants in this study were thirty-seven medical professionals who were working in the Orthopedic Surgery Ward of Hospital A at the time the infection outbreak occurred, and who were still working there when the interviews were conducted. Interviews were conducted from January to April 2015, and the data from the interviews were analyzed using the “Trend Search 2008” text mining software. As a result of the analysis it was found that the nurses primarily communicated information by passing messages to the nurses who took over the duty at shift changes, but did not pass on the information to staff in other occupations or to the ward as a whole. The nurses clearly remembered that the ward was closed and it was a difficult experience, but did not remember details of the patients they were in charge of. The physicians clearly remembered individual patients they were in charge of, but they were not aware of the situation and state throughout the ward. The findings suggest that this difference is due to the differences in the occupational nature and sense of values of the staff involved. It is also found that physiotherapists did not feel a sense of crisis about the norovirus outbreak because they felt the patients in the ward appeared to be in better condition than patients in other wards, and that pharmacists lacked communication with staff in other occupations because they usually have heavy workloads. In concept mappings of physicians, physiotherapists, and pharmacists, the keyword places in the center of the maps, and is linked to and . Because the nurse plays a central role to report information among the four occupations, nurses should be aware of and assigned to play the role to coordinate team collaboration