Vol.12

FALL 2002

NEWS FROM JANS
Greetings from the New Chairperson
Sachiyo Murashima, Ph.D, R.N.
I would like to extend my warmest
greetings to all our members and international colleagues as I begin my firstyear as the Chairperson of the Board of
Directors of the Japan Academy of
Nursing Science (JANS). At our annual
meeting in December 2001 I together
with the thirteen members of the Boardof Directors and two auditors were approved unanimously for three-year
terms of office. JANS, founded in 1981,
is now in its 22nd year. Its membershiphas been increasing steadily, and as of
September 30, 2001 there are 3,363
members.
Two events during the last year
helped us acknowledge the importantrole of nursing science. In September
the 4th International Nursing Research
Conference was held in Mie Prefecturewith Sumiko Maehara, Dean and Professor, Mie Prefectural College ofNursing as chairperson. Its theme was"A Holistic Approach: A Better Qualityof Life for All-In Search of Core Principles for Nursing in the 21st Century."More than five hundred (521) participants from 11 countries attended theconference and 222 research projects
were presented. In December the 21st
Annual Conference of JANS chaired by
Noriko Katada, Professor, Hyogo
Prefectural College of Nursing Art andScience was held in Kobe. Its themewas "Examining Ethical Perspective on
Nursing in the 21st Century." More than
two thousand (2,141) attended and 300

research projects were presented.
Both conferences were great successes. At the threshold of the new
century when our community is facedwith unprecedented problems causedby the aging population, the role ofnursing science is more important andcrucial than ever.
Looking back at the last three years,
I want to recognize the notable accomplishments made through the distinguished and extraordinary leadershipof the former chairperson, Dr. Noriko
Katada. These include opening the
JANS website, publishing the online
journal and initiating the managementof citizen forums, to name a few. In December the academy gave its approvalfor opening a new independent office
and revising the membership fee.
These will provide further stability for
our work in the future.
As I review those accomplishments,
I recognize that we face more challenges. Some of the priorities in mymind include 1) smooth managementof our new independent office, 2) activities required for the registration ouracademy as an incorporated organization, 3) promotion of our journal sales,and much more. A new committee willbe established soon to enhance social
awareness of the importance of nursing science, which is integral to ouracademy becoming an incorporated organization. A new research award system will be set up to encourage JANS

Academy Organization
Committee memberships for 2002 to 2005 were approved by the Board of
Directors in April. Each committee's functions and new chair are listed
below.
Chairperson : Sachiyo Murashima(Graduate School of Medicine, The University of Tokyo)
Vice Chairperson : Noriko Katada(College of Nursing Art and Science, Hyogo)

Sachiyo Murashima, Ph.D, R.N.
members to write more theses and tohave their efforts recognized. In orderto achieve these goals, I AM DETERMINED TO WORK HARD.
The 22nd Annual Conference of JANS
will be held at the Tokyo International
Forum on December 6 and 7, 2002.
The chairperson of this year's conference is Michiko Hishinuma, Dean &Professor of St. Luke's College ofNursing. I hope that all the members of
JANS will make time to share this occasion.
I would like to express appreciation
for the help and support from each andevery member of JANS and from its
friends and colleagues around theworld. Your continued assistance andunderstanding are indispensable andessential for our activities and success.
As new Board begins its work, we lookforward to increasing international collaboration as well as continued development of our activities in Japan.

1. Editorial Board
Tasks include: publishing journals
quarterly; promoting contribution of research papers; developing the review
system; and participating in the commendation system.
(Sayumi Nojima<Chief>: Departmentof Nursing, Kochi Women's University & Setsuko Hisatsune <Associate> : Faculty of Nursing andMedical Care, Dept. of Nursing, Keio

NEWS FROM JANS
University)
2. Research/Academic Information
Tasks include: facilitating research bydeveloping an information system regarding nursing science (including obtaining grant for promoting informatics);
designing a system for distribution ofresearch outcomes; and further development of our web-site and on-line
journal.
(Satoko Tsuru: Div. of Nursing, Ins.
of Health Science, Faculty of Medicine, Hiroshima University)
3. Liaison with Japanese Academy
Council
Tasks include : overall business relating to Japanese Academy Council; facilitating the goal that nursing
academies to send members to theJapanese Academy Council; and participating in Council of Japanese Academy Council.
(Misako Kojima : Osaka Prefecture
College of Nursing)
4. Examining Nursing Terms
Tasks include: identifying issues andmethods or strategies in order to organize nursing technical terms for the
future development of nursing sciencein Japan; proposing nursing technicalterms; and discussing infrastructures
for organizing nursing technical terms.
(Keiko Kazuma : Graduate School of
Medicine, The University of Tokyo)

ence through international exchange;
distributing Japanese research to othercountries; investigating directions of international conference in the future;and reviewing the English version ofbylaws and other documents.
(Junko Tashiro: St. Luke's College ofNursing)

9. Research Commendation System
Task is to design and develop the research commendation system to recognize outstanding research andultimately to further develop methods
for research about nursing.
(Katsuko Kanagawa : Ishikawa
Prefectural Nursing University)

6. Nursing Ethics
Tasks include: identifying ethical issues in nursing research, education,and practice; collecting and distributing
information regarding ethical issues insociety relating to nursing and developing responses for JANS to these ethical issues.
(Toshiko Ibe : St. Luke's International Hospital)

10. General Affairs
Tasks include: managing office work
for membership, board and council
meetings, proceedings of general
meeting, business and supportingtasks of committees, JANS journalsales; distributing information regarding membership and responding toother inquiries; and other business notconducted by committees.
(Mami Kayama: Graduate School of
Medicine, The University of Tokyo)

7. Public Relations
Tasks include: collecting information
about the contributions of JANS and its
members; developing channels to
spread that information more widely tothe public; and providing services tothe public in addition to the Forum for
Citizens at Annual Meeting.
(Setsuko Hisatsune : Faculty of
Nursing and Medical Care, Dept. of
Nursing, Keio University)
8. Incorporated Organization Preparation
Task is to assist the Chairperson especially relating to incorporation of JANS.
(Takako Mitoh: Nagano College ofNursing)

5. International Exchange
Tasks include: improving nursing sci-

11. Accounting
Tasks include: managing for all accounting business; establishing an accounting system appropriate to anincorporated organization; planning fora solid financial base for the incorporated organization; and financial management of the office.
(Katsuya Kanda: Graduate School of
Medicine, The University of Tokyo)
12. Auditing
Tasks include: oversight all business of
JANS and its assets; and auditing theacademy accounts.
(Junko Kondo: Tenshi College &Sawako Kawamura: Tokyo Metropolitan University of Health Science)

Change the ByLaw
The revision to these Bylaws shall become effective on Dec. 1, 2001.
CHAPTER 1. GENERAL PROVISIONS
Article 2. Secretariat
The secretariat of the Academy is located at 303 Fujimi
Building, 3-37-3 Hongo, Bunkyo-ku, Tokyo 113-0033,
Japan.
CHAPTER 9. RESEARCH AWARD
Article 36. Research Award
In order to promote nursing research that develops nursing science, on occasion the Academy may recognize distinguished research by a member of the Academy.

Implementing Regulations
Article 36. Selection Committee for the Research Award
1. The Selection Committee for the Research Award will be
responsible for selecting the research for recognition.
2. The Selection Committee will consist of the following
members: the Chairperson of the Board of Directors, theChairperson of the Editorial Committee, and three members appointed by the Board of Directors: Board member(one) Trustees (two)
3. The Chairperson of the Board of Directors is the chairperson of this committee.
4. Committee members appointed by the Board of Directors
will serve for one year; the term may be extended.

The 22th Assembly of Japan Academy of Nursing Science

Chair Person : Michiko Hishinuma (Dean, St.Luke's College of Nursing)
Date :

December 6 (Fri.) & 7 (Sat.), 2002

Venue :

Tokyo International Forum

Main Theme : Telling People How Nursing Makes a Difference

Keynote Speech : Michiko Hishinuma (St.Luke's College of Nursing)"Develop Evidence in Order to Tell People How Nursing Makes a Difference"
Educational Speech : William L. Holzemer (University of California, San Francisco)"Translating Nursing Research to Practice"
Symposium :Ⅰ. "Quantitative Research Focusing on Changing Practice"
Ⅱ. "How Qualitative Can Change Nursing Practice?"
Forum for Citizens :"Thinking About Death and Dying at Home"
Open Forum
Presentation (Oral & Poster)

The Office for 22th Assembly of Japan Academy of Nursing Science:
Event & Convention House
Address: Sai-Tower 4th FL, Matsunaga-cho, Kanda, Chiyoda-ku, Tokyo 101-0023, JAPAN
Tel: 03-3255-0900

Fax: 03-3255-7377

E-mail : jans22-sec@gp.knt.co.jp
URL: http:// square.umin.ac. jp/ jans22

NEWS FROM JANS
Current Research
Abstracts from Vol.21 of Journal of Japan Academy of Nursing Science
1. Nakajima,T. (2001). Reliability and validity of the maternal attachment inventory Japanese version. Vol.
21(1). 1-8.
The purpose of this study was to evaluate the reliability andvalidity of the Maternal Attachment Inventory Japanese Version (MAI-J). The 26 item MAI-J is a self-report questionnaire designed to measure maternal affectionate attachment
to infants. The Maternal Attachment Inventory original version was translated into Japanese and then back-translated
into English using translators not involved in the originaltranslation. The subjects were 255 mothers of healthy
infants.The results demonstrated the MAI-J to be highly adequate internal consistency reliability, with a Cronbach's
alpha coefficient of 0.92, and for stability, with a test-retest
reliability of 0.84. Content validity was established at 100%.
Construct validity was not adequately supported, although
the results of the principal component analysis and the factor
analysis showed MAI-J to be an essentially one dimensional
scale, and there was a moderate correlation of 0.63 with thescale of What Being the Parent of a New Baby is LikeReversed-Japanese Version. Measure of concurrent validity
was not adequately supported, showing a correlation of 0.38
with the scale of Feeling Towards Infant.The results showed
the MAI-J to be highly adequate reliability but did not adequately support validity. Therefore further testing of the scale
is necessary.
2. Uchida,Y., Shimanouchi, S., & Kouno, A. (2001). Outcome evaluation and cost-effective of home care service. Vol.21(1). 9-17.
The purpose of this study was to evaluate outcome of homecare clients and to identity cost-affecting factors in client'condition and care characteristics by cost - effectivenessanalyze. Subjects were 64 clients who received home careservices and 11 nurses in a visiting nursing station. As a result, the solution rate of clients' needs was improved in areas
such as "cleanliness" and "excretion" while the stability rate
was high in "ADL disability". Overall client satisfaction was
high. Two areas of distribution, better and worse groups,
were shown in the cost-effectiveness with the solution rate ofclients' need and satisfaction. Independency affected thecost-effectiveness, and it was high in the better group but
low in the worse group (t＝2.14, p<0.05). "Rehabilitation"
was high in the better (t＝3.69, p<0.01), whereas "medical
treatment" was high in the worse group (t＝ 2.44, p＜0.05).
It is necessary for nurses to improve clients' independency
by care provision and utilization of social resources.

3. Ogawa, K., Shimanouchi,S., & Kouno, A. (2001).
Evaluation of home nursing care for patients with terminal cancer from perspective of bereaved families
and nurses. Vol.21(1). 18-28.
The purpose of this study was to examine home nursing
care services related to satisfaction of family and nurse, differences of results between families and nurses, and factors
contributing to these differences. Questionnaires were given
to 48 bereaved families of patients with terminal cancer and21 nurses at visiting nursing stations. The subjects of analysis were 47 families (response rate: 97.9%) and 21 nurses.
(1) The following home nursing care services were related tofamily satisfaction : informed consent, relationship of mutual
trust, peace at the time of death, acceptance of death, bereavement support, maintain comfort, pain management,
medication, emotional family support, and family support for
relief of physical fatigue. Nurses reported other services including nutritional assessment, excretion care, and hygiene
support in terms of nurse satisfaction. (2) The results ofevaluation were different between families and nurses (p<.001). Emergency measure, acceptance of death, and collaboration with health care institutions were the top-threeservices in consistency between families and nurses whilefamily support for relief of physical fatigue was the lowest.
(3) Several factors significantly contributed higher consistency in the results between families and nurses : longer
nursing career on acceptance of death, older age of patientson acceptance of death and collaboration with health careinstitutions, and older age of family members on family support for relief of physical fatigue. This study suggests important care services that we need to pay attention in evaluationof home nursing care for patients with terminal cancer.
4. Honjo,K. (2001) Revision of the self-care agency
questionnaire for patients with chronic illness. Vol.
21(1). 29-39.
This research was conducted to revise of the Self-Care
Agency Questionnaire (SCAQ). The validity and the reliability of the SCAQ were tested for this purpose. The SCAQ
consists of the scale of 29-items, which includes four
subscales : a) ability to perform self-care operations, b) ability to adjust one's own physical condition based on personal
weaknesses, c) ability to concentrate one's attention on selfcare, and d) ability to receive valid support.The age of subjects ranged from 40 to 65 years. Most of those subjects had
been suffering from diabetes, cardiac disease, or hypertension. The construct validity of the SCAQ was tested using
factor analysis and the known-groups technique. And there
was significant relationship between the SCAQ and the Exercise of Self-Care Agency Scale 35 items version (r＝.72,
p<.001). The stability of the SCAQ was tested using testretest reliability (r＝.85, p<.001). Internal consistency wasalso tested, Cronbach's alpha for the SCAQ was .91.The validity and the reliability of the SCAQ were supported. The
ability to adjust one's own physical condition based on personal weaknesses of the SCAQ were distinctive features as
self-care agency's subscale.
5. Hanade, M. & Sato,R. (2001). Quality of life in survivors of head and neck cancer in the first five years
after treatment. Vol. 21(1). 40-50.
The purpose of this study was to investigate the aspects ofquality of life (QOL) in survivors of head and neck cancer inthe first five years after treatment, and nursing intervention
to enhance the QOL. Semi - structured interviews with
twelve survivors were conducted to elucidate their perception of their life experiences, and qualitative data wereanalyzed.Ten themes and positive aspects describing
meaning-of-life experiences indicated three life processes
with a significant impact on QOL : (a) coping with the possibility of head and neck cancer relapse, (b) making compromises that inconvenience on one's own life, and (c)accepting one's present condition.These findings indicated
six nursing interventions to enhance the QOL in survivors ofhead and neck cancer : (a) properly responding to the anxiety of cancer relapse, (b) improving self-care ability to meetbasic needs, (c) enhancing motivation to rehabilitate, (d) facilitating proper family social support, (e) encouraging socialization to maintain relationships with others, and (f)facilitating awareness of one's own positive changes.
6. Suzuki, M. (2001). Parents' decision making in determining the living setting of respiratior-dependent children. Vol. 21(1). 51-60.
The purpose of this study was to investigate the interactions
among variables in a theoretical framework derived from theMishel Theory of Illness Uncertainty (1988; 1990), which
represents parents' decision making about the setting of living for their children based on the following hypotheses. Hypothesis 1) Parents who can notice the changes in thereaction of their own children tend to challenge to the uncertainty in illness, resulting to raise the quality of decision making about the living setting of children. Hypothesis 2) Parents
who can not notice such changes in their children's reaction
tend to persist in the uncertainty in illness, resulting to lower
the quality of decision making about the living setting of children. Hypothesis 3) Parents who are confident in the care of
their own children tend to challenge to the uncertainty, resulting to raise the quality of decision making about the living
setting of their children. Hypothesis 4) Parents who are little
confident in the care of their own children tend to persist in
the uncertainty, resulting to lower the quality of decision
making about the living setting of children. Hypothesis 5)
Parents who are not burdened down with the care of children tend to challenge to the uncertainty, resulting to raise
the quality of decision making about the living setting of children. Hypothesis 6) Parents who are burdened down withthe care of children tend to persist in the uncertainty

resulting to lower the quality of decision making about theliving setting.A total of 101 parents who had decided the living setting for their respirator-dependent children (0-15
years old) wearing a respirator for more than 3 months wereused as the subjects. A survey was made using six forms ofquestionnaire and the statistical analysis was performed bymultiple regression analysis and the interactions between
two variables except for the influence of other variables wereexpressed with path coefficient. The present results supported neither of the correlation between the notice of children's changes and the persistence in the uncertainty for
Hypothesis 2) nor the correlation between the burden of careand the challenge to the uncertainty for Hypothesis 5). The
present study provided useful information to establish a support system for parents by which it would become easy forparents to decide the living setting of children to satisfaction
through converting the uncertainty as to the children's illness
to a challenge to it by nursing professionals in future.
7. Shinkoda, H., Matsumoto, K., & Mishima, M. (2001).
Change of primipara and multipara mother's sleepwake behaviors from late pregnancy to postpartum
weeks. Vol. 21(2). 1-11.
It was the purpose of this study to investigate the changes of
sleep-wake behaviors of primiparas and multiparas from latepregnancy to postpartum weeks respectively. The subjects
26 women that consist of 14 primiparas and 12 multiparas.
They kept a sleep logs everyday from 7 th week before delivery to 15th week after delivery and 8 of them also kept another record about their babies. From 1st to 11th week after
delivery, mother's nocturnal total sleep time decreased andwake after sleep onset (WASO) increased significantly, compared to those in late pregnancy. The sleep efficiency significantly decreased from 1st to 8th week after delivery.
Especially the date from primiparas shows significantly increase in WASO and the mean duration per a awakening,and decrease in sleep efficiency from 2nd to 6th week after
delivery. In conclusion, the irregularity of primiparas' nocturnal sleep is greater especially, compared to that ofmultiparas. The irregularity continues until about 11th week
after delivery. However, after 12th week, with the development of their infants' sleep-wake rhythm and feeding rhythm,
the sleep-wake behavior of mothers also seems to no interrupted.
8. Katsuda, H., Katada, N., Ebina, M. et al. (2001). Child's"Kakugo" and its influential factors for procedure
and/or treatment. Vol. 21(2). 12-25.
The purpose of this study is to clarify the child's experience
when he/she is facing a procedure and/or treatment. The design of the study was a inductive qualitative method. The
data was obtained through observation and interview. The
grounded theory approach was used to analyze the data.
Children who are receiving procedure/treatment were observed. Interview was conducted to 18 paired of child, parent, nurse, and physician who had participated in the child's

NEWS FROM JANS
procedure/ treatment.When children were facing and starting the procedure and treatment, children seem to go
through the emotional/cognitive state to determine to accept
the consequence. We had named this phenomena as a
"Kakugo" of the child. Furthermore, when the child had to do
Kakugo, the child was balancing emotion, cognition, andpsychomotor aspects. After the Kakugo, the child would face
the procedure/treatment with full acceptance. Factors influence the child's Kakugo were identified as following: people
surrounding the child, image of past experience, possibilityof child choice of action, feeling oneness with people surrounding, some benefit for procedure/treatment, and declaration of own Kakugo.Above mentioned factors weresummarized into three ways to strengthen the child's ability
to control the situation. The first one is to promote child's potential to utilize his/her ego power to balance cognition andemotional preparedness. The second is participant's understanding of the child as the primary person who has to balance his/her emotion and cognition. This understanding
would enhance the feeling of self-control in the child which
will promote child's ability to control his/her behavior. The
third is for the child to find a good timing with others to makea Kakugo which lead the child to take action.
9. Okamura, H. (2001). A study of the variations in maternal temperature during labor. Vol. 21(2). 26-36.
The purpose of this study was to describe variations in maternal temperature during normal labor. The subjects werethirty-three women experiencing a vaginal birth at term, andwere less than 5cm dilated. Their temperatures were measured continuously during the labor period, with the firstmeasurements between 6 and 14 o'clock. In this study,"temperature" indicates skin temperature, measured by the
CORETEMP CTM-205 monitor. The results are as follows:1.
The range of temperature in normal deliveryThe range forcenter temperature was 34.2-37.9 degrees, and the mean of
the individual temperature variation range was 1.3±0.6 degrees. The range for peripheral temperature was 25.7-36.7
degrees, and the mean of the individual temperature variation range was 4.1±2.3 degrees. This variation was greaterthan in a previous study. For temperatures taken in theaxilla, the mean was 37.1 degrees at the time of delivery,and 5 cases exceeded 38 degrees. High temperature is usually considered a sign of infection. But, if the high temperature occurs only during delivery, it is not considered a sign ofinfection. (For the women in this study, the temperature decreased naturally during the 12 hours after delivery, and thebabies were doing well.) 2. Variations of individual
temperatureWith respect to central temperature, twenty-six
out of thirty-three women showed a significant change oftemperature as delivery progress, 15 showed a rise in temperature and 11 showed a decrease. With respect to peripheral temperature, twenty-eight of thirty-three women showeda significant change of temperature as delivery progress, 6
showed a rise in temperature and 22 showed a decrease.In
studying the above results, I found that maternal

temperature might exceed 38 degrees during a normal delivery. The tendency for temperature fluctuation was found inevery case-rise, decrease, and no remarkable change.
These results suggest that temperature variations may not
only be abnormal signs, but may also provide data to assessdelivery progress.
10. Tsuboi, K. & Yasukata, F. (2001). Development of aself-efficacy inventory toward nursing practice teaching and investigation of its reliability and validity. Vol.
21(2).37-45.
The present study aimed at developing a teacher selfefficacy inventory for nursing teachers in nursing practice.
50-item questionnaires were mailed to 433 nursing teachersof which 245 were returned completed. Factor analysis identified 7 factors with 28 items: conference management, confidence in nursing practice, respect for students, utilization ofteaching skills, preparation for practice education, appreciation of student situation, and facilitation of student learning.
The 7 factors of the "Self-Efficacy toward Nursing Practice
Teaching Inventory (SENPTI)" had an accumulation contribution percentage of 57.8. SENPTI had promising reliability
with Cronbach's alpha of 0.937. Both content validity and criterion-related validity were assessed. The criterion-related
validity revealed medium correlation between SENPTI and aself-efficacy scale which measures general self-efficacy.
Moreover, concepts related to teacher efficacy in practiceeducation were examined. As a result, self-efficacy towardnursing practice teaching displayed a significant correlation
with job-orientedness and job satisfaction. Results indicatethat SENPTI is an instrument which can measure teacher efficacy and also that it has potential for analysis of related
factors.
11. Imai, N. & Kido, Y. (2001). Quality of life of outpatients treated with low anterior resection or anterior
resection for colorectal cancer -Correlation between
dyschezia and self - completed QOL questionnaire-.
Vol. 21(3). 1-10.
This study examines the correlation between dyschezia andquality of life in an outpatient population that received either
low resection (LAR) or an anterior resection (AR) as treatment for colorectal cancer.
The outpatients answered a questionnaire examining the severity of their dyschezia and it's impact on their quality of life.
One hundred ninety two outpatients, with a mean age of
64.6 years (SD=10.4 years) and from 1 to 36 months after
surgical resection respond to the questionnaire. Two assessment scales were included in the questionnaire: The
Defecative Dysfunction Assessment Scale (DDAS) and aself-completed questionnaire for QOL revised (QUIK-R).
Data were analyzed using a Mann-Whitney test, KruskalWallis test and Spearman rank correlation coefficient, andstep-wise multiple regression was also performed.
DDAS scores were significantly higher for patients receiving
low anterior resection (LAR) than for those receiving anterior

resection (AR). A significant relationship was also observed
between DDAS and QUIK-R scores, in particular, between"soiling" on the DDAS. Multiple regression analysis revealed
that DDAS and resection technique used for treatment accounted for 22.3% of the variance in QUIK-R.
In conclusion, the findings suggest that the severity ofdyschezia is related to the resection technique used to treat
colorectal cancer. Furthermore the severity of the dyschezia
was found to exert a significant influence on quality of life.
12. Kondoh, Y. (2001). Effects of flexed posture withboundaries following endotracheal suction in very
low birth weight infants. Vol. 21(3).11-20.
The purpose of this study is to determine differences in behavioral (stress signs and sleep-wake state) responses following endotracheal suction in very low birth weight infants
between routine care and flexed posture with boundaries.
The nine infants in this study had a mean gestational age of
26.96 weeks (ranging for 23 weeks and 6 days to 28 weeks
and 6 days) and a mean birth weight of 968.4 grams (ranging for 572 to 1,524 grams).
Heart rate and arterial oxygen saturation were monitored for
estimating autonomic functions, while the motor system parameters were measured visually through observations. The
autonomic and motor system variables were integrated andused to trace stress signs. States of sleep were assessed
according to the Thoman classification. Observations weremade every 2 minutes for 30 minutes, beginning at the baseline and finishing 30 minutes after the end of suctioning.
A total of 42 sessions were recorded, among which 20 were
for the experimental and 22 were for the control group. Twogroups did not differ significantly in birth weight andgestational age at birth. The results of two-way repeatedmeasures (ANOVA) for each variable indicated that thegroups differed significantly in stress signs. There were significant differences in effects of time (F=3.530, p=0.0001),
intervention (F=12.476, p=0.01)and intervention-by-time interaction for stress signs (F=3.018, p=0.001). In the experimental group exhibited fewer stress signs than in the control
group. The time before onset a quiet sleep state differed significantly between the groups (t=-2.529, df=35, p=0.016). In
the experimental group was significantly shorter time than in
the control group. The flexed posture in the prone position
with boundaries around the infant's body are needed to help
the very low birth weight infants enhance self-regulatory behavior to maintain a behavioral integrity.
13. Okawa, A. & Kido, Y. (2001). Study on the factors
relevant to the mood of the pre-operative patients With a focus on their perception of support network
and HLOC-. Vol. 21(3). 21-29.
The authors studied the effect of the perception of support
network and HLOC on the mood of the pre-operative patients. Forty-seven cases of gastric- or esophagus-cancer,
who were hospitalized for radical surgery after being announced, were chosen as subjects of the study. For the

rating of interior- or exterior intermediary factors scales of
support network and JHLC (Japanese Version of Health
Locus of Control) were used, and for the rating of the moodor states of mind the scale of POMS (Profile of Mood States)
was used. The results show that in the subjects with positive
perception of emotional support network relatively lower levels of the feelings of "depression slump", "fatigue" or "confusion" factors were observed. Because an instrumental
support network lowers the feeling controlled by "life" or"vigor" factor, it is important for the pre-operative patientsthat they are given such spiritual support as to encouragethem to perceive the "emotional support network". Thoughno significant correlation between JHLC and states of moodof the patients was observed, it will be significant to create acondition or take a way of contact which would make clear
the existence of patients' inherent control.
14. Eto, H. (2001). One month-old infants sleep at nightat home Vol. 21(3). 30-39.
This study set out to clarify the characteristics of infant
sleep-wake states by behavioral observation at night at thefirst month after birth. A total of 36 healthy first-born infants(average age 30.8 days) participated in this study. Infant
sleep-wake states in the night were recorded using
videosomnography for two consecutive nights, and data of
the second night coded and analyzed using an establishedprotocol. Mean total sleep time was 7.4 hours, 70 % of themean total recording period. The ratio of the percent of total
sleep time in active sleep (AS) to the percent of total sleep
time in quiet sleep (QS) was 7:3. The mean length of all
sleep periods was 124 minutes. Principal component analysis of night sleep yielded two components: "sleep stability"and "sleep depth". The component of "sleep stability" consisted four variables: mean sleep period; percentage ofsleep time; number of waking; and standard deviation of
awake period. The component of "sleep depth" consisted
two variables: % AS and % QS. Two variables from thisanalysis, mean sleep period and standard deviation of
awake period are newly defined sleep parameters, andshould be considered actual sleep features of one month-old
infants. It is necessary to examine these newly identified
sleep parameters in more depth. Moreover, it is important todiscover whether and how patterns at one month persist inlater months. Further studies using the methods of this study
and also methods to document mother-infant interactions
during nighttime sleep and feeding are indicated.
15. Azuma, M., Shirata, K., Yasumori, Y., & Kawabata, K.
(2001). Subjective well-being and psychological aspects of quality of life in patients with osteoporosis.
Vol. 21(3). 40-49.
The aim of the present study was to examine the necessity
for nursing care with psychological consideration, throughthe investigation of the quality of life in patients with osteoporosis by assessing their subjective well-being, including theiranxiety, depression and self-esteem, which may influenceNEWS FROM JANS
their happiness and mental health. The study had subjects
themselves fill in questionnaires utilizing four psychologicalscales; Life Satisfaction Index A (LSIA) to assess the subjective well-being, Self-Esteem Scale (SES) to assess psychological aspects, The State-Trait Anxiety Inventory (STAI),and Self-Rating Depression Scale (SDS). Subjects were
230 females aged 64.9 on average, and who were osteoporosis outpatients visiting clinics in Osaka prefecture. The
level of quality of life of osteoporosis patients was found to
be relatively low in terms of subjective well-being, and thosepatients were in the state of anxiety or mild depression.
However, approximately 90% of the subjects showed highscores of the Self-Esteem Scale (SES). Patients with vertebral fractures and those faced impaired activities in daily life
appeared to be depressive. An inclination of anxiety was
found in most subjects having an acquaintance and/or family
members who had osteoporosis disease as well. It turned
out from the results obtained by multiple regression analysis
that self-esteem, anxiety, disease duration, health satisfaction and depression are major factors that affect the subjective well-being of osteoporosis patients. The study has
indicated that it is important for nursing care to raise the selfesteem of osteoporosis patients.
16. Saiki-Craighill, S. (2001). Preparing for a child's
death: Intuiting the time of the death as a nursing
skill. 21(3). 50-60.
The purpose of this study was to investigate how and why
nurses intuit the time of death of the child. By analyzing interviews of twenty-five pediatric nurses, it was discoveredthat they intuit the time of the death by observing changes inboth the physical condition and the actions of the child. Although many nurses could make their assessments by observing a child's physical condition, fewer could make theirassessments based on a child's actions since this required
more sensitive observation. However, nurses that are able
to make these sensitive observations possess a unique andvaluable skill since they become able to predict an imminent
death before it is detectable in the physical condition andmedical tests.
Intuiting the time of death is associated with the task of preparing for the death. The nurses shared their intuitions withother nurses and physicians in order to make sure everyone

is on alert, they can reduce the child's agony, and to makesure the physician will be present at the time of death. The
nurses also share their intuitions with family members to encourage them to come to terms with the situation and to arrange for people to be at the bed side at the time of death.
For these reasons, intuiting the time of death is the fundamental skill needed by nurses to make sure the death occurs
in a well controlled situation according to the terms of a'good death'.
17. Fukui, S. (2001). The effect of educational group intervention on satisfaction with information among
Japanese women with primary breast cancer. 21(3).
61-70.
Many studies have pointed out that most cancer patients
have unmet informational needs and they are often dissatisfied with information they receive. However, no studies haveinvestigated the effect of informational supports on the satisfaction with information for Japanese cancer patients. The
aim of this study was to determine the effect of an educational group intervention in improving satisfaction with information among patients with primary breast cancer in arandomized controlled trial. The patient selection criteria
were age less than 65 years, and surgery undergone within
the previous 4-18 months as of the start of the study. We
conducted a 6-week educational group intervention. The intervention consisted of health education, coping skills training, and relaxation. Subjects were assessed for thesatisfaction with medical information and psychological information using the Visual Analogue Scale (VAS) at the baseline, at 6 weeks, and at 6 months. Fifty (33%) of the 151
patients participated and were randomized, and 46 (30%)
completed the study. The experimental group had significantly higher scores than the controls for the satisfaction
with the information about breast cancer (p=.04), stress of
having cancer (p=.0001), and coping methods to cancer (p=.0001), and the satisfaction with total medical services theyreceive (p=.0009) over the study period. The results of thisstudy suggest that a short-term educational group intervention produces significant long-term improvement in the satisfaction with information of Japanese patients with primarybreast cancer.

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