Perceptions of nurses in Japan toward their patients' expectations of care: A qualitative study

Objectives: This study aimed to investigate ideal nurse involvement based on the expectations of patients.Data on conflicts between nurses and patients were obtained.The patient situation involved standard nursing treatment,rather than acute phase or palliative care.Methods: Questionnaires were distributed among senior nurses attending a series of trainings in 2012 and 2013.The nurses were requested to return their completed questionnaires within two weeks.We ensured the effectiveness of the interview process to obtain accurate answers.The sample comprised 240 head nurses and assistant head nurses who were asked to respond anonymously to 57 questions about non-acute (stable) psychiatric or physical nurse-patient scenarios.Qualitative data analysis was conducted using these responses.Results: We received 41 completed responses (response rate =17.1%).The expectations of patients and their families were reflected in five categories,namely,inference,empathic understanding,listening attitude,individual treatment,and reliable skills and explanations.Inference was independently categorized as a particularly strong characteristic of Japanese patients' expectations.Conclusions: Nursing care in situations where conflicts or misunderstandings may arise can be improved by encouraging nurses to be attentive to the moods,feelings,and expectations of patients and their families.The findings from this study can improve the quality of Japanese nursing care with regard to sensing (inferring) and reacting to the expectations of patients.

Learning Outcomes Using Cooperative Learning in Communication Classes: Evaluation Using Text Analysis

Objectives: The study examined nursing students’ acquisition of good communication skills via text analysis of learning outcomes using cooperative learning. Methods: The study involved 90 first-year students enrolled in the nursing department of a Japanese university. Participants were asked to learn three learning tasks considered to heighten communicative ability through firsthand experience using the discussion-based technique of cooperative learning: 1) to engage in self-reflection, 2) to imagine something beyond your own experience, and 3) to accept something that does not fit within the scope of your own experience or thought. A questionnaire survey consisted of five items, including learning challenges 1) to 3) as well as 4) “Satisfaction with the exercises” and 5) “Students’ hopes.” These items were evaluated using text analysis. Results: A total of 79 survey questionnaires were collected (87.8% recovery rate) for analysis. “Self-reflection and self-realizations prompted by the communication exercise” was observed as a characteristic of Task 1, “becoming aware of ideas and opinions different than one’s own by listening to the opinions of others” as a characteristic of Task 2, “deepening relationships by learning about diverse ideas and values through interactions with others” as a characteristic of Task 3, and “the effects of communicating with student subjects” as a characteristic of Task 4. The responses to Task 5 were diverse;no common characteristics were found. The intervention was found to be useful for student engagement and the communication required of nurses. Conclusions: Using cooperative learning discussion in communication class was found to be effective. As nursing is an inherently interpersonal occupation, such effects include important elements.

Good Relations between Nurses and Patients: Spreading the Wings of Imagination, Protecting Patients’ Souls

Objective: To ascertain a method for building good nurse-patient relations from the narratives of veteran nurses who have accumulated profound nursing experience, and to show these phenomena in model form. Methods: Semi-structured interviews were conducted, verbatim records of the contents of the interviews produced, and qualitative analysis undertaken. Results of analysis and concepts considered important were shown in model form. Results: Veteran nurses, utilizing their nursing specialization, showed “Concern as humans,” transcending their professional specialty. This was expressed as “spreading the wings of imagination” in order to know what is important to patients, and “protecting souls” in order to defend, together with patients, what is most important to the latter. “Spreading the wings of imagination to protect patients’ souls” became the key to build good nurse-patient relations. Conclusion: Nurses with deep experience expressed building good nurse-patient relations as “spreading the wings of imagination and protecting patients’ souls.” We were able to ascertain that in nursing practice, using the sensitivity of veteran nurses, is one way of manifesting nursing conduct.

Changes in Japanese Nurses’ Awareness of Patient Interactions Following a Japanese Tea Ceremony

This study provided foundational data for use in nursing interventional methods for improving nurse-patient relationships. This was a descriptive study on the effectiveness of a Japanese tea ceremony (in Japanese: chado) intervention for improving nurse-patient relationships. I conducted a Japanese tea ceremony and examined changes in nurses’ awareness regarding interactions with patients after this intervention. The tea ceremonies were conducted with the cooperation of an Urasenke tea ceremony lecturer. A quiet environment with chairs and tables was provided for all participants while they provided written answers to a descriptive survey, which was administered before and after the intervention;they required approximately 20 min to complete the survey. The mean length of each nurse’s description was 800 characters. The tea ceremony was effective in bringing about definite changes in nurses’ awareness concerning interactions with patients. This study is useful in that it suggests how nurses can maintain good interpersonal relationships with patients.

Features of Suffering Perceived by Japanese Patients in a Stable Condition: A Text Analysis

Objectives: We performed a text analysis of telephone consultation content regarding features of suffering (thoughts that patients cannot express to nurses) perceived by Japanese patients in a stable condition. Methods: Semi-structured interviews were conducted by 8 telephone counselors who listened to patients’ suffering. Interview content was recorded verbatim, text was organized, and a text and association analysis was conducted (cluster analysis, bubble plot analysis, and a co-occurrence network analysis). Results: Seventy-two conversations were obtained and analyzed. It was confirmed that suffering as perceived by stable, Japanese patients had consistent concerns such as “lack of inference,” “privacy issues,” and “nurses’ not intervening on patients’ behalf.” Additionally, expectations of patients when patients are suffering are extremely diverse and were not characterized by specific tendencies. Conclusions: Emotions have a complicated influence in the context of Japanese patients’ suffering. It is necessary to consider the cultural background of expression in Japan to treat patients’ suffering.