These results show the importance of off-the-job training programs designed to foster exposure to a wide variety of personal and professional experiences. They also illustrate the importance of planned on-the-job training programs that promote an understanding of the nature of the field, as well as developing planning and administrative competency in career development.

Aim: The aim of this study was to develop a new scale, the Competence Scale for Senior Clinical Nurses (CS-SCN), to assess and evaluate senior clinical nurses in hospitals, and to confirm the validity and reliability of the scale. Method: A cross-sectional questionnaire survey was undertaken at a hospital in Japan, using an anonymous self-administered questionnaire administered to clinical nurses (n = 374). A useable sample of 218 was achieved, which was used in the analysis. Statistical analysis examined exploratory/confirmatory factor analysis, internal consistency, and construct validity. Results: A five factor solution with 22 items was extracted for nursing competence in senior clinical nurses, which was the interpretable questionnaire. In the confirmatory factor analysis, the indices of fitness supported these results. Cronbach's alpha coefficient was 0.93 for the total score and varied between 0.63 and 0.90 in the five factors. Five factors emerged from an oblique factor analysis, with a cumulative variance of 66.7%: "role accomplishment"; "self-management"; "research"; "practice and coordination"; and "work implementation". The five factors had only a moderate correlation (0.30-0.77, P < 0.001) with each other, which indicated construct validity. Conclusion:The CS-SCN, a concise scale to measure and evaluate the competence of senior clinical nurses, was developed. Results suggest initial support for the new instrument as a measure of competence of senior clinical nurses, but it must be further refined, tested, and evaluated. Both the validity and reliability of the scale were verified. Future studies using the CS-SCN might lead to improvement in the competence of senior clinical nurses.

The purpose of this study is to assess the number and need of health and welfare services of the latent bedridden elderly in the community using the new criteria developed by the Ministry of Health and Welfare. A survey conducted in Ayase city revealed 145 bedridden elderly, out of which 52 were receiving home care (the home visit group), but 44 were the newly detected cases with not-receiving any services (the newly detected group). Comparing these two groups, conditions of the bedridden elderly seemed to be more severe for the home visit group, but there were no significant differences in conditions of caregivers for either group. For the newly detected group, information on health and welfare services had been provided by public health nurses, and more than half applied for some services.These results suggest that the role of public health nurses in both the case finding and delivery of the services is important.

The study was conducted in the Prefecture of Longevity, Okinawa, on the elderly living in the village of Ogimi. It was revealed that those in the good sleep health group took short naps, a significantly fewer number fell into dozes, and a significantly greater number exercised regularly or walked. A significantly greater number of this group maintained regular eating habits over a 10-year span, and consumed more seaweed and fish. Participation in senior citizens' clubs was higher, reflecting high emotional adaptability. The study's results indicates a relationship between lifestyle and sleep health among the elderly, and suggest that deterioration of sleep health is related to physical and mental health.

Caring culture is a concept embodying the perceptions and caring practices of caregivers, acknowledging the unique role of cultural beliefs in shaping behavior. A qualitative descriptive study with 13 caregivers of adult family members with a cancer diagnosis in Japan was conducted to gain insight into perceptions and experiences surrounding caregiving. Several major categories were identified, representing rarely reported cultural constructs of high cultural value for the Japanese: On-repayment for what the patient has given, Caregiving as performing a socially expected role, Enryo/meiwaku-restraint in asking for help, Family decision making reflecting strong bonds, Omoiyari-empathizing with the patient's feelings, and Inori-praying to myriad gods and ancestors. The Japanese cultural construct of ie (the strong relationship to family lineage and spiritual connection to past and future generations) is helpful in understanding these categories. Invisible yet powerful cultural constructs permeated caregiving practices. Insights from Japanese cultural concepts and beliefs may foster sensitivity and individualized care in diverse settings, cultures, and societies.