There were two objectives of this study. The first was to identify the attitudes of home-visit nurses towards clients with schizophrenia that lead to the provisions of effective care and positive client outcomes for clients with schizophrenia. The second was to develop a framework to understand how nurses acquire nursing attitudes that lead to such provisions. Seven expert home-visit nurses who had successfully prevented rehospitalization of clients with schizophrenia for more than 2 years were interviewed. In the semistructured interviews, the nurses described their experiences in assisting one or two clients. Data were analyzed qualitatively. The central theme was having equal footing with the client. An effective nursing attitude was acquired through recognizing one's own preconceptions of clients with schizophrenia through two steps: encountering unexpected client behaviours and becoming aware of one's problematic care. For these clients, it was essential that the nurses reflect on their preconceptions towards clients with schizophrenia and alter these preconceptions by working with the clients and believing in their innate ability to live in the community. The findings suggest that the field of mental health home-visit nursing might benefit from adding these educational components in order to cultivate effective nursing attitudes for assisting clients with schizophrenia.

: 24-33 psychological and physical self-management of people with schizophrenia in community psychiatric rehabilitation settings: A qualitative study This study had three objectives: to explore the psychological and physical self-management behaviours of people with mental illness; to identify their motivations for their self-management behaviours; and to develop a framework to understand the generative processes of healthy vs. unhealthy conditions. The participants were eight persons with schizophrenia who were attending psychiatric rehabilitation centres. We conducted semi-structured interviews with the participants on their observations regarding public health nurses' counselling with them. The data were analysed qualitatively. Six categories of health self-management behaviours were identified. The primary motivations that led to the participants' behaviours were 'getting a job in the near future' or 'maintaining my current level of living'. The use of their own methods caused unhealthy conditions when health management was excessively strict or there was a discrepancy between their and care providers' recognition of the appropriate level of self-management.

The population of Japan has become multi-cultural, and there is more demand for culturally competent nursing care. The purpose of this study was to explore cultural characteristics of nursing practice in Japan focusing on behaviour. We interviewed 25 professionals with experience in or knowledge of nursing practice both in Japan and either the United States, the United Kingdom, Sweden, Thailand or South Korea. Qualitative content analysis has yielded three themes for cultural characteristics of nursing practice in Japan: practice expectations, communication and relationships with patients. Practice expectations for nurses in Japan involved various aspects; nurses conducted a wide range of basic nursing tasks, including bed baths and toileting. They often relied on non-verbal communication to deliver thoughtfulness and perceptiveness. They typically show deference to doctors and colleagues, emphasizing building and maintaining harmony with them. This emphasis on a multifaceted, non-verbal, and harmonious approach seemed characteristic of practice among Japanese nurses.

Home healthcare nurses could give more attention to pressure ulcer prevention. Regular self-checks of quality indicators may remind the nurses of the importance of prevention.

This study aims to determine the relationship between recreational drug use in HIV-positive males in the past year and socio-economic factors and/or social support networks in Japan. A national online survey in a cross-sectional study was conducted by HIV Futures Japan project from July 2013 to February 2014. Of the 1095 HIV-positive individuals who responded, 913 responses were determined to be valid; responses from the 875 males were analysed. A total of 282 participants used addictive drugs (32.2%) in past year. New psychoactive substances were used by 121 participants (13.8%), methamphetamine or amphetamine by 47 (5.4%), air dusters/sprays/gas by 31 (3.5%), 5-methoxy-N,N-diisopropyltryptamine (5MeO-DIPT) by 16 (1.8%) and cannabis (1.0%) by 9. Multiple logistic regression analysis was performed with the use of alkyl nitrites, addictive drugs, air dusters and thinners, which are low illegality, as dependent variables. We found that the odds ratio (95% confidence interval) for use among participants with full-time and temp/contracted/part-time employees compared to management/administration professions were 2.59 (0.99-6.77) and 2.61 (0.91-7.51). Also, a correlation was observed between alkyl nitrites and new psychoactive substances and usage rates in people engaged in few HIV-positive networks. It is necessary to develop targeted policies for drug use prevention and user support among HIV-positive men and to support and provide care for drug users who are isolated or have a narrow HIV/AIDS support network.