This study aimed to clarify the factors related to self-efficacy experienced by psychiatric nurses. Analysis of qualitative descriptive data from a free self-description questionnaire administered to 16 psychiatric nurses working in psychiatric hospitals revealed 24 codes across the following 8 categories as factors that increase self-efficacy: A1. possibility of practical use in nursing, A2. nursing judgment, A3. improvement of psychiatric symptoms, A4. the patients presenting a positive attitude, A5. building a relationship of trust with the patients, A6. building a relationship of trust with other nurses, A7. work progressing according to plan and A8. team medical practice. Twenty-five codes across the following 10 categories were identified as factors that decrease self-efficacy: B1. lack of communication, B2. uncertainty in caregiving, B3. recurrence of psychiatric symptoms, B4. feeling overpowered by a patient, B5. sense of being too busy to work adequately, B6. difficulty in bringing about self-improvement, B7. sense of loss regarding one's role as a nurse, B8. lack of physical strength, B9. mechanical performance of nursing and B10. fluctuating view of nursing due to mistakes. These factors require intervention for psychiatric nurses' self-efficacy.

The average length of hospital stay in the psychiatric ward is longer, and the risk of patientto-nurse violence is higher than that in other departments. Therefore, psychiatric nurses' work environment may differ from that of other nurses. The factors related to psychiatric nurses' self-efficacy may also differ from those of general workers or other nurses. Mental health care that considers the characteristics of psychiatric nurses requires exploration of self-efficacy unique to psychiatric nurses. This cross-sectional study aimed to explore the distinct factors related to psychiatric nurses' self-efficacy. The developed 24 items related to improvement in self-efficacy and 25 items related to decrease in self-efficacy were examined. The Generalized Self-Efficacy Scale was used to measure the validity of the factors. To extract the factors of self-efficacy, data from 132 nurses and assistant nurses who provided informed consent were analyzed, and the reliability and validity of the factors were calculated. The factors associated with improvement in self-efficacy were "Positive reactions by patients," "Ability to positively change nurse-patient relationship," and "Practicability of appropriate nursing." The factors associated with decrease in self-efficacy were "Uncertainty in psychiatric nursing" and "Nurses' role loss." The Cronbach's α for all factors exceeded .70. Of the five factors, four had significant weak-to-moderate correlations with the Japanese version of the Generalized Self-Efficacy Scale; therefore, the validity was quantitatively confirmed with four factors. Interventions based on these four factors may improve psychiatric nurses' self-efficacy. Additionally, it is possible that this tool assesses the unique facets of self-efficacy rather than psychiatric nurses' general self-efficacy. Interventions to improve psychiatric nurses' self-efficacy based on the characteristics of psychiatry are needed.

Recent studies have found a relationship between fear of COVID-19 and mental health problems. Medical workers caring for COVID-19 patients tend to suffer from mental health problems; however, the impact of their personality traits, in the form of mental problems like depression and anxiety in Japan is unclear. In this study, we investigated the risk of nurses’ depression and anxiety, predicted by the fear of COVID-19 and the Big Five personality traits. A total of 417 nurses working in hospitals providing care to COVID-19 patients in Wakayama prefecture of the Kansai region participated in this study. The questionnaires comprised items on nurses’ basic characteristics and three scales: the Fear of COVID-19 Scale 2020, the Big-Five Scale, and the Japanese version of the Hospital Anxiety and Depression Scale (HADS). Depression and anxiety in the HADS were set as dependent variables, and basic attributes, fear, and personality traits as independent variables; multivariate logistic regression analyses were conducted. The questionnaire, with no missing items was distributed from February to March 2021. Neuroticism (OR = 1.06, 95%CI = 1.03–1.09) was the only significant factor associated with the depression symptom, and both FCV-19S scores (OR = 1.16, 95%CI = 1.09–1.23) and neuroticism (OR = 1.09, 95%CI = 1.06–1.13) were the significant factors associated with anxiety. The Nagelkerke’s R squared was 0.171 in the depression model and 0.366 in the anxiety model. Thus, it was found that it is necessary to support nurses’ mental health by developing methods suitable to their personalities.

Nurses experienced uncertainty about the care needs of older patients, the ethical problems of Enhancing the patients' QOL by using risky care, and the evaluation criteria used to judge their own nursing care after the patients' death. All nurses had the goal of ensuring a natural death for all patients. Nurses' acceptance and evaluation of their own care was critically influenced by the patient's family's responses to their care after patients' death. Further research is necessary to develop evaluation criteria and educational programs for end-of-life nursing care of older adults.