This study investigated nursing practice in continuing nursing care with the aim of identifying the key factors in nursing practice during discharge support. A literature review of papers published in Japanese in 2000 and 2011 was conducted using ‘case management’, ‘care management’, ‘continuing nursing care’, ‘discharge support’, ‘discharge planning’ and ‘elderly person’ as key words. An analysis of 54 papers revealed the following five aspects of continuing nursing care: (i) a cyclical approach aimed at realising the lifestyle desired by the person concerned; (ii) management of medical conditions for lifestyle stability; (iii) support for the patient as someone who can live independently; (iv) support to raise the ability of families to care for themselves; and (v) team approach to achieve implementation of patient‐centred care. Understanding these aspects allows nurses to recreate the lifestyle of patients and families and facilitate the implementation of a systematic team approach.

Background Comprehensive care is necessary for people with epilepsy (PWE) to lead a fulfilling life at home and in the community. The purpose of this study was to determine the epilepsy-related knowledge, attitudes and practices of home healthcare nurses (HHNs) in the Sanin region of Japan. Methods A questionnaire survey was conducted by mail of 546 HHNs working in Tottori and Shimane Prefectures. The questionnaire assessed the epilepsy-related knowledge, attitudes and practices of HHNs. For the analysis, simple and cross tabulation of questionnaire responses were conducted, and the chi-squared test was used for statistical testing. Results A total of 285 HHNs participated in the study. Of the respondents, 43.9% had experience taking care of PWE in a home healthcare nursing setting. Regarding the cause of epilepsy, in descending order the percentage of correct responses were 86.7% for stroke, 85.3% for head injury, and only 13.3% for dementia. Concerning how to respond to an epileptic seizure, almost all respondents answered correctly, but 29.8% gave the incorrect answer of "place something inside the mouth." Regarding the practices of HHNs in relation to caring for PWE, nurses scored 52.0% for collaborating with the attending physician, indicating the need for improvement. The score for "provide information about social resources" was low at 18.4%. Of the respondents, 95.8% answered that epilepsy-related knowledge and technical skills were necessary for home healthcare nursing practice, and 87.7% were interested in participating in a workshop on epilepsy. Conclusion The study revealed an inadequate level of knowledge of epilepsy with dementia and corresponding epileptic seizures, a low awareness of nursing care in collaboration with physicians, and the importance of providing information about social resources. There is a need to offer information and education on the latest knowledge about epilepsy to HHNs.

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Objective: To clarify aspects of autonomous nursing judgement in newly graduated visiting nurses with 2 years or more of experience.Methods: We conducted semi-structured interviews with seven newly graduated visiting nurses with 2 years or more of experience. Responses were analyzed descriptively and qualitatively.Results: The core structure of autonomous nursing judgement was for the nurses to make judgements about helping to ensure a better life and livelihood for patients ("finding out with the patient through trial and error what a better life with medical care means" and "noticing changes and determining the degree of urgency") through patient-centered thinking ("considering what could be done to help patients live a life that is uniquely their own"). The nurses also make better judgements because they " take initiative in consulting nurses in the same station to share decisions."Conclusion: Newly graduated visiting nurses with 2 years or more of experience use patientcentered thinking to work with patients to find out through trial and error how patients can lead a better life. They determine the degree of urgency when the patient's condition changes and adjust decisions accordingly. They also take the initiative to consult senior nurses to guide better nursing judgement. 要 旨 目的：2 年以上の勤務経験を有する新卒訪問看護師における自律的判断の様相を明らかにすることを 目的とした． 方法：2 年以上の勤務経験を有する新卒訪問看護師 7 名に半構造化面接を行い，質的記述的に分析した． 結果：2 年以上の勤務経験を有する新卒訪問看護師における自律的判断のコアは， 【利用者が自分らし 受付日：2021 年 2 月 12 日 受理日：2021 年 10 月 10 日

Objective: To obtain a definition of nursing judgment in home healthcare nursing practice as performed by home healthcare nurses in Japan.Methods: A total of 33 literature references published in Japan were assessed. Rodger's method was employed for concept analysis.Results: The following four attributes were extracted: "understanding patients as individuals with their own lifestyles, opinions, and values", "proactive perspective", "discussing care for patients to meet their lifestyle needs", and "careful patient-centered consideration". In addition, 3 antecedents were extracted: " characteristics of nursing in daily life " , " intention to exercise professional judgment", and "ability of each nurse". Finally, 2 consequences were extracted: "contents of judgment" and "conduct of appropriate care for patients". Conclusion:Nursing judgment in home healthcare nursing practice by home healthcare nurses in Japan was defined as the process of understanding patients as individuals with their own lifestyles, opinions, and values and discussing the care required to meet their lifestyle needs with the patients as well as the people surrounding them. This process should be performed proactively and should be based on careful patient-centered consideration. Through this process, the patient's condition, care, and involvement are determined, so that appropriate care for each patient can be provided in nursing practice.