Physician–nurse collaboration is essential for realizing the team approach to health care. The current status of this collaboration must be examined from the viewpoints of both physicians and nurses. The present study, part of a larger study, aimed to translate the Jefferson Scale of Attitudes toward Physician–Nurse Collaboration （JSAPNC）, developed by Hojat et al. （1999）, into Japanese and to assess the attitudes of physicians and nurses toward collaboration in Japanese hospitals.
1）A self–administered questionnaire survey was distributed to 520 physicians and 2139 nurses at 4 hospitals in 4 prefectures, and valid responses were received from 51.0％ of physicians and 76.2％ of nurses.
2）Factor analysis revealed that the factorial structure of the Japanese version of the JSAPNC was different from that of the original version. The Cronbach’s alphas of the scale were 0.79 for total scores and 0.5 to 0.7 for subscales.
3）The total score on the JSAPNC was higher for nurses than for physicians. No demographic characteristics of physicians were correlated with their total scores on the JSAPNC. In contrast, nurses’ age, length of clinical experience, qualifications, position, and affiliation were correlated with their total scores on the JSAPNC.
4）The total score on the JSAPNC could be used to compare the attitudes towards collaboration of physicians and nurses between Japan and other countries. The results show that the total score on the JSAPNC of our subjects in Japan was lower than those in previous studies in other countries. Education for facilitating and evaluating collaboration is needed.
5）Further investigation of factors related to physicians’ attitude toward collaboration is required. For nurses, it is necessary to investigate factors related to their attitude in combination with organizational factors.

Headaches caused by metastatic brain tumors result from dural tension and traction of the sites of nociceptive nerves that originates from displacement of cerebral vessels and intracranial hypertension caused by the tumor. Causes of such headaches also include meningeal irritation resulting from intrathecal dissemination of tumor and carcinomatous meningitis.Treatment of headaches resulting from intracranial hypertension involves alleviation of cerebral edema and reduction of intracranial pressure using hyperosmolar therapy and steroid administration, but treatment is often complicated by a lack of pressure reduction. We encountered 2 cases of headaches with intracranial hypertension that did not improve following hyperosmolar therapy and steroid administration, but resolved with increased opioid dose.In cases where intracranial pressure does not decrease, or for headaches attributed to direct stimulus of intracranial nociceptive nerves rather than intracranial hypertension, attempts to treat the patient with initiation or increased dosage of opioids may prove effective from a clinical standpoint.

To improve the quality of palliative care in the Kyoto region, we thought that closely connecting hospice and palliative care units (PCU) is necessary. Subsequently, we established the Kyoto PCU Liaison Committee in September 2017. This committee was created as a place to casually discuss the problems that individual PCU facilities have, deliberate on their worries together, grow and develop, and support newly launched facilities. Furthermore, discussions were held on current topics (emergency hospitalization, blood transfusion, smoking, bereaved family meetings, etc.) at the liaison meetings. While meetings were adjourned in 2020 due to the COVID-19 pandemic, we continued to exchange opinions on infection control, PCU management, etc., using the email network at first. Later, these meetings resumed via web conference systems. Thus, by having face-to-face relationships on a daily basis, we were able to maintain cooperation between PCUs even during the pandemic, and collaborate with cancer treatment hospitals. Overall, by forming a team of PCUs in Kyoto Prefecture, we aim to enable patients and their families to live with peace of mind wherever they are.