Purpose: To investigate the present situation and to explore future problems in bereavement care. Methods: A questionnaire survey was mailed to approximately 1,000 home-visit nursing stations throughout Japan. Results: A total of 296 (29.8%) valid responses were returned. Of the responding stations, 6.1% answered that they “positively perform” bereavement care, 73.1% “perform [it] when necessary,” and 20.7% “seldom perform” bereavement care. A total of 91.4% of the responding stations provided bereavement care by visiting nurses after a patient’s death. A total of 73.6% of the responding stations always performed care in the form of appreciation for their efforts. A total of 32.4% of the responding stations contacted related organizations to request that the organizations watch bereaved family members who suffered from dementia but lived alone. Reasons for not contacting related organizations included not knowing which organization to contact (17.5% of the responding stations). Conclusion: Approximately 90% of the responding stations provided bereavement care by visiting nurses after the patient’s death, with emotional support as the main activity. Visiting nurses were asked to acquire abilities: 1) to provide bereaved families with information about health and welfare services that could be used in addition to long-term care insurance to rebuild their lives, 2) to ascertain which bereaved families would need continuous support, and 3) to assign these bereaved families to relevant organizations.

Purpose: To elucidate the problems recognized by visiting nurses when local communities support the bereaved families of users of home-visit nursing stations. Methods: A questionnaire survey was mailed to approximately 1,000 home-visit nursing stations throughout Japan. Results: We then analyzed 211 free descriptions and extracted 8 problems, including “Grief care is difficult to continue because it is a voluntary activity,” “It is insufficient in assessing bereaved families and I don’t know the social resources to introduce to bereaved families,” “I am reluctant to be involved with bereaved families,” “Because of the Act on the Protection of Personal Information, it is difficult to support bereaved families,” and “A formal & informal support for bereaved families has not been established.” Conclusion: No system has been established for grief care in Japan and grief care does not generate a profit; therefore, visiting nurses felt limited in their ability to be continuously involved in grief care, although they were concerned about the situations of bereaved families. This study indicated future tasks that home-visit nursing stations that perform grief care for the bereaved families of their users and home-visit nursing stations that request this care be provided by community general support centers should be evaluated in terms of medical remuneration points.

Purpose: The aim of this study was to extract factors for home-visiting nurses to determine family caregivers who need support after bereavement. Methods: A questionnaire was constructed and administered to 105 family caregivers of terminally ill patients. Using the survey responses, factors were extracted that would allow home-visiting nurses to judge the necessity of bereavement support before and after the deaths of the patients. Of the 105 family caregivers, 30 consented to participate in the survey. Researchers interviewed the 30 family caregivers using the Center for Epidemiologic Studies Depression Scale and the SF-8TM health survey to assess the health-related quality of life. The obtained data were analyzed using the mathematical quantification theory class II. Results: The extracted factors included: the existence of a disease under medical treatment, the existence of dissatisfaction with medical services, the existence of the economic burden of a disease, a married couple consisting of persons aged over 75 years, family members living in the home who tended to leave care to the primary caregiver, no reliable family members or relatives outside the home, and a tendency to refrain from requesting others’ help (the discrimination hit ratio was 76.7%, the correlation ratio was 0.42, and P=0.001). The criterion-related validity of judgments by home-visiting nurses was verified. Conclusion: These seven factors were revealed as important for determining family caregivers who need support after bereavement.

Purpose: We clarified the relationship between attitudes towards ambiguity in nurses’ communication with patients and families, emotional coping strategies and attitudes towards end-of-life care among nurses in general wards. Methods: Requests for participation in a survey were sent to nurses working in general wards with 3 or more years of work experience. The survey was in the form of an online self-administered questionnaire. Results: The responses of the 239 nurses who answered the survey were subject to analysis. Among nurses’ attitudes towards ambiguity, the highest scores were for “control of ambiguity” followed by “enjoyment of ambiguity.” Among emotional coping strategies, the highest scores were for “regulating both patients’ and one’s own emotions.” “Positive attitudes toward caring for dying persons” was most significantly associated with “enjoyment of ambiguity.” “Recognition of caring for the pivot dying persons and his families” was most significantly associated with “regulating both patients’ and one’s own emotions.” Conclusion: The results suggest that nurses working in general wards may need to foster attitudes towards “enjoyment of ambiguity” in communication with patients and families, and also coping abilities “regulating both patients’ and one’s own emotions”, so that they can enhance the attitude toward end-of-life care.