ObjectiveThis study aimed to evaluate the effects of the care coordination of pleural mesothelioma program (CCOM program), an educational program that we developed for nurses to improve their knowledge, attitude, and confidence on the care coordination of pleural mesothelioma (PM) patients.MethodsIn this randomized controlled study relative to the CCOM program, we measured the self‐reported total scores of knowledge, attitude, and confidence of nurses before (pre‐test) and after (post‐test) the CCOM program. The CCOM program consisted of a care guide and nine study videos featuring various aspects of PM (2 h 15 min) and a face‐to‐face workshop (3 h 30 min). Sixty participants were randomly assigned to the intervention group (n = 30; with program) and control group (n = 30; without program). Fifty‐eight participants completed the study (intervention group, 28; control group, 30). The total scores of knowledge, attitude, and confidence at pre‐test and post‐test were compared using one‐way repeated measures analysis of variance (ANOVA).ResultsAt pre‐test, the groups showed no significant differences in age, experience of taking care of PM patients, and working department, except for the years of experience as a nurse. The CCOM program improved the knowledge, attitude, and confidence in the intervention group, whereas the control group showed stability in the scores. Repeated measures ANOVA showed significantly greater beneficial changes in the intervention group on main measurement scores.ConclusionsThe CCOM program was effective in improving the knowledge, attitude, and confidence of nurses on the care coordination of PM patients.

AimsThis study aimed to provide a clear definition of the concept of maternal stress in the neonatal intensive care unit (NICU), which has been inconsistently described in previous studies. It also aimed to identify the essential attributes, antecedents, and consequences of maternal stress through concept analysis.MethodsRodgers' concept analysis method was used. A search was conducted using the web version of the Central Journal of Medicine, PubMed, PsycINFO, and CINAHL, yielding 223 hits. Of these, 32 were selected for the analysis.ResultsThree attributes of maternal stress in the NICU were identified: “Earnest feelings for my infant,” “Stuck feeling,” and “Vague anxiety about the future.” Six antecedents and four consequences were identified.ConclusionsThe results of this study indicated that mothers felt a sincere desire for their infants, as well as a vague sense of helplessness due to circumstances beyond their control, and anxiety about the future. These findings suggest that while the NICU environment can be a source of stress for mothers, it may also serve as a supportive space and an opportunity for them to reflect on their role as mothers.

We read with interest the descriptive analysis of certified disaster-related deaths following the 2024 Noto Peninsula earthquake (Kida & Ishikawa, 2025). The tabulation of ICD-10 categories (Table 2, p. 5) and the co-occurrence network of narrative descriptors (Figure 2, p. 6) provide useful information for practice and policy. For readers outside Japan, we should clarify one point of terminology that bears directly on inference. In Japan, disaster-related death is not a clinical diagnosis or a sociological construct; it is an administrative certification issued by municipalities after a family application and committee review, primarily within the condolence-grant system. As Kida and Ishikawa (2025) notes, stating this administrative basis at first mention may help align expectations about what such data can demonstrate. Recent nationwide evidence underscores this context. A cross-sectional study of 755 certified indirect disaster-related deaths after the 2011 Great East Japan Earthquake found that only 9.8% of death certificates and 19.2% of medical records explicitly mentioned disaster relevance, while 71.0% relied on bereaved-family self-reports. Tsuboi et al. (2025) describes these deaths as certified and recorded by municipalities at family request for condolence grants. These features indicate that the label primarily reflects a legal-administrative judgment of indirectness rather than a standardized biomedical attribution of causality. Three issues deserve attention: Case ascertainment reflects procedures as well as health status. The analyzed population comprises cases that underwent application, certification, and consent for public release. As acknowledged in the Methods and Limitations, fatalities not applied for are excluded; under-ascertainment of indirectly disaster-associated deaths is therefore possible. Administrative certification is not a causal estimate. Pairing ICD-10 “direct causes of death” (Table 2) with narrative descriptors is informative descriptively; yet without a defined at-risk denominator, counterfactual comparisons, or standardized medical documentation of “disaster relevance,” causal effects or effect sizes cannot be inferred from these data alone. Finally, the text network should be interpreted cautiously: it visualizes word co-appearance rather than causal mechanisms. The co-occurrence map summarizes word co-appearance in public narratives under a Jaccard-based approach and does not encode etiologic direction or magnitude; an explicit note in figure captions could help avoid mechanistic interpretations. This aligns with broader findings in the literature on classification and interpretation of disaster-attributed mortality (Combs et al., 1999; Hayakawa, 2016). These points do not detract from the article's practical insights—for example, the prominence of circulatory and respiratory causes among certified cases—but may help readers frame these findings as signals for service planning rather than as established causal pathways. That perspective aligns with work positioning disaster related death as an indicator of medium- to long-term impact with caveats for causal interpretation (Yamamura et al., 2024). To support valid inference while preserving the descriptive value of the study, we offer concise, neutral wording adjustments that remain close to the design: Definition at first mention: Describe disaster-related death as a municipal administrative certification used in the condolence-grant system, distinct from clinical cause of death or notions such as “social death.” Event terminology: Consider “reported events temporally associated with certified deaths” in place of “causal events.” Scope of inference: Note that the analysis describes associations within certified cases and does not estimate causal effects or population-level risks. Figure/Results captions: Clarify that the network shows textual co-occurrence (no directionality), and that ICD-10 codes denote immediate/official causes of death distinct from the administrative certification. We appreciate the careful assembly of municipal public data and view the study as a constructive contribution to disaster nursing. Clear separation among legal certification, clinical cause of death, and hypothesized pathways should facilitate future linkage studies and comparative designs that can quantify risks and mechanisms more directly. This work was supported by Health Labour Sciences Research, Grant Number 24LA2001. The authors declare no conflicts of interest.

AimThis Viewpoint analyzes the policy implications of Real‐World Data (RWD) utilization in Japanese nursing research, comparing Japan's revised Next‐Generation Medical Infrastructure Law with the European Union's European Health Data Space (EHDS) regulation. The paper explores how data standardization, interoperability, privacy protection, and technological integration can be improved in Japan and proposes actionable policy solutions for RWD integration into nursing practice and health policy.MethodsThe paper draws on a review of empirical studies and policy documents, comparing Japan's fragmented RWD framework with the EU's EHDS regulation. Focus areas include data standardization, interoperability, privacy protection, and technological integration. The review analyzes case studies from chronic disease management, nursing workflow optimization, and predictive analytics.ResultsThe comparison reveals barriers to RWD integration in Japan, such as inconsistent data standards, fragmented IT infrastructure, and lack of centralized data repositories. The EU's EHDS law offers a cohesive framework for cross‐border data sharing through standardized data formats, enhanced interoperability, and privacy protections. The paper argues that Japan must adopt similar policies to improve data governance, enhance interoperability, and develop integrated systems for nursing research.ConclusionsJapan must strengthen its data governance frameworks, establish centralized data repositories, and adopt standardized practices to fully capitalize on RWD's potential. By aligning its policies with the EU's EHDS regulation, Japan can improve RWD integration in nursing practice and health policy, leading to better outcomes and more effective interventions.

AimTo propose a nursing‐led pathway for safe task sharing in Japan to address population aging and workforce shortages.MethodsThis Viewpoint outlines a practical route centering on five shared competency domains (decision‐making, safety management, communication, equipment operation, and troubleshooting) verified through interprofessional simulation. We describe a common competency credential (CCC) assessed via standardized scenarios, objective rating scales, and mastery thresholds.ResultsA nursing‐led policy pathway would align education, credentialing, and financing via the national fee schedule. By embedding stop rules, clear supervision levels, and psychological safety, the approach addresses concerns regarding safety, legal accountability, and hierarchy in the Japanese context.ConclusionsWith the 2024 fee schedule emphasizing team‐based care, nursing‐led interprofessional simulation and a CCC offer a feasible, evidence‐informed route to safer care, greater efficiency, and a more sustainable workforce.

AimThis study aimed to clarify the relationship between the implementation of multi‐professional collaboration to support “medical care in daily life” for technology‐dependent children in community settings and their outcomes.MethodsA cross‐sectional survey was conducted in 18 prefectures across Japan, involving 343 professionals, including consultation support specialists, visiting nurses, care workers, school nurses, and school nurse teachers. Fifty‐five items related to the three elements of multi‐professional collaboration—Gearing up individually, Working together, and Achieving results—were analyzed using factor analysis, one‐way ANOVA, multiple regression analysis, and the Mann–Whitney U test with SPSS version 29. Ethical approval was obtained from the ethics committee.ResultsNine factors were identified: two related to prerequisites, four to collaborative practices, and three to outcomes. All factors demonstrated high internal consistency. Appropriate staffing of professionals, openness to new members, and the presence of a leader were significantly associated with all collaborative practices. Furthermore, communication through shared problem‐solving and mutual respect for professional roles was associated with all activities. Collaboration centered on the needs of individuals and families showed the strongest association with positive outcomes.ConclusionThree essential elements for strengthening multi‐professional collaboration were identified: (1) structured placement and flexible integration of professionals, (2) mutual trust and respect among professionals, and (3) sustained collaboration centered on the needs of individuals and families. These findings provide a practical framework for improving team‐based care for technology‐dependent children in community settings.

AimsDiabetes‐related stigma poses challenges for individuals with diabetes, including impaired self‐care. Understanding its relationship with healthcare professional support is essential to clarify strategies for reducing stigma. This study aimed to examine the association between diabetes stigma and the support provided by physicians and nurses.MethodsA cross‐sectional survey was conducted from October 2022 to May 2023 in Osaka, Japan, among outpatients attending hospitals and clinics with diabetes specialists. Participants were aged ≥18 years with type 1 or type 2 diabetes; those with gestational diabetes or unable to complete the questionnaire were excluded. Diabetes‐related stigma was assessed using the Kanden Institute Stigma Scale, whereas support from physicians and nurses was evaluated using the doctors' and nurses' support scale. Data were analyzed using multivariate logistic regression. Ethical approval was obtained prior to study initiation.ResultsDiabetes‐related stigma was inversely associated with physicians' support and nurse's support. Social and self‐stigma were associated with physicians and nurses' support among participants aged <65 years but not among those ≥65 years. By contrast, discordant stigma was associated with physicians' support in the younger group and with both physicians' and nurses' support—particularly in health information subscales—among older participants.ConclusionsSupport from physicians and nurses may reduce diabetes‐related stigma. Younger adults may benefit from advocacy and personalized care, whereas older adults require enhanced emotional and informational support. Healthcare professionals should address stigma to improve self‐management and quality of life among people with diabetes.