岩瀨 敬佑

Abstract Background Recent advancements in digital health technologies have led to the accumulation of large volumes of unstructured text data, particularly in electronic health records. Given that nursing documentation frequently includes detailed descriptions of daily living activities and psychosocial contexts, existing medical natural language processing (NLP) tools may not be directly applicable without adaptation. Moreover, the integration of standardized nursing terminologies into NLP systems remains limited. Although NLP has the potential to support risk detection, information management, and care planning, its practical applications in nursing have not yet been systematically mapped. Objective This scoping review aimed to map the practical applications of NLP in nursing practice, with a specific focus on real-world clinical use, particularly for assessment, documentation, and interventions, and to identify the study characteristics, application domains, outcomes, and challenges. Methods Following the Joanna Briggs Institute methodology and PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines, a systematic search was conducted across PubMed, CINAHL, the Cochrane Library, Scopus, Embase, and Ichushi-Web in October 2023 and June 2025. The population-concept-context framework (population: nurses; concept: NLP applications; context: clinical settings) was used to guide study selection. Two independent reviewers screened 2889 unique records and reviewed the full texts of 72 studies. Data were descriptively synthesized and thematically classified. Results Six studies met the inclusion criteria, indicating that empirically evaluated applications of NLP in real-world nursing practice remain limited. NLP applications were categorized into three domains: (1) text summarization and generation, (2) information extraction and classification, and (3) real-time detection and screening. NLP was applied across multiple stages of nursing practice, including handovers, assessment, care planning, continuity of care, and patient safety management. Notably, NLP was used as a form of augmented intelligence to complement, rather than replace, nurses’ clinical judgment and to support clinical decision-making. These findings also highlight a substantial gap between rapid technological advances and the limited implementation of NLP in real-world nursing practice. Conclusions This review highlights the substantial gap between rapid technological advances and the limited implementation of NLP in real-world nursing practice. NLP may help reduce manual review workload, support early risk identification, and facilitate individualized care planning in selected nursing contexts. However, direct empirical evidence regarding its effects on nursing workflows, nurses’ clinical decision-making, and patient-level outcomes remains limited. Future research should prioritize real-world implementation studies and evaluate nurses’ acceptance, adoption barriers, workflow integration, and the influence of NLP on clinical decision-making.

OBJECTIVE: Amid growing calls for respect for gender diversity, Japanese law restricts midwifery qualifications to women, excluding individuals assigned male at birth. By contrast, in some countries, all individuals can pursue midwifery qualifications regardless of gender. These differences highlight varying institutional frameworks and levels of social acceptance. To clarify nursing students' acceptance of midwifery qualification acquisition across gender identities and sexual orientations. METHODS: An anonymous online survey was conducted from April to May 2024 among 98 undergraduate nursing students (10 men and 88 women) enrolled at a single anonymous health sciences university in Japan. Acceptance of midwifery qualification acquisition was assessed using the proportion of positive evaluations for nine gender identity and sexual orientation categories. Evaluations were measured on a 4-point Likert scale. Data were analyzed using descriptive statistics, cross-tabulation, and χ2 tests. RESULTS: Heterosexual women had the highest level of acceptance (96.9% positive evaluations), while heterosexual and bisexual men had the lowest (46.9%). There were substantial gender differences in the level of acceptance for different sexual orientations; however, none were statistically significant. CONCLUSION: Acceptance of midwifery qualification acquisition varied by gender identity and sexual orientation categories, suggesting that gender roles and cultural perspectives may influence attitudes. The findings indicate that systems should be reviewed to allow anyone, regardless of gender, to qualify and work as a midwife. They also highlight the importance of fostering an understanding of diversity through education.

BACKGROUND: Sleep quality is crucial for maintaining and enhancing health and quality of life in older adults. However, the specific components of sleep-related lifestyle advice associated with improved sleep quality remain unclear. This exploratory study aimed to describe the themes of personalised health guidance provided to community-dwelling older adults by targeting those whose scores on the Athens Insomnia Scale (AIS), a validated self-reported measure of insomnia severity, improved after an intervention that combined sleep monitoring and personalised health guidance. METHODS: In a 3-month intervention, 12 trained healthcare professionals (including nurses and public health nurses) delivered individualized health guidance using sleep data obtained from a non-wearable actigraphy device, the Active Sleep Analyser. Among them, 11 provided guidance to the participants whose data were included in the present analysis. Of the 168 older adults who received the intervention, the data from 162 participants with complete AIS scores were analyzed. From this group, 57 individuals who displayed improvements in their AIS severity classification over a 3-month period were selected for qualitative analysis. The guidance sessions were recorded, transcribed verbatim, and analyzed using an inductive content analysis approach. RESULTS: The analysis revealed seven major categories comprising 18 sub-categories. The categories were: (1) Praise for improvements in sleep quality and behavioural change efforts; (2) evaluation and continuous support for behaviour change; (3) establishing appropriate napping habits; (4) developing a healthy daily routine and rhythm; (5) establishing appropriate sleep habits; (6) addressing factors affecting sleep quality; and (7) appropriate medical advice and recommendations to consult physicians. CONCLUSIONS: This exploratory study described the themes observed in the personalized health guidance provided to older adults who showed improvements in AIS scores. These findings provide descriptive insights and may inform the development of future interventions or hypothesis-driven studies to support sleep health among community-dwelling older adults.

BACKGROUND: In home care nursing, nurses are required to assess not only the care recipient's condition but also their living environment. However, conventional paper-based case studies make it difficult for students to grasp the actual living environment. OBJECTIVE: This study aimed to develop a learning support application (app) that combines 360-degree camera images with a paper-based case scenario and evaluate its usability among nursing students. METHODS: Four areas inside the home of a single home care recipient were comprehensively photographed using a 360-degree camera. Thereafter, an app was developed to enable the users view the 360-degree images online by scanning with a smart device a QR code attached to a paper-based case scenario. To evaluate its usability, nursing students used the app and participated in semi-structured interviews. The data were analyzed using text mining techniques. RESULT: Text mining analysis revealed a co-occurrence network comprising four subgraphs. The representative keywords for each subgraph are as follows:Subgraph 1: Consider, Home, Fall, Risk, EnvironmentSubgraph 2: Think, Danger, Imagination, WatchSubgraph 3: Assessment, Learning support app, Residential environment, Home settings, UseSubgraph 4: Life, See, Person, Situation. CONCLUSION: The app supported students in understanding the home care environment and contributed to the development of care planning competence. Future studies should increase the number of cases and perform quantitative comparisons.