看護における高度な実践ジャーナル

Aim: To provide a narrative review of the literature and discussion addressing the issue of young university undergraduate students, patterns of disordered eating and the relationship between stress and stress coping.

Background: The term disordered eating reflects the spectrum of disturbed eating patterns, including anorexia nervosa and bulimic nervosa. In the last three decades a significant amount of research has been undertaken internationally in relation to this area, with increasing concern as disordered eating impacts upon the individual’s long-term health prospects, but also their ability to function and achieve as undergraduate students.

Methods: A narrative review and discussion of the literature from 1980, against 7 databases with assessment of the papers applying a quality criteria scale. 35 papers were finally included for consideration in this review.

Conclusion: There are a large number of young undergraduate students probably struggling with or at risk from disordered eating. A significant proportion of this may be undisclosed and presents sub-clinically. There may be issues relating to mental health in some of the cases, but the literature suggests at least a proportion of the students are perhaps struggling with stress/distress and poorly developed coping resources. The emergence of or exacerbation of disordered eating may present as a negative coping response. The discussion and review suggests a need for greater qualitative enquiry to expose more of the student’s voice in terms of eating and their stress/distress experience. Such deeper enquiry might better inform support for young students in managing stress in the early years at University.

Developmental Dysplasia of the Hip (DDH) captures a range of hip disorders which requires early identification and management and as such is a significant public health and primary care issue. The incidence of late diagnosis is higher in Ireland that other countries. Hip ultrasound is not widely practiced in Ireland. After birth, Public Health Nurses (PHNs) practitioners in Ireland may be the first health professional to be alerted to a missed case of DDH. The aim of this paper is to use a case study to illustrate the complexities of public health nursing practice with parents to screen, intervene and manage DDH. The paper highlights the way in which PHNs fulfil their public health role by implementing interventions, at the level of individuals, communities and systems, to address public health issues, informed by the Public Health intervention Wheel (The Wheel). Implications for education and practice are also discussed.

Daily checklists are shown to improve outcomes and adherence to quality measures in ICU care however completion of them consistently throughout institutions varies. Patients’ loved ones are more present in the ICUs than in previous decades and can be a valuable resource for both information and use as a prompter for a daily checklist. In conjunction with the bedside nurse and health care providers, patients and their loved ones can add to the successful use of a daily ICU rounding checklist.

The number of tools developed by researchers has increased in recent years. Still the demand and need for development of new and standardized tool is increasing to a great extent, the simple reason is either standardized tools are not available or available tools lacks reliability and validity in that setting. This article explores the steps and process which provides base by which a reliable and valid tool can be developed. Method followed was indepth review of published research articles. This article reviews tool development procedures used in 17 articles published in leading journals from 1992 to 2007. It points out the steps of tool development viz. item generation in which theoretical basis to be used. Next step is reliability in that internal consistency, equivalence by inter-rater and stability by test-retest method is checked; validity i.e. face, content, concurrent and construct validity to be calculated. Further in construct validity factor analysis including principal component analysis, pre-analysis checks and factor extraction is to be analysed. Based on the review, the author mentioned the steps of tool development which will guide researchers to improve the tool development process.

Background/Objectives: Postoperative delirium is common in the elderly and is associated with poor outcome. However, its diagnosis is often missed or delayed. Nursing staff is at the frontline and plays a crucial role in the early detection and management of delirium. This study was designed to explore the knowledge and attitudes of nursing staff about delirium in the scope of an educational program implementation.

Methods: Qualitative and quantitative analyses conducted in four surgical wards and one intensive care unit in an Academic Hospital in France. A questionnaire was administered to 171 nurses and nursing assistants and semistructured interviews were conducted.

Results: A total of 89 questionnaires were completed (response rate of 52%). Regarding symptoms, most of the nursing staff knew about disorientation and incoherent speech. However, few knew about acute onset and fluctuation, and the hypoactive form of delirium was virtually unknown. Regarding risk factors, while many knew about dehydration, drug use and the use of physical restraints, few knew about fecaloma, sensory impairment and infection. The staff globally knew about the main prevention measures, but knowledge on patient management was especially poor. Finally, no respondent knew about or used the Confusion Assessment Method. The qualitative analysis revealed a trivialization of delirium onset among older inpatients and the continuity of preconceived ideas on delirium, its diagnosis and its risk factors.

Conclusions: On the whole, this study provides a clearer understanding of staff learning needs and identifies potential issues to be addressed in order to increase future intervention efficacy.

Globally, more than 200 million children under five years fail to reach their potential in cognitive and social development due to poverty, poor health, malnutrition, and deficit care. The prevalence rate of cognitive development problem in Bhutan is 15%, 33.5% of children less than five years are stunted and 9.9% of infants are born with low weight of less than 2,500 grams. Five main factors identified in contributing to growth and developments at early childhood are nutrition, parent’s behaviours, parenting, social and cultural practices, and environment. Understanding the extent and magnitude of these problems especially within 1000 days of child includes from the date of conception till the child attends 2 years of age is very important. If timely interventions are taken within this critical period, the problems are reversible and will gain maximum benefits. A healthy child especially within this age will have better cognition and learning capabilities, and consequently have impact on social, economic, physical and cognition. Therefore, healthy children within 1000 days will lay the foundation for nurturing bright school children, healthy and productive adulthood thus will promote Gross National Happiness of the country.