看護における高度な実践ジャーナル

Background: Near end of life cancer patients are suffering from multiple distress that can affect their quality of life. Oncology nurses as primary care givers of cancer patients are committed to provide high quality care considering complex ethical issues to this extremely delicate and sensitive patient and their families.
Purpose: To evaluate the ethical commitments of oncology nurses practice during the end of life period.
Methods: After the usage of different electronic database with specific key words, the number of the found articles was 31 articles, but only six articles were met the inclusion criteria and were used for the current review.
Results: This integrative review found that the oncology nurses are not completely adhere with ethical practice for terminally ill cancer patients. Lack of proper forms and documents combined with poor knowledge and understanding of nurses about ethical sensitivity was the major factors which led to poor end of life quality care and outcomes. The oncology nurse managers and their team members need to seriously take more responsibility with honesty and dignity to improve the situation. The oncology nurses should have the capability to identify the different needs of each patient specifically towards the late stage of disease progress.
Implications and Recommendations: In order to maintain a high quality care at the end of life which is critically important to manage the symptoms as soon as possible, and for more enhancements, the oncology nurses need comprehensive programs to increase their awareness about the importance of ethical practice and care.

Background and objectives: Pregnancy is a unique, exciting and often joyous time in a woman’s life. It is said that labor can be one of the most tiring and energetic experiences of a woman’s life. Primigravidae is the one who is more anxious about labor because of the lack of previous exposure to labor. In order to educate and encourage the primigravidae, to improve their knowledge regarding labor process, the study was conducted to evaluate the Effectiveness of video assisted teaching regarding knowledge on labor process among primigravidae attending antenatal OPD at selected maternity hospital, Bengaluru.
Methods: Pre-experimental design, with purposive sampling method was used. Information was collected from 40 primigravidae regarding labor process using the structured interview schedule. VAT was implemented and posttest was conducted after 7 days to find the effectiveness.
Results: Majority of respondents were from 19-26 years were Hindus, belongs to nuclear family, completed middle school education, occupation being home maker, monthly income below Rs. 3,000, attained menarche at 19-21 years; between 32-34 weeks of gestation. Major information had from family members/relatives. Regarding effectiveness of VAT, the overall mean knowledge score in the pre-test was 37.9% and 79.5% in the post test with enhancement of 41.5% and it was significant at 5% level. Analysis of socio-demographic variables showed significant association between age in years, occupation, age at menarche, gestational age with knowledge score at 5% level (P>0.05).
Interpretation and conclusion: Overall findings showed that pre-test knowledge scores were found to be 37.9% and after VAT, knowledge or primigravidae was enhanced by 41.5% regarding labor process. Hence the result has proved that VAT was effective in improving the knowledge of primigravidae on labor process.

Aim: To determine if a virtual (telephone) two week wait (2 ww) clinic affects patient satisfaction and delivers a comparable service to a traditional face to face assessment.
Study design: Part one is a case cohort comparative study of 100 consecutive patients (divided by referral criteria into virtual (n=50) and face to face (n=50) cohorts). Patient satisfaction in both cohorts was assessed by an adapted version of the Grogan et al. validated patient satisfaction questionnaire. The questionnaire was piloted first and was found to have high internal reliability (Cronbach's alpha=0.945). Part two is a three month data capture to compare specific quality indicators, such as, number of referrals for additional investigations or further clinic episodes between the two cohorts (virtual n=251 and face to face n=403).
Results: Overall satisfaction scores showed; 90% of patients in the virtual cohort and 98% of patients in the face to face cohort, strongly agreed that they were satisfied with the care they received. Mean satisfaction scores in the two cohorts revealed that the virtual cohort achieved less strongly agrees than the face to face cohort but this was not significant (p=0.5). Further analysis of the responses to each question demonstrated no statistical significance when comparing the two cohorts. Analysis of the three month data collection revealed no significant difference between the two groups and referrals for additional investigations (virtual 10%, n=25. Face to face 9.4% n=38) However, the face to face group yielded a higher number of further clinic episodes (virtual 1%, n=1. Face to face 3%, n=16) and colorectal cancer diagnoses (virtual 4%, n=10. Face to face 10%, n=40).
Conclusions: The study offered patients the opportunity to reflect on service delivery enabling a more responsive approach to healthcare within the colorectal 2 ww service. It provides strong evidence that virtual 2 ww clinics provide an assessment method that is essentially, as acceptable as traditional face to face clinics.

Background: There is the fact that low health worker motivation may affect the success of health care system. Therefore this study is aimed at identifying factors affecting motivation of primary health workers working at public health centers of West Arsi zone of Ethiopia.
Methods: This facility based was a cross-sectional study, pretested questionnaire were self-administered to 307 health workers from various clinical specialties. The responses were collected and analyzed; results were presented in frequency and tables.
Results: This study revealed that considerable proportions, 41.7% of the participants were demotivated towards providing routine health care of clients. Job satisfaction and professional advancements were factors positively affecting motivation of the respondents. Respondents’ attained professional advancements were 3.5 times more likely motivated than those not advanced providers. Likewise, the odd of being motivated for those satisfied at their job was 5 times higher than those unsatisfied at their jobs.
Conclusions: Significant numbers of the primary health care providers participated in this study were found to be demotivated towards jobs. Job satisfaction and professional advancements were factors influencing job motivation among the primary health care providers. Therefore, administrative measures aiming at raising the primary health care providers’ motivation should be placed.

We have conducted a series of studies on communication between nurses and elderly patients in geriatric facilities in Japan. The average speech duration per day for elderly people in nursing homes was roughly 4 minutes. The reason for such a short speech duration was that 76% of the nurses’ communication content was composed of “type I” communication (“task oriented” communication) and that “type II” communication (“life-worldly” communication) made up for only 24% of the total. We also analyzed the ways in which “type I” communication constrained spontaneous speech by the elderly whereas “type II” communication tended to promote and encourage it. This article, based on the findings obtained from our research, aims to encourage reconsideration and advancement in the research of nursing communication.