看護とケアのジャーナル

Background: Nursing Process is a systematic problem-solving approach used to identify, prevent and treat actual or potential health problems and promote wellness. It has five steps- assessment, diagnosis, planning, implementation, and evaluation. Objective: To assess factors affecting implementation of nursing process among nurses in selected governmental hospitals from February-April, 2011 at Addis Ababa, Ethiopia. Method: A cross-sectional quantitative study was conducted on selected governmental hospitals in Addis Ababa. Purposive sampling was used for selection of hospitals. Black Lion, St. Paul, Ras Desta Damitew Memorial, and Yekatit 12 hospitals were convenient for the study. The sample size was 202. Data was analyzed using SPSS 16th version. Result: Nurses working in a stressful working environment were 2.8 (adjusted OR: 0.357, 95%CI: (0.157-0.814)) times less likely to implement nursing process than disorganized working environment adjusting for facility accessibility, knowledge, and sex. Forty eight (25%) of respondents were anxious from high patient flow. Among those 15(31.3%), 22(45.8%), and 11(22.9%) have committed knowledge, executive, and slip/slap error respectively. Highly knowledgeable respondents were 38.913 (Adjusted OR: 38.913, 95%CI: (10.3-147.006) times more likely to implement nursing process than low knowledge group nurses adjusted for working environment, facility, and sex. Conclusion: The study has identified organizational factors, patient related factors, and level of knowledge and skill were among those factors highly influenced nursing process implementation. This factors cause poor quality of nursing care, disorganized caring system, conflicting role, medication error and readmission with similar problem, dissatisfaction with the care patients have received, and increased mortality.

The EU Directive on Sharps Injury Prevention in the Healthcare and Hospital Sector (Council Directive 2010/32/EU came into force in all EU member states on 11th May 2013. To ensure its success it is important that all medical and surgical personnel across Europe are aware of, and comply with, the legislation that has come into force as a result. This article discusses the impact that sharps injuries can have on a healthcare worker and their employer, the requirements of the EU Directive, as well as the best practices that healthcare organisations should adopt in order to create a safe working environment for their staff.

Introduction: To date there is limited research related to the perceived learning needs of adjunct clinical nursing instructors and the development of an effective clinical instructor certificate program. The purpose of this study is to identify the perceived learning needs of clinical instructors teaching in a variety of clinical settings. Methods: A qualitative survey is designed and administered to 230 adjunct clinical instructors at a small urban college in the Northeast using an Internet-based survey. The central aim of the survey is to identify the level of support for a formal orientation program and the "Nurse of the Future Core Competencies" that are of most value. Results: 80% of respondents reported that a structured orientation program would be of value. Legal and ethical issues, reflective practice and informatics were identified as priority topics to be incorporated into the program. The study also identified concerns related to aging clinical nursing faculty and the institutional support necessary to foster the development of clinical nursing instructors. Conclusion: As critical stakeholders in the development of nursing students, this study supports the need for a structured orientation program in order to improve nursing clinical education and retain qualified nursing clinical faculty members. The information gained from this study could serve as a basis for a future structured orientation program that may result in a successful model of well-prepared clinical faculty.

This is a systematic review that aims to identify scientific publications in databases that cover the bone marrowderived adult stem cells implantation in heart disease patient with changes in ejection fraction. For the study were used the databases LILACS, MEDLINE, Cochrane, Embase, CINAHL, PubMed and Ovid. In the five eligible trials with 279 patients, bone marrow – derived adult stem cells implantation indicates that there is statistical significance, although the number of studies are not conclusive for expressive statements to allow inferences about the effectiveness of the outcome. Based on the results we point out that the nurse should be focused on promoting adherence to treatment through conventional education measures.

As the frontrunner of ageing countries, we would like to introduce the role of public health nurses in Japanese long-term care prevention projects in the community and our research on healthy longevity in this review article. Previous studies in Japan reported that lack of participation in social activities was significantly related to an increased risk to suffer from disability and subsequently requiring the application of Japanese long-term care insurance. As for primary/secondary prevention for old populations, public health nurses are expected to develop and utilize the social capital in health promotion interventions at individual and community levels in Japan. Since 2006, long-term care insurance was revised focusing on preventive care by detecting people aged 65 years and older who are at high risk of needing future care or support. There will be increasing demand for health care professionals to promote a community's overall health status in cost-effective ways, and public health nurses should play an important role to make it.

Introduction: Patient experience has been used as an indicator to measure the quality of health care provided by nurses. However, this information is rarely available in countries like Ethiopia without which improving the quality of service and demonstrating the benefits of changes in nursing practice is usually difficult. The aim of this study was to assess nursing care experience and associated factors among adult inpatients in Black-Lion hospital, Addis Ababa, Ethiopia from March to April 2012. Method: An institution-based cross-sectional study was employed among 374 adult patients admitted to Medical, Surgical and Gynecologic wards in Black-Lion hospital, Addis Ababa. Patients admitted during the study period was considered and convenient sampling was used. A modified

Objective: For individuals living with mental health challenges, the provision of homeless shelters can offer a temporary respite in overwhelming life circumstances. There is, however, limited evidence regarding the subjective experiences associated with shelter services by Aboriginal women in Canada. The purpose of this study was to develop an understanding of the day-to-day experiences of Aboriginal women as they seek and provide safety, comfort, health, and healing in the context of mental illness and insecure housing. Methods: The study design was a secondary qualitative analysis of data collected in a primary mixed method study involving persons faced with mental health and housing challenges in southern Ontario, Canada. Narrative analysis was used to identify common experiences among 11 shelter service users and 10 shelter service providers, all of whom where Aboriginal women. Results: Regardless of whether the women received or provided shelter services, they consistently described experiences about being “kicked” and nurtured. Their stories about being “kicked” described experiences associated with compounding losses. Juxtaposed to this reality, were accounts about being nurtured or “lifting each other up.” Nurturing relations were essential to address the pervasive health and social disparities experienced by the women. Relationships within homeless shelters were directed towards supporting the health and well-being of individual women and their broader community. Conclusion: This study’s findings extend the community mental health body of nursing literature regarding Aboriginal women living with mental illness and homelessness. Despite the protective and restorative components of nurturing within shelter services, cooperative networks need to be developed to build communities that eradicate the pervasive losses experienced by Aboriginal women who continue to be “kicked.”

Background: Gestation and birth are physiological events and it might be easier for a woman to accept changes in her body image resulting from changes occurred in her body. Purpose: This study aims to determine body alterations, thoughts and behaviors of pregnant women which reflect their body image, and evaluate the effectiveness of education. Methods: The data for the intervention research was collected through face to face interviews conducted with 39 volunteer women who applied to health centers with the use of 36-item “Body Image in Pregnant Women Form”. In examination of data, t-test is used. The study approvals of relevant institutions are obtained. Results: The body and image satisfaction of pregnant before the pregnancy was 97.4 %, whereas it is 84.6% during pregnancy. In statistical analyses measuring the difference between the desire of eating (t=5.783 p<0.01), the habit of looking at the mirror (t=2.041 p<0.05), weigh checking behavior (t= 5.818 p<0.01), behavior of calling themselves names (t=4.638 p<0.01) pre-gestation and during gestation, a significant relationship was determined. All of the respondents stated that they were satisfied with the education and the subjects of training were beneficial. Conclusion: When the results of the study examined, it was concluded that body image was changed during pregnancy, the pregnant were happy despite the alterations in body image, the education made contribution to the improvement of body image by changing the behaviors reflecting the body image.

Background: Although a common thread among diabetic behavior is the importance of perceived glycemic control, little is known of the factors that lead to psychosocial status in this population. Purpose: We determine whether the psychosocial factors of health locus of control, self-efficacy, self-care behavior, and depression relate to glycemic control in type 2 diabetes. Method: We used a descriptive correlational design. In total, 285 subjects were enrolled from diabetic outpatient clinics in Southern Taiwan. We applied the health locus of control, self-efficacy, self-care behavior and depression questionnaires. Glycemic control was assessed by HbA1c. Results: The internal health locus of control was significantly positively correlated with self-efficacy and self-care behavior, and significantly negatively correlated with depression. Combined depression and self-efficacy partly mediated the relationship between internal locus of control and self-care behavior (P ＜.01), and completely mediated the relationship between external health locus of control and self-care behavior (P ＜.01). Depression and initial HbA1c directly and significantly affected final HbA1c value. Higher depression had the worst HbA1c. Conclusion: Internal health locus of control was partly mediated the relationship between depression and self efficacy. The finding could form a basis for caring people with type 2 diabetes and provide a reference for further research.

There is proportionate increase in the health problems along with increase in elderly population in India. Nurses need to be well equipped with knowledge and should also have a positive attitude regarding elderly care. The current cross sectional study was undertaken with an objective to assess the knowledge and attitude of nursing students regarding care of elderly. Using purposive sampling technique, 267 undergraduate nursing students were enrolled in the study. A pre validated self-administered questionnaire was used to assess the knowledge and attitude of nursing students regarding elderly care. The knowledge questionnaire consisted of 28 multiple choice questions with one right answer. Total score was further categorized as poor, average and good as per the score obtained by the subjects. The attitude was assessed on a Likert five-point scale, ranged from ‘strongly agree’ with 5 score to ‘strongly disagree’ with 1 score. It consisted of 16 items. The total score was further categorized as unfavorable, neutral and favorable attitude as per the scores obtained. Majority (95.5%) of the subjects were females. Mean age (yrs) ± SD was 22.61 ± 3.31 with the range of 19-48 yrs. More than half (53.9) were from urban locality. Only 29.2% were staying with the grandparents. Mean knowledge score ± S.D. was 22.10 ± 2.91, with the range of 9-27. Around two third (76.4) were in the good category of knowledge score. Mean attitude score ± S.D. was 60.38 ± 8.95 with the range of 22-78. 64.6% were in the positive category of attitude. Knowledge and attitude were positively correlated.

Diabetes is a chronic incurable disease of high prevalence in older people due to changes in glucose homeostasis, diabetes-related complications and other comorbidities that affect physical and cognitive functioning and have implications for medicines use. Polypharmacy is common and represents a significant medicine and selfcare burden, risk of medicine-related adverse events, and inappropriate prescribing. Some medicines used to treat diabetes such as insulin, sulphonylureas, warfarin and antiplatelet agents are known as ‘high risk’ medicines because of their association with adverse events. Managing medicines is a complex process that requires particular knowledge and skills and strategies to proactively identify risks and plan care to reduce the risk such as following evidence based recommendations/ guidelines, comprehensive assessment and monitoring, using decision support tools such as BEERs, STOPP and START criteria, and importantly, involving the individual and/or carers in medicine decisions to personalise medicines education and the medicine regimen.

Women in the developing world are experiencing "unimaginable suffering" due to lack of effective care during pregnancy and childbirth as many end up with debilitating injuries such as Vesico Vaginal Fistula (VVF). VVF is an abnormal communication between the urinary bladder and the vagina that results in the continuous involuntary discharge of urine. Most women affected are living in shame and isolation, often abandoned by their husbands and relatives. The aim of this study was to assess the extent to which abandonment, social isolation and stigmatization significantly influence the coping strategies of women affected by VVF in Akwa Ibom State, Nigeria. The study adopted Ex- post Facto design using mixed method of quantitative and qualitative approach. Transactional model of stress and coping directed the study. A sample of 120 VVF women (inpatients and outpatients), 18 VVF women coming back for follow-up care after repairs and 3 key informants were purposively selected for the study. Instruments for data collection were structured interview guide and in-depth (unstructured) interview. Regression analyses was used for quantitative data analysis and verbatim transcription/coding for qualitative with result presented in themes. The results showed that the three independent variables were significant predictors of coping strategies of VVF women in the area of study, with abandonment and stigmatization having a high influence though with a negative coefficient while social isolation exerted a weak influence. This implied that the more abandoned and stigmatized the VVF women, the less active their coping abilities while social isolation exerted less influence on their coping strategies. The study concluded that there exist a significant influence of abandonment stigmatization and social isolation on the coping strategies of VVF affected women.

Problem The purpose of this research was to evaluate the impact of an advanced practice nurse-directed patient education approach to heart failure treatment integrating the use of an interactive 4G android tablet, will enable patients to experience enhanced patient activation and engagement in chronic disease self-management and fewer 30-day rereadmissions. Data source This was a prospective patient randomization, multi-center quasi-experimental design study of 50 patients comparing an advanced practice nurse-directed education of disease self-management and use of a 4G android tablet (TC) group (n = 25) and routine medical management (MC) group. The study length was 12 months. Conclusions Descriptive statistics were computed, and the intervention and control groups were compared for differences. Descriptive statistics using ANOVA was conducted to calculate for statistical significance of readmissions between the two groups at 30 days. T-tests showed that the 30-day readmissions rate was significantly lower for the tablet groups compared to the medical group at 30 days (8% and 28% respectively; P=0.010). Implications for Practice The results support that integrating 4G android tablet technology does have a significant impact on enhancing patient activation and engagement in chronic disease self-management and correlated to reduced 30-day readmissions in people with heart failure.