看護とケアのジャーナル

The purpose of study was to evaluate the impact of depressive symptoms on the QoL in patients following acute coronary syndrome treated with percutaneous coronary intervention (PCI) at week one of hospitalization and 6 months following ACS. Methods The study population included 140 patients hospitalized for acute coronary syndrome who underwent PCI. Depression was evaluated using the Beck Depression Index, which is a self-scoring test for symptoms and severity of depression composed of 21 questions. QoL was evaluated with the use of the Mac New questionnaire, specifically designed for cardiology patients. The QoL evaluation in all Mac New dimensions in the depressed and not depressed groups was statistically different both at baseline and at 6-month follow up. At baseline and at the 6- month follow-up, the mean Emotional Dimension, Physical Dimension, Social Dimension and evaluation of the General Quality of Life dimension the results were lower in the depressed group compared with the not depressed group. The dynamics of change in QoL at 6 months following PCI was verified using the Wilcoxon test and a statistically significant improvement in quality of life was found in all Mac New dimensions in both groups. However, the dynamics were more beneficial in the depressed group. Depression in ACS patients has a strong negative effect on QoL both in early and late observations. Early depression, on the other hand, is a statistically significant and independent predictor of a lower QoL outcome. As such, diagnosis and treatment of depression in patients hospitalized with ACS should become a therapeutic standard.

Introduction: Discovering the potential benefits of conducting an informative group session prior to prosthetic hip and knee surgery. The contents of this session were agreed upon by Orthopaedic and Trauma Surgery, Rehabilitation, Physiotherapy and Nursing. The contents and the organizational format for this session at the Hospital de Denia are described. Materials and Methods: Patients awaiting prosthetic knee and hip surgery were randomly divided into two groups. The study group (n=23) was invited to an information session prior to their surgery. The control group (n=23) followed the usual protocol that consist on receiving general information about de procedure in the outpatient clinic. Pain, degree of satisfaction, knee mobility, and start of ambulation and days of hospital stay were recorded. Results: Forty six patients were included. Patients from the study group had a greater degree of satisfaction (100% satisfaction of 9/10), began walking sooner and had a shorter hospital stay than the control group. A rapid decrease in pain was recorded in the study group, reaching levels significantly lower than those of the control group as of the second day. Conclusions: In prosthetic joint surgery, educating patients increases their satisfaction and reduces their hospital stay. Thanks to this study, the prosthetics school has been routinely established in our hospital with a high degree of satisfaction for the patients, family members and professionals involved.

The United States healthcare system is faced with a critical shortage of nurses and nurse educators at the national and state levels. This shortage directly impacts the supply and demand of registered nurses (RNs) in the clinical work environments and the ability of these nurses to deliver high quality patient care. One of the challenges faced by deans and directors of schools of nursing is to identify strategies that will encourage faculty to stay in academe. Establishing a clear relationship between these variables is vital to resolving the problem of faculty shortage. A search of relevant literature across disciplines was conducted to identify the factors that contribute to the job satisfaction and /or job dissatisfaction and the intent to stay of nursing faculty who teach in BSN and graduate nursing programs. The literature review provided limited accounts of the various dimensions of the factors that predict nursing faculty’s job satisfaction and / or job dissatisfaction and intent to stay in academe. None of the studies found in the literature completely focused on the subject of intent to stay of nursing faculty in academe. Therefore, this literature review will focus on the nature of faculty work, job satisfaction, demographic factors of (age, education, health, family responsibilities, teaching experience) and intent to stay.

Objective: The purpose of this paper is to describe the problems that arise in relation to nursing students' handling of patient information as well as the current status of students' instructions on the matter. The instructions needed to avoid these problems are also presented. Methods: Research was conducted by giving self-report questionnaires to nursing faculty at Japanese nursing colleges as well as those directly instructing nursing practice. Results: At present, these problems are not occurring by chance, but instead stem directly from students' low awareness of information privacy issues—suggesting that there is a need for more thorough instruction. Nursing faculty felt that the instruction they were already giving was effective for the most part in preventing most privacy problems. However, even instructions that a great number of nursing faculty members are implementing have been shown to be ineffective in some regards.At the same time, while detailed, time-consuming instruction and instruction that requires coordination with hospitals have been shown to be effective, there are few instructors who have experiencecarryingtheseout.In order to determine the appropriate features of instruction that would effectively prevent problems from occurring, a survey was again conducted on "necessary instruction". As a result, a diverse set of eighteen instruction items were identified, among them "emphasis on prohibited actions" and "implementation of review when problems occur". Conclusion: The type of instruction deemed necessary is critical for the proper handling of patient information and includes basic content that can be applied outside of Japan as well.

During labour the fetal heart rate is the primary measurement to determine the health of the fetus and full use of modern electronics is made to measure the rate and variability in the rate which occurs in both a healthy and compromised fetus. Real time documentation is also part of the process. At birth the heart rate remains the primary vital sign of the neonate but measurement now relies on auscultation without any real-time documentation, at least until a satisfactory signal from pulse oximetry can be obtained. Pulse oximetry takes at least one minute before the signal is reliable but during this first minute critical decisions regarding care have to be made and during this time critical damage to the neonatal brain can occur if the wrong decision has been made. We describe how this gap in accurate measurement and documentation can be closed.

The body of research-based knowledge in paediatric caring science has been increasing leading to dramatic improvements in treatment. The purpose of this manuscript was to analyze results as stated by the researchers', in recently published articles on nursing and psychosocial research, within Swedish pediatric oncology setting. This was done through a review of 137 published articles about paediatric oncology related to caring science in Sweden. The result shows that the illness has affected, in both positive and negative ways, the wellbeing of everyone coming into contact with the child. The cancer also causes distress related to all aspects of life including physical, psychological, existential and social. Mediating factors for the experience of distress and wellbeing are: disease and treatment severity, age, gender and ethnicity of the participant, time since diagnosis, the use of internal and external support, and the identity of the person reporting the data. Health promoting aspects frequently reported are: family togetherness, coping strategies, engaging in normal life and activities, and quality of care which includes emotional support, information and family participation in care. The hospital staff has to be aware of the psychosocial issues experienced by children with cancer and their families, and they have to acknowledge the value of formal interventions, reporting benefits for children, families, and themselves.

Oral health inequalities exist in Scotland and although regular dental attendance contributes to good oral health outcomes, socio-economically deprived families are less likely to attend the dentist even when dental care is provided free of cost. Communication is key to developing good relationships between health care providers and service users, which is influential in ensuring attendance. Aim: To develop a toolkit to facilitate communication between socially excluded parents and Dental Health Support Workers (DHSWs) to aid their dental attendance. Method: Discussions between public health dentists and service designers resulted in an interactive storyboarding toolkit called CHATTERBOX. Results: CHATTERBOX is made up of a timeline base, activity cards and appointment postcards. The activity cards are pictorial representations of everyday family activities and of barriers identified by parents as influencing dental attendance. Nine blank cards allow for parents to describe other concerns not already represented. Parents select relevant cards and place them on the timeline to construct a visual narrative of their day. The cards are also used to raise issues relating to dental attendance such as transportation, childcare, social support, previous dental experiences and other dental-related concerns that families may have. The DHSWs use CHATTERBOX to initiate a structured conversation around the populated timeline to identify where, when and why problems occur when attending for dental care. The timeline is photographed and used again in subsequent visits. CHATTERBOX encourages a two-way interaction by opening up dialogue between DHSWs and parents. CHATTERBOX becomes a platform for parents to reflect, identify problems, consider solutions and eventually solve their own problems. Conclusion: The discussion between players aids the development of confidence and consolidates relationships between DHSWs and families. This improved communication allows the DHSWs to tailor support according to the specific needs of the family, which further improves the family’s likelihood of attending for dental care.

Purposes: Horticultural therapy (HT) is an enjoyable and accessible method of recreation that readily lends itself to a variety of healthful lifestyle activities. HT is valued for its physical, cognitive, social, emotional, and recreational benefits. This study was designed to examine the effects of HT on the psychological well-being and hope of rural women. Methods: HT consists of three stages: establishing credibility (sessions 1-3), well-being and interpersonal relationships improvement (session 4-22), and maintenance (sessions 23-24). Participants consisted of 45 women from rural Korea, of which 21 were assigned to the experimental group and 24 to the control group. The experimental participants attended 24 sessions of HT. Results: Two groups undergone the program had a significant difference in the psychological well-being and hope. Conclusions: The findings of this study show that HT has positive effects on psychological and emotional health, and can be utilized as an intervention to help rural women.

Objectives: Living-donor lung transplantation (LDLT) is a real therapeutic option for pediatric patients in Japan. However, not all families with sick children can take advantages of a LDLT because of luck of suitable donors. Mental care for such a family becomes important when the parents cannot be donor candidates due to their own illness. The aim of this report is to describe the emotional and psychological status of donor candidates who could not be a lung donor due to malignancy. Methods: A semi-structured interview was performed with a donor candidate who was unable to donate due to whose own malignancy. The recipient was a 12 year- old girl, and the donor candidates were her parents. Results were obtained by a qualitative inductive analysis. Results: Donor assessment revealed that the recipient’s mother had malignancy. She was excluded from being a donor candidate and the planned living donor transplant for her daughter was cancelled. The mother’s emotional responses when she failed to donate to her sick daughter were the major theme extracted from the data. In this context, nine codes were obtained and this theme was detected across three main categories including mood disturbances, anxiety symptoms, and affective reactions. A transplant team supported the donor’s and recipient’s emotional health. The donor developed a more positive attitude at overcoming her own disease and began to expect brain-dead donor could save her daughter’s life. Three years later, the recipient underwent a successful lung transplant from a brain-dead donor. Conclusion: These findings have the potential to help transplant nurses develop interventions to improve the emotional health of living donors who failed to have the ability to donate their organs. Mental health promotion, assessment, and treatment must become priorities to improve the overall domestic mental environment of having a sick child waiting for lung transplant.

Although a number of studies have dealt with the emotional pain and suffering of older people with dementia, most of the research done so far has approached the topic from the standpoint of Behavioral and Psychological Symptoms of Dementia (BPSD) treatment. To acquire comprehensive insight into the emotional and spiritual pain and suffering of older people with end-of-life dementia beyond the scope of BPSD, we explored the emotional and spiritual pain and suffering of older people with end-of-life dementia as observed by nurses and care workers. As the results, we extracted eight dimensions of emotional and spiritual pain such as “they do not let me do the things I want to do” or “I am given medical treatment against my will”. We conclude that our results help enhance the quality of end-of-life care provided to older people with dementia who are often unable to voice their pain and suffering.

Objective: Implementing a multimodal campaign could be resulted in a sustained increase in hand hygiene (HH) compliance rates. However, most studies of HH campaign have been conducted in the developed countries. This study was aimed to evaluate the effectiveness of hand hygiene campaign in a university hospital in China. Methods: During the period of the HH campaign, the WHO hand hygiene improvement strategy was implemented to improve hand hygiene compliance. We collected and evaluated the effect of hand hygiene campaign by the questionnaire of WHO hand hygiene observation, consumption of alcohol-based hand rub (AHR), liquid soap and gloves, and the quality of HH by adenosine triphosphate (ATP) test. Results: Of the 4,177 opportunities of hand hygiene evaluated, the HH compliance improved significantly from 24.2% to 41.0% after the intervention. Health care workers in the ICU showed higher hand hygiene compliance compared with those in other departments. In general, Nurses’ hand hygiene compliance was higher than those of physicians and surgeons. The consumption of AHR and the ATP pass rate increased after the intervention. Conclusion: Through the intervention, medical staff hand hygiene compliance was greatly improved from 24.2% to 41.0%. The WHO Hand Hygiene Strategy was also effective in hospital of China.

This paper examines the challenges facing health systems, and hypothesizes community participation as a panacea toward tackling them. Health systems are constrained by many internal and external problems such as human resources, financing, drugs, supply system, information use and generation, overall policy environment, political instability and the quality of governance, prompting health agencies to adopt various approaches toward tackling them. This includes adopting service-specific or disease-specific programs. Despite these approaches, a lot of health systems have remained too fragile to cope with the rising challenges of global health. Some measures that can be harnessed to deal with the internal problems have been proposed, but regrettably, the external factors cannot be easily controlled, but with a well laid down autonomous structure for the health systems, their effects can be significantly reduced. Altogether, community participation in driving the machinery of these health systems offers promising prospects toward strengthening them

Simulation activities performed in nursing programs can provide many learning opportunities for nursing students. Real life simulation activities, allow students to put their knowledge into practice, while recognizing areas of weakness that need improvement. The environment to perform these activities is a safe learning environment to allow students to make and recognize mistakes prior to entering the career field. Debriefing activities allow for reflection to encourage students to self-evaluate and recognize areas for improvement. Faculty encourage students and assist in improving areas of weakness. By participating in the activities, student’s cognitive and psychomotor skills can be enhanced and students can gain a better understanding of didactic material.

This article is dedicated to outlining two nursing care models for elderly people in Germany and China. Shaped by the European welfare state model, Germany has launched a statutory long-term care insurance program aimed at integrating multiple actors, such as the family, intermediary organizations, non-profit organizations and private providers into a supply structure within a mandatory social care insurance system, where the welfare state acts as lawmaker and regulator for public nursing care. Compared to the German system, China has a rudimentary nursing care system characterized by a hybrid model, which relies on both conventional family care and individual private insurance. After introducing elderly care in both countries, this review article explores the possibility of transferring the German model of long-term care insurance to China to reduce the increasing problem of elderly care. The soaring demand for elderly care and underdeveloped public services for nursing care represent a great challenge for contemporary Chinese society.

Background: Nursing care models provide the infrastructure for organizing and delivering care to patients and families. Over the decades, different models have waxed and waned. Since the 1980s, the primary nursing model has gained increasing prominence. However, there is no systematic research evidence on the effects of this model for patients, their family members, nursing staff or the care organization. This subject has much current relevance because of the requirement to develop evidence-based nursing care. Objective: To describe the effects of the primary nursing model for patients, their family members, nursing staff and the care organization. Design: A systematic literature review. The studies selected for review (n=9) were appraised for quality using the Quality Assessment Tool for Quantitative Studies, as developed by the Effective Public Health Practice Project. Data sources: The research data were collected from four databases from January 1990 to March 2013. Results: Research on the effects of the primary nursing model has largely been restricted to the effects for patients and nursing staff. No data are available on how it affects the patient’s family members or the care organization. The preliminary evidence suggests that the primary nursing model may have beneficial effects for patients in the context of maternity care. There is less evidence of the primary nursing model’s positive effects for nursing staff. However, it is possible that the model contributes to an increased sense of job control and autonomy. Conclusion: The existing body of research has methodological shortcomings, and more RCT studies are needed to establish the effects of the primary nursing model, for instance on the organization’s costs, nurses’ job satisfaction and staff retention. Further research is also needed into the effects of the primary nursing model on numerically measurable outcomes, such as medication errors during hospital care and the length of treatment periods.

Background: Improving care outcomes in trauma patients is regarded as important and linked to an appropriate model of care particularly in social unrest area where there are limited resources and accessibility after discharge. To facilitate prompt management to improve patient recovery or quality of life and decrease some complications, a specific model of continuing care for those trauma survivors is required. Objective: This participatory action research (PAR) aimed to develop the trauma-based continuing care model (TCCM) for enhancing care outcomes in trauma patients affected from Social Unrest area. Method: A three-phase of PAR design was implemented with stakeholders in both hospital and community services related to care for trauma survivors and their families. In the first phase, 11 trauma survivors were interviewed and 3 focus group discussions with nurses and related health care staff were conducted to identify existing systems and problems encountered. The second phase consisted of two workshops, involving 20 key informants and allied health staff for the purpose of developing the model. The final phase evaluated the initial effects of the model after implementing with 20 patients by measuring the care process and outcomes such as nurses’satisfaction, patients’quality of life, patients’self care ability, caregivers’ ability to care. Data were analyzed using descriptive statistics for care outcomes and content analysis for the care process. Result: The model consisted of a) trauma-care process through a trauma nurse-initiated discharge planning program b) patient-family follow up. With the PAR process, the following steps included 1) preparing the multidisciplinary health care team including patient and family caregivers, 2) organizing the system, identifying individual role and function for continuing care, and 3) collaborating with community support network for patient and family management. The main strategies to drive all process were teamwork involvement, care coordination, and staff education. The model could enhance both health care staff and family caregivers in providing better care. In this study, most patients were able to manage themselves. Twenty patients and 10 family caregivers were satisfied with the care process and obtained better outcomes regarding health status and quality of life. In addition, the developed trauma nurse-initiated discharge planning program was also discussed for further implication. Conclusion: The key success was derived from trauma nurse-initiated discharge planning process and collaborating with community support network. To enhance the sustainability of the model, care managed by enhancing networking of community nurse, patient and family after discharge needs to be further explored.