地域包括ケアシステムの中で急性期医療を受ける患者の願い : 希望がなきゃ生きていけない``Nursing Care for Patient Goals''(NCPG)への示唆

JNI : The Journal of Nursing Investigation


The Structure of Staying Power, The Set of Skills that Empower Nurses Long-Term Continuation in the Profession

Objective: To define staying power, conceptualized as the set of skills veteran nurses acquire as theycontinue working that empower them to remain in the profession. Methods: Semi-structured interviews wereconducted with nine veteran nurses who had worked continuously at a local university hospital in Japan for20 years or more. Interview contents were analyzed using Kinoshitas Modified Grounded Theory Approach(M-GTA). Results: Staying power was defined in terms of 22 concepts in nine categories: determination tokeep up with ones peers, determination not to repeat the same mistakes, positive mindset, emotional selfcontrol, good maintenance of physical and mental health using a compatible approach, sociability to build goodpersonal relationships, resolution to fulfill ones responsibilities as a nurse, drive to improve and discover onesfull potential as a nurse, and choosing a compatible work style. Career nurses acquire the determination to keepup with their peers prior to employment: this ability is a core strength, which influences the acquisition of allother component strengths, and is maintained and reinforced as they continue in the profession. Conclusions:Establishing a supportive workplace culture that sustains and reinforces nurses determination to keep up withtheir peers should be an essential aspect of turnover prevention and nurse retention strategies.

目的:ベテラン看護師が獲得した働き続ける上での「心の強さ」の構造を明らかにする．方法:勤続年数20年以上の看護師9名に半構造化面接を行い，データを木下のM-GTAで分析した．結果:「心の強さ」には，周りに追いつくための努力ができる力，失敗を繰り返さないように努力ができる力，ポジティブな思考ができる力，自分の気持ちを調整する力，自分に合った方法で心身の健康管理ができる力，良い人間関係を構築する力，看護師としての責任を果たそうとする力，より良い看護を目指し自分ができる看護を探求する力，自分に合う働き方を選択する力があった．彼らは就業前より周りに追いつくための努力ができる力を獲得しており，その力は他の全ての「心の強さ」の獲得に影響し，職業を継続する中で維持・強化されていた．結論:看護師の職業継続には，周りに追いつくための努力ができる力を維持・強化する支援的な職場環境が重要であると示唆された．

Journal of Japan Society of Nursing Research


地域包括ケアシステムの中で急性期医療を受ける患者の希望を地域につなぐための患者状態とニーズの抽出ー"Nursing Care for Patient Goals1(1NCPG)の構造化―


小学生の喫煙および健康に関する意識

小学生の喫煙および健康に関する意識


A Japanese literature review on the work continuation of mind-career nurses: focus on the reasons for leaving and career continuation

中堅看護師の職業継続に関する文献検討-「離職」と「職業継続」の理由に焦点を当ててー

Abstract Purposes: The aim of the present study was to clarify the factors that affect leaving and career continuation of mid-career nurses from prior literature and to obtain suggestions for vocational continuity support.

Method: A literature search of Japan Medical Abstracts Society, Medical Online, and CiNii Articles databases was conducted using the following keywords: "nurse and leaving," "mid-career nurse and leaving," "mid-career nurse and occupation continuation, " and "mid-career nurse and duties continuation," including all studies published between 2005 and 2017. We investigated 21 studies that mentioned "the reason why mid-career nurses wanted to quit work" and "the reason why they continue working." Further, we classified inductively "the reason why they wanted to quit work" and "the reason why they continue working" based on similarity and categorized them.

Result: "The reason why mid-career nurses wanted to quit work" was represented in seven categories, which included the following: [disagreement with the career plan], [lack of worth doing of work], [stress caused by human relations], [bad working environment], [uneasiness about nursing practice ability], [growth restraint of self-efficacy], and [there is no reason that continues working in particular]. In addition, "the reason why mid-career nurses continue working" was represented in the following seven categories: [agreement with the career plan], [with the worth doing], [good human relations], [good working environment], [experience to enhance self-efficacy], [there is not a reason to quit work in particular], and [stress management].

Conclusion: "Career plan," "worth doing," "human relations of the workplace," "work environment," "nursing practice ability," and "self-efficacy" were related with the factor that nurses wanted to quit, including reasons for continuing occupation. However, stress management was a factor found in career continuity alone, and effective stress management was suggested as a factor that would change mid-carrier nurses' feeling of wanting to quit work into wanting to continue work.

要 旨 目的:本研究は，日本における中堅看護師を対象にした先行文献から，中堅看護師の離職と職業継続に影響を与える要因を明らかにし，職業継続支援への示唆を得ることを目的とする．

方法:文献は，「医学中央雑誌Web(ver.5)」，「メディカルオンライン」，「CiNii」を使用し，「看護師and離職」，「中堅看護師and離職」，「中堅看護師and職業継続」，「中堅看護師and職務継続」というキーワードで検索をした．検索の範囲は，2005年から2017年までとした．対象文献は，「辞めたいと思った理由」と「働き続ける理由」について記載がある21文献で，「辞めたいと思った理由」と「働き続ける理由」を類似性に基づいて帰納的に分類し，カテゴリー化を行った．

結果:中堅看護師が「辞めたいと思った理由」として，【キャリアプランとの不一致】【やりがい不足】【人間関係によるストレス】【労働環境が悪い】【看護実践能力についての不安】【自己効力感の形成阻害】【特に働き続ける理由がない】のコアカテゴリーが抽出された．また，中堅看護師が「働き続ける理由」として，【キャリアプランとの一致】【やりがいがある】【良好な人間関係】【労働環境が良い】【看護実践能力についての自信】【自己効力感を高める体験】【特に辞める理由がない】【ストレス・マネージメント】のコアカテゴリーが抽出された．

考察:看護師が離職を考える要因には，キャリアプランや，仕事のやりがい，職場の人間関係，職場の労働環境，自身の看護実践能力と自己効力感が大きく関わっており，それらは共通して職務継続の要素にもなっていた．しかし，ストレス・マネージメントは，職業継続にだけみられる要因であり，効果的なストレス・マネージメントは，離職を思い留まらせることが示唆された．中堅看護師の職業継続には，ストレス・マネージメントに着目した支援が重要である．


Sensitive Test for Screening for Autonomic Neuropathy of Type 2 Diabetes

Information : an International Interdisciplinary Journal


Measuring quality of sleep and autonomic nervous function in healthy Japanese women


The relationship between sleep condition and autonomic nervous function in women in their 70s with type 2 diabetes mellitus


Characteristics of Cognition, Behavior and Influencing Factors related to Eating Attitudes in Adolescent Women with Type 1 Diabetes

1型糖尿病をもつ思春期女性における摂食態度に関連する認知や行動と影響要因の特徴

Japanese Journal of International Nursing Care Research


Changes before and after improvement of subjective sleep state of a man diagnosed with pre-diabetes and sleep disorder


Use of a Dialogue System to Retrieve the Memories of Elderly Individuals with Dementia and Determine the Physiologically Effective Evaluation Indicators

International Journal of Advanced Intelligence (IJAI)


The effects of smoking prevention education to high-school students, and its ripple effects to their families

高校生を対象とした喫煙防止教育の効果及び家族への波及効果

The aim of this survey was to clarify the effects of smoking prevention education to the highschoolstudents, and its ripple effects to their families. Participants were same group of630students.Questionnaire surveys were conducted, self-reporting and anonymous, immediately beforeand after the lecture meeting, and after8month in2011‐2012fiscal year. As a result, significantfavorable changes were observed in female students regarding the images of smoking and the predictionof behavior associated with smoking in the future. However, favorable outcome was notobserved among both male and female students after eight months. As useful educational contents,to help stop smoking behavior in the future, the causes of vulnerability to cancer and strongdependence on nicotine were pointed out. Significantly high rates were observed : male studentsselected the"economical reasons"", social responsibility"and"transition of smoking rate"; femalestudents selected the"effect on appearance"and"effect on babies". Also, the smoking rate of theparents of targeted students was lower than the national average, which revealed that their parentswere grappling with the problem of smoking abstinence, caused by the chance of having conversationsabout smoking with their family members. We conclude that it is necessary to construct theeducational contents appropriate for the characteristics of each targeted group including familybackground in order to make smoking abstinence a success. Future studies are also necessary todevelop effective educational continuous and periodical approaches of the lecture meeting, whichwill trigger the cessation of smoking and promote conversation within the family unit.


A県における防煙及び喫煙防止教育の実態と課題

A県における防煙及び喫煙防止教育の実態と課題


Relationship with Self-reported Values, Accurate-Reported Values, And Ideal Values on Height and Weight in Collage Students

大学生男女における体格の自己申告値と実測値及び理想値の関係


Influence of frontal lobe tests on heart rate variability in young adults

前頭葉機能検査が心拍変動に与える影響‐青年期を対象に‐

人は精神的ストレスによって自律神経活動に影響を受け，ストレスの程度が大きければ自律神経失調などの症状を引き起こす．そこで，前頭葉機能検査を負荷試験として自律神経活動の変化を心拍変動でとらえ，前頭葉に対する負荷が自律神経活動に与える影響について検討した．その結果，前頭葉機能検査前にCVRRが高く検査が始まると低下するタイプと，検査前にはCVRRが低く，検査が始まるとCVRRが高くなるタイプの2つのパターンがあることが示唆された．また，前頭葉機能検査の種類によって反応は異なり，Stroop test時にはLFやLF/HFは低下していたが，WCST時ではStroop test時に比べてLF/HFは高値であった．Stroop testの成績は自律神経活動に反映されており，高次処理依存ストレッサーとして利用できる可能性が示唆された．

JNI : The Journal of Nursing Investigation


Infuluence of smoking prevention education on attitudes of nursing students toward smokers and its structure

喫煙者に対する看護学生の態度に防煙・禁煙教育が及ぼす影響とその構造

2004年に日本看護協会が看護学生の防煙・禁煙教育の推進という方針を打ち出して以降，多くの看護師養成所で看護学生の防煙・禁煙教育が実施されている．本研究では，喫煙者に対する看護学生の態度を明らかにすることを目的とし，防煙・禁煙教育の効果と，防煙・禁煙教育を受けた経験が喫煙者に対する態度にどのように影響したかを構造化した．研究の対象者は最終学年に在籍する33名の看護学生で，年齢は21歳から23歳で，煙草を吸った経験のある者が7名，喫煙者が2名含まれていた．分析の対象は，防煙・禁煙プログラムについての自由記述方式の感想である．質的統合法(KJ法)を用いて分析した結果，看護学生たちは喫煙者に対して，最初は，幻滅，嫌悪などの否定的感情を抱いていたことがわかった．そして，家族や友人など身近な人に禁煙を進めたが成功しなかった体験から，禁煙指導を難しいと感じ，無駄だと諦めていた．また，喫煙は本人の自由で，健康を害してもその責任は喫煙者自身にあり，他人に害が及ばなければよいと考えていた．一方で，喫煙者に対して可哀想など同情の感情も持っていた．しかし，禁煙指導方法の学習が進むにつれて，看護学生たちの考え方は変化し，喫煙者を否定するのではなく，共感し，禁煙の方法を一緒に考える姿勢が必要だと感じ始めた．そして，禁煙指導は困難なことではあるが，看護師には禁煙を推進する責務があり，喫煙者を見放さず，根気強く，取り組む必要があるとの考えに到達していた．看護学生の，喫煙者への態度や禁煙指導に対する考え方は，学習の到達度によって変化していた．入学から卒業までの段階を追った防煙・禁煙教育プログラムは有効であり，入学時の教育に留まるのではなく，継続的に学習を進めていく必要があることが示唆された．

JNI : The Journal of Nursing Investigation


Literature Study on Affective State Estimation for Human and Robot Interaction Using Physiological Indicators


Autonomic activity changes in frontal lobe function tests in young adults with high-functioning pervasive developmental disorder

高機能広汎性発達障害における前頭葉機能検査中の自律神経活動の変化


Relation between Electronic Nursing Staffs Daily Records and Nurses Workload in the A Psychiatric Hospital

Information : an International Interdisciplinary Journal


Issues in the vaccination recommendation for nursing students --- consideration from an image research by the SemanticDifferential Method

看護学生に対する予防接種推奨の課題 --- SD法によるイメージ調査からの検討

Background : An investigation of immune antibody titer against pediatric infectious diseases and hepatitis B was conducted to nursing students. They were then instructed to vaccinate against communicable diseases they were not yet immunized against. Although they recognized the importance of vaccination, only few actually vaccinated themselves. Consequently, an image research was conducted to find factors determining the attitude toward vaccination. This has clarified issues in vaccination recommendation. Methods : Group questionnaire surveys were conducted to the subjects of 104 nursing students before and after an instruction on vaccination and after 2 months sandwiching vacation. For an image research, the Semantic Differential Method was employed, setting five concepts of : Vaccination, Nurse, Self, Rubella, and Hepatitis B. Results : In the comparison of images to vaccination before and after the instruction, the responses to the questions, ``Cheap-Expensive'' and ``Simple-Complicating,'' changed significantly in a negative direction, (p< 0.01)after the instruction. Between the concepts of ``Nurse'' and ``Self,'' the responses to ``Healthy-Sickly'' (p <0.01)and ``Resistant-Vulnerable'',(p<0.01)were positive in ``Nurse'', whereas the responses to ``Uneasily sickened-Easily sickened'' (p<0.01) and ``Safe-Risky'' were positive in ``Self.'' This represented a contradiction in the subjects' logic : while the students thought they were uneasily sickened and felt safer than nurses, nurses were seen as healthier and more resistant then the students but easily sickened. Their images toward ``Self'' did not change from before to after the instruction. Conclusion : The enhancement of vaccination rate requires an environmental approach to the barrier to vaccination, for example, by improving consultation methods and by financial support. Furthermore, the nursing students represented self- contradiction ; although they realized they lacked certain immunity, they were overconfident about their health. What remains to be seen is the education to enable them to change their attitude toward their own health and realize their self- contradiction.

背景:看護学生に対して小児感染症とB型肝炎の免疫抗体価を検査し，免疫を持たない感染症について予防接種の指導を行った．しかし，予防接種が必要であると認識しながらも，実際に予防接種を受けるという行動に結びついた学生は少なかった．そこで，予防接種に対する態度を規定する要因を明らかにするためにイメージ調査を行い，予防接種を推奨する上での課題を明らかにした． 方法:看護学生104名を対象とした．集合質問紙調査法により予防接種の指導前後と長期休暇をはさんだ2ヵ月後に予防接種などに関するイメージ調査を行った．イメージ調査にはSD法(Semantic Differential Method)を用い，コンセプトは「予防注射」，「看護師」，「私」，「風疹」，「B型肝炎」の6つとした． 結果:予防注射に対するイメージについて指導前と指導後で比較すると「安い-高い」，「簡便な-面倒な」はマイナスの方向に有意に変化した(p<0．01)．「看護師」と「私」のイメージを比較すると，「健康な-病弱な」(p<0．01)，「抵抗力がある-無防備な」(p<0．01)は「看護師」の方が有意にプラスイメージで，逆に「病気にならない-病気になる」(p<0．01)，「安全な-危険な」は「私」の方が有意にプラスイメージであった．学生は看護師よりも病気にならず安全と感じ，同時に，看護師は学生よりも健康で抵抗力があるが病気になりやすいと矛盾した論理をもっていた．「私」についてのイメージは指導の前後で変化しなかった． 結論:接種率を向上させるためには，受診方法の改善や費用の助成等を行って，予防接種についてのハードルを低くし，環境面からアプローチする必要がある．また，学生は自分が免疫を持たないことを認知しながらも，自己の健康を過信し，自己矛盾を抱えていた．学生が自分自身の健康に対する意識を変え，自己矛盾に気づくよう教育することが今後の課題である．


衣服の圧迫による血圧測定への影響 --- コロトコフ法とオシロメトリック法による検討

第39回日本看護学会論文集‐看護教育‐

第39回日本看護学会論文集‐看護教育‐


Estimation methods for the communicatuion between "a robot and a human" using physiological indicators

Proceedings of the Fifth International Conference on Information


Questionnaire survey on the use and the introduction of nursing management system in the psychiatric hospitals


The relationship between autonomic nervous activity and physical activity in children

There have been few studies that have reported on heart rate variability and the development of autonomic nervous function in children. This study investigated the relationship between heart rate variabilities at night and physical activity in children. The study subjects were 29 children, including 17 boys and 12 girls. The daily activity product and heart rate variabilities during sleep at night (00.00-05.00 hours) were measured and several aspects of these parameters were analyzed. In one child (an 8-year-old girl), heart rate variability and the physical activity product were measured for 12 days. There was a negative correlation between the mean R-R interval and the duration (min) of heavy exercise per day (r = -0.39, P < 0.05). In the 8-year-old girl, from whom data was obtained for 12 days, the duration of heavy exercise per day was negatively correlated with the mean R-R interval (r = -0.63, P < 0.05), the number of changes in successive R-R intervals greater than 50 msec (RR50) (r = -0.74, P < 0.01), and the high frequency (HF) component (r = -0.66, P < 0.05). Furthermore, the daily number of steps was negatively correlated with the mean R-R interval (r = -0.66, P < 0.05), RR50 (r = -0.71, P < 0.05) and the HF component (r = -0.66, P < 0.05). There was a negative correlation between the amounts of energy consumption and the mean R-R interval (r = -0.69, P < 0.05). There was a negative correlation between the amounts of energy consumption and RR50 (r = -0.76, P < 0.01). Moreover, there was also a negative correlation between the amount of energy consumption and the HF component (r = -0.71, P < 0.05). These findings suggested that physical activities increase heart rate during sleep, but reduce parasympathetic nervous activity at night. Because both the HF component and RR50 reduce with growth, the exercise-related inhibition of parasympathetic nervous activity may be a developmental stimulus to reach a balanced autonomic nervous pattern in adults.


Experience of Mood Adjustment and Trend toward Addictive Behavior --- Analysis of the Cause and Effect

気分不良体験の調整方法とその嗜癖的行動化 --- 因果関連図からの検討


情緒障害児短期治療施設入所児童への性教育の効果と自己肯定感の関連

情緒障害児短期治療施設入所児童への性教育の効果と自己肯定感の関連


Changes in high school students' attitudes towards smoking habits before and after the smoking prevention education

喫煙防止教育前後における高校生の喫煙に対する態度と意識の変化

In order to prevent the smoking habit, it is important to start a smoking prevention education (SPE)earlier. Implementing educational intervention with appropriate timing and content is necessary during and after the high school years when a smoking habit is easily formed. The purpose of this research was to clarify high school students' attitudes and beliefs towards smoking before and after SPE and to examine how to provide optimal SPE in the future. The subjects were 680 high school students in the A prefecture. The SPE was implemented, their attitudes and beliefs towards smoking habit were measured using a scale of``belief and attitude towards smoking habits'', and its changes were assessed before and after the education and eight months later. The scores showed significant change in negative attitude toward smoking habit immediately after the SPE. However, the survey after eight months showed the SPE effects were not maintained except one item. Gender and the presence or absence of smokers in their family was involved in the continuation of the effects of SPE. It was suggested that it is necessary to have an appropriate intervention method to the subjects' characteristics and the optimal intervention timing should be discussed and an approach to reinforce the continuance of effects of SPE are required for the SPE in the future.


対話による認知症高齢者の自律神経系への影響

対話による認知症高齢者の自律神経系への影響

認知症高齢者と健常者が対話を行う際に，話しの受け手である認知症高齢者の自律神経系にどのような影響があるのかを評価することが目的である．調査協力者はA 介護老人保健施設に入所している認知症高齢者14 名(平均年齢89.43 ± 3.98 才，男性2 名女性12 名，長谷川式簡易知能評価スケールの平均得点は11.79 ± 4.37 点)である．調査協力者と研究者が対話を行い，対話前後の収縮期血圧，拡張期血圧，脈拍，唾液アミラーゼ活性値，体温，SpO2 を測定した．心電図は実験開始とともに記録を開始し，実験終了まで継続して記録した．全ての指標で有意差はみられなかった．しかし，対話前後で唾液アミラーゼ活性値が9 名で低下していた．交感神経機能の指標であるLF/HF は4 名で対話中に上昇し，対話後に低下していた．副交感神経機能の指標であるHF は5 名で対話中に減少していた．認知症高齢者との対話の効果を評価するための生理評価指標として，唾液アミラーゼ活性値，LF/HF が挙げられる資料を得たと考えられた．また日中に効果的な対話を行うことは，認知症高齢者の自律神経活動を，日中は交感神経活動が優位で夜間は副交感神経活動が優位に働くという健常者に類似した自律神経活動に誘導する一助となる資料を得たと考えられた．

香川大学医学部看護学科紀要

香川大学医学部看護学科紀要


Research of the intramusucular injection technique to gulterus medius muscule using an ultrasonograph

14th East Asian Forum of Nursing Scholars (EAFONS)


高齢者を対象者とした介護実習の学びが基礎看護学実習へ及ぼす影響

高齢者を対象者とした介護実習の学びが基礎看護学実習へ及ぼす影響

日本看護学会論文集老年看護

日本看護学会論文集老年看護