Physical Rehabilitation Patterns and Clinical Categorization in a Japanese Psychiatric Hospital: A Retrospective Content Analysis


Effects of the COVID-19 Pandemic on the Lifestyle and Physical Activity of School-aged Children : Survey of Students at Japanese Language Supplementary School in the United States

Coronavirus disease 2019 (COVID-19) and associated lockdowns affected many people regardless of location, age, or gender. This study aimed to focus on school-aged children studying at a Japanese Language Supplementary School (JLSS) in the southwestern region of the United States and assessed the impact of COVID-19 on their lifestyle and physical activity (PA). An online-based cross-sectional survey was administered to students (age range : 6-18) enrolled in a JLSS as of June 11, 2021. Data were collected from 151 students. The questionnaire consisted of lifestyle and PA questions. A paired and Student t-test was used to test the differences in changes before COVID-19 and during COVID-19 among children. Chi-square tests were used for comparisons with descriptive analyses of frequencies. Level of statistical significance was set at p <.05. Screen time was significantly longer on weekdays (t = 8.71, p<.001) and weekends (t = 5.94, p < .001) than before COVID-19. The number of children who went to bed after 10 pm was significantly higher (χ2 = 4.06, p < 0.05) than before the new coronavirus infection. The frequency of PA per week was significantly higher (χ2 = 4.01, p < 0.05) in the group using digital devices. Findings suggested that the use of digital devices for PA can enhance PA frequency in JLSS students. J. Med. Invest. 72 : 117-123, February, 2025.

The Journal of Medical Investigation : JMI


Association Between Dynapenia/Sarcopenia, Extrapyramidal Symptoms, Negative Symptoms, Body Composition, and Nutritional Status in Patients with Chronic Schizophrenia.

Background/Objectives: This study aimed to determine the association between chronic schizophrenia, extrapyramidal symptoms (EPSs), body composition, nutritional status, and dynapenia/sarcopenia. Methods: Data from 68 chronic patients with schizophrenia were analyzed using Spearman's rho correlation coefficients, Kruskal-Wallis test, Mann-Whitney U test, and Cramér's V statistics. Results: Among the participants, 32.4% had no loss of muscle mass or function, 39.7% had dynapenia, and 27.9% had sarcopenia. This study identified five key findings: (1) Bilateral grip strength, skeletal muscle index, and walking speed are interrelated, with higher negative symptom scores linked to slower movement and rigidity, particularly in the sarcopenia group, indicating that negative symptoms may contribute to muscle weakness and progression to sarcopenia. (2) Increasing age is associated with a decrease in chlorpromazine equivalent dose and an increase in the severity of EPSs. (3) Blood urea nitrogen (BUN)/creatinine ratio and all sarcopenia risk indicators were significantly negatively correlated. (4) Dynapenia and sarcopenia groups exhibited significant differences in muscle mass and nutritional status compared to the non-penia group, including reduced muscle mass, lower basal metabolic rate, and lower visceral fat levels. (5) There was an association between the Barthel Index (BI) score for activities of daily living (ADL) and dynapenia/sarcopenia. Particularly with regard to ADL, it seems necessary to pay attention to muscle weakness in partially independent patients who score 60 points or more. Conclusions: BUN/creatinine ratio, BI, EPSs, body mass index, grip strength, total protein, and albumin were useful indicators for detecting the risk of dynapenia/sarcopenia in routine psychiatric care.


Development Issues of Healthcare Robots: Compassionate Communication for Older Adults with Dementia

International Journal of Environmental Research and Public Health


Development of an Elbow Joint Assist Suit with a Velocity-Based Mechanical Safety Device: Design and Control

International Journal of Advanced Intelligence (IJAI)


The Effect of In-Service Educational Programs on Nurse Managers Understanding of the Theory of Technological Competency as Caring in Nursing


Mental Health Conditions of Persons in the Community and of Health Care Workers During the COVID-19 Pandemic: An Integrative Review

International Journal of Nursing & Clinical Practices


Potential legal issues when caring healthcare robot with communication in caring functions are used for older adult care

The issue of older adults' care is becoming a serious concern in Japan, which has a rapidly aging population and a low birthrate. The development of robots is pushed forward as a measure to compensate for the healthcare worker shortage. The purpose of this paper is to consider the potential legal issues of caring healthcare robot (CHR) for older adults' care. A CHR must recognize the speech, face, and presence of older adults, and make judgments and relay information based on acquired information. CHRs fulfill the caring function by being close to patients, to know them deeply, and to look after them. Therefore, communication functions by advanced artificial intelligence based on caring in nursing are essential for CHRs. The ability to maintain and improve the activities of daily living (ADL) of older adults is to facilitate activities through bidirectional information relay. Furthermore, without guarantees on the safety and ascription of responsibilities, the introduction of CHRs in clinical practice will not proceed. As laws differ from country to country, it is necessary to examine Japanese policies and related laws when using CHRs in Japan. Currently, there are no central rules on information security. In Japan, the law is made after a case has occurred; thus, dealing with novel issues as they occur will not have the benefit of legal guidance. Creating a broad legal framework or taking preventive measures at an early stage is needed. Therefore, as a first step, establishing guidelines for the use of CHRs will be valuable.


Rehabilitation care with Pepper humanoid robot:A qualitative case study of older patients with schizophrenia and/or dementia in Japan

Humanoid robots are increasingly deployed in various health facilities to complement long-term care in Japan. Although this technology influx is still in its infancy, many health providers are optimistic about its capabilities. Thus, it is crucial to investigate its preliminary utilization and effects as precautionary measures in understanding the use of humanoid technology in healthcare. The study intends to describe the rehabilitation care experience for older patients with schizophrenia and/or dementia in the use of Pepper humanoid robot. A qualitative case study was conducted to explore the rehabilitation recreational activities of older patients with schizophrenia and/or dementia (n=9) in geriatric health facilities. After securing ethical clearance, observational data were recorded and analyzed using a case-oriented understanding and framework of reaction, interaction, and benefaction. Reaction focuses on their attitudes and impressions toward Pepper. During the rehabilitation and recreational sessions, interaction deals with the relationship between older patients with schizophrenia and/or dementia, Pepper, and providers. Lastly, benefaction reflects the actual health outcome of the reaction and interaction with Pepper. As observed, humanoid robots can elicit simple and individual instructions for simple activities (e.g. exercise) and start the simple conversation (question-answer loop) with its subjects. However, deploying humanoid robots in long-term care requires numerous improvements in robotic technology to elicit an increase in communication and other physical activities, motivation, and a sense of calmness from its clients.


Development of a knee joint assist suit with a velocity-based mechanical safety device: Control method and experiments

The aim of this study is to examine the proposed control method of the assist suit with a Velocity-Based Mechanical Safety Device (VBMSD) for patients with difficulty moving their lower legs by themselves. The proposed control method for the assist suit assists the patients as if the patients move their knee joint under zero gravity. A physical simulation model is used to examine whether the gravitational torque of the subject's lower leg and foot was canceled by the torque generated by the assist suit. Experimental results indicated that the gravitational torque of the subject's lower leg and foot is canceled by the torque generated by the assist suit. The control of the assist suit was not adversely influenced by the VBMSD. That is, the VBMSD did not prevent the control of the assist suit. The proposed control method makes the assist suit assist the patient in moving his/her knee joint in a zero gravity-like environment. However, a weight of 3kg was used instead of an actual patient in the experiment. Experiments with actual patients should be conducted to verify the effectiveness of the proposed control method in clinical use. Furthermore, it will be necessary to take into consideration the patients' general conditions and symptoms.


Evaluation of the Remote-controlled Drone System using an Eye-tracking device through the Internet for patients in bedridden conditions

In many countries, the rate of aging in their population is rapidly increasing. It is expected that this increasing trend influences the number of patients in bedridden states who have difficulty moving their extremities, such as those patients with amyotrophic lateral sclerosis (ALS). The patients are limited in many aspects of their daily lives; this includes not seeing what is outside of their rooms, affecting their quality of life (QOL). Thus, this study aims to evaluate the Remote-controlled Drone System using the Eye-tracking device through the Internet (RDSEI) to improve QOL for patients in bedridden conditions. The novel RDSEI is proposed and developed by the Kai laboratory. The RDSEI consists of a drone, a transmitter, a control screen, an eye-tracking device, a video capture device, a server computer, and a client computer. The subjects of this experimental evaluation of the RDSEI were five healthy male adults (average age: 20.6 years old). Experimental results indicated that all the subjects could control the drone easily by using this system, although there were delays, blurriness, and freezing of the video. Therefore, it was concluded that by using this system, the subjects could control the drone by only their eye movements, thereby enabling them to see the outside world through the drone's camera. In the future, the patients will be able to control the RDSEI from remote locations and converse with persons in remote locations.


Autonomic nervous activity of patient with schizophrenia during Pepper CPGE-led upper limb range of motion exercises

Healthcare for the increasing senior population is a significant challenge. To address this problem, the use of healthcare robot is increasingly being recognized to have strong potential in addressing older adult and psychiatric patients' healthcare and welfare needs. The purpose of this preliminary study is to evaluate the changes in the autonomic nervous activity of an elderly patient with schizophrenia during upper limb range of motion (ROM) exercises led by Pepper (SoftBank Robotics) with the application program of Care Prevention Gymnastics Exercises (Pepper-CPGE) made by Xing Company in Japan. A Pepper-CPGE-led three-minute radio gymnastics program (Radio Exercises #1, consisted of three types of exercises) and instructions were developed. The normal aging 69-year old schizophrenic subject followed instructions from Pepper throughout the intervention. Electrocardiography (ECG) records, heart rate, acceleration score, and ROM exercises of upper limb were collected and analyzed using the GSM's Bonaly Light instrument and Image-J analysis. (1) The high-frequency (HF) (indicative of parasympathetic nervous activity), and low-frequency (LF)/HF ratio (indicative of sympathetic nerve activity) were increased in reference from the baseline data before the exercise stretching the chest. (2) The momentum decreased as the ROM of shoulder joint flexion declined. Declines in both parasympathetic and sympathetic nervous activity were observed. Also, (3) when the exercise "bend the body forward" was performed, the HF and LF/HF also decreased. Evaluation of robot-based rehabilitation exercise program effectiveness by the ROM exercises image analysis and autonomic nervous activity is essential for the futurist programming of ROM exercise among patients with schizophrenia.


Legal Issues Arising from Care Robots and its Examination

ケアロボットのもたらす法的問題点とその検討

Our research group studies on care and rehabilitation using Care Robots(CRs). Legal issues arising from these CRs are diverse. In this paper, we examined legal issues that should be considered in each stage ; manufacturing, processing, installation, use, deterioration, and disposal of CRs, and especially the cases where CRs as medical devices cause damage to patients. Thus, this paper pointed out the subjects as below : ``Product Liability Act mainly and secondary general tort law in the manufacturing stage'', ``Defect liability in the processing stage'', ``General tort law in the installation stage'', ``Obligation of security or faulty performance responsibility in the use stage'' and ``Personal Information Protection Law at the disposal stage''. In addition, we suggested the presumed issues that should be examined and indicated the direction of the way of thinking. This study will contribute to creating safety guidelines for the future use of CRs.


A comparison of strengths-oriented attitude by Principal Component Analysis among nurses, psychiatric social workers, and occupational therapists in psychiatric hospitals

主成分分析による精神科病院に勤務する看護師・精神保健福祉士・作業療法士のストレングス志向の比較

The purpose of this study was to compare the strengths-oriented attitude among psychiatric nurses(PNs), psychiatric social workers(PSWs)and occupational therapists(OTs)working at psychiatric hospitals using principal component analysis. Survey subjects were 899 PNs, 100 PSWs and 90 OTs employed at 17 psychiatric hospitals in Japan who consented to participate in the study. The self-administered questionnaire was mailed and returned between from October 2013 to January 2014. The subjects' strengths-oriented attitude was evaluated using the Strengths-Oriented Attitude Inventory(SOAI)developed by the authors based on the work by Rapp and Goscha. The loading of the primary ingredient of the SOAI was compared by Principal Component analysis among occupations. A common strengths-oriented attitude of PNs, PSWs, and OTs was the assessment for psychiatric inpatients' social life, the ability to perform activities of daily life (ADL), mental status, and taking care and therapeutic intervention. Especially, in the differences of characteristics depending on the specialty, PNs focus on physical health, PSWs emphasize economics and housing, and OTs emphasis on functional recovery of their ADL. Differences in strength-oriented attitudes have shown the commonality and specialty of each healthcare provider.


The Optimization of Humanoid Robots Dialog in Improving Communication between Humanoid Robot and Older Adults


A UAV system using an eye-tracking device for ALS patients (Design of its control screen considering field of vision and experiments)

ALS 患者のための視線検出デバイスを用いたマルチコプタの操作システム (視野を考慮した操作画面の設計および実験)


Encounter of Pepper-CPGE for the elderly and patients with schizophrenia: an innovative strategy to improve patient's recreation, rehabilitation, and communication

In Japan, humanoid robots has been introduced in the medical and elderly care environment. The application program of Care Prevention Gymnastics Exercises for Pepper (Pepper-CPGE) made by Xing Company, Japan is a body-brain gymnastics recreation program for 40 minutes tailored to the elderly's functional level. It consists of moving, watching/healing, and playing. "Move the body" exercise and other active range of motion activities are done according to the music. Pepper-CPGE was introduced as a clinical trial at the Mifune hospital, beginning in May 2018. At the units where clinical trials are done, 80% of the patients are with mental illness diagnosis with decreased physical functions often moving by wheelchair only. When Pepper-CPGE was introduced, the following changes were observed : (1) communication between patients and nurses during rehabilitation care using Pepper-CPGE was increased ; (2) patients wereinteractive, engaged, and actively participated in the Care Prevention Gymnastic Exercises using Pepper-CPGE ; (3) patients had fun and enjoyed talking to Pepper-CPGE. Interventions using Pepper-CPGE appear to be an effective rehabilitation strategy to increase engagement and participation of elderly patients who require long-term care and rehabilitation. J. Med. Invest. 66 : 50-53, February, 2019.

The Journal of Medical Investigation : JMI


Characteristics of Transactive Relationship Phenomena among Older adults, Care Workers as Intermediaries, and the Pepper Robot with Care Prevention Gymnastics Exercises

Healthcare for older adults is a significant problem in Japan and in other developed countries. To address this problem, healthcare robots, now realized, can assist and meet healthcare and welfare practice demands. The aim of this study was to clarify characteristics of Transactive Relationships (TR) in older adults, in care workers as intermediaries, and Pepper (Softbank Robotics Corporation) a robot equipped with the application program of Care Prevention Gymnastics Exercises for Pepper (Pepper-CPGE) made by Xing Company, Japan. Data were collected by observing TRs between Pepper and older patients in Kagawa Prefecture,Japan between from May 8 to August 1 2018. The Transactive Relationship Theory of Nursing (TRETON) was used to explain how Pepper-CPGE led the exercises with older adults as physical exercises. The role of PepperCPGE was to provide instructions for the older adults in performing gymnastic exercises. During the exercising activity, care workers were present to prevent falls of the older adults, and to operate and observe the video presentations by supporting and caring for the participants. In using Pepper-CPGE, it was possible to change the role of the healthcare providers, originally thought to contribute to increasing the quality of older adult care and their rehabilitation. J. Med. Invest. 66 : 46-49, February, 2019.


Criterion-related Validity of the Perceived Inventory of Technological Competency as Caring in Nursing (PITCCN) in Acute Care Settings

The Perceived Inventory of Technological Competency as Caring in Nursing (PITCCN) based on Locsin's theory of Technological Competency as Caring in Nursing (TCCN, 2005) was developed (Kato et al. 2016) and revised by Miyamoto et al. (2017). The purpose of this study was to verify criterion-related validity of PITCCN using the Practice of Caring Behavior Questionnaire (PCBQ, Shigehisa, 2007). The study was approved by the Ethical Review Board of Tokushima University Hospital. Data were collected from September 2017 to October 2017. Of the 402 questionnaire copies distributed, only 299 copies were returned and analyzed to determine correlations between total score value and Mean Factor Point of each factor for PITCCN and PCBQ. These were analyzed using Pearson correlation coefficients. Statistical significance was at .01 levels. Strong positive correlation coefficient was obtained between total score values (r=.76, p?.01) and factors of PITCCN and PCBQ (r=.19 to .68, p?.01) , except the PITCCN's factor 3 : "Utilization of information obtained from technology and continuous knowing" and PCBQ's factor 6 : "Enriched relationships between patient and nurse", (r=.13, not significant). From these results, the criterion-related validity of PITCCN as the inventory of TCCN could be confirmed. J. Med. Invest. 66 : 42-45, February, 2019.


Nursing and Rehabilitative Care of the Elderly Using Humanoid Robots

Japan's declining birth rate and increasing aging population prompted intercessory efforts towards robot technologies in nursing practice for theelderly. Today, technological companies are developing robots that meet universal health care technology demands. While human caring focus on human-to-human relationships,but between humans and nonhumans, e.g. Humanoid Nursing Robot (HNRs)-to-human relationships, caring practices have not been forthcoming. When HNRs can support patients independently, capabilities much like being human will be required, including intelligence and skill competencies. Currently, Tanioka's research group is conducting clinical trials of humanoid robots equipped with applications using Pepper (manufactured by SOFTBANK CORPORATION), towards elderly care and rehabilitation at the Mifune Hospital, Kagawa prefecture. Care Prevention Gymnastics Exercises (Pepper-CPGE) was madeby Xing Company, Japan. Therefore, this paper aims to describe the clinical trial outcomes based on the Transactive Relationship Theory of Nursing (TRETON) (Tanioka, 2017) emphasizing nursing engagement processes between HNRs and human persons. Observable effects include positive changes in relationships of patients, humanoid robots and healthcare providers. Emphasizing ethical concerns and human person safety as critical factors of care, and fears for divergent robot use are observed. Cooperative undertakings with various interdisciplinary activities mark the visioning of Japanese human caring ideas for an aging society. J. Med. Invest. 66 : 19-23, February, 2019.


A Reflective Journey of Caring : A Case Study Between A Patient with Schizophrenia and the Interdisciplinary Team

This case study focuses on caring for a patient living with schizophrenia who has been isolated from the community caused by long-term hospitalization in Japan. Using the philosophical perspective of caring, which focuses on nurturing the wholeness and well-being of persons in caring relationship, the case study illuminates the caring, empathy, and courage among the interdisciplinary team. The purpose of this case study is to discuss the interdisciplinary caring process for patients living with schizophrenia using Carper's ways of knowing. Personal knowing is presented through the lens of patients and families and the stigma associated with mental illness. The expression of respect and caring for the patient and their families led by the interdisciplinary team aided in destigmatization of mental illness. Empirical and ethical knowing is demonstrated through the mental health care team's delivery of high quality and clinical excellence with competence, compassion and caring. Aesthetic knowing was offered by the interdisciplinary team focused on the patient's underlying hopes, dreams and aspirations. Through the support of the interdisciplinary team, patients are able to move toward their goals,hopes and dreams, externalizing tasks, as they grow together through mutual caring. J. Med. Invest. 66 : 15-18, February, 2019.


Psychiatric nurses' anxiety, learning motivation, learning behavior, knowledge, experience concerning intramuscular injection technique for long acting injectable antipsychotics

精神科看護者の抗精神病薬持効性注射剤の筋肉注射に関する不安，学習意欲，学習行動，知識，経験との関連性


Efficacy and Safety in Intramuscular Injection Techniques Using Ultrasonographic Data


Evaluations of echogenicity in gluteal muscle in patients with schizophrenia treated with second generation long-acting injectable antipsychotics: risperidone or aripiprazole

Second generation long-acting injectable antipsychotics (SG-LAIs) injected muscle region show high-echogenicity with acoustic shadowing on B-mode scan. This study aimed to distinguish two specific types of SG-LAIs at the gluteal muscle. Forty-seven patients [risperidone (RLAI): 28 patients, aripiprazole (ALAI): 19 patients] were examined using grayscale histogram analysis of echo-intensities. Pre- and immediately after (post)-injected SG-LAI region of interest (ROI) was placed on the same sites of gluteal muscle, and the grayscale histograms were recorded. Pre- and post-injected echogenicity values were analyzed using paired t-test, and Pearson's moment correlation coefficient. Mixed effects model regression analysis was performed on variations in average echogenicity from age and medication type. Statistical significance was at 5%. There was no significant correlation between age and average echogenicity of ROI pre-intramuscular (IM) injection (r = 0.26, p = 0.078). In both RLAI and ALAI, the mean echogenicity post-IM injection was significantly higher than pre-IM injection (p < 0.001). With increasing age, the values of echogenicity of post-injection was decreased significantly (p = 0.002). The increasing values of the echo-intensities post-injections of RLAI showed significantly higher than ALAI (p = 0.002). It was considered that administered type of LAI could be identified because each LAI exhibits specific echographically findings, it also will be able to applied clinically.


コミュニティに関するケアリングの概念分析

コミュニティに関するケアリングの概念分析


Family Environment Factors to Impact on the Effect of the Smoking Prevention Educational Program for Elementary and Junior High School Students


Comparative Examination between the Perceived Inventory of Technological Competency as Caring in Nursing (PITCCN) and the Technological Competency as Caring in Nursing Instrument (TCCNI)

International Journal of Nursing & Clinical Practices


Recognition and Status of Practicing Technological Competency as Caring in Nursing by Nurses in ICU


Evaluation of Expression Recognition Function in Autism Spectrum Disorder Using Near-Infrared Spectroscopy


The Relationship among Chronic Disease, Feeling-for-Their-Age, Sleep Quality, Health-Related Quality of Life and Activities of Daily Living of Community-Dwelling Persons over 55 Years of Age


Effects of Depth of Needle Insertion with Risperidone Long-Acting Injectable in Persons with Schizophrenia: A Randomized Double-Blind Study


Daily Activities and Sleep Durations of Patients with Ischemic Heart Disease Who Were Discharged to Their Homes after Elective Percutaneous Coronary Intervention


The Development of the Perceived Inventory of Technological Competency as Caring in Nursing

看護におけるケアリングとしての技術力の認識尺度の開発

The purpose of this research was to develop the Perceived Inventory of Technological Competency as Caring in Nursing(PITCCN)for Intensive Care Unit(ICU)nurses. The inventory has twenty three item statements derived from Locsin's theory on caring. The research study received approval from the University of Tokushima Hospital Clinical Study Ethical Review Board (Approval No.2585). The time frame was from September2016to November2016. Copies of the Inventory were sent to426ICU nurses working in hospitals in Japan. Only308questionnaire copies were returned with no missing value(response rate was72%). Factor analysis(principal factor analysis, varimax rotation), the Kaiser-Meyer-Olkin(KMO)and the Bartlett's test of Sphericity were used to assess the adaptive validity of the factor analysis. Factor loadings were set at0．4or more for the configuration of items. Internal consistency and reliability were established using Cronbach's alpha coefficient. Statistical significance was at0．05level. Four factors were extracted and labelled as(1)Training of nurses to provide optimal care,(2)empirical knowledge and whole human knowing,(3)Utilization of information obtained from technology and continuous knowing, and(4)Intentional and ethical nursing of persons. Cronbach's alpha was 0．894 for the questionnaire(20 items)and 0．869, 0．872, 0．876, and 0．734, for the four factors respectively. This showed that the over-all data obtained high internal consistency for each factor. The KMO sample adequacy was0．88and the Bartlett's test of sphericity was p<0．001. These results showed that the Perceived Inventory of Technological Competency as Caring in Nursing was reliable.


義足を使用して社会生活を送っている女性の体験に関する症例報告

義足を使用して社会生活を送っている女性の体験に関する症例報告

It is imperative that a concern of physical function is addressed such as ability to walk, and how the disease and the sophistication of artificial devices influence person's quality of life(QOL). A woman in her 50s who has a lower limb prosthetic device after amputation. She lived with this prosthesis for more than 20 years. Interviews were recorded, transcribed, and analyzed. The findings of the study revealed that hoping for a better QOL can be lost due to unbearable suffering from adverse reactions during chemotherapy. This lived experience made her decide to discontinue chemotherapy giving her greater than expected grief experience than her postamputation. Watchful ambulation became distinctive and purposive with each step so as not to fall. This walking style was to show her normal gait, rather than worrying about the gaze from people. Furthermore, it was found that feelings of incompleteness still existed even with the prosthetic device. This was often attributed to the physical pain and discomfort while wearing this device even while knowing that she is now a whole person. Still she felt incomplete in the moment. Visible artificial device becoming her essential part, provided a meaningful life that enabled her to grow with the family.


Relationship among Sleep Quality Physical Health Conditions and Lifestyle Habits among Elementary School Students


Recommended Design and Direction of Development for Humanoid Nursing Robots Perspective from Nursing Researchers


Characteristics of a Transactive Phenomenon in Relationships among Older Adults with Dementia, Nurses as Intermediaries, and Communication Robot


新卒看護師が入職する精神科病院の特徴

新卒看護師が入職する精神科病院の特徴

The current state of employment of nursing staff at psychiatric hospitals is beset with patient care problems such as of shortage of nurses and the increasing number of older nurses.Considering these situations, Nurse administrators in psychiatric hospitals are challenged to increase the number of younger nurses as a solution towards improving the staffing shortage thereby enhancing quality of nursing services. The purpose of this study was to clarify the characteristics of psychiatric hospitals that newly graduated nurses found to be a good place to practice their profession. A survey was conducted using a questionnaire which was provided to 277 sychiatric hospital nurse administrators. About 40% of the 234 hospitals administrators who responded employed newly graduated nurses. Employment of newly graduated nurses was significantly related to hospitals with 200 beds or more than 200 beds or less(x2 ＝35.37∼13.75,φ＝0.40∼0.25, p<0.001). The characteristics of a psychiatric hospital where newly graduated nurse found to be a good place to practice their profession enters are as follow(: 1)Hospital Nursing staff taught courses in psychiatric nursing at the newly-graduated nurses nursing school/nursing college( 2)The students had their clinical experience at the particular psychiatric hospital and(3)The hospital has employed a Certified Nurse Specialist or Certified Nurse in Psychiatric Mental Health Nursing. A useful approach to the employment of newly graduated nurses in psychiatric hospitals were suggested as follow(: 1)To establish a procedure in which the essence and appeal of psychiatric nursing are recognized, such as promoting psychiatric clinical practice settings and providing staff to conduct lectures at particular nursing education institutions and(2)To nurture and recognize nurses who have become excellent role models.


The Development of the Transactive Relationship Theory of Nursing (TRETON): A Nursing Engagement Model for Persons and Humanoid Nursing Robots


Relationship between Lifestyle, Quality of Sleep, and Daytime Drowsiness of Nursing Students of University A


精神科看護とケアリング 事例にもとづく患者理解の検討

精神科看護とケアリング 事例にもとづく患者理解の検討

The Japanese Journal of Psychiatric Nursing


Characteristics of Psychiatric Hospital Work Environment Found Attractive by Professional Nurse Administrators in Japan

International Journal of Nursing & Clinical Practices


Availability of Thickness Estimation of the Subcutaneous Fat by Using the Near-infrared Ray Measuring Device


Prioritizing Patient Assessment Data (PAD) Using the Japanese Psychiatric Nursing Assessment Classification System (PsyNACS)©


Comparison of Gluteal Muscle Intramuscular Injection Sites of Japanese Healthy Subjects: Considerations for Optimal Insertion of Injection Needle Length


Relationship between sleep-wake rhythms and autonomic nerve activities of elementary school children through Actigraphy

小学校高学年児童の睡眠・覚醒リズムと自律神経活動の関係

The purpose of this study was to clarify the relationship between sleep-wake rhythms and autonomic nerve activities using actigraphy and heart rate variability(HRV)analysis. Subjects were comprised of six children who were in the fourth to sixth grade levels of elementary school(four boys and two girls). The study was conducted between January and December 2015. The data collection procedure was performed following the Private Information Protection Law, with approval from Tokushima University Hospital Ethics Board(approval number 2021). These subjects were evaluated in an Attentive-Care-Needed stress state based on the PSI(Public Health Research Foundation Type Stress Inventory)and PSQI-J(Pittsburgh Sleep Quality Index, Japanese Version). In analyzing their sleep-wake rhythms, autonomic nervous activities were determined using an actigraph and HRV through RR interval sequence electrocardiography. The results of actigraph data of sleep efficiency in Subject Number 6 was low(76.47%). Regardless, the subject experienced subjective sleep satisfaction. However, Subject Number 2, insisted that she could not easily wake up in the morning because of being sleepy. Low Frequency(LF)/High Frequency(HF)data indicated sympathetic nervous activity showing that all subjects had significantlyhigher LF/HF value during wakefulness than when asleep. HF data indicated parasympatheticactivity of five out of the six children showing significantly higher value during sleep than when awake. Subject number 3 expressed that he was sleepy and could not get up in the morning,and also had trouble going to and maintaining sleep. However, this subject's results of the PSQI-Jindicated that he had no problem expressing subjective sleep satisfaction. Furthermore, in the actigraph and HRV analysis, findings showed that subjects had good sleeping patterns. These findings strongly signify the importance of determining the sleep-wake rhythms of school children based on data from subjective and physiological evaluation methods.


Intramuscular Diffusion Status of Risperidone and Aripiprazole Long Acting Injectable (LAI) by Ultrasonography


Lived experience of caring for dying patients in emergency room.


Explanatory Variables as Evidence for Precision in Intramuscular Long-Acting Injections of Patients with Schizophrenia


The Development of the Japanese Psychiatric Nursing Assessment Classification System (PsyNACS©)


Characteristic Autonomic Nervous Activity of Institutionalized Elders with Dementia


Development of the Diabetes Oral Health Assessment Tool © for Nurses


Nurse administrators and hospital directors' perspectives about nurses' abilities in performing specific medical practices in hospitals within Tokushima Prefecture

徳島県内の看護職員高度人材育成研修推進事業における特定行為に係る実態調査

The purpose of this survey was to determine nurse administrators and hospital directors' perspectives about nurses' abilities in performing specific medical practices in hospitals in Tokushima Prefecture. The nurse administrators and hospital directors of all hospitals (113 hospitals) in Tokushima Prefecture were invited to respond to a survey questionnaire by mail posted during the period between February and March of 2015. Responses were received from 46 nurse administrators (response rate, 41%) and 38 hospital directors (response rate, 34%). The obtained data were analyzed using descriptive statistics and the narrative descriptions summarized. Majority of responses from nurse administrators and hospital directors were accepting that nurses have responsibilities for administering medicines such as tranquilizers, anti-anxiety and anticonvulsant drugs. This result was not affected by the size of the hospital, in which fifty four percent (54%) of respondents were from hospitals with less than 100 beds. In Japan, only hospitals with 100 beds or more may have procedures involving highly invasive treatments. Because of this, many of the respondents answered ``not applicable'' to statements in the questionnaire which were related to invasive treatments. Recruitment of nurses, strategies to cope with accidents and education curriculum were important concerns of nurse administrators and hospital directors which remain to be answered in future investigations.


Clarifying the Strengths-Oriented Attitude among Nurses in Psychiatric Hospitals in Japan


The Effect of a Psycho-Educational Program on Psychiatric Symptoms, Drug Attitude and Treatment Satisfaction of Patients with Schizophrenia


The Effect of Intentional Communication, Recreation, and Rehabilitation on the Autonomic Nervous Activity of Elderly Persons with Dementia : A Case Study


Professional Nurses'Attitudes towards the introducution of Humaniod Nursing Robots(HNRs) in Health Care Settings


Employment of Newly Graduated Nurses by Psychiatric Hospitals in Shikoku region

四国地方における精神科病院の新卒看護師採用に関する実態

It is important for psychiatric hospitals (PHs) to have experienced nurses who are interested in nursing patients with psychiatric/mental health problems. Recruitment of newly graduated nurses who share a passion for patients with these conditions is critical to both the profession and to the nurses. In doing so, it is critical that these nurses are nurtured and valued, who can show a high level of practical nursing ability. However, at present, it is difficult to employ experienced psychiatric nurses especially those newly graduated nurses. Therefore, an inquiry survey was conducted to determine the situation and condition concerning the employment of newly graduated nurses by PHs in Shikoku region. Participants were nurse administrators of PHs, institutions that are concerned with the psychiatric patient care within the Shikoku Region. There are 62 PHs that are members of the Japanese Psychiatric Hospitals Association in the Shikoku region. Administrators of 61 of these hospitals were provided with the survey forms, however, only 58 survey forms were returned. Results of the survey showed that twenty-four PHs (41．4%) have not hired any new nurses for more than several years now, and forty-six PHs (79．3%) have not hired any new nurses in 2014. The PHs that hired the most new nurses hired only one to two nurses. Regarding the employment of newly graduated nurses, findings revealed that nursing administrators wanted nurses to feel attracted to psychiatric nursing and that they wanted to nurture and retain them. However, they also believed that they were not positioned to accept newly graduated nurses and that they could only accept experienced nurses. Since it is believed that the present conditions, where hiring newly graduated nurses is difficult, will continue in the future, further efforts will be required to secure jobs for new nurses.


Reliability Verification and Practical Effectiveness Evaluation of the Nursing Administration Analysis Formulae Based on PSYCHOMS®


Characteristics of Male Family Caregivers in Japan and Their Sense of Care Burden, Capacity to Deal with Stress, and Subjective Sense of Well-Being


Characteristics of Nursing Care for Terminally Ill Patients in Hospice/Palliative Care Unit


Methodology for Developing a Nursing Administration Analysis System

Nursing administration requires a large volume of wide-ranging information, and nurse administrators are limited in their ability to compile and analyze information for nursing administration. The purpose of this study is to create methodology for developing a nursing administration analysis system to aid nurse administrators in performing outcome analysis. In this methodology, information required for nursing administration in the PSYCHOMS? (Psychiatric Outcome Management System, registered trademark) database is analyzed according to the individual needs of nurse administrators. It features a combination of a classification method and an extraction method for obtaining quantitative and qualitative data as information required for nursing administration, and enables nurse administrators to easily obtain analysis results that they directly need. This methodology converts the time required nurse administrators to collect and organize information into time for making considerations in order to devise strategies for improving the quality of nursing care services, and can improve the quality and efficiency of nursing administration. This may lead to an increase of the quality of nursing care services at psychiatric hospitals. This methodology is highly versatile as it can be applied in information management, not only for nursing, but for the entire psychiatric hospital.

看護管理に必要な情報が多岐にわたり膨大となっている．看護管理のための情報の整理や分析は看護管理者の努力だけでは限界があり，看護管理者が行うアウトカム分析を支援することを目的に看護管理分析システムを開発した．看護管理に必要な情報を看護管理者個々のニーズに応じて，PSYCHOMS○R(Psychiatric Outcome Management System, registered trademark)のデータベースに保存されているデータを分析する．その特徴は，分類と抽出の2種類の方法を混合して量的・質的データをアウトプットとして表示することができるため，看護管理に必要な情報を出力できる．看護管理者が直感的に必要と考えたことに対する分析結果を簡便に得ることができる．このシステムを活用することで，看護管理者が情報の収集と整理に要していた時間を，看護サービスの質を改善するための方略を考えるための思考の時間に変換することができるため，看護管理の質と効率性を高めることができる．その結果，精神科看護サービスの質向上につなげることが可能となる．本システムは看護だけにとどまらず，精神科病院全体の情報管理にも応用可能であり，汎用性がある．


Development of Algorithm and System for Automatic Generation of Nursing Summaries from Nursing Care Plans


Occupational stress and its related factors among university teachers in Japan


Changes of sleep conditions of patients with ischemic heart disease (IHD) who underwent elective percutaneous coronary intervention during hospitalization and after discharge from the hospital


Develop a Staff Assignments Support Program based upon the Nursing Administrator's demand function in Psychiatric Hospitals

Information : an International Interdisciplinary Journal


Sensitive Test for Screening for Autonomic Neuropathy of Type 2 Diabetes


Clarification of a Demand Function Required for A Staff Assignments Support Program for Nursing Administrator-use in Psychiatric Hospitals


The Challenges of the Nursing Administration for Staff Assignment Determination in Psychiatric Hospitals


Discussion of Nursing Robot's Capability and Ethical Issues


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


Optimal needle insertion length for intramuscular injection of risperidone long-acting injectable (RLAI)


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


The relationship between body mass index, thickness of subcutaneous fat, and the gluteus muscle as the intramuscular injection site


Factors associated with discharge of long-term inpatients with schizophrenia in Japan: a retrospective study

Deinstitutionalization for people with mental disorders has only begun to be implemented in Japan. The purpose of this retrospective study was to examine factors associated with discharge for long-term patients with schizophrenia. Seventy patients were judged capable of discharge with psychiatric rehabilitation (special staff service). As a result of rehabilitation efforts, 37 patients were discharged and 33 patients remained in the hospital. Significant differences were found in age, level of family agreement about patient's disability, and length of the special staff service. These factors might be important to predict patients' potential for discharge.


Optimal length of intramuscular injection needle and drug absorption by ultrasound evaluation

超音波診断装置による筋肉針の長さと薬液拡散状態

The administration of an intramuscular injection (IMI) is a basic nursing skill, primarily involving the gluteus and deltoid muscles. Nurses must determine the appropriate needle type, gauge, and depth of insertion for giving an IMI while avoiding injury to blood vessels and nerves. The primary purposes of this study were to determine the appropriate depth of injection for administering risperidone long-acting injectable (RLAI) and to evaluate the injected drug absorption using B-mode ultrasonography. In this study, the subjects were three patients with schizophrenia being treated with RLAI. The IMI procedures were monitored using B-mode ultrasonography during the injection of RLAI. One patient received an adequate injection in the gluteus medius muscle; however, the other two patients received inadequately positioned injections. Ultrasonography was useful for checking the absorption progress of the RLAI-loaded microspheres.


Collaborative agencies and quality discharge support for the long-team care inpatients with mental illness

Long-term hospitalization is a problem for psychiatric care in Japan. The purpose of this research was to clarify the demands placed on public health nurses' (PHN) involved in the discharge of long-term inpatients (LIPs) with mental illness, and their lack of support. A questionnaire was mailed to 516 health centers, and 112 health centers replied. The response rate was 21.7 percent. The mail survey questionnaire was based on original questionnaire developed by the authors. Significant differences were found among collaborative agencies selected as essential for the discharge support project for the LIPs with mental illness. These differences were evident in the following question items on insufficiency of support: "Incompatibility with the policy of the public health center on discharge support"; "Opposition to discharge of a LIPs with mental illness by hospital staff"; and "Shortage of PHN in charge of the discharge support project for the LIPs with mental illness". It was clarified that the discharge support project required not only the involvement of health and medical welfare personnel but also the cooperation of local human resources such as local residents, neighbor associations, social workers, real-estate agencies and others.

The Journal of Medical Investigation : JMI


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)


Required Function of the Caring Robot with Dialogue Ability for Patients with Dementia

AIA International Advanced Information Institute


Retrospective study of Japanese patients with schizophrenia treated with aripiprazole.

Aim. The purpose of this retrospective study was to evaluate changes in clinical indicators which influence the quality of life (QOL) of patients with schizophrenia treated by antipsychotic therapy before and after switching to aripiprazole. Methods. A retrospective chart review of 27 patients diagnosed with schizophrenia and who were switched from one antipsychotic to aripiprazole was performed. Clinical indicators about the daily dosage of antipsychotics and antiparkinsonian drugs, psychiatric condition, and glucose/lipid metabolism, clinical evaluation by nursing observation were used to measure the responsiveness of subjects to aripiprazole. Results. Of the 27 subjects, 14 responded to the switch to aripiprazole with significant improvement of the Brief Psychiatric Rating Scale (BPRS) score (P = 0.04), significant decrease in dosage of antipsychotics in 71% of patients (P = 0.03), and tendency toward reduction in dosage of antiparkinsonian drugs (P = 0.07) and body mass index (BMI) (P = 0.06). However, 8 of 27 subjects had a significant increase in lipid levels after switching to aripiprazole (P = 0.01). Conclusion. QOL for subjects who responded to the switch to aripiprazole improved as indicated by lower doses of antipsychotic and antiparkinson medications, improvement in BPRS score, and a decrease in BMI. Results indicate little influence on patient's QOL.


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.


Development of the Reflection and Self-Assessment scale for nursing student : study of its reliability and validity

看護学生用リフレクション自己評価尺度の開発 : 信頼性・妥当性の検討

本研究の目的は，看護学生用リフレクション自己評価尺度を開発し，その信頼性と妥当性を検討することである．Gibbs のExperiential Learning CycleのReflective cycleを理論的基盤として，「リフレクション自己評価尺度」原案を作成した．看護学生150人を対象に，臨地実習終了後，「リフレクティブジャーナル」を使用したリフレクションを実施後，「リフレクション自己評価尺度」原案の回答を求めた．探索的因子分析で尺度原案を修正し，8項目，「意識変容・行動計画」，「評価・分析」，「記述・表現」の3因子構造であることを確認した．共分散構造分析による検証的因子分析を行った結果，探索的因子分析で得られた仮説モデルの適合度が確認された(GFI＝0．903，AGFI＝0．795，CFI＝0．894)．尺度の信頼性については，▯係数が0．77であり，項目分析から内的一貫性を確認した．妥当性については，因子がGibbsのReflective cycleと類似していることから内容的妥当性を，職業的アイデンティティ尺度と批判的思考態度尺度の相関から基準関連妥当性を確認した．「リフレクション自己評価尺度」はある程度の信頼性と妥当性を備えた尺度であり，リフレクションの自己評価のための測定ツールとして，有用な尺度であることが示唆された．

JNI : The Journal of Nursing Investigation


The effects measurement of hand massage by the autonomic activety and psychological indicators

This study examined the effects of hand massage on autonomic activity, anxiety, relaxation and sense of affinity by performing it to healthy people before applying the technic in actual clinical practice. Findings were showed below: 1) the significant increase in the pNN50 and the significant decrease in the heart rate meant the intervention of massage increased the autonomic nervous activity, improved the parasympathetic nerve activity and reduced the sympathetic nerve activity. This means the subjects were considered to be in a state of relaxation. 2) Salivary α amylase has been reported as a possible indicator for sympathetic nerve activity. In this study, there was no significant difference in the salivary α amylase despite a decrease after massage. 3) State anxiety score is temporal situational reactions while being in the state of anxiety and this score decreased significantly after massage. 4) The level of willingness to communicate with other person and the sense of affinity toward the massage-performer had a positive change of 70 percent. From this, it can be considered that a comfortable physical contact between a patient and a nursing profession, who are in a supported-supportive relationship, leads to an effect of shortening the gap in their psychological distance.


Relation between television commercial of alcoholic beverage and alcoholism

アルコール依存症とテレビコマーシャルの関係

Alcoholism is a disease that greatly ruins body mental health, family's health, and a social property. Moreover, it is a disease that a few drinking are connected with the danger of the relapse because there is a control trouble of the drinking desire. The purpose of this survey is to clarify the relation between television commercial of alcoholic beverage (CM) and alcoholism. Questionnaire survey on CM and the drinking desire of alcoholism was carried out. Participants were 104 abstinent patients (AP) and 221 healthy control subjects (HCS). HCS were ruled out alcohol dependence syndrome range by Alcohol Use Disorders Identification Test. Statistical analysis was performed using Chi-square and Fisher's exact tests as well as adjusted residuals to compare AP and HCS. In addition, AP was analyzed the relationship between period of abstinence and CM. The average period of abstenence from drinking was 3.38 +/- 1.55 years. AP had the experience of receiving stimulation to the drinking desire by CM. AP had the unpleasantness to the CM. Also, they hoped to discontinue CM, they felt the unpleasantness when they watched CM. Generally, three years are considered to be a stability period after abstains from drinking. Thirty-seven% of AP with 3 years and 27% of AP with 5 years answered "It is very which question about "I want to drink alcohol when I watched CM of alcohol beverage". It was suspected the CM stimulation was a risk element of an external trigger of the drinking desire, and AP had significantly felt "unpleasant" and hoped that "Discontinuance of CM". It was suggested that it is necessary to reconsider the CM stimulation from the viewpoint of relapse prevention of AP.

Japanese Journal of Alcohol Studies & Drug Dependence

日本アルコール・薬物医学会雑誌


長期入院の精神障害者の退院支援に関わる精神科看護の魅力

長期入院の精神障害者の退院支援に関わる精神科看護の魅力

本研究の目的は，長期入院の精神障害者の退院支援のための精神科看護の魅力について文献検討により明らかにすることである．日本においては長期入院の精神障害者に対する積極的な退院支援が行われている．しかし，退院後の継続的な支援環境が整わないために，退院できない状況もあり，看護師は仕事への無力感を感じる場合も多い．それでもなお，精神障害者の退院支援に魅力を抱いている看護師がいる．したがって看護師らが退院支援に対して抱く魅力は何かを明らかにすることが長期入院の解決に対して重要である．文献検討の結果，長期入院の精神障害者の退院支援の魅力として(1)患者との相互作用のなかでの自己洞察と自らの人間的成長，(2)患者と看護師の関係発展過程から得られる患者の本質的な理解，(3)看護師が主体性を持って患者と関わることができるという特徴が示唆された．


The relationship between psychological comfort space and self-esteem in people with mental disorders

The purpose of this study was to demonstrate a causal model of the sense of having psychological comfortable space that is call 'ibasho' in Japanese and self-esteem in people with mental disorders who had difficulty in social activities. The subjects were 248 schizophrenia patients who were living in the community and receiving day care treatment. Data were collected from December 2007 to April 2009 using the Scale for the Sense of ibasho for persons with mentally ill (SSI) and the Rosenberg Self-Esteem Scale (RSES), and analyzed for cross-validation of construct validity by conducting covariance structure analysis. A relationship between the sense of having comfortable space and self-esteem was investigated. Multiple indicator models of the sense of having psychological comfortable space and self-esteem were evaluated using structural equation modeling. Furthermore, the SSI scores were compared between the high- and low-self-esteem groups. The path coefficient from the sense of having comfortable space to self-esteem was significant (0.80). High-self-esteem group scored significantly higher in the SSI subscales, 'the sense of recognizing my true self' and 'the sense of recognizing deep person-to-person relationships' than the low-self-esteem group. It was suggested that in order to help people with mental disorders improve self-esteem, it might be useful to support them in a way they can enhance the sense of having comfortable space.

The Journal of Medical Investigation : JMI


Support for people with both alcohol dependency and affective disorder, and their families

アルコール依存症と感情障害を抱える人とその家族への支援

アルコール依存症と感情障害の関係性は以前から指摘されている．アルコール依存症とうつ病は，自殺企図者の精神障害の内訳の半数を占め，それらが合併した場合には自殺の危険性を一層高める．また，アルコール依存症治療において，患者がうつ症状を呈している場合，再飲酒のリスクが高くなり治療の継続を妨げる原因となりうる．そのため，うつ病の治療にも注意を払うことが求められる．さらに，家族からの支援はアルコール依存症患者の断酒を継続するなどの治療において重要な役割を果たしている．しかし，患者の断酒の継続に注意を払いすぎるあまり，それがストレスとなり患者の問題飲酒を助長することになったり，家族自身がさまざまな悩みを抱え苦しんだりすることが考えられ，家族への支援もとても重要となる．加えて，親がアルコール依存症である場合，子どもも将来アルコール依存症となる危険性が高くなるなど，子どもに与える影響も大きい．そこで医師，看護師，ソーシャルワーカーが支援に関わることや自助グループを活用することが重要となる．本総説ではアルコール依存症と感情障害の関係と治療方法，アルコール依存症と感情障害を抱える患者とその家族への支援に焦点を当て，包括的な支援のありかたを検討した．


The relationship between emotional empathy, self-acceptance and interest in disaster nursing of the nursing students who recently-enrolled in the university

The purpose of this survey was to clarify relationship between emotional empathy, self-acceptance and interest in disaster nursing of the nursing students who recently-enrolled in the university. The participants were the first year students at the nursing university, and questionnaire survey was conducted in June, 2009. There were 60 response rate, 80．0% of the nursing students responded that they were interested in disaster nursing. Those students of 22．9% knew the meaning of ``triage'', and 50．0% of them knew the posttraumatic stress disorder. The students who answered that they have desire to participate in the disaster rescue and nursing positively when becoming registered nurse in the future were46(76．7%). Therefore, it was suggested that the necessity for educating basic principle of disaster nursing at the earliest time after entering university. Moreover, there was significant differences in students who had answered that want to participate in the disaster nursing and others who had not answered so (59．98±5．98 vs. 55．57±6．60; P＝0．03)in the emotional-warmth. There was also a significant difference in the emotional-coolness(22．00±7．64 vs. 30．14± 10．55; P＝0．01). Also, there tended to be a difference in self-acceptance(SA)of the students who interested in disaster nursing, and the students who was not so (19．27±4．14 vs. 16．25±5．26; P＝ 0．07). Consequently, it was considered to contribute to helping students, and to improve level of SA to increase student's awareness of the disaster nursing.


リスパダールコンスタ専用針を用いた筋肉注射手技の正確性 中臀筋への確実な筋肉注射に必要な注射針の検討

The Japanese Journal of Psychiatric Nursing


Illness experiences of patients with iscemic heart disease during their transitional phase from hospitalization to discharge in Japan

The purpose of this study was to explore the experience of patients with ischemic heart disease (IHD) during the transitional phase from hospitalization to discharge. Twenty-four patients who experienced IHD for the first time comprised the sample of the study. Semi-structured interviews were conducted during the transitional phase. The results of the qualitative inductive analysis showed two categories of illness experience: (i) the connection of heart attack experience with the self, and (ii) the instability of the self as a patient with heart disease. The participants were found to vacillate between the self as patient with a heart disease and the typical self before the disease onset. The transitional phase is the time when patients experience changes in their symptoms and physical conditions rather than a condition of stability signifying recovery. Patients are expected to manage the symptoms of their heart disease by themselves; however the participants showed signs and symptoms of confusion and anxiety about facilitating their own care. These findings suggest the importance of outpatient nursing practice focusing on the support and emphasis on nursing interventions for patient anxiety and alleviation of confusion through the management of symptoms of heart disease after discharge.

The Journal of Medical Investigation : JMI


Clinical pathway focused on team care of the behavioral and psychological symptoms of dementia BPSD and family support

認知症に伴う行動障害と精神症状(BPSD)の改善および家族支援に焦点をあてた認知症のためのクリニカルパスの検討

Japanese Journal of Geriatric Psychiatry


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


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

Information : an International Interdisciplinary Journal


Image and usage of the health food in nursing and nutrition students


Introduce on Phlippines nursing educationl system, and health care systemes of the Philippines general Hospital in Manila

フィリピンの看護教育及び病院視察報告

It is an important theme in nursing education to offer an opportunity of an international exchange so that the nursing student living in global society of the 21 st century can have an international field of vision. A purpose of this report is to raise interest to a Philippine nursing education system and care system. Because we thought that the transaction with an Asian region is predicted to become more and more active in future. Therefore we inspected a nursing education of a Philippine university and a care system of Philippines General Hospital. In addition, we visited University of the East Ramon Magsaysay Memorial Medical Center(UERM), College of Nursing(a private school). All the nursing education in a Philippine nursing education was made at University/college, and the teacher thought that graduates of their university were nurses having ability for high practice. We had explanation that the Philippines General Hospital was the national major general hospital which provided from medical treatment to the third medical treatment and 90% of the patient who used there were no income or low-income people. Most of patient's room was the room for the plurality of patients, and we saw that a family attended the patient there. We thought that there was a similar problem in quitting a job and a shortage of nurses. But we were able to have a suggestion to nursing education during short inspection.

21世紀のグローバル社会を生きる学生が国際的な視野を持つ事ができるよう，国際交流の場を提供することは看護教育における課題である．本稿の目的は，フィリピンの看護教育制度への関心を高めることにある．なぜならば，アジア地域との交流は今後ますます活発になる事が予測されるからである．そこで，フィリピン大学の看護学教育および隣接するPhilippines General Hospital の看護システムを視察した．また，University of the East Ramon Magsaysay Memorial Medical Center(UERM)，College of Nursing(私学)も視察した．看護教育はすべて大学でなされ，大学の卒業生は高い実践能力を有する看護師であると考えていた．Philippines General Hospital は利用者の90%が無収入か低所得者とのことで，1次医療から3次医療まで対応している国立の大規模な総合病院であった．病室の大半が総室で家族の付き添う姿も見られた．看護職の離職および不足においては日本と類似した問題を抱えていた．短時間の視察であったが，看護教育への示唆を得ることができた．

JNI : The Journal of Nursing Investigation


Developing the Method of Server Controlled Outcomes Management and Variance Analysis

This paper is to describe a way to develop the Psychoms process for mental health patient management and variance analysis system has been developed using artificial intelligence. Although it is agreed that there is a need for clinical pathway variance analysis, methods for creating a system are less well defined. The procedure and systematic process described aims to improve patients' quality of life through consistent and timely care. Ultimately, its potential influence is to assist in the improvement of quality health care services. This paper illustrates a method of outcomes management and variance analysis as the prospective development of future research.

本論文では，人工知能を使って開発されたメンタルヘルス患者管理と差異分析システムのためのPSYCHOMSプロセスを開発する方法を記述した．それは，臨床経路差異分析の必要性があることが合意されているが，システムを作成するための方法は，あまりよく定義されていない．このシステムの開発過程において，タイムリーなケアを提供することによって患者の生活の質を改善するための組織的なプロセスと手順が明確にされた．最終的に，その潜在的な影響は，質の高い医療サービスを支援することである．本論文では，今後の研究や前向きの開発などのアウトカム管理と差異分析の方法を示した．

Electronic Notes in Theoretical Computer Science


The Technique of Emotion Recognition Based on Electroencephalogram

We aim to develop the mechanism that is possible to sympathize with man, and we target at the thing to read feelings which man feels from the brain wave. This time, as an initial stage of the research how the subject is able to make judgments to be impressed from the brain wave is verified. Concretely, it is investigated by using electroencephalograph (EEG) that the brain is an active state when the subject own declaring to have been impressed. Three kinds of evaluation method are used for this research. One method is statistically evaluated based on the strength of potential. Other method is evaluated objective based on the place which brain waves activate. Another method is evaluated by comparing a subject's subjectivity with change of EEG. Subjects are two persons and a small number this time, and since those attributes are partial, a question remains in the justification of a result. However, it is also the fact which becomes clear from this result that a subject's impression condition can fully be judged from the activity state of brain waves.

我々は，人に同情することが可能であるメカニズムの開発を目指して，脳波から感じる人の感情を読み取る事をターゲットにしている．今回は，研究の初期段階として，被験者の脳波から感動したかどうかの判断を行うことができる方法を検証した．具体的には，脳は，対象が感動したと宣言所有アクティブ状態であることを脳波計(EEG)を用いて調べた．この研究のために3種類の評価法を使用した．一つ目の方法は，可能性の強さに基づいて統計的に評価した．二つ目の方法は，脳波がアクティブな場所に基づいて客観的に評価した．もう一つの方法は，EEGの変化に被験者の主観を比較することによって評価した．被験者は，今回二人と少数であり，それらの属性が不完全であるため，少し問題が残っている． しかし，それはまた，この結果から，被験者の印象条件が完全に脳波の活動状態で判断することができることが明らかになった事実だった．


Empathetic Understanding as Caring in Nursing Using Electroencephalographic Data as Evidence

We presume that the measurement of electroencephalographic (EEG) changes, those activities that are considered physiological indicators, enables an objective understanding of changes in emotions of those who have difficulty in expressing these through facial expression or physical action. Generally, EEG is used in the hospital to examine encephalopathy and brain disorder. Using an electroencephalograph device to acquire digital data we propose a method to objectively capture changes in the recognition state of people from changes in EEG activities (action potential), and a way to apply it into a clinical situation.


Functions required for walking supporting devices to improve the level of elderly people's quality of life in Japan


Survey on Community Resident's Attitudes and Images for Mentally Handicapped Person and Mental Disorder

住民の精神障害者に対する意識調査:精神障害者との出会いの経験と精神障害者に対するイメージ

BACKGROUND: The mental health care and welfare have shifted from hospital care to the community care. Stigma and discrimination with mental health problems have been identified as major obstacles for this plan. AIM: The purpose of this study was to clarify community attitudes and images for mentally handicapped person of the people living in a small community. METHOD: A mail survey was conducted in the area covered by A health center in B prefecture. The candidate 600 residents (2.2% of all residents) who live in B County were selected (age range: 20-60 y.o.). Participants comprised 293 respondents (recovery ratio: 48.8%). RESULTS: About 50% of respondents who are in 20's and 30's answered that they became aware of mentally handicapped persons when they were between elementary school to high school age. The general tendency at that time was negative including "he/she has changed badly" (19.9%) and "he/she is fearful" (15.8%). On the other hand, positive images were less than ten percents including "he/she is not different from an ordinary person"(5.5%), "he/she is friendly personality" (2.3%). The mentally handicapped persons who respondents usually met were only with dementia. CONCLUSION: The images about mental illness at school ages are important. Any intervention aimed at changing attitudes to mentally ill people in the community should be targeted to children. It is also important to make an opportunity of warm interaction between people with mental disorders and community residents in the psychiatric hospital, a rehabilitation institution, etc.

スティグマと疎外が精神疾患の治療と精神障害者の社会復帰を妨げていることが,精神保健上の問題として明らかにされている.地域住民の精神障害者との出会いの経験と精神障害者に対するイメージについて明らかにする目的で,郵送法による質問紙調査を行った.その結果,20代と30代の回答者の約50%が,精神障害者を意識した時期が小学校から高校であったと回答した.その当時の精神障害者のイメージは,否定的イメージが多かった.またその内容は,「変わっている」「こわい」が上位にあり,「普通の人と変わらない」は1割以下であった.回答者らが,実際に会ったことのある精神障害者は認知症のみであった.精神保健福祉施策は入院医療から地域ケアへと移行している.したがって,精神障害者やその障害について地域住民が理解する機会を我々は増やしていかなければならない.今後は,さらに若い年代から病院や施設等で精神障害者と日常的に交流を持てるような,ふれあいの場を作ることが重要である.また若い年代に対する精神障害者や精神障害に対する固定観念やスティグマを緩和ないし減少させるためのさらなる啓発活動が求められることが示唆された.


Clarification of Caring Behaviors by the Family of Elderly Relations Living in Rural Japan


Survey on community resident's experiential knowledge of mental disorders and reaction to people with mental disorders

地域住民の精神障害関連の行事への参加と精神障害者に対する意識調査

Background : It is essential for mentally disabled persons who live in the community to be understood and cooperated by local residents. Aim : This study investigated the relationship between the participation of the residents to the event held in the psychiatric hospital and their attitudes towards mentally handicapped persons. The research objective is to find the method to the residents for promoting an understanding of mental disorders. Method : A mail survey was conducted in the area covered by the B health center in A prefecture. The candidate600 residents(2 2% of all residents)who live in B county were selected(age range : 20-60 y.o.). Participants comprised 293 respondents(recovery ratio : 48 8%). Comparison was carried out by the respondents who joined or did not join the event held in the psychiatric hospital. Results : Their understanding of mental disorders is relatively high in the participants. Most of them are willing to do something for mentally disabled persons' social rehabilitation. Ten percent of all respondents would choose `can't go along with mentally handicapped persons' social rehabilitation support'. Conclusion : The results suggest that the provision of the opportunity for personal contact with mentally handicapped persons are important for improving the educational activity of the public about mental illnesses and considered to be important measures for promoting the acceptance and support of the mentally handicapped persons by the local residents.

精神障害者が地域で生活するためには地域住民の理解と協力が不可欠である．精神障害者が参加する行事への住民の参加度と精神障害者に対する意識に加え，彼らとのつきあい方との関係を明らかにし，さらに，それによって精神障害および精神障害者に対する理解を促進するための住民への啓発方法を検討することが本報告の目的である．A県のB保健所の管轄区域の住民600人を対象とした郵送法による質問紙調査を行った．回収率は48．8%(293人)であった．地域住民のなかで精神障害者が参加する行事に参加した経験のある人は，1)精神障害への認識度が高かった，2)精神障害者の社会復帰のために「何か役に立ちたい」と思っている人が多かった，一方で3)精神障害者の社会復帰への支援に，協力できないと回答した人は全回答者の1割しかいなかった．精神障害者が地域で生活するために必要なものは「地域住民の精神障害についての関心と理解そして精神障害者に対する支援である」と，住民自らが感じていた．住民を巻き込んだ体験的啓発活動の実践が，精神障害者に対する理解や支援を拡大させることになるということが示唆された．


山間地域で生活する一人暮らし高齢者の介護度の変化とQOL

山間地域で生活する一人暮らし高齢者の介護度の変化とQOL


Challenge of Psychiatric Rehabilitation for Patients With Long-Term Hospitalizations Using the Nirje's Normalization Principles As a Valuation Standard: Two Case Studies

This research investigates the current care of hospitalized, chronically mentally ill persons to determine to what extent current hospitalization supports Nirje's principles of normalization. We propose that care-providers try to incorporate rehabilitation programs that help the patients acquire the pattern and rhythm of living necessary for them to live in the community in their daily hospital life rather than to fit the patients into hospital rules or schedule. Therefore, care-providers must look back on their own views of the humanity, disabled people, and support and may have to change them if necessary. It is important that care-providers do not give up having psychiatric patients not give up restoration of normal social living. To develop such individual attempts into rewarding activities, it is necessary to set goals in the hospital and to let an interdisciplinary team work to achieve them. Moreover, the situation is expected to change if efficient care management is implemented to support psychiatric patients in the community. High-quality care to realize independent living of patients in the community including collection and distribution of information, management of symptoms, assistance for self-care, and psychological education is provided at hospitals that maintain the idea of, and strong belief in, providing high-quality care for returning patients to the community. The findings of this study will provide insights into how to design better hospitalization and/or community care for the mentally ill.

The Journal of Medical Investigation : JMI


Identifying important nursing skills in psychiatric wards

精神科病棟で実施されている看護技術についての実態調査


Gender differences in association of plasma adiponectin with obesity reflect resultant insulin resistance in non-diabetic Japanese patients with schizophrenia

我々は，抗精神病薬服用中の慢性期統合失調症患者においてhypoadiponectinemiaが肥満およびインシュリン抵抗性に関係しているかどうかを検討した．その結果男性では，血漿adiponectinにおいて，BMIとHOMA-IRの間に負の相関が見られたが，女性には認められなかった．男性の肥満群は，非肥満群と比較して有意に低い血漿adiponectinであり，HOMA-IRは有意に高値を示した．しかし女性では有意差は認められなかった．血漿leptinにおいては，BMIおよびHOMA-IRの間に有意な相関が認められた．肥満群における血漿leptinは，非肥満群よりも有意に高値を示した．血漿leptinとは対照的に，血漿adiponectinでは，BMIおよびHOMA-IRに関して性差を示した．


Home nursing skills of the registered visiting nursing stations

訪問看護ステーションにおける看護技術の実態調査

本研究はT県における，訪問看護ステーションで実施されている看護技術の実態を明らかにすることを目的として行われた．回答のあった全ての事業所で1ヶ月に1度以上実施されていた項目は「関節可動域訓練」「歩行介助」「移動の介助」「寝衣交換など衣生活援助」「バイタルサインの観察」「適切な体位の保持」であった．日常生活援助のうち，移動の援助，清潔の援助や排泄の援助が多く実施されていた．救命·救急に関する項目については実施頻度が低い傾向がみられた．臨地実習における学生の経験が困難と予測される項目には学内で理解を深める工夫が必要である．

JNI : The Journal of Nursing Investigation


山間地域の在宅高齢者の外出状況の実態

山間地域の在宅高齢者の外出状況の実態

本研究の目的は，山間地域で生活する在宅高齢者の外出状況の現状を調査し，介護予防上の問題と課題を明らかにすることにある．対象は，山間地域に居住 する65歳以上の者3，109人である．自記式質問調査票を用いた郵送調査である．調査は2003年10月∼12月末に行った．調査内容は，基本的属 性，外出状況および岡本らの開発した介護予防アセスメントツールを対象地域の特性に合わせて一部改編したものである．集計の結果，外出頻度が週1回以下 の者は対象者の過半数を占めており，そのうちの6割弱は，来訪者や近所づきあいを通した交流があることがわかった．ほとんど外出しない者の中に，身体· 心理·社会的側面の活動性低下がみられる者が潜在することが推察され，「閉じこもり」につながると思われた．


医療福祉を学ぶ学生に対するより良い生命倫理教育のあり方を検討することを目的に，その端緒として，大学生の「いのち」観，すなわち宗教性，「死」，「遺体」および最先端生命科学技術に対する考え方を，質問紙調査法を用いて調査した．調査目的および方法を口答および文書にて教示し，同意が得られた学生に調査協力を依頼した．結果的に574名の回答を解析の対象とした(回収率96．9%，有効回答率83．5%)．得られたデータを解析した結果，約半数の学生は， 一見宗教には全く関心がないようであるが，古来からの霊魂観念，加護観念を受け継いでいることがわかった．これらの観念は，臓器移植やヒトクローン個体作成のような最先端科学技術に対する考え方に影響を与えていることが推察されたが，同時に彼らの体験がその「いのち」観との強い関わりが示唆された．さらに，彼らのいのちにまつわる倫理観は可変的であり，教育の重要性が再確認された．


統合失調症用のクリニカルパス及びアウトカム管理の確認項目の作成と重要性の検討

統合失調症用のクリニカルパス及びアウトカム管理の確認項目の作成と重要性の検討

近年，クリニカルパスはケアを改善するために用いられるようになった．この研究の目的は統合失調症用のためのCPを開発することである．その主要な焦点は，①ノーマライゼーションの理念に基づいたチームケアを実践すること，②CPと連動した患者アウトカム管理用の重要な品質管理項目を明確にすることである．アウトカム管理を病院で行うことによって，患者·家族のQuality of Lifeの向上，良好な費用対効果，医療者の満足度の向上，入院期間の短縮等の効果が得られる．筆者らは，(Interdisciplinary Collaborative Team Care Model: ICTCM)を2000年に導入し，1999年の平均在院日数205．7日(1994年の平均在院日数675．5日)を2004年には155．2日に短縮した病院において，学際的なケア提供者と事務責任者を調査対象として，聞き取り調査を行い，統合失調症用のCPとアウトカム管理項目を作成した．


A report of FD in psychiatric nursing practice --- utilization of coaching skills

精神看護学臨地実習におけるFDの取り組みの報告 --- コーチングスキルを活用して

コーチングスキルの活用の視点から精神看護学実習指導について検討を加えた．「傾聴する」「質問する」「承認する」「提案する」などの基本的コーチングスキルを実習指導に用いることで，学生は見守られたり支えられていることを実感として感じていた．学生の心に響く個別性に合わせて「承認」を伝える工夫などが今後の課題である．


No association of the Trp 64 Arg mutation of theß3-adrenergic receptor gene with obesity, type 2

日本の統合失調症患者における代謝性疾患と関係する 3-adrenoreceptor遺伝子の突然変異(Trp64Arg)を横断的に調査した．3つの遺伝子型に89人の患者を群分けして，代謝性疾患のある患者とない患者のTrp64Argの対立遺伝子頻度とその独立性を分析した． その結果，統合失調症と診断された年齢，肥満度指数，ウエスト部-腰部比率および以外のいくつかの血液のパラメータで有意差は認められなかった(コレステロール値の低下を除いてp=0．046)．64Argの対立形質の変化は，日本の入院中の統合失調症患者の中で肥満，2型糖尿病，脂質代謝および高血圧症には関係していないと結論付けた．


学際的連携によるチ-ムケア実践のための教育

学際的連携によるチ-ムケア実践のための教育

精神障害とリハビリテーション

精神障害とリハビリテーション


介助犬のような作業を行うロボットを開発するための要素技術のなかの重要なものの一つに，ロボットが周辺の設備や人間と接触した場合に，ロボット，人間，設備のいずれかが損傷を受けることがないようにするための技術がある．ここでは，主に4足歩行ロボットに位置指令型のインピーダンス制御を適用し，仮想のばね，質量を適切に設定することにより，接触時に大きい力を発生しないような制御を行うことが可能であることを示した．

Research Bulletin / Kochi University of Technology


中山間地域における介護保険による認定を受けていない在宅高齢者の外出状況の検討

中山間地域における介護保険による認定を受けていない在宅高齢者の外出状況の検討


A walking support/evaluation machine for patients with parkinsonism

様々な歩行を支援するシステムが考案·開発されている．しかしながら，それらはパーキンソン病の患者障害を支援するための歩行障害の評価を行えるような設計にはなっていない．この研究では，パーキンソン症候群の典型的な症状を考慮して歩行を支援するためのモニタリング·システムのモデルを開発し，評価した．この歩行支援およびモニタリング·システムでは，(i)歩行中に発生するすくみ足，(ii)小刻み歩行，(iii)前傾姿勢，突進歩行，(iv)最初の一歩がなかなか踏み出せない症状をモニタリング可能であった．医療スタッフは，このシステムから得られたデータに基づく患者の回復の状態を評価し，リハビリテーションのガイダンスのような目的のためにそれらを使用することが可能である．

The Journal of Medical Investigation : JMI


Real-Time measurement of frozen gait in patient with parkinsonism using a sensor-controlled walker

Patients with Parkinson's disease develop gait disturbances. Although the use of walkers is very effective for maintaining locomotive ability, patients who have symptoms such as frozen gait (FG) and festinating gait may fall even with a walker equipped with a brake as they cannot use the brake well in an emergency and fail to follow the accelerating walker. None of the studies on walking aids to date have addressed real-time detection of FG or the use of this information for the control of the walking aid, monitoring of the state of improvement in the ambulatory function, or evaluation of the effect of the use of a walker. In this study, we evaluated whether the state called FG, a characteristic symptom of Parkinson's disease, can be detected by the use of a sensor-controlled walker with heel-to-toe pressure sensors. The following two measurements were carried out in one male healthy and a one male patient with stage 3 Parkinson's disease by the Hoehn-Yahr scale showing mild muscle rigidity, hypokinesia, and FG. In the healthy subject, the heel-to-toe pressure showed smooth heel-to-toe shifts during the standing phase. In the patient with Parkinson's disease, the heel-to-toe response time was about 2.4 times longer than in the healthy subject at the beginning of walking, and FG could be recorded as the difficulty in lifting the foot by the toes. Also, when FG was observed during walking, the pressure waves recorded by the same sensors showed two peaks occurring at short interval, indicating double landings.

The Journal of Medical Investigation : JMI


Investigation of QOL of hospice patients by using EORTC-QLQ-C30 questionnaire

This study was designed to investigate the quality of life (QOL) of cancer patients being cared for in a hospice, in the expectation that the results would serve as useful basic materials for improving the care of such patients. The subjects were 24 patients who had been diagnosed as having cancer and were hospitalized in the hospice wing of a hospital. The study was carried out as a crossing investigation using the Japanese version of the EORTC-QLQ-C30 Ver.3 questionnaire prepared by the European Organization for Research and Treatment of Cancer. The results of the survey showed that it was important to be prepared to prevent or treat diarrhea at the time of bowel movement and confirmed the need for care aimed at reducing fatigue. In addition, the emotional functioning and financial problems of the patients showed strong correlations with the QOL, revealing the need for psychological and financial support of cancer patients in hospices.


新しい連続的他動運動装置を用いた際の可動域変化の検討 --- 膝関節可動域制限患者に対して

今まで整形外科疾患や形成外科疾患患者の関節可動域(ROM)運動に対しては，手術直後から連続的他動運動装置(CPM)が広く用いられてきた．しかしCPMの軌道は各関節の持つ生理学的な運動に一致せず，一定の股·膝関節同時屈曲伸展運動しか行えないなど，さまざまな欠点が指摘されている．そこで我々は，新しい連続的他動運動装置である(TEM)を使用して下記の疾患へのROM訓練の効果を検討した，本研究では，膝関節ROMの短期変化と筋電図変化，および運動中の抵抗感を示す膝関節トルクの変化を分析することで，その即時的ROM変化の要因について検討した．


Temperament,character,and eating attitudes in japanese college women

精神分裂病と本態性パーキンソン病は，前者が脳内ドパミンの過剰仮説により説明されることが多く，後者がドパミン欠乏により生ずることにより，互いに相反する疾患として一般的には理解され，合併することはないと考えられている．しかし，筆者らはその治療経過から，全く相反する疾患として捉える根拠がないことを，その発症機制についての検討を加えて報告した．


Effect on Peripheral Hemodynamics of Soothing Touch to the Soles of the Feet

足底のタッチングによる抹消循環動態と主観的反応の変化

本研究は看護技術の一つであるタッチングによる反応を末梢循環動態と主観的反応の変化から明らかにすることを目的にした．耳朶の血流量と皮膚温度との間には有意の相関関係が認められた．タッチングに関する主観的な反応は全員が快反応であった．足底のタッチングにより血圧が低下傾向を示したことや末梢血流量の増加傾向から，タッチングにより末梢血管の拡張が引き起こされたものと推察された．さらに末梢皮膚温度の上昇は末梢血管の拡張に基づくものと考えられた．


Study of Life Satisfaction and Quality of Life of Patients Receiving Home Oxygen Therapy

在宅酸素療法患者への援助の基礎的な資料を得るために，生きがいおよびQOLについて郵送調査を行った．QOLは，活動性尺度，健康状態/満足感，身体症状尺度および経済状態から捉えた．満足感および健康状態は，精神的活動性との関連が大きく，経済状態は，すべての項目と大きく関連していた．本研究から，在宅酸素療法患者に対して，疾患の増悪防止に加えて，生きがいにつながる活動性の拡大，経済的な基盤整備が重要と考えられた．


入院中の慢性期精神分裂病患者の口腔衛生調査 --- 口腔衛生および嗜好調査から

入院中の慢性期精神分裂病患者の口腔衛生調査 --- 口腔衛生および嗜好調査から

慢性期精神分裂病患者の口腔内において，歯及び歯肉の病変を見ることは珍しいことではない．このような観点から，入院中の慢性期精神分裂病患者に対する口腔衛生及び嗜好調査と歯科検診を行い，これらの結果を健常対照群との間で，比較検討した．その結果，慢性期精神分裂病患者において，比較的若年齢で残存歯数や健全歯数の減少，高い全歯喪失率を認めた．歯磨き回数と歯磨きに対する必要性に関する意識は健常対照群と変わりがみられないのに残歯数が少ないのは，精神分裂病によるセルフケア不足や，認知機能のずれがあるのではないかと考察され，口腔衛生指導の必要性が大きいことを報告した．

Bulletin of School of Medical Sciences, the University of Tokushima

徳島大学医療技術短期大学部紀要


Analysis of the Effect of Motor Learning on Weight Discrimination Tasks using Motor Evoked Potential --- 重量判別課題による検討

運動誘発電位を用いた運動学習効果の検討 --- 重量判別課題による検討

本研究では経頭蓋磁気刺激による，一次運動野の出力細胞(錐体細胞)の運動誘発電位の変化を解析して，ヒトの運動学習による上位運動中枢の関与を検討した．その結果，運動学習および運動記憶に対して閉眼時に一次運動野の出力細胞の興奮性が増大し，主動筋と共同筋との間の関連性が強くなることが示唆された．


The effects on the public and patients of opening the psychiatric hospital --- 病院開放化の効果と患者の社会性の獲得

精神病院における音楽療法コンサート --- 病院開放化の効果と患者の社会性の獲得

精神病院における4年間のべ60回のコンサートの経験をまとめた．また，この論文を作成するにあたって，谷岡のこれまでの音楽療法コンサートに関する論文を引用しつつ作成した．コンサートの企画は主として谷岡が行った． 本研究で得られた知見は4年間に行ってきたコンサート時に行った地域住民に対する意識調査結果を基にしたものである．このコンサートによって，病床回転率は0．4から1．2%に上昇し精神病院の悪いイメージが減少した．


Development of a novel instrument to measure Japanese psychiatric nurses technological competency as caring in nursing

To effectively advance person-centered care (PCC) practice, it is important to equip healthcare providers with person-centered values and beliefs while simultaneously transforming their work environment to align with PCC. Thus, instruments to measure caring practice status in nursing competency for psychiatric-specific behavioral limitations, ethico-moral behavior, technology use, and PCC need to be developed. This study developed the Technological Competency as Caring in Psychiatric Nursing Instrument (TCCNPNI) to measure practice status and test its content and construct validity. Five different phases were followed: 1) Literature Review; 2) Operational definition of the construct and development of items; 3) Two-round Delphi method; 4) Validity measure; and 5) Reliability measure. The online survey was conducted in 2024. The developed instrument comprises 22 items with a 4-factor structure: competency to practice caring and person-centered care (Factor 1); competency to recognize and respond to ethical issues in psychiatry (Factor 2); competency to utilize technology in psychiatry (Factor 3); and competence to practice care for the preservation of human dignity and shared decision making (Factor 4). Cronbach's alpha for the entire scale was 0.864, while that for factors 1-4 was 0.911, 0.814, 0.773, and 0.64, respectively. Cumulatively, these four factors contributed 49.6% and explained nearly 50% of the total data. Item-total correlation values were 0.6 or higher among factors 1-3. However, factor 4, for which items were Q30, Q33, Q34, and Q35 ( = 0.03, 0.04, 0.21, 0.11, respectively), were inverted items and had low I-T correlation values. These low correlations suggest that these items capture different concepts. The developed TCCNPNI allows for the measurement of the practice of nursing as caring in psychiatry, the state of ethico-moral behavior, and the practice status of technological competency as caring in psychiatric nursing. This study demonstrated satisfactorily and efficiently evaluated the practice status of technological competency in psychiatric nurses' caring. Measuring technological competency as caring in psychiatric nursing can be an important adjunct for in-service education in psychiatric hospitals or formalized nursing education in nursing universities.


精神科単科の病院に新卒看護師を獲得するための 魅力ある職場環境

精神科単科の病院に新卒看護師を獲得するための 魅力ある職場環境

第49回(平成30年度)日本看護学会論文集 精神看護

第49回(平成30年度)日本看護学会論文集 精神看護


看護管理者が求める精神科看護に必要な技術力

看護管理者が求める精神科看護に必要な技術力

第49回(平成30年度)日本看護学会論文集 精神看護

第49回(平成30年度)日本看護学会論文集 精神看護


Gender differences of the influential factors on the mental health condition of teachers in the A university.

The Journal of Medical Investigation : JMI


Development of Rating Scale for Novice Nurses' Recognition of Working Environment

新人看護師の職場環境認識に関する尺度の開発

The purpose of this study was to develop a rating scale for novice nurses' recognition of working environment. The survey questionnaire on working environment was sent to 810 novice nurses in the western region of Japan, of which 634 were returned with a response rate of 78%. A principal factor analysis with a varimax rotation was conducted on the final 16‐item scale and two factors (11‐items) were extracted. The Cronbach α coefficient for the total scale was 0．882, indicating high internal consistency. The first factor was named ``educational-support environment,'' and consisted of six items regarding instruction in the workplace, tackling issues, and relationship with managers, and the second factor was ``working environment satisfaction,'' which consisted of five items regarding human relationships in the workplace, relationship with patients, and vacation. The developed ``rating scale for novice nurses' recognition of working environment'' can easily evaluate the cognitive state of a subject's workplace environment. Therefore, it was considered that this scale was useful when examining working environment.


精神科における持効性注射剤の安全な筋肉注射の方法 超音波診断によるエビデンスにもとづいた安全な投与部位と注射針の刺入深度

The Japanese Journal of Psychiatric Nursing


Effectiveness of nursing interviews using concordance skills aimed at acquisition of self-confidence toward community life for long-stay patients with schizophrenia not wishing to be discharged

退院を望まない長期入院統合失調症患者に対する地域生活の自信獲得に向けたコンコーダンス・スキルを活用した看護面接の効果

In the present study, we conducted nursing interviews using concordance skills (CS interviews) aimed at acquisition of self-confidence toward community life for two long-stay patients with schizophrenia who did not wish to be discharged from psychiatric hospital, and evaluated the effectiveness of CS interviews. Case A was a woman in her 70s who was diagnosed with schizophrenia at around age of 17 years and had been institutionalized for approximately 30 years since her ninth admission. Case B was a man in his 30s who was diagnosed with schizophrenia at around age of 22 years and had been admitted 15 times due to auditory hallucination, delusions, suffers a relapse, has been in hospital for two years and six months since his latest admission. As a result of interviews, scores on the Self-Efficacy for Community Life Scale improved from 150 to 160 points for Case A and from 66 to 82 points for Case B. In the Case A, the Global Assessment of Functioning (GAF) score was 35 with no changes before and after intervention. In the case B, GAF score improved from 25 to 35, before and after six months intervention. These findings suggest that CS interviews are effective for promoting self-confidence toward community life among long-stay patients and useful for providing support without exacerbating the severity of psychiatric symptoms or functional level of long-stay patients during the stage in which they nurture the dreams and hopes to be discharged.


精神障害者のためのコンコーダンス・モデルに基づいた新しい看護面接

精神障害者のためのコンコーダンス・モデルに基づいた新しい看護面接

Mental health measures in Japan are moving from hospitalization-centered care to community-based care. With the demand for changes in the functions of psychiatric hospitals and clinics, the role of nurses is growing. The primary role of nursing is to enable each and every individual to maintain a healthy life, which involves providing those individuals with assistance to maximize their vitality and healing capacity and enable them to exploit those abilities as best they can. In order to practice such nursing interview, following basic concepts are useful : (1) It should be based on a concordance model ; (2) It should set opportunities to promote remarks from mentally ill individuals and utilize concordance skills that elicit their thoughts ; and (3) It should utilize the Strengths Assessment Sheet that focuses on lifestyle including the abilities, environment, and hopes of mentally ill individuals. In this article, we describe a proposed new nursing interview framework based on a concordance model for people with mental disorders.


Clarification of a staff assignment process based upon the thought process of nursing administrators in psychiatric hospitals

精神科病院における卓越した看護管理者の人員配置に関する思考過程の明確化

Assignment of appropriate staff is a very important role of the as nursing administrator. The purpose of this research was to clarify a staff assignment process based upon the thought process of distinguished nursing administrators in psychiatric hospitals in order to create a computerized system towards improving patient care outcomes. Participants were seven nursing administrators in psychiatric hospitals which have psychiatric acute care unit and dementia care unit etc. in Japan. A semi-structured interview procedure was using to determine the requirements necessary for systematizing process of designing the staff assignment, and survey contents were ``method of information gathering required for staff assignment determination'', ``what information required for decision-making'', and ``how to evaluate from the collected information''. This study used the qualitative analysis of narratives from participants. As a result, the daily record for unit management, interview, personnel information and patient information through the work schedule were collected, and nursing administrator had determined quantitative and qualitative number of staff assignment through the process of three steps of assessment. As a one important issue for staff assignment, it became clear a lot of nursing administrator's precious time was spent in gathering, organizing and analyzing information for staff assignment determination.


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.


7対1看護体制導入後の急性期病院一般病床における看護師の人員配置に対する評価

7対1看護体制導入後の急性期病院一般病床における看護師の人員配置に対する評価

It has been5years since an introduction of the nursing system of one nurse for every seveninpatients. The aim of this study was to determine whether this nursing system leads to meet thedemands of the inpatients and to clarify improvement factors in adequate personnel distribution.Participants were196head nurses of28acute hospitals in the Chugoku and Shikoku regions inJapan. As a result of analysis, the numbers of nurses have been increased by the introduction ofthis system. However, the employing of a large number of new nurses with almost no experience,it caused shortage of personnel, and reduction in nursing service quality. Also, as inclined allocationof personnel was not conducted according to the degree of nursing care need, imbalanced personnelallocation was observed in survey data. Furthermore, there was no significant correlationbetween bed occupancy rate and the number of nurses ; therefore it was thought that there is notstaff placement depending on busyness of nurse. For the adequate personnel allocation and carefulnursing system, it was thought that calculation of the number of nurse placement based on appropriatemeasurement of nursing care need and evaluation of nurses' competence was necessary.


療養病床における看護職と介護職の業務負担と連携における課題

療養病床における看護職と介護職の業務負担と連携における課題

本調査の目的は，療養病床における看護職と介護職の業務負担の実態を明らかにし，業務負担を軽減するための看護及び介護職員の連携の課題を明らかにすることである


地域で生活する虚血性心疾患患者のQOLの変化―待機的PCI患者と緊急PCI患者，性別での比較―

日本看護学術集会―地域看護―

日本看護学術集会―地域看護―


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


女性の急性心筋梗塞患者と待機的経皮的冠動脈インターベンション患者の退院前後の活動リズム変化ー2症例の考察ー

経皮的冠動脈インターベンション(PCI)治療をうけた女性の急性心筋梗塞(AMI)患者と待機的PCI 患者の症例から，退院前後の活動リズムの違いについて検討した．対象者は，60 歳代の病状が安定した患者各1 名とした．調査方法は，入院中から退院後7 日間，腕時計型加速度センサー(アクチグラフ)を用いて，生活リズムを測定した．アクチグラフ装着中は生活日誌も記入してもらった．活動区間(Up Interval)から時間，平均身体活動数，体動活動指数，体動加速指数を専用のソフトで解析し，入院中と退院後の平均値を比較した．また，退院前3 日間を基準値としたその後の変化率を比較した．その結果，AMI 患者は，入院中よりも退院後全ての期間で平均身体活動数は低下し，時間の経過とともに平均身体活動数は増加した．また，体動加速度指数も入院中よりも低下し，退院後ゆっくりとした活動をしていた．一方，待機的PCI 患者の平均身体活動数は，退院後全ての期間で増加し，入院中から連続的な活動をしていた．症例のAMI 患者と待機的PCI 患者では退院前後の活動リズムが異なることが推察された．

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)


The role of nurse administrators and managers in quality psychiatric care

Psychiatric healthcare services in Japan demand continuous improvement to ensure quality care. Psychiatric nurse administrators and managers greatly influence the quality of services. To improve treatment, the following are considered necessary: clarification of service goal, proper assessment of treatment outcome, shortening of hospitalization, patient-centered care, establishment of trust relationships based on open communication with patients, and effective interdisciplinary teamwork. Additionally, administrators and managers must evaluate the clinical competence of individual nurses and appropriately assign them, especially when personnel shortage is an issue. Furthermore, in collaboration with other healthcare professionals, nurse managers must provide optimal care by setting goals of psychiatric services for patients in acute, sub-acute, or convalescent phases. This article presents the roles of nurse administrators and managers in improving the quality of Japanese psychiatric healthcare services.

The Journal of Medical Investigation : JMI


精神科におけるクリニカルパスとコンピュータによる看護管理システム(PSYCHOMS)によるアウトカムの管理

日本病院・地域精神医学会総会プログラム・抄録集

日本病院・地域精神医学会総会プログラム・抄録集


退院支援施設入所後1年が経過した精神障害者の生活能力

退院支援施設入所後1年が経過した精神障害者の生活能力

研究目的は，退院促進支援により退院し，退院支援施設で生活した精神障害者の生活能力を明らかにし，看護のあり方を検討することである．調査対象者は，施設入所後1年が経過した長期入院であった精神障害者17名(男性12名，女性5名)で，平均年齢は，52．5歳，平均入院期間は11．3年であった．データ収集は，調査対象者一人ずつに約20分程度の半構成的面接を行った．その結果，逐語録から255のラベルが得られ，11のサブカテゴリーに分類された．これらから「自分自身のペースに合わせた生活リズムの獲得」，「病気を悪化させないための自己管理」，「施設退所後の生活のための心の準備」，「良好な対人関係の構築」という4つのカテゴリーが抽出された．これらの結果から，施設利用者は自分なりのペースで社会復帰に向けての準備をしながら，着実に生活能力を身につけていることが示唆された．

JNI : The Journal of Nursing Investigation


アリピプラゾールの特徴，利点をふまえた看護のポイント

アリピプラゾールの特徴，利点をふまえた看護のポイント

The Japanese Journal of Psychiatric Nursing


Fundamental study for the clarification of gender differences of actigraphic assessments of life rhythms in healthy adults

Information : an International Interdisciplinary Journal


Trouble to education and research activities of rookie faculty member who work in the 4 year university nursing program

看護系大学に勤務する新人教員の教育・研究活動に対する悩み

PURPOSE : This study was designed to identify the problems in teaching and research that novice faculty members face in university nursing programs. METHODS : A self-administered questionnaire was mailed to novice faculty members holding appointments in university nursing programs. Mean age of the subjects (n 69) was 31 7 years. A semi-structured instrument was developed to identify difficulties encountered by the subjects in teaching and research activities. Also their unstructured written comments were analyzed. The cover letter to potential respondents clearly indicated that informed consent was assumed on completion and return of the questionnaire. RESULTS : The subjects' responses sorted into the following categories : six for educational activity, eight for student advising in clinical practice, and six for research activities-a total of 20 categories. Data analysis revealed that in their educational activity and student advising, novice teachers had difficulties with instructional methods including lectures, class exercises, and clinical practices. They also faced problems in their personal relationships with senior staff and others. In research activities, most subjects revealed lack of knowledge and experience, i.e., applying scientific methodology, doing research reluctantly, and lacking the ability and experience to conduct research. CONCLUSIONS : Novice faculty members lacked confidence not only in teaching and conducting research but also in fulfilling other aspects of an unfamiliar role to them. These concerns included problematic relationships with a senior colleague and other staff. University administrators and experienced faculty members might plan an institutional program and/or procedure to mentor and support their junior colleagues.

本研究の目的は，新人教員が認識している教育および研究活動に対する悩みを明らかにすることである． 調査対象は，全国の看護系大学に勤務する新人教員とした．調査方法は，郵送による自由記載方式の質問紙調査である．倫理的配慮として，調査の趣旨，守秘義務および調査目的以外の使用，個人情報等の保護を調査依頼文で説明し，調査に同意を得られた場合に記入後，返送してもらった．69名から回答があり，平均年齢31．7歳であった．分析は，教育および研究活動に対する悩みが記載されている文章を対象とした．記載内容については，文章単位とし，意味内容の類似性に従いカテゴリ化し，タイトルをつけた．分析の結果，カテゴリは20抽出した．≪教育活動に対する悩み≫6カテゴリ，≪実習に対する悩み≫8カテゴリ，≪研究活動に対する悩み≫6カテゴリに分類できた．教育活動では，講義，演習，実習に関わらず教育方法や指導方法などの具体的な方法に関する悩みを抱えていた．またそれ以外に，上司などとの関係の悩みがあった．研究活動では，研究方法に関するものが最も多く，不本位な研究を行うこと，研究者としての経験および力不足に関する悩みが上位を占めた． 新人教員は，教育・研究活動を行うための具体的な方法に自信がみられなかった．また上司との関係や関係機関との調整と，教育・研究の両方の役割を担う者としての経験不足と力不足に悩んでいることが推察された．それらを視野に入れた支援の必要性が示唆された．