This study aimed to structure the effect of functional recovery care in a private home with care services for older people by analyzing employees’ narratives. Interviews with employees of the facility revealed the following structure: By adopting [elaborate methods for evidence-based care] or functional recovery care, employees realized [improvements in residents’ mental and physical functions] and the [calmness of residents’ lives in the facility], and such a realization resulted in [employees’ increased motivation and sense of fulfillment]. [Employees’ increased motivation and sense of fulfillment] [promoted professional awareness] and [organizational growth], promoted [approaches and awareness toward future development], and contributed to the [further enhancement of the organizational capacity]. The results clarified a structure, where functional recovery care in a private home with care services for older people leads to employee and organizational growth.
Background: This study reports a critique of advance care planning (ACP) by primary care physicians (PCP) in the at-home medical-care field in Japan. Methods: A cross-sectional survey was designed from previous research, piloted, revised, and sent out to all PCP during April and May 2019. The target participants were all the total 914 PCP registered online nationwide in Japan. After piloting, there were 28 question items with five Likert scale, plus some open-ended response items, treated by factor analysis to discover the leading essential characteristics of ACP. Results: The mean scores for each of the 28 items ranged from 3.73 to 4.85, and the leading 18 items were analyzed to reveal there were five factors. These were;- 1. Trust in the Doctor-Patient Relationship, 2. Building-up Cooperation, 3. Enlightenment and Awareness of ACP, 4. Level up Views on Life and Death among Health Care Providers, and 5. Patient and Family Preparedness for Death. The inter-factor correlation ranged from 0.06 to 0.44, and Cronbach alpha coefficient ranged from 0.74 to 0.95. Findings showed that more PCP, than not, considered the important characteristics to be (a) Experience of bereavement with someone close, p <0.01, (b) Attached home visiting nurse office, p =0.04, and (c) Medical fee point as home care supporting clinic, p =0.02. Conclusion: A total of five factors were statistically discovered to be necessary for ACP in Japan, and a total of three statistically confirmed basic characteristics.
The objective of this study was to discover communication gaps in interprofessional collaboration and examine ways to fill these gaps to mitigate communication difficulties in interprofessional collaboration during the discharge of patients with dementia (PWD) from hospital. The survey results obtained from 401 doctors, nurses, medical social workers (MSW), care managers, and visiting nurses were statistically analyzed. The analysis indicated the significant differences in “having knowledge of dementia” (p < .01), “hospital discharge tends to be short notice” (p < .001), and “sufficient time spent in interprofessional discussions for the discharge of PWD” (p < .01). As for the “things given importance upon discharge of PWD”, “cardinal symptoms of dementia” (p < .01), ”feelings of the patients” (p < .001), “feelings of family members” (p < .001), ”feelings of healthcare professionals” (p < .01), “support system for their families” (p < .05), and “support system for the patients” (p < .05) were significantly different, suggesting communication gaps among intersectoral healthcare professionals. It is critical to understand interprofessional differences in perspectives and thoughts about PWD to minimize communication gaps in interprofessional collaboration during discharge of PWD from hospital.
Objectives:To assess the quality of life (QoL) in Japanese patients receiving standard chemotherapy for unresectable pancreatic cancer. Patients and Methods: This prospective observational study included 30 Japanese patients with unresectable pancreatic cancer (PS 0–1) who were starting standard first-line chemotherapy. QoL was assessed using the European Organization for Research and Treatment for Cancer Quality of Life Core Questionnaire, version 3.0. Anxiety and depression were measured using the Hospital Anxiety and Depression Scale. Assessments were performed at baseline, 2 weeks, and then monthly during chemotherapy. Results: At baseline, the global health status (GHS) score was low (50/100), and 9 patients (30%) were experiencing significant levels of mental distress. Scores for the GHS, five functional scales (physical, role, emotional, cognitive, and social), nine symptoms (fatigue, nausea and vomiting, pain, dyspnea, insomnia, appetite loss, constipation, diarrhea, and financial difficulties), anxiety and depression generally did not deteriorate during chemotherapy. However, the QoL scores varied during chemotherapy according to the patients’ characteristics. Patients who achieved tumor control tended to have well-controlled QoL scores. A high survival rate was significantly associated with having a high baseline GHS score. Conclusions: Japanese patients with unresectable pancreatic cancer might maintain their QoL during standard chemotherapy, with tumor control being associated with well-controlled QoL. In addition, a high QoL at baseline was associated with a good prognosis.
The purpose of this study is to examine the relationship between Selective Mutism (SM) and Autism Spectrum Disorder (ASD). We conducted an individual questionnaire survey of kindergarten and elementary school teachers about the children with SM (n=17), children with ASD (n=12) and children with Typical Development (TD) (n=12) in their classes. The questionnaire included screening tests for SM, using the Selective Mutism Questionnaire-Revised (SMQ-R), and ASD, using the Autism-Spectrum Quotient (AQ). The results showed that in the SMQ-R, the scores for children with SM were significantly higher than those for other children. Meanwhile, in the AQ, the children with SM and ASD scored significantly higher than the children with TD, but no difference was observed between the two. This suggests that many children with SM are likely to show ASD traits. In future, to support children with SM, we need to find effective approaches to both the SM and ASD aspects of their condition.
In Japan, the aging population has increased, prompting local governments to develop care preventive programs for older adult residents. However, this localized approach makes it difficult to determine the types of care preventive programs that have been developed throughout the country. Therefore, this study carried out an inventory survey of care preventive programs that were certified by the local government as having long-term care rates of 15.0% or less. The response rate of the questionnaire survey by mail was 39.5%. The results indicate that the most frequent care preventive activity was exercise. Local governments implemented care preventive programs that older adult residents tried and continued to use until participation rates for the programs were reduced for environmental maintenance. Additionally, local governments focused on developing care preventive programs that provided resident-based activities in the area.
Despite the fact that advances in Japanese medical technology have saved lives in childbirth, the number of children requiring medical care due to some sort of disorder or disease continues to increase every year. Because children, unlike adults are still growing and developing, educational support and community support are required in addition to medical and nursing care. This study set out to analyze the role and function of coordinators by reviewing papers concerning support for children and families who need at-home medical care in Japan, so as to clarify the current situation and challenges pertaining to them. In terms of research design, the literature review made use of Igaku Chuo Zasshi (ICHUSHI-Web), Medical Online, and CiNii Articles. The keywords used were “medical care,” “children,” “at-home,” “coordinator,” and “community” (in Japanese). This resulted in the identification of 189 papers. Of those, 18 papers conforming to the objectives of this study were selected as targets for analysis. The following four groups were generated with regard to support for children in need of medical care: Support for parents and children as well as co-resident family members, Support for integrated healthcare networks, Educational support, and Support for challenges entailed by continuing to live at home. Focusing not only on mothers and children, but also on all co-resident family members provides a deeper understanding of at-home treatments and leads to smoother transition to at-home care. Also, cross-institutional and cross-disciplinary cooperation and collaboration with healthcare and welfare providers, communities, and government agencies is essential for continuing to provide support for children who require medical care at the society and community level. Care manager with the specialty of the child is necessary. Moreover, an educational approach can help families become aware of children’s developmental challenges and foster an awareness of roles within the family unit.
The purpose of this study was to examine the scales used in medicine and nursing studies related to menstruation in Japan and overseas, and to obtain indications for the development of a scale for menstrual abnormalities. For our search of overseas papers, we used CINAHL with Full Text and combined searches of “Menstruation” with “female”, “Factor Analysis”, “Adolescent”, “Scale” and “Premenstrual tool”, from which we chose 6 papers out of 67 results. For papers from Japan, we used Ichushi’s web version, and combined searches of “menstruation” with “scale” and “factor analysis”, from which we obtained 12 pieces of papers from 20 results. We covered a total of 18 papers (12 domestic and 6 overseas) for our study. We found scales for issues such as menstrual symptoms and menstrual pain, behavior during menstruation, premenstrual syndrome (PMS) diagnosis, menstrual self-care, and premenstrual dysphoric disorder (PMDD); however, we were not able to find any scales for abnormal menstruation. Since we could not find a scale specializing in menstrual abnormalities, we determined that there is a need to develop one to help encourage women who have abnormal menstruation but have not had a medical examination to make the choice to visit a medical institution.
In Japan, in order to realize inclusive education, teachers involved in special education need to have expertise to meet the diverse needs of children. However, as a result of the survey, it has been pointed out that a sufficient cooperation system has not been established with information on children's disability status is required to be shared reliably by related organizations. Therefore, this study aimed to reviews the framework of intellectual disability in Japan and to reviews the definition of intellectual disability on a physiology / pathology perspective. According to the classification of ICD-11, one of the neurodevelopmental disorders include intellectual disability and autism spectrum disorder (ASD). Schizophrenia, Epilepsy and Down Syndrome (DS) are separate categories and are not included in intellectual disability. Therefore, the low intellectual function found in some people with DS or Epilepsy should not be equated with intellectual disability as a neurodevelopmental disorder. In conclusion, to promote special education in the future, it is necessary for teachers to understand children's diseases and disorders physiologically/pathologically.
The purpose of this study is to clarify characteristics of the grief process, and the adjustment to a new life of an elderly woman who encountered the unexpected death of her spouse at home. Semi-structured interviews were conducted and data were analyzed using Steps for Coding and Theorization (SCAT).
The elderly woman experienced difficulties in thinking and acting in an ordered way. The response of the police and the autopsy imaging procedure had confused and irked her, and she had not been given much time to bid her husband farewell before his body was removed. Features related to the unexpected death scene were “unforgettably shocking” for her, but more that, the personality and memories of her husband became “unforgettably important and precious.” This was one of the facilitative factors of grief work. Her current life was constructed as a mixture of “a life that can be continued without being aware of the absence of the spouse,” “a life of recognizing the absence of the spouse,” and “a life of acquiring a new object of love or a new role.” She adjusted to a new life, by rendering various matters and the local community, such as traditional customs of death and cooperation of locals, useful as the facilitative factors of grief work.
As the size and role of the local community had diminished, it became evident that it was necessary to focus on other facilitative factors of grief work. This included resilience, prior relationship with the spouse, family’s functioning, and role acquisition.