OBJECTIVE : The aims of this study were to clarify the characteristics of outpatients with schizophrenia receiving psychiatric nursing at home and to evaluate factors related to re-hospitalization.
METHODS : The subjects were 55 outpatients with schizophrenia who were receiving psychiatric home visits and 31 non-users. An interview was conducted based on a questionnaire on age, gender, family members, psychiatric symptoms, attitude to drug use, and self-assessment of efficacy etc.; and we examined factors related to re-hospitalization.
RESULTS : Most subjects (86%) lived with their families. The percentage that lived alone was higher among those receiving nursing visits than non-recipients. Of the average age of the nursing recipients was higher than that of the non-recipients, the mean period of hospitalization was longer and the period after discharge was shorter than for the latter. The self-assessed score for efficacy among the nursing recipients who were re-hospitalized was higher than among those who were not re-hospitalized.
CONCLUSIONS : It is suggested that schizophrenia patients with serious symptoms or without family support can live in the community by using home visits by psychiatric nurses. The visiting nurses are requested to advise the patients so that they are able to assess their own capabilities and to control their own condition.

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Introduction: Although community medicine clerkship has been introduced in many medical universities, no study of students’ learning during the clerkship has been conducted. Also, no evaluation of students’ learning about family and community has been carried out.
Methods: Sapporo Medical University fifth-grade students in the fiscal year 2006 to 2007 experienced two-week community medicine clerkships. They were obliged to record their clerkship experiences on a daily reflection sheet. We analyzed all the reflection sheets to understand what the students learned during their clerkships. We extracted all points considered to be examples of learning from the students’ descriptions, and classified these by content, and we also extracted examples of learning about family and community.
Results: The total number of points with learning content that were extracted was 2243 in 2006, and it was 3193 in 2007. Learning content about family and community averaged 5.2% and 3.7%, respectively, in 2006, and 10.7% and 7.9% in 2007. The total number of points of learning about family and community in 2007 increased significantly in comparison with the number in 2006.
Conclusion: By changing the viewpoint of learning by the introduction of a reflection sheet regarding family and community, even if the experience in community medicine clerkship was the same, students’ learning may have changed substantially. It was considered that the establishment of the framework of reflection was an important step.

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Introduction: Recently, the significance of “shared decision-making” in which patients were actively involved in decision options for treatment on the basis of informed consent, has been recognized. However, few studies concerning this issue have been reported regarding rheumatoid arthritis (RA). We conducted a questionnaire survey on patient involvement in treatment decision-making.
Methods : Five hundred RA patients who attended the May 2009 annual meeting of the RA Patient Association in Japan were enrolled in this study. A questionnaire included disease activity and severity, and preferences regarding the extent of patient involvement in deciding on treatment options. Desired and actual roles were chosen from the following descriptions: #1: I prefer to leave all decisions regarding treatment to my doctor. #2: I prefer my doctor to make the final decision after showing me the best option. #3: I prefer that my doctor makes the final decision after showing me all possible therapeutic options. #4: I prefer that my doctor and I share responsibility for deciding which treatment is best for me. And #5: I prefer that the decision about which treatment I will receive should be made by myself.
Results: The questionnaire was returned by 76.4% of the patients, 91% of whom were women, and 71% were 60 years of age or older. While 54% of the patients selected “#4” as their desired role in the decision-making process, 44% of them indicated that “#3” was their actual role, indicating that they accepted the opinion of the attending physician. The desired role was concordant with the actual role in 45% of the patients, who were more satisfied with their medical care and relied on the physician more than those whose desired and actual roles were in conflict.
Conclusion: The physician should assess individual patient preferences and tailor care accordingly.

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Introduction: Recently, we reported on the effectiveness of short-term educational programs in clinic-based clinical clerkships that focus on medical care for elderly patients. To evaluate the need for providing a preliminary explanation of the medical care system and the medical equipment related to our programs, we assess the basic knowledge indispensable for all medical students for clinic-based training.
Methods: Before the training, we distributed a questionnaire related to our programs to medical students of Oita University who had participated in clinical clerkships.
Results: The analysis of the questionnaire data revealed that only 11.4% of the students knew the difference between the numbers of beds in a clinic and a hospital. In addition, 24.3% and 35.7% of the students did not know that vaccinations and medical examinations, respectively, are not approved for health insurance coverage in Japan. Of the students, 31.4% could not see the inappropriateness of addressing elderly female patients as “Grandma”. Furthermore, 28.1% of them did not know the sizes of needles and catheters, and only 18.6% of them knew the difference between a normal syringe and a catheter-tip syringe. In regard to the long-term care insurance system, 62.9% of them did not know of the concept of daily-life group care for elderly dementia patients.
Conclusion: These results suggest that preliminary explanations of the medical care system and the medical equipment related to our programs must be provided at the beginning of the training.

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Objective: Gender differences in the usage of supplements by working adults and their awareness of them.
Methods: Full-time employees of Company A in the Tokai region of Japan and their spouses were given cross-sectional questionnaires (response rate: 61.3%), and 658 responses from full-time employees and their spouses were analyzed.
Results: Supplements were used by 23.7% of the participants. They were used by significantly more women than men, and women also had a greater tendency to seek advice regarding supplement use (advice sought by: women, 44.9%; men, 24.1%; p=0.01). Advice was only rarely sought from professionals. The greatest number of respondents stated that they were unsure whether they were satisfied with their supplement use.
Conclusions: Few participants sought out professional advice when taking supplements and many participants appeared to continue using supplements without noticing any improvement. This suggests both the need for further training of professionals to give more appropriate advice regarding necessary supplement use as well as the need to encourage education aimed at creating eating behavior that does not rely simply on supplements.

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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