An Official Journal of the Japan Primary Care Association
Online ISSN : 2187-2791
Print ISSN : 2185-2928
ISSN-L : 2185-2928
Volume 43, Issue 4
Displaying 1-15 of 15 articles from this issue
  • Shizuko Tanigaki, Yuko Nishina, Hiroko Nagae, Chie Norikoshi
    2020 Volume 43 Issue 4 Pages 116-122
    Published: December 20, 2020
    Released on J-STAGE: December 29, 2020
    JOURNAL FREE ACCESS

    Introduction: The purpose of this study was to clarify the specific components of nursing practice performed by experienced nurses to establish collaboration for home care support.

    Methods: A focus group interview was conducted with 6 experienced nurses in October 2016. Qualitative data were collected and analyzed by an inductive approach.

    Results: The mean age of the participants was 46.0 years old and the mean length of nursing experience was 16.2 years. Five categories were extracted: "patient-centered decision-making support," "representing the needs and wishes of patients and family members," "organizing care team members by anticipating required actions," "meeting to discuss with the care team members in person," and "understanding the care team members' personalities and determining the appropriate care approach for each patient."

    Conclusion: Experienced nurses consider the future life of both the patients and their family members based on their needs and wishes, and establish a collaborative care team by anticipating the required actions. They also build a connection with each team member by recognizing and understanding each member's personality.

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  • Kinuyo Tsunozaki, Anna Adachi, Yasumori Izumi
    2020 Volume 43 Issue 4 Pages 123-128
    Published: December 20, 2020
    Released on J-STAGE: December 29, 2020
    JOURNAL FREE ACCESS

    Introduction: An outpatient treatment center is used by a number of medical departments, but mainly by internal medicine. It is intended for the examination of patients with a poor physical condition, and for performing different treatments and blood transfusion. The problems faced in the outpatient treatment center are the long stay and wait times for consultations. We examined the effects of assigning a nurse practitioner (NP) to the center.

    Methods: We performed a retrospective study at the outpatient treatment center to evaluate the difference in the wait times for a period of 10 months based on patient records before and after assigning the NP.

    Results: The total number of patients visiting the outpatient treatment center before assigning the NP was 13,154 and it was 15,257 after. The average number of patients significantly increased per day. On analysis of waiting patients (1,079 before assignment and 1,112 after assignment), although the consultation wait time was not shortened, the stay time was significantly reduced by 10 minutes. For hospitalized patients, the stay time was significantly reduced by 30 minutes.

    Conclusion: Assigning a NP to the center significantly shortened the stay time for patients waiting for consultation and for those who were hospitalized. Thus, assigning a NP led to more efficient medical treatment at the center.

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  • Tatsuya Ogawa, Shuhei Fujimoto, Kyohei Omon, Tomoya Ishigaki, Shinzo M ...
    2020 Volume 43 Issue 4 Pages 129-137
    Published: December 20, 2020
    Released on J-STAGE: December 29, 2020
    JOURNAL FREE ACCESS

    Introduction: In this study, we developed a patient-reported instrument to measure shared decision-making (SDM) in rehabilitation medicine, and examined its reliability and validity in the field of physical therapy.

    Methods: The SDM for rehabilitation (SDM-Reha) prototype was created from the elements of SDM determined to be necessary in the rehabilitation field by a previous study. This survey was conducted for patients undergoing physical therapy in the inpatient or outpatient setting and community.

    Results: Data from 218 patients (mean 70.1 ± 13.3 years) were used for exploratory factor analysis and the SDM-Reha of 10 items with a one-dimensional nature was developed. The internal consistency of Cronbach's α of 0.94 and test-retest reliability of ICC (1,1) 0.93 were above acceptable thresholds. Concurrent validity was significantly correlated with the 9-item SDM questionnaire.

    Conclusion: We developed the SDM-Reha as a new instrument based on the concept of SDM in the rehabilitation area. The SDM-Reha was confirmed to be reliable and valid for measuring SDM in rehabilitation practice.

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  • Yoshihiro Mizuma
    2020 Volume 43 Issue 4 Pages 155-157
    Published: December 20, 2020
    Released on J-STAGE: December 29, 2020
    JOURNAL FREE ACCESS
    Supplementary material

    Purpose: The novel coronavirus disease (COVID-19) has spread, and the usefulness of point-of-care ultrasound (POCUS) performed by clinicians themselves on patients was reported overseas, but not in Japan. I report a case in which an abnormality was found by POCUS performed as a physical examination following auscultation in the fever outpatient clinic, which was later diagnosed as COVID-19.

    Method: Of the 265 patients who visited the fever outpatient clinic of our hospital between March 9th and May 16th, 2020, respiratory POCUS was performed on all 37 examined by the author.

    Results: POCUS demonstrated a coalescent B-line, chest CT revealed ground-glass opacity, PCR was positive, and the case was diagnosed as COVID-19.

    Conclusion: The accuracy of POCUS is superior to that of auscultation and plain chest X-ray. Chest CT can diagnose pneumonia at an early stage, but it is more problematic in terms of nosocomial infection than POCUS. In Japan, where CT is widespread, POCUS can be an option for physical examination in situations where performing immediate CT increases the risk of nosocomial infection.

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