[in Japanese]

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We studied the nutritional management in 25 patients with amyotrophic lateral sclerosis (ALS) using tracheostomy positive pressure ventilation (TPPV) and tube feeding. The amount of energy by the tube feeding in all patients was lower than the total energy expenditure calculated by the Harris-Benedict method, however, most of the patients had a normal level of serum albumin. It is difficult to estimate the appropriate amount of energy need for ALS patients using TPPV. We considered an idea in which the scale of the activity index of the Harris-Benedict method might be reduced to a lower level, such as 0.9, for the situation of TPPV. The level of serum zinc was revealed to be low in many patients, especially in the group using older enteral foods. Considering the importance of zinc, we should select a new generation of a zinc-rich type.

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It is natural for dissatisfaction to occur due to the difference in viewpoint between the medical staff (hospital) and patient who receives medical treatment.
In this report, we paid attention to MRI inspection, and by having the medical staff play the role of patient, verified what kind of dissatisfaction can occur.
A problem can be solved by doing business improvement with the conception of the patient being viewed as the leader. This can result in permanent results.
We found that the degree of patient's satisfaction was improved by making improvement immediately relating to the patient.

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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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[in Japanese]

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