Aim: The aims of the study were to classify the intensive care experience of patients admitted to ICUs, and to clarify the relationship between the intensive care experience and anxiety and depression.
Study design: a descriptive correlational study.
Methods: The participants were 201 adult patients who were intubated, mechanically ventilated and stayed in general ICUs for more than 48 hours. A structured interview was performed using the Intensive Care Experience Questionnaire (ICEQ), and a self-administered questionnaire using the Hospital Anxiety and Depression Scale (HADS) was conducted after patients were discharged from the ICUs.
Results: A hierarchical cluster analysis classified the intensive care experience into 4 clusters: (1) situationally aware without any traumatic memory, (2) unapprehensive with a blurred memory, (3) no recollection, and (4) a frightening and uncertain experience. 17.9% of patients were in the "frightening and uncertain experience" group, which had significantly higher anxiety and depression levels (8 or higher) compared to the other groups.
Conclusion: These findings will contribute to a future longitudinal cohort study to confirm whether having "a frightening and uncertain experience" is a predictor of post-traumatic stress disorder (PTSD) related symptoms after receiving intensive care.

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This study determines what kind of nursing an experienced nurse practiced to the family who arrived after the hospitalization of the emergency conveyed patients and is intended that we obtain a suggestion of the future nursing intervention. For the eight nurses who worked in a critical care center more than five years, we collected data in a semi-structured interview, and the method of the study made it a category in reference to content analysis of Krippendorff, K and analyzed it.
In this study, we found 11 nursing intervention of the mastery of skills nurse for the relation to the family who arrived after the hospitalization of the emergency conveyed patients. Nursing intervention is [we ascertain a shock, the need of the family from the information that we exert a way and obtained], [we try for security and the expedient adaptation to circumstances of the unity to correspond to a confused family], [we are anxious and continue being associated with feelings and the physical condition of the family in the limited situation]. The family continued a relation to feelings and the physical condition of the family including the preparations corresponding to the family before arrival, and the experienced nurse was concerned with a family positively. Also, a family received explanation in peace, and the experienced nurse considered it so that environment fixed for a wait was provided.

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The purpose of this study was to clarify the psychological distress and conflicts experienced by patients with Implantable Ventricular Assist Devices (VAD) and their caregivers with regard to home care as well as the changes in their health-related quality of life (SF36) and to consider nursing care based on the findings. The authors adopted a mixed method design wherein qualitative and quantitative studies were concurrently conducted. The participants in the qualitative study were 13 patients and 13 caregivers. The participants in the quantitative study were 19 patients and 10 caregivers. The authors collected and then analyzed data pertaining to the participants for the period spanning from immediately before discharge until 12 months after initial discharge from hospital. The results revealed that, even after they had returned to home care, the patients still faced problems of limited physical function and complication prevention, and they also struggled to adjust to society. The caregivers, on the other hand, were caring for such home-return patients in a self-sacrificial manner while struggling to cope with psychological distress. However, the psychological distress of both patients and caregivers was not reflected in their health-related quality of life. In addition, in the course of their home care-centered lifestyle, the patients and their caregivers-each of whom experienced psychological distress-exhibited mutual interactions and attempted to adjust to the lifestyle changes. It is necessary to understand the subjective experiences of patients and their caregivers and to adopt a continuous approach that commences from before the surgery.

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The purpose of this study was to investigate actual conditions and factors that influenced the attitudes of nurses in intensive care unit (ICU) toward the management of terminal care. A self-report questionnaire was administered to nurses with minimum 1 year of clinical experience in ICU. The self-report questionnaire consisted of personal attributes and views on life and death using the Japanese version of the Frommelt attitudes toward care of the dying scale (FATCOD-B-J). Responses were obtained from 414 nurses and analyzed.
The average score of the FATCOD-B-J of nurses in ICU was 113.3 ±11.1 points. The terminal care attitude of nurses in the ICU had positivism equal to that of nurses in the general ward with similar age and clinical experience. The views on life and death, which does not avoid thinking about death, finding significance in life and destination mission, often thinking about death, and experience in departments other than ICU influenced the terminal care attitude of nurses. Therefore, I speculate that qualitative factors, such as their age and years of experience, but not quantitative factors, influence the terminal care attitude of nurses in ICU.

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Objective: To clarify the temporal change in moisture levels on the tongue and labial mucosa in intubated patients after open-heart surgery.
Methods: A total of 25 subjects were included; the moisture levels of the tongue and labial mucosa were measured in orally intubated patients: preoperatively, every hour postoperatively, before intraoral moisturizing care, just after intraoral moisturizing care, and 1 h after intraoral moisturizing care. The moisture levels of the tongue mucosa were measured using clinical diagnostic criteria by direct observation and using KISO-WeT^® wetness test papers. The moisture levels of the labial mucosa were measured using the oral cavity moisture meter Mucus^®.
Result: The moisture levels of the tongue and labial mucosa were significantly lower postoperatively than preoperatively, (p<0.05), it was found that was dry. For the temporal change of post-operative in moisture levels, were not significantly difference observed at each time, it was going gradually reduced drying with the lapse of the surgery.
Conclusion: The moisture levels of the tongue and labial mucosa in intubated patients after open-heart surgery were significantly lower postoperatively than preoperatively, and then also was reduced gradually with the course of surgery.

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This study aimed to investigate nurses' perceptions of and clinical nursing for psychological problems of patients discharged from the ICU.
Involving 36 nurses who participated in Intercommunication Session 3 during the 10th Annual Meeting of Japan Academy of Critical Care Nursing, a focus group interview of 4 groups was conducted to investigate nurses' perceptions of and clinical nursing for memory distortions of patients discharged from the ICU. The obtained data were analyzed using a qualitative descriptive analysis. As the results, the following categories were extracted: 3 categories including "patients with marked anxiety are likely to have distorted memories" as [factors for memory distortion], 4 categories including "memory distortion can occur in patients with delirium or even those with clear consciousness" and "memory loss of patients treated in the ICU may serve as a defense mechanism" as [relationships between memory distortion and events occurring in the ICU], and 4 categories including "difficulties providing timely care for patients with distorted memory" as [coping measures by nurses for patients with distorted memory]. It is necessary to examine practical measures to provide care for such patients in the future.

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Aim: The association between microbial colonization of the oral cavity and the lungs in critically-ill patients who develop ventilator-associated pneumonia in the intensive care unit setting has been reported. Therefore, the Institute for Healthcare Improvement recommends oral care for intubated patients. However, oral care for intubated patients is not yet standardized in Japan. In this article, we measured the bacterial number in the oral cavities of intubated patients before and after the oral health care and showed the importance of oral care.
Method: We measured the bacterial number in the oral cavities of 42 intubated patients using Saikinkaunta^® every hour until extubation after thoracotomies.
Result: The bacterial number was significantly decreased after the oral care (358×10⁵cfu/ml vs. 124×10⁵cfu/ml) (p<0.01). The bacterial minimum number was after the oral care (124×10⁵cfu/ml). The bacterial number then increased 4 hrs after oral care (233×10⁵cfu/ml) (p<0.05).
Discussion: The bacterial number in the oral cavity decreases after removing plaque with brushing. We recommend performing of oral care at every 4hrs, because the bacterial number increased 4hrs later after oral care.

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[in Japanese]

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