The objective of this study was to clarify the actual status of interactions performed at home between demented elders and their family caregivers. An inductive qualitative study was conducted by using a grounded theory approach.
Subjects were 25 elderly individuals with dementia of Alzheimer type, and 28 caregivers in their family. The study was performed using the participant observatin and interviews in their homes.
Based on a constant comparative analysis, results revealed the levels of”certainty” and”maintenance of self” of the elders as core variables in interactions between the elders and the caregivers. Characteristic interactions were found to fall into three categories. This paper discusses part of the interactions, i. e., category 1 representing interactions associated with persistence in”certainty” of the elders.
Category 1 included the phenomena to be referred to as”looking for the hole,””digging the hole” and ”filling in the hole.” Characteristics and differences of the phenomena were reviewed.”Looking for the hole” means the interactions where the caregivers check”certainty” and/or”uncertainty”of the demented elders by testing their memory, and the demented elders unconsciously express themselves as they are.”Digging the hole” means the interactions where the caregivers try to draw”certainty” from”uncertainty” of the demented elders, and the elders degrade themselves in confusion.”Filling in the hole” means the interactions where the caregivers compensate”uncertainty" of the demented elders without checking their ”certainty,” and the elders express what they like to express.
This study revealed a part of actual interactions between the demented elders and their caregivers, and a part of the world which demented elders may experience in interaction with their caregivers.

View full abstract

The purpose of this study was to identify the demention of normalization and normalization process among adolescent patients with chronic illness. Thirty adolescent subjects with either asthma or diabetes mellitis were interviewed.
Findings include the identification of three dimentions of normalization. these three dementions are: (1) the adolescent's self concept; (2) the evaluation of the situation; and (3) activities of daily living. These dementions were made up fourstages with similar processes. First the adolescent experiences confusion. Next he or she beings to establish a conceptual foundation. Then comes the ability tomake some personal decisions. And finally, the chronically ill adolescent is able to examine multiple options and negotiate complex decisions and judgments in a creative manner. Perhaps because of the adolescent's developmental stage, normalizing process of the adolescent's self concept was found to be unique.

View full abstract

The purpose of this study was to investigate the energy expenditure of pediatric patients with kidney disease in hospital and the influence of changing energy expenditure on their condition of kidney disease. The subjects were 42 pediatric patients with kidney disease. The total daily energy expenditure during hospitalization was measured for two weeks a pediatric patient continuously using Kenz Calorie Counter. In addition the energy expenditure during staying out was measured. The relation between the total daily energy expenditure and the total urine protein per day was analyzed.
The results were as follows:
1) There were big differences between individuals on the energy expenditure during hospitalization and also big defferences individually on the range ot the fluctuation.
2) The energy expenditure of 26 in 36 pediatric patients were more then the daily living activity intensity number I (light), and 4 of them were more than the intensity number II (medium) as regards the average of the total daily energy expenditure. Also the energy expenditure of 34 in 36 pediatric patients were more than the intensity number I, and 10 of them were more than the intensity number II as regards the most total daily energy expenditure.
3) The gearing linkage relation between the energy expenditure and the urine protein was found in half of pediatric patients with chronic nephritic syndrome.
4) The tolerance limit of the total daily energy expenditure of pediatric patients with kidney disease maintaining stable condition was near%BMR 125.

View full abstract

Airborne fungal flora in clean room and ordinary hospital rooms were examined using a pin-hole sampler. No micro-organisms were detected in a clean room to which no patients were admitted. On the other hand, the numbers of fungal (0-0.6/cf) and bacterial colonies (0.6-1.6/cf) in the four clean rooms to which patients were admitted were detected. The medical staff should be careful with their behavior and their use of medical equipment in the clean room. The numbers of fungal (2.6-12.3/cf), and bacterial colonies (0.8-2.7/cf) in ordinary rooms, and the numbers of fungal (7.6/cf) and bacterial colonies (8/cf) in the corridors were higher than those in the clean rooms. In the air samples, pathogenic fungi belonging to the genus, Alternaria, Aspergillus, Cladosporium, Curvularia, Paecilomyces, Penicillium, Scopulariopsis, Cryptococcus, Rhodotorula were detected as 72%of the total colonies, and the pathogenic Staphylococcus and Pseudomonas bacteria were detected as 27% of the total colonies. It is suggested that immunosuppressed patients might have a high risk of opportunistic infection by airborne microorganisms during the hospitalization.

View full abstract