This study examines the correlation between dyschezia and quality of life in an outpatient population that received either low anterior resection (LAR) or an anterior resection (AR) as treatment for colorectal cancer.
The outpatients answered a questionnaire examining the severity of their dyschezia and it's impact on their quality of life. One hundred ninety two outpatients, with a mean age of 64.6 years (SD=10.4 years) and from 1 to 36 months after surgical resection responded to the questionnaire. Two assessment scales were included in the questionnaire: The Defective Dysfunction Assessment Scale (DDAS) and a self-completed questionnaire for QOL revised (QUIK-R). Data were analyzed using a Mann-Whitney test, Kruskal-Wallis test and Spearman rank correlation coefficient, and step-wise multiple regression was also performed.
DDAS scores were significantly higher for patients receiving low anterior resection (LAR) than for those receiving anterior resection (AR). A significant relationship was also observed between DDAS and QUIK-R scores, in particular, between“soiling”on the DDAS. Multiple regression analysis revealed that DDAS and resection technique used for treatment accounted for 22.3% of the variance in QUIK-R.
In conclusion, the findings suggest that the severity of dyschezia is related to the resection technique used to treat colorectal cancer. Furthermore the severity of dyschezia was found to exert a significant influence on quality of life.

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The purpose of this study is to determine differences in behavioral (stress signs and sleep-wake state) responses following endotracheal suction in very low birth weight infants between routine care and flexed posture with boundaries.
The nine infants in this study had a mean gestational age of 26.96 weeks (ranging for 23 weeks and 6 days to 28 weeks and 6 days) and a mean birth weight of 968.4 grams (ranging for 572 to 1,524 grams).
Heart rate and arterial oxygen saturation were monitored for estimating autonomic functions, while the motor system parameters were measured visually through observations. The autonomic and motor system variables were integrated and used to trace stress signs. States of sleep were assessed according to the Thoman classification. Observations were made every 2 minutes for 30 minutes, beginning at the baseline and finishing 30 minutes after the end of suctioning.
A total of 42 sessions were recorded, among which 20 were for the experimental and 22 were for the control group. Two groups did not differ significantly in birth weight and gestational age at birth.
The results of two-way repeated measures (ANOVA) for each variable indicated that the groups differed significantly in stress signs. There were significant differences in effects of time (F=3.530, p=0.0001), intervention (F=12.476, p=0.01)and intervention-by-time interaction for stress signs (F=3.018, p=0.001). In the experimental group exhibited fewer stress signs than in the control group.
The time before onset a quiet sleep state differed significantly between the groups (t=-2.529, df=35, p=0.016). In the experimental group was significantly shorter time than in the control group.
The flexed posture in the prone position with boundaries around the infant's body are needed to help the very low birth weight infants enhance self-regulatory behavior to maintain a behavioral integrity.

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The authors studied the effect of the perception of support network and HLOC on the mood of the pre-operative patients. Forty-seven cases of gastric- or esophagus-cancer, who were hospitalized for radical surgery after being announced, were chosen as subjects of the study. For the rating of interior- or exterior intermediary factors scales of support network and JHLC (Japanese Version of Health Locus of Control) were used, and for the rating of the mood or states of mind the scale of POMS (Profile of Mood States) was used. The results show that in the subjects with positive perception of emotional support network relatively lower levels of the feelings of“depression slump”,“fatigue”or“confusion”factors were observed. Because an instrumental support network lowers the feeling controlled by“life”or“vigor”factor, it is important for the pre-operative patients that they are given such spiritual support as to encourage them to perceive the“emotional support network”. Though no significant correlation between JHLC and states of mood of the patients was observed, it will be significant to create a condition or take a way of contact which would make clear the existence of patients' inherent control.

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This study set out to clarify the characteristics of infant sleep-wake states by behavioral observation at night at the first month after birth. A total of 36 healthy first-born infants (average age 30.8 days) participated in this study. Infant sleep-wake states in the night were recorded using video-somnography for two consecutive nights, and data of the second night coded and analyzed using an established protocol.
Mean total sleep time was 7.4 hours, 70% of the mean total recording period. The ratio of the percent of total sleep time in active sleep (AS) to the percent of total sleep time in quiet sleep (QS) was 7: 3. The mean length of all sleep periods was 124 minutes. Principal component analysis of night sleep yielded two components:“sleep stability”and“sleep depth”. The component of“sleep stability”consisted four variables: mean sleep period; percentage of sleep time; number of waking; and standard deviation of awake period. The component of“sleep depth”consisted two variables: % AS and % QS. Two variables from this analysis, mean sleep period and standard deviation of awake period are newly defined sleep parameters, and should be considered actual sleep features of one month-old infants.
It is necessary to examine these newly identified sleep parameters in more depth. Moreover, it is important to discover whether and how patterns at one month persist in later months. Further studies using the methods of this study and also methods to document mother-infant interactions during nighttime sleep and feeding are indicated.

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The aim of the present study was to examine the necessity for nursing care with psychological consideration, through the investigation of the quality of life in patients with osteoporosis by assessing their subjective well-being, including their anxiety, depression and self-esteem, which may influence their happiness and mental health. The study had subjects themselves fill in questionnaires utilizing four psychological scales; Life Satisfaction Index A (LSIA) to assess the subjective well-being, Self-Esteem Scale (SES) to assess psychological aspects, The State-Trait Anxiety Inventory (STAI), and Self-Rating Depression Scale (SDS). Subjects were 230 females aged 64.9 on average, and who were osteoporosis outpatients visiting clinics in Osaka prefecture.
The level of quality of life of osteoporosis patients was found to be relatively low in terms of subjective well-being, and those patients were in the state of anxiety or mild depression. However, approximately 90% of the subjects showed high scores of the Self-Esteem Scale (SES). Patients with vertebral fractures and those faced impaired activities in daily life appeared to be depressive. An inclination of anxiety was found in most subjects having an acquaintance and/or family members who had osteoporosis disease as well. It turned out from the results obtained by multiple regression analysis that self-esteem, anxiety, disease duration, health satisfaction and depression are major factors that affect the subjective well-being of osteoporosis patients. The study has indicated that it is important for nursing care to raise the self-esteem of osteoporosis patients.

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The purpose of this study was to investigate how and why nurses intuit the time of death of the child. By analyzing interviews of twenty-five pediatric nurses, it was discovered that they intuit the time of the death by observing charges in both the physical condition and the actions of the child. Although many nurses could make their assessments by observing a child's physical condition, fewer could make their assessments based on a child's actions since this required more sensitive observation. However, nurses that are able to make these sensitive observations possess a unique and valuable skill since they become able to predict an imminent death before it is detectable in the physical condition and medical tests.
Intuiting the time of death is associated with the task of preparing for the death. The nurses shared their intuitions with other nurses and physicians in order to make sure everyone is on alert, they can reduce the child's agony, and to make sure the physician will be present at the time of death. The nurses also share their intuitions with family members to encourage them to come to terms with the situation and to arrange for people to be at the bed side at the time of death. For these reasons, intuiting the time of death is the fundamental skill needed by nurses to make sure the death occurs in a well controlled situation according to the terms of a 'good death'.

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Many studies have pointed out that most cancer patients have unmet informational needs and they are often dissatisfied with information they receive. However, no studies have investigated the effect of informational supports on the satisfaction with information for Japanese cancer patients. The aim of this study was to determine the effect of an educational group intervention in improving satisfaction with information among patients with primary breast cancer in a randomized controlled trial.
The patient selection criteria were age less than 65 years, and surgery undergone within the previous 4-18 months as of the start of the study. We conducted a 6-week educational group intervention. The intervention consisted of health education, coping skills training, and relaxation. Subjects were assessed for the satisfaction with medical information and psychological information using the Visual Analogue Scale (VAS) at the baseline, at 6 weeks, and at 6 months.
Fifty (33%) of the 151 patients participated and were randomized, and 46 (30%) completed the study. The experimental group had significantly higher scores than the controls for the satisfaction with the information about breast cancer (p=.04), stress of having cancer (p=.0001), and coping methods to cancer (p=.0001), and the satisfaction with total medical services they receive (p=.0009) over the study period.
The results of this study suggest that a short-term educational group intervention produces significant long-term improvement in the satisfaction with information of Japanese patients with primary breast cancer.

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The aim of this study was to investigate the features of perinatal attachment according to each type of internal working models, for determine whether a relation exists between the mother's internal working models (IWMs) and perinatal attachment by using the Muller's attachment model.
A prospective study was performed with data collected during the third trimester of pregnancy and 1 month after delivery, and the following results were obtained.
1) There was a modest correlation between prenatal and postnatal attachment.
2) Mother's internal working models are classified into 3 types: Secure, Ambivalent and Avoidant. The prenatal attachment score of the secure type mother was significantly higher.
3) In the secure type mother, there was a strong correlation between prenatal and postnatal attachment. In ambivalent and avoidant type mothers, the correlation between prenatal and postnatal attachment was week.
The results demonstrated a relation between the mother's internal working models and perinatal attachment in Müller's model. IWMs is one of the key concepts in assessing the subject of inter-generational transmission of attachment, IWMs must be considered not only postnatally but in the prenatal period as well.

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