The object of this study was to analyze the causes of discontinuation of home care in ALS (amyotrophic lateral sclerosis) patients during the period from the onset to the critical stage of respiratory disorders and further to discuss possible supports to be provided. Discontinuation of home care was defined as the transfer of the place of care from home to non-home environment due to circumstantial reasons of patients. 29 previously published case reports were reviewed and analyzed. Additionally, 4 patients were interviewed. Items for analyses were conditions of main caregiver, the causes of discontinuation of home care as well as the places of care after of discontintion of home care. The findings included: 1) Out of 33 patients, 31 patients were transferred to medical facilities, one patient, to a welfare facility, and one patient died during home care. 2) Reasons for discontinuation of 32 patients excepting one patient who died at home were categorized into three factors: aggravation of physical functions, lack of family care potentials, and insufficient community support systems. Those factors were doubled or tripled in cases.
A comparative study of privacy was done to analyze the difference between the patients' privacy awareness and nurses' perceptions of their awareness concerning the information. The items included in the questionnaire were: 1) items related to patients' feelings when asked to provide personal information. 2) items related to patients' opinions concerning the sharing of information among nurses. 3) those related to patients' understanding as to the necessity of information for treatment or care. 4) those related to patients' requests for explanations by nurses why such information should be necessary. The findings included: c Both patients and nurses had negative feelings concerning the provision of such information and information sharing as related to "educational background", "job", "family member", or "religion". (2) Neither patients nor nurses had definite opinions about the information sharing among nurses. (3) Significant correlations were observed between the recognized necessity for treatment or care and such factors as patients' feelings when asked to provide information or opinions related to information sharing among nurses. (4) Significant differences were found between patients' awareness of privacy and nurses' perceptions of their awareness. Basis on the findings, it was suggested that nurses should deepen their perceptions of privacy issues, and explain reasons for the necessity of specific information to obtain patients' agreement to the information taking.
[Objective] The oxygen uptake of the elderly during activities of daily living (ADL) including movements using upper limbs (arms) was compared with that of the younger generation. [Methods] The subjects were 7 healthy elderly women (the mean age of 71.8 years: elderly group) and 7 healthy younger women (the mean age of 20.3 years: younger group). All subjects of both groups were instructed to perform each of the following 7 tasks for 2 minutes: (1) Putting things on a shelf; (2) hanging out the washing to dry; (3) having a meal; (4) having a wash; (5) combing her hair; (6) changing her clothes; and (7) folding clothes after drying in the sun. [Results and Discussion] There was no significant difference between the two groups concerning METs during exercises at the conversion rate of 3.5 [ml.kg^<-1>.min^<-1>] to the MET. Regarding the oxygen uptake obtained by actual measurement in a resting-sitting subject (3.32 in the elderly group and 4.16 in the younger group) as 1 MET, however, the values of the elderly group were 1.7,1.6,1.5,1.9,1.8, 2.4, and 2.1 METs for tasks 1 through 7, respectively. Those of the younger group were 1.4,1.3,1.3, 1.5, 1.3, 1.8, and 1.7 METs for the corresponding tasks, respectively. The elderly group showed significantly (p < 0.05) high values for all the tasks. Based on these results, it is desired that the oxygen uptake obtained in a resting-sitting position by actual measurement be employed in the determination of oxygen uptake during ADL using the arms. In both groups, "resting", "shelving", "combing", and "changing clothes" were found to be independent exercise tasks.
The purpose of the study was to examine the relationships between behavior disturbances of preschool and school children with developmental delays and their mother's stress appraisals (parenting burden). The study subjects were 319 mothers of children using the therapeutic day care center for children with developmental delays and 1,030 mothers of children using the special education school for children with developmental delays in S prefecture. In the study survey, the questionnaires including children's demographic characteristics (sex, age, grade, types of impairment, diagnosis, and behavior disturbances), mother's demographic characteristics (age, the number of children, family structure, and working), and parenting burden were administered. The data collected in the survey were analyzed using a structural equation modeling (SEM). In the analysis, a multiple regression model with latent variables (multiple-indicator model) was constructed to describe the relationships between children's behavior disturbances and mother's parenting burden. The result showed that children's behavior disturbances were positively related to mothers' parenting burden (contributing rate = 31.0 %). Focusing on the effects of the behavior disturbances domain, difficulty in emotional control was more strongly associated with "negative feelings to the child" and "negative feelings to the child-rearing" than the others. Based on the above findings, the authors discuss how practitioners should manage the children's behavior disturbances, to reduce the mother's parenting burden.
Sensory integration therapy for children with developmental disabilities consists of providing sensory stimulation using various toys in accordance with the individual characteristics of the disabilities. A type of therapy that stimulate the vestibular system employs a method in which the child receives swinging stimulation while riding a bolster swing that is hooked to the ceiling while trying to maintain postural balance. Many therapists have provided this therapy to disabled children with maldeveloped postural reactions. However, few studies have used objective indicators to analyze postural reactions in subjects riding the bolster swing. Furthermore, effects of the bolster swing have not yet fully analyzed. The present study used a three-dimensional motion analysis to examine healthy 5 to 6year-olds head and trunk reactions of when riding the bolster swing. Children who were able to ride the bolster swing showed different reaction tendencies of head and trunk and of lateral displacement of the top of the head compared to those who were unable to ride the bolster swing.
For the purpose of maintaining the high performance of diagnostic X-ray equipment in Tokyo metropolitan hospitals and improving the quality control technology, an X-ray equipment quality control project was developed jointly with the Tokyo metropolitan hospital's 7 facilities. Using indirect measurement system composed of non-invasive measuring instrument and X-ray output waveform measuring instrument developed in this university, quality control was done at each hospital in a handed-round method at 6-month intervals. The system was calibrated at the university prior to the project execution and the identical measurement conditions were maintained to assure measurement precision. Quality control items included X-ray tube voltage, X-ray tube current, exposure time, reproducibility of X-ray output for general radiographic X-ray equipments. As a result, the quality control of X-ray equipment the measurement of which was difficult in the clinical facilities before could be done with high precision and the availability of the system was supported. The development of this project enabled maintenance of the equipment quality, discovery of early troubles, comparison between hospitals. It was also useful for the improvement of the patient service.
For the purpose of maintaining the high performance of diagnosistic X-ray equipment in hospitals and improving the quality control technology, X-ray equipment measuring system and X-ray equipment quality control project have been developed modeled on one section of Tokyo metropolitan hospital. Through this, the convenient quality control X-ray equipment system with good accuracy became available in clinical facilities. However, systematization and popularization of high-performance quality control technology should be necessary for the development of quality control. This time, we attempted to systematize the quality control and develop a measuring technique manual and a smooth implementation method for all Tokyo metropolitan hospitals. As this result, Tokyo metropolitan hospital X-ray equipment quality control committee for all Tokyo metropolitan hospitals was organized, and a quality control system for identical measuring system and identical measurement level was established in each facility. Cooperation between university and metropolitan hospitals and effective utilization of measuring system became possible. The system was useful for the popularization and improvement of the quality control technology in hospitals.