JOURNAL OF THE JAPANESE ASSOCIATION OF RURAL MEDICINE

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　　The purpose of this study was to identify the factors affecting the stair-climbing ability of patients with hip fractures. 　　Out of a total of 75 inpatients with hip fractures, 14 disabled elderly patients, whose ability to perform independently the basic activities of daily living was assessed as rank B or C before injury, and 10 demented elderly patients, whose ability was rank II, III, IV or M, were excluded. The remaining 51 patients were selected for the present study. The subjects were divided into two groups: 19 patients who were able to ascend and descend the stairs (the riser height: 20cm) by holding the handrails and 15 patients who could not.. In another experiment, the 51 subjects were divided into two groups: 19 patients who were able to go up and down the stairs without the aid of the handrails and 32 patients could not. Age, gender, height, weight, fracture type, number of postoperative days, hip abductor strength, knee extensor strength, level of pain, leg length discrepancy, tandem stance time, and stair-climbing ability were investigated. 　　First, the correlation between the parameters and stair-climbing ability was verified using a univariate analysis. Subsequently, a multiple logistic regression analysis was performed using the parameters that represent a significant correlation with the stair-climbing ability as the dependent variable. 　　These analyses revealed that “non-fractured knee extensor strength” was significantly associated with the stair-climbing ability when the subjects were allowed to use the handrails, while “non-fractured knee extensor strength” and “tandem stance time” were significantly associated with the stair-climbing ability without the aid of the handrails. 　　These findings suggested that the improvement of non-fractured knee extensor strength was important for the acquisition of stair-climbing ability with the aid of the handrails and the improvement of static balance as well as non-fractured knee extensor strength was important for the acquisition of stair-climbing ability without the aid of the handrails.

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　　It was February 2007 that the pediatric surgery department was established in our hospital. Since then, the number of surgical cases of inguinal hernia has been increasing year after year. During 2013, a total of 48 patients underwent hernia surgery. Operations were performed mostly on the day the patients were hospitalized. Before the surgery, the patients and their relatives were told about the nature of the disease and treatment by word of mouth. Actually, however, we were to busy to take much time to talk with them. After surgery, members of patients’ families, being all anxiety, frequently asked us such questions as: - how soon will the patient be allowed to have a cup of tea or juice?; when can the patient do without the IV drip?; and how should the family take care of the patient at home? We presumed that the anxiety might stem from the inadequate explanation given orally by inexperienced nurses. To improve the situation, we, staffers in charge of pediatric inpatient care, and physicians in the outpatient clinic of the pediatric surgery department teamed up to prepare a pamphlet including a list of standardized answers to supposedly most frequently asked questions in the hospitalization setting. The draft of the pamphlet was shown to ward nurses to sound out their opinion on the contents. Based on the results of this survey, the pamphlet was completed. This paper deals with the pamphlet and a summary of nurses’s views on it.

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