JOURNAL OF THE JAPANESE ASSOCIATION OF RURAL MEDICINE
Online ISSN : 1349-7421
Print ISSN : 0468-2513
ISSN-L : 0468-2513
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Volume 65, Issue 6
Displaying 1-22 of 22 articles from this issue
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The 65th Congress of the Japanese Association of Rural Medicine
LECTURE BY ASSEMBLY CHAIRMAN
SPECIAL LECTURE1
SPECIAL LECTURE2
EDUCATIONAL LECTURE
CULTURAL LECTURE
PUBLIC OPEN LECTURE
KANAI PRIZE WINNER’S LECTURE
SYMPOSIUM
WORKSHOP1
WORKSHOP2
WORKSHOP3
WORKSHOP4
REVIEW
  • Concept Analysis of Delirium Care on a General Ward
    Kyoko TAHARA
    2017 Volume 65 Issue 6 Pages 1148-1156
    Published: March 31, 2017
    Released on J-STAGE: April 25, 2017
    DOIhttps://doi.org/10.2185/jjrm.65.1148
    JOURNAL FREE ACCESS
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        This concept analysis attempted to define acute delirium care on a general ward. A total of 30 articles were analyzed and categorized using Rodgers' evolutionary concept analysis. The following attributes of delirium care were extracted: development of preventive measures for delirium, collaborating with various medical professionals, safety management, delirium care evaluation through careful observation, improving patients' cognitive functioning, and effective utilization of human resources. Antecedents of delirium care included nurse-related factors, social factors, the medical environment, and patients' personal characteristics. The extended consequences of delirium care included potential to reduce delirium prevalence, impact on nurses' feelings, effective evaluation of delirium care provided by nurses, and cooperation between various medical professionals. Thus, the concept of acute delirium care on a general ward was defined as involving several factors including general care. Even if delirium prevention is difficult, nurses can effectively implement prevention programs by collaborating with other healthcare professionals. Thus, comprehensive care also involves providing a facilitative environment. Early detection and cooperative multidisciplinary involvement can help improve the effectiveness of care particularly for multifactorial delirium, which is difficult to prevent.
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ORIGINAL
  • Interpretation Ability of Auxiliary Radiology Technicians in Emergency Medical Care
    Takehiko AMBE, Hidehisa HASHIMOTO, Takao TASHIRO
    2017 Volume 65 Issue 6 Pages 1157-1167
    Published: March 31, 2017
    Released on J-STAGE: April 25, 2017
    DOIhttps://doi.org/10.2185/jjrm.65.1157
    JOURNAL FREE ACCESS
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        Expansion of the work of medical radiology technicians has made it possible for them to assist in interpreting medical images. Questionnaire surveys have reported that such assistance is particularly needed in emergency medical care. This paper describes the results of a computerized tomography (CT) image interpretation test that was administered to 45 medical radiology technicians working in Gifu Prefecture, to assess and identify factors that may improve their interpreting ability. The test results revealed that a relatively higher percentage of correct answers were obtained when reviewing CT images of critical cases, while a lower percentage was observed when reviewing less critical cases such as small tumors or tumors in the digestive tract. Also, the overall percentage of correct answers increased slightly with the number of years of experience, but interpreting scores dropped dramatically among radiology technicians with less than 3 years of experience. Statistical analysis further revealed that those radiologists who exhibited higher abilities in CT image interpretation were certified with various CT-related skills, had report writing skills, or were full-time CT staff. These are factors that can help improving CT image interpreting ability for medical radiology technicians.
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  • Perceptions and Meanings of Chronic Knee Joint Pain Among Elderly Rural Residents
    Rie NAKANO, Motomi YOKOTA
    2017 Volume 65 Issue 6 Pages 1168-1176
    Published: March 31, 2017
    Released on J-STAGE: April 25, 2017
    DOIhttps://doi.org/10.2185/jjrm.65.1168
    JOURNAL FREE ACCESS
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        This study sought to clarify the perceptions and meanings of chronic knee joint pain, as well as the factors that affect them, among elderly people living in rural areas in order to obtain suggestions for improved nursing care. Semi-structured interviews were conducted with 14 elderly people living in rural areas with a history of chronic knee joint pain for at least 1 year. The interview data were then qualitatively and inductively analyzed. Participants were recruited from the Federation of Senior Citizens' Clubs and outpatient internal medicine clinics. The perceptions of knee joint pain of elderly people living in rural areas were found to have features of perceptions measured according to the need for medical care, perceptions in relation to daily life, and perceptions of oneself as a person with knee joint pain. To these elderly people, knee joint pain meant “something that raises awareness of one's remaining time in life,” “something that can't be helped in life”, and “proof that one has worked hard in life.” Perceptions and meanings of knee joint pain were influenced by “not being impeded in behavior related to excretion” and other areas of life. It is important that nursing professionals support elder ly people so that they are capable of proper self-care and ensure that elderly people are “not impeded in behavior related to excretion.” In addition to providing support for symptoms of knee joint pain and behavior, nurses need to proactively ask elderly people to talk about their experiences of having knee joint pain, and determine and provide the nursing care considered necessary at that stage while considering individual elderly persons' perceptions and meanings of knee joint pain.
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  • Clinical Research Support in Mito Kyodo General Hospital: Current Practice and Future Problems
    Sanae AOTO, Keiko FUJIE, Yoshio NAKATA, Hiroyuki KOBAYASHI, Shigeyuki ...
    2017 Volume 65 Issue 6 Pages 1177-1187
    Published: March 31, 2017
    Released on J-STAGE: April 25, 2017
    DOIhttps://doi.org/10.2185/jjrm.65.1177
    JOURNAL FREE ACCESS
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        Clinical research is essential for the practice of evidence-based medicine. This study reports on our current practice of clinical research support in Mito Kyodo General Hospital and discusses future challenges. In April 2013, the University of Tsukuba hired a clinical research assistant to provide clinical research support in Mito Kyodo General Hospital. The clinical research assistant worked full-time in the hospital in collaboration with 3 university faculty members. The target population for this study comprised 450 medical personnel including doctors, nurses, and other medical staff. From April 2014, 1 of the 3 faculty members visited the hospital once a month to offer clinical research consultations and deliver a lecture on nursing research. We analyzed past records of clinical research support and conducted a questionnaire survey to explore the level of satisfaction of the medical personnel. Four-hundred and ninety records of 91 research topics proposed by 68 medical personnel were identified. Of these, 93.4% were proposed by doctors or nurses. Most studies employed an observational study design (64.8%) and were conducted in order to make a presentation at an academic conference (51.1%). The consultation sessions were held 1–5 times, for 40–405 min, and lasted from 1–84 days per research topic. Consultations mostly pertained to research design and protocol planning (57.1%). Forty-seven clients were invited to participate in the questionnaire survey, 30 of whom provided valid responses. The results showed that 96.6% of the clients were satisfied with the consultations. The number of clients who participated in the consultations comprised only 15.1% of the target population. These practice biases need to be addressed in future. However, nearly all respondents were satisfied with the consultations. These findings suggest that our clinical research support was beneficial to medical personnel.
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RESEARCH REPORT
  • Creating a Strategy for Improving Dementia Care in a General Hospital
    Yoshihisa HIRAKAWA
    2017 Volume 65 Issue 6 Pages 1188-1193
    Published: March 31, 2017
    Released on J-STAGE: April 25, 2017
    DOIhttps://doi.org/10.2185/jjrm.65.1188
    JOURNAL FREE ACCESS
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        Inpatients with dementia are prone to delirium and aimless wandering, and they often become verbally and physically abusive. Thus, caring for these patients places considerable burden on nurses. This article reports on the creation of a strategy for dementia care in a general hospital. Subjects were staff of Konan Kosei Hospital ─ 2 deputy chief nurses, 1 section chief nurse, 3 unit chief nurses, 2 medical social workers, 1 integrated community support social worker, and 1 section chief nurse (home-visiting division) ─ and 2 independent care managers. Focus group interviews were conducted to collect data, and extracted labels were classified into subcategories and categories according to similarity in meaning. A two-dimensional development method was used to prioritize tasks in each category. The highest priority tasks were discussed and sorted using characteristic diagrams. It is necessary for a new team dedicated to dementia care to be created and for education, enlightenment, and training to be provided so as to increase understanding of dementia care and empathy among a wider range of professionals working in the hospital.
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CASE REPORT
  • Advanced Dementia with Lewy Bodies Showing Remarkable Improvement of Activities of Daily Living by Interventions in the Recovery Rehabilitation Unit
    Masaki HAKOMORI, Kazunori TOYODA, Satoshi SUTOU, Haruka NOGUCHI, Hiroy ...
    2017 Volume 65 Issue 6 Pages 1194-1200
    Published: March 31, 2017
    Released on J-STAGE: April 25, 2017
    DOIhttps://doi.org/10.2185/jjrm.65.1194
    JOURNAL FREE ACCESS
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        A 76-year-old woman with dementia with Lewy bodies (DLB) was transferred to our Recovery Rehabilitation Unit because of systemic muscle weakness due to disuse. She had been bed-ridden for about 6 months because of treatment for deep venous thrombosis and urinary tract infection. Weakness and features of parkinsonism were severe and she could barely turn over in bed. On admission, she needed considerable assistance to sit up and have meals. Her Unified Parkinson's Disease Rating Scale (UPDRS) score was 129 and Functional In de pendence Measure (FIM) score was 27 at the first evaluation. The doctor organized the dose of the drugs for DLB, and physical rehabilitation therapists performed repeated arm stretching exercises using Red Cord, raising the body, and standing exercises. Recreational activities such as ball-throwing games and singing songs gradually made her feel positive. She returned home on day 84 after admission. On discharge, she could stand and transfer to a wheelchair by slight assistance. The final evaluation showed that her UPDRS and FIM scores were 105 and 43, respectively. The outcome in this case suggests that adequate interventions in recovery rehabilitation units can improve ADL in patients with advanced neurodegenerative disease.
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