JOURNAL OF THE JAPANESE ASSOCIATION OF RURAL MEDICINE
Online ISSN : 1349-7421
Print ISSN : 0468-2513
ISSN-L : 0468-2513
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Special Issue on the 73rd Annual Meeting of the Japanese Association of Rural Medicine
LECTURE BY CONGRESS PRESIDENT
  • Initiatives for the Well-Being of Society and Residents in a Rural Area
    : The Challenge of Sado Island
    Kenji SATO
    2025 Volume 73 Issue 6 Pages 501-509
    Published: 2025
    Released on J-STAGE: April 30, 2025
    DOIhttps://doi.org/10.2185/jjrm.73.501
    JOURNAL FREE ACCESS
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    　Japan's declining birthrate and aging population are serious problems. The elderly population will eventually begin to decline, but the rapid decline in the productive and child populations will greatly exceed this. At the same time, advances in medicine and the increasing demand for safety management will lead to an increase in healthcare and welfare costs, further widening the gap between the demand and response capacity for these services. In the city of Sado, where the proportion of the elderly population exceeds 43%, the number of hospitals is decreasing, and the number of long-term care facilities is also beginning to decline, providing a glimpse into Japan's not-too-distant future.
    　The present healthcare and long-term care insurance systems cannot be maintained without an increase in the proportion of the productive population. Two possible countermeasures are to respond with fewer resources by better sharing and utilizing information, efficiently using local resources, and preventing serious illness through early intervention, and to prevent an increase in the demand for healthcare and welfare services by raising people's awareness of maintaining good health, with the goal of creating a well-being-oriented community.
    　The “Sado Himawari Net” information-sharing platform was launched in 2013 to share residents' healthcare information with medical institutions, long-term care facilities, and the local government. At present, 30% of residents and 60% of healthcare and welfare facilities have registered with the platform. Information that is directly linked to people’s lives, such as family structure, decision-makers, and living abilities, is more valuable to share than healthcare information, and a system to share such information and promote communication is currently under development. In addition, an AI-based system to assist in the selection of long-term care facilities that match the needs of each resident is also being developed as part of the plan to promote the efficient and effective use of local resources.
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SPECIAL LECTURE
EDUCATIONAL LECTURE I
EDUCATIONAL LECTURE II
CULTURAL LECTURE
KANAI PRIZE WINNER'S LECTURE
SYMPOSIUM I
SYMPOSIUM II
SPECIAL RESEARCH PROJECTS
SPECIAL FEATURE
ORIGINAL
  • Exploratory Study on Appropriate Nursing Support for Promoting Independence in Elderly Patients
    : Observations from Care Scenarios Involving Activities of Daily Living
    Natsuyo YAMAGUCHI, Wakaya FUJII
    2025 Volume 73 Issue 6 Pages 592-606
    Published: 2025
    Released on J-STAGE: April 30, 2025
    DOIhttps://doi.org/10.2185/jjrm.73.592
    JOURNAL FREE ACCESS
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    　Introduction: Promoting independence among the elderly is an important issue in Japan's super-aged society. However, because of the priority on treatments caused by shortened hospital stays and the demands of complicated nursing duties, support for elderly patients' activities of daily living independence have tended to be overlooked. Objective: To clarify the characteristics of nursing support for activities of daily living based on the content of nurses' actions and verbal support, and the reasons for performing them, as well as to examine the ideal nursing support necessary for maintaining and improving independent living, based on reinforcement theory. Methods: Areas where activities of daily living care for elderly patients were provided were observed according to the natural observation method, and nurses’ actions and verbal support as well as patients' behaviors were recorded. Thirty observations were categorized into “no support,” “support,” and “full support.” Nurses' actions and verbal support that appeared to affect patients’ activities of daily living were extracted and categorized based on similarities and assigned names. Results: Support for “full support” patients who were unable to perform activities of daily living was ‘ambiguous’ and ‘hurried,’ and nurses’ speech was strong and quick. Support for patients unable to perform activities of daily living was “obedient” and “unilateral,” and nurses were often silent. Conclusions: In the case of “full support” patients, the nurse's ‘ambiguous’ and ‘hurried’ support with strong and fast speech served as aversive stimuli and reduced the patient's motivation to perform the action. ‘Obedient’ and ‘unilateral’ are habitual supportive actions of nurses, suggesting that patients learn this pattern and do not perform the action. Nursing support that involves pleasant stimuli is important to maintain and improve independent living in elderly patients.
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CASE REPORT
  • Two Cases of Small Cell Carcinoma of the Prostate
    Fumitake KOBAYASHI, Sachiei TAKAHASHI, Jiro IMURA
    2025 Volume 73 Issue 6 Pages 607-612
    Published: 2025
    Released on J-STAGE: April 30, 2025
    DOIhttps://doi.org/10.2185/jjrm.73.607
    JOURNAL FREE ACCESS
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    　Small cell carcinoma of the prostate is a rare, highly malignant disease with a poor prognosis that often presents with metastatic lesions at the time of diagnosis. A previous study reported that neuroendocrine differentiation occurred during hormonal therapy for prostate cancer and progressed to small cell carcinoma. We encountered one case in which small cell carcinoma was diagnosed at the first visit and another case involving possible neuroendocrine differentiation.
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MATERIAL
  • Training of Clinical Technologists to Support Assisted Reproductive Technology Services at Our Hospital
    Yasuo ITO, Jun ICHIKAWA, Hidemi TSUGA, Akari ASAMI, Yuka HAYASHI, Yasu ...
    2025 Volume 73 Issue 6 Pages 613-619
    Published: 2025
    Released on J-STAGE: April 30, 2025
    DOIhttps://doi.org/10.2185/jjrm.73.613
    JOURNAL FREE ACCESS
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    　Since 2005, one of our clinical technologists has been involved in providing assisted reproductive technology (ART) services ranging from egg retrieval to embryo transfer, which were previously performed only by doctors at our hospital. In 2011, the clinical technologist was certified as a clinical embryologist by the Japanese Society of Clinical Embryologists. Around 2020, insurance coverage for ART related to infertility treatment began to be considered. Consequently, the training and development of ART-supporting clinical technologists became an urgent issue. In response, we developed a training program for ART-supporting clinical technologists that covers egg retrieval assistance, fertilization, culture, embryo freezing/thawing, and embryo transfer. By the end of fiscal year 2022, we had successfully trained two new ARTsupporting clinical technologists, bringing the total to three.
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