This study examined whether an automatic bottoming-out releasing system influences interface pressure, bottoming-out, and the integrated value（pressure value × bottoming-out time）. The participants were aged 65 or over, had either a current or previous pressure ulcer on the ischial tuberosity or coccyx area, and experienced problems with their seating position. We used an automatic self-regulating alternating pressure air-cell cushion. The intervention group used cushions with an automatic bottoming-out releasing system. In the control group, this system was turned off. 17 participants were enrolled and 3 outcomes were assessed: interface pressure, rate of total bottoming out, and integrated value. In the intervention group for seating position A, in which the back was in contact with the back support, there was no significant difference between optimized pressure and nonbottoming out（p = 0.16）. In the control group, the interface pressure value associated with non-bottoming out was significantly higher than the optimized pressure（p = 0.00）. The rate of total bottoming out in the intervention group for seating positions A and B（in which the back left the back support and the load was directed perpendicular to the seat）and D（in which individual returned to position A after assuming position B or C, causing movement of the limbs and corresponding shifting of the load）was significantly lower than in the control group（p = 0.00）, as was the integrated value（p = 0.03）. These findings indicate that the automatic bottoming-out releasing system operated appropriately and may be effective in preventing and aiding recovering from pressure ulcers developed in a seating position.
The purpose of this study was to clarify how patients with a temporary stoma following low anterior resection for rectal cancer cope with their situation. A semi-structured interview was conducted with 5 outpatients. The responses were analyzed qualitatively and inductively. The post-operative follow-up period fell into two phases with 12 categories. Patients in the initial phase of ‘Accepted the temporary stoma amidst feelings of confusion’ proceeded to the ‘Acceptance of temporary stoma placement despite misgivings’ as a temporary and inevitable phase of their therapy following the ‘Shock and anxiety caused by discovery of cancer.’ In the next phase of ‘Looking forward to stoma closure,’ the patients engaged in caring for their stoma despite reporting ‘Misgivings on the realization of having a temporary stoma.’ After discharge, they endured ‘Confronting the difficulties of living with a stoma’ by relying on the ‘Support of those around’ them and the desire ‘to return to（my）former, healthy state’ so that they were able to achieve a ‘Lifestyle of accommodating the stoma.’ On the other hand, some patients initially faced with ‘Confronting the difficulties of living with a stoma’ maintained their determination to improve, and tried immediately to achieve a ‘Lifestyle of accommodating the stoma.’ Based on these findings, nursing staff should assist patients experiencing stress and anxiety about having a stoma by encouraging their desire ‘to return to（my）former, healthy state’ while improving their access to available sources of support. On the other hand, the efforts of less distressed patients to achieve a ‘Lifestyle of accommodating the stoma’ should be validated and their confidence in the ability to cope should be encouraged.
The purpose of this study was to clarify how patients who experienced defecation dysfunction following closure of their temporary stoma due to a low anterior resection for rectal cancer felt about, and coped with, their condition. Data were collected from 5 outpatients in a semi-structured interview and analyzed qualitatively and inductively. The findings indicated that patient responses fell into 2 phases and 10 categories. In the first, ‘Response to defecation dysfunction phase’ patients who had just undergone stoma closure and experienced the ‘Relief of getting（one’s）body back’ were suddenly confronted with the ‘Pain and distress of defecation dysfunction’ and made over themselves by ‘The effort that rouse themselves.’ After that they engaged in ‘Adapting to life with diarrhea.’ In the second, ‘Integrating the experience of living with cancer’ phase, patients who confronted their feelings were able to ‘Begin enjoying life again.’ Through validating their experiences, they were able to progress to ‘Accepting stoma placement surgery’ and reported ‘Higher awareness about health.’ Patients who were less disturbed by defecation dysfunction, adapted more quickly, and proceeded immediately to the ‘Begin enjoying life again’ phase were fundamentally more optimistic in outlook, but also less concerned about health. Thus the nursing staff should tailor their care to patients’ needs as inferred from their responses; patients with high levels of stress and anxiety should receive positive encouragement from the nursing staff to heighten confidence and emotional strength, while patients less solicitous of their own health can be taught to focus on coping strategies and on their past successes against cancer in order to assist their continued recovery.
The aim of this retrospective study was to clarify the relationship between sign- and symptom-related catheter failure（SRCF）and patient characteristics including blood test data and intravenous fluids. Data were obtained from medical records after 2 months of research at a university hospital in Tokyo, Japan. Information on a total of 4,854 catheters placed in 2,150 patients was collected, among which there were 857 SRCFs. SRCF risk factors were female sex, irritant infusate, and blood test results that were recorded nearest to the day of catheter removal.C-reactive protein（≥ 2.0 mg/dL）and albumin（≤ 3.5 g/dL）were significantly associated with SRCF after adjustment in multivariate analysis（adjusted odds ratios（OR）=1.37, 95% confidence intervals（CI）=1.11－1.69, 1.35, 1.07－1.70, respectively）. Furthermore, low serum albumin was associated with SRCF even without irritant infusate administration on the day of catheter removal（adjusted OR=1.57, CI=1.14－2.16）. Thus, low serum albumin may promote SRCF. SRCF risk factors included not only sex, medical history, and irritant infusate but also blood test results, most notably serum albumin concentration. Healthcare providers should not only observe traditional signs and symptoms but also consider other patient characteristics, including blood test data.