This study aimed to elucidate how colon cancer patients coped with their feelings of loss caused by the placement of a permanent stoma. The subjects were six patients who received an ostomy for colorectal cancer more than five years before the study. Qualitative data collected through semi-structured interviews were analyzed with the Grounded Theory Approach（Saiki）. As a result, 17 different categories were extrapolated spanning two qualitatively different periods labeled, ‘Breakdown of values’ and ‘Groping in the dark.’ Furthermore, three different ‘types’ of coping behavior with which the patients passed through these periods were identified, namely, ‘sharing anguish with fellow patients,’ ‘enduring sadness,’ and ‘coping with reality.’ During the ‘breakdown of values’ period, patients suspended their feelings of anguish regardless of their behavior type. In the ‘groping in the dark’ period, those sharing their anguish with fellow patients（type 2）initially experienced psychological distress as they passed through ‘sadness caused by having a stoma’ to the ‘search for meaning in undergoing ostomy placement’ but experienced alleviation through sharing their anguish. Patients choosing to ‘endure their sadness’ tried to cope with ‘the sadness of having a stoma’ on their own through making efforts to ‘coexist with their stoma’ but continued to experience anguish. Those exhibiting these two behavior types showed no indication of searching for meaning. These findings demonstrate the importance of long-term support during the ‘groping in the dark’ period when patients experience ‘sadness caused by having a stoma.
Ultrasound measurements of residual urine volume is important for nursing care in the urination disorder. The aim of the study was to compare the bladder volume estimated with the ultrasound device（desktop-type device, hand-held devices, Bladder ScanTM）.
Subjects included 13 adult volunteers（8 men, 5 women aged 43.2 ± 9.4 years）. The ultrasound devices included a ViamoTM（Vi: TOSHIBA MEDICAL SYSTEMS, Corp.）, a Vscan（Vs: GE HELTHCARE Japan, Corp.）, SONIMAGE P3（P3: KONICA MINOLTA, Inc）, BVI 6100（BVI: SYSMEX, Com.）. Urine volume was measured with the Vi and Vs by measuring the long diameter of the bladder from images in horizontal cross-section and its anteroposterior diameter and short diameter from sagittal-section images and calculating the volume using the formula（long diameter（w）× short diameter（d）× anteroposterior diameter（h））/2. On the P3, the “Bladder Volume" mode was used for the calculation. The mean values for the actual measured urine volume and the urine volumes measured by each method were calculated.
The mean actual measured value was 236.8 ± 125.9 mL（65-425 mL）. The error rates were Vi（50.5 ± 13.3%）, Vs（55.1 ± 14.7 %）, P3（20.3 ± 16.6 %）, BVI（32.3 ± 27.4 %）. A high correlation was demonstrated between true volumes and ultrasound estimation（r=0.84-0.96）. Conclusion Our results showed that the P3 had a comparatively lower error rate than the ultrasound devices, hand-held multipurpose devices should be used in routine clinical nursing practice.
Some patients with diabetes develop calluses on their feet and such calluses become ulcerated due to inflammation. The present study aimed to clarify the causes of calluses and of inflamed calluses in the feet of patients with diabetes, with a focus on factors associated with plantar pressure. We obtained data about inflamed calluses from thermography images, sensory neuropathy, and plantar pressure from the medical records of 134 patients who attended a diabetic foot clinic between December 2009 and November 2010. Among the 134 patients, 52（38.8%）had 149 calluses. Of the total 149, there were 30 calluses on the first toe, and 25 calluses on the first metatarsal bone. The maximum pressure on the resting forefoot sole（MPRFS）was significantly higher among patients with calluses on the forefoot than among all of the others（2.59±1.25 vs. 1.57 ±0.90 kg/cm2; p<0.001）. Five patients had inflamed calluses and all of them had sensory neuropathy. The MPRFS in three of those five was 2.12, 2.85, and 4.52 kg/cm2. The average MPRFS of the patients without inflamed calluses was 2.57±1.18 kg/cm2. The MPRFS is a factor involved in calluses among patients with diabetes. The MPRFS did not tend to be larger in patients with than without inflamed calluses. This result suggests that a factor other than plantar pressure affects the process of callus ulceration accompanied by inflammation.