The proportion of cases of aspiration pneumonia to total cases of pneumonia increases with age. The number of elderly patients with aspiration pneumonia is expected to continuously rise. In this study, we investigated patient risk factors influencing elderly patients to enter health facilities after hospital discharge among elderly patients hospitalized for developing aspiration pneumonia at home. The study involved 23,781 patients aged ≥65 years who were admitted to hospitals due to aspiration pneumonia between April 2018 and March 2019. Patients were grouped into those “discharged from hospital and returned home” and those “entered health facilities after discharge”. Patient characteristics from each group were compared using the Mann–Whitney U test and chi-square test. We examined the relationship between patient factors and places chosen after discharge. We used logistic regression analysis to control the covariates. “Age 75 to 84”, “age 85 and older”, “activities of daily living (ADL)”, “dangerous behavior”, “tube feeding”, “central venous hyperalimentation”, “circulatory or respiratory care”, “drainage management”, “dangerous behavior and tube feeding”, “circulatory or respiratory care and pressure ulcer”, and “increased need for medical care” influenced entering health facilities (area under the curve=0.76, p<0.01). ADL and medical treatment were identified as key factors.

The subjects were care workers and nurses at a geriatric health services facility. The objectives were to confirm the factorial structure and invariance of a good organizational climate and to investigate the relationship between the degree of favorability in the organizational climate and the inter-occupational factorial invariance, as well as to investigate the relationship between the degree of favorability of the organizational climate and the Sense of Coherence; i.e. the relationship between stress coping ability and a health maintenance index. To achieve these objectives, simultaneous multi-group analysis was performed using anonymous, self-administered questionnaires.

The results indicated that the degree of organizational climate favorability showed inter-occupational consistency and allowed for the identification of the following four factors: 1. Clarity of role objectives; 2. Psychological reward; 3. Trust and cooperation; and 4. Self-expression. The significance of the scores was found to be universal rather than dependent on occupation. It was also found that, for both occupations, the higher the degree of organizational climate favorability, the higher the Sense of Coherence, indicating a positive relationship between the two. Furthermore, it was found that the relationship was of the same degree regardless of occupation type.

These results suggest the importance of the organizational climate in maintaining and improving a Sense of Coherence as it is related to success or failure in stress coping.

Hospital preparedness for disaster is important in the present “mega”-disaster era.

Purpose: To evaluate the infrastructure preparedness of Japanese hospitals.

Methods: A disaster preparedness questionnaire was sent to 2537 hospitals including university hospitals and members of the Japan Hospital Association in Japan in 2018, and the completed responses of 495 hospitals were analyzed.

Results: A tertiary emergency center was present in 105 hospitals. The potential disaster risks included earthquake directly above the center of the building in 283, plate-boundary quake in 230, flood in 205, tsunami in 118, and soil liquefaction in 108. Despite the high probability of future disasters, notification of hospital staff to the potential risk was poor for disasters such as earthquake greater than seismic intensity scale 5 in 14% and risk of flood around the hospital in 11%. Emergency electric generators were checked annually by 50% of hospitals and every two months in 38%. In 65% of hospitals, a water reservoir was located on the rooftop. In the event of an earthquake, damage to the reservoir would risk flooding the hospital below.

Conclusions: Many of the hospitals that responded had high vulnerability to disasters; however, medical staff were not satisfactorily informed of the risks. The frequency of checking emergency electric generators was adequate. To avert flooding from the top of the hospital building, rooftop water reservoirs should undergo reinforcement or be relocated.

The objective of this study was to compare the fatigue, amount of physical activity, and sleep quality of nurses working a 16-hour shift during pregnancy by comparing these qualities in two groups as follows: One consisting of nurses at <20 weeks of pregnancy and one consisting of nurses at ≥20 weeks of pregnancy. The subjects were 14 nurses, 6 of whom were in the <20-week group and 8 in the ≥20-week group. Their fatigue (investigation of subjective symptoms), cumulative fatigue symptoms index (CFSI), and Japanese-language version of the Pittsburg Sleep Quality Index (PSQI-J) scores by work shift (day, night, days off) were assessed using a self-administered questionnaire. Their actual degree of intensity of physical activity was investigated using a physical activity meter. The results showed that the <20-week group had a higher number of subjects with lower PSQI-J scores and recovered from fatigue before and after the day shift, night shift, and days off. However, the ≥20-week group had a higher number of subjects with higher PSQI-J scores and a strong tendency toward sleep disorders. These results suggest that during the transition from the day shift to the night shift, and then to days off, those in the ≥20-week group may not recover from sleepiness and physical fatigue in particular. In addition, there was no difference between the two groups in terms of the amount of physical activity at approximately 20 weeks of pregnancy.