The importance of a team effort in healthcare is increasing rapidly. Currently, provisional legislation for the certification of nurses' specified capacities is being discussed with the goal to promote team medical treatment. However, the current condition leading to the creation of such legislation raises important questions such as "what is team medical treatment?" and "what is the nature of medical care work?" In this article, we will critically discuss the theory of "team-based medical treatment" as used in the debate on this system and also discuss the future of teamwork and the training of medical professionals who will care and cure.

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The research on Medical Sociology typically employed a form, in which it criticizes the putative hierarchical structure of medical professionals with physicians positioned at the top dominating patients and the other specialists. In the late 1990's, however, during my fieldworks conducted at hospitals and clinics I saw medical professionals for interdisciplinary collaboration, even though it appeared uneasy to realize. I am taking fieldwork as the way of my fundamental approach to the reality of the people; during the procedure I interview and observe as much as possible. My research on site has revealed not the simple confrontations but also involvement of complicated human relations, tangled systems, organizational structure, and cultures. The current medical care seems suffering from various issues such as pressure against long hospitalization toward care at home, patients' will to live comfortably in their own community, and struggle of medical professionals to fulfill patients' wish in the face of strict regulations. I would like to focus in this lecture on the team approach, which could be the key concept in these circumstances, and overview how each individual intends to get committed in the medical care.

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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We conducted a questionnaire survey to explore respondents' and their families' experience of medical accidents. The survey involved 2000 people living in Fukuoka Prefecture, who were sent a questionnaire by mail. The valid response rate was 27.9%. One hundred and seventy-five medical accident cases were reported. We categorized all cases using ICD-10 codes and clinical categories regarding the nature of the problem. As a result, 14.3% were classified as "neoplasms" by ICD-10 codes, and 32.0% as "diagnosis" by the clinical categories. We identified three conditions of medical accidents recognized and judged by patients and their families. In the first, there was an unanticipated family member's death, or a condition suddenly worsened under treatment. Secondly, a result contrary to their expectation based on the prognosis was given. Thirdly, there were differences in the diagnosis, treatments, and outcome of medical care by medical professionals.

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Adoption is sometimes recommended to infertile patients. However, little has been clarified about the experiences of patients who have selected adoption. This paper examines this issue through interviews with five adoptive mothers who were introduced to a child by the Osaka office of Kateiyogosokushinkyokai, an adoption agency, after they stopped infertility treatments. The interviews clarify five points about their experiences: 1) husbands and parents sometimes opposed adoption; 2) the agency sometimes refused their applications; 3) they sometimes suffered from the trying acts of the adopted child; 4) they sometimes worried about their attachment with the child; 5) during the adoption process, they were uncertain whether Special Adoption would be permitted. These findings suggest a model of the experiences of infertile patients who select adoption.

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This study examines the motivation of nurses who work as medical safety managers by the social survey. The questionnaires were mailed to the 2,317 healthcare organizations, which have accreditations of medical safety from the Japan Council for Quality Health Care and responses from 930 healthcare organizations (40.1%). About 40% of the answers indicate dissatisfaction with their job. As a result of the analysis, the motivation that influences their job satisfaction is the evaluation of safety managers by other staff, the attitude of healthcare organizations on medical safety, and the usefulness of the incident and accident report data, but the evaluation of safety managers by patients and their families is not recognized as statistically significant by logistic regression.

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In many preceding studies on dementia, the view that elderly people with dementia sometimes behave as if they live in other worlds has become self-evident and also that caregivers should "acknowledge" these worlds. Therefore, many preceding studies have come to neglect what constitutes them. This article aims to describe their structure and to suggest how they connect with the "real" world. In order to achieve these two purposes, this study refers to Goffman's dramaturgical approach and Schutz's theory on multiple realities. In conclusion, both other worlds and the "real" world are defined as the "stage," with "the definition of the situation" as its core. Also, the connection between these two worlds might be based on "materiality," which is significant for dementia care.

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