［Objectives］This study aims to elucidate the perceptions and supportive behaviors of clinical ward nurses toward hand hygiene of patients with limited activity.　
 ［Methods］We conducted a self-documented questionnaire survey of 250 clinical ward nurses.　
 ［Results］Overall, 160 respondents who addressed full items in the questionnaire identified “the hands of the patients considered to be contaminated” with the median score of 5 and that of other items ranged 2-4. In addition, 131 (81.9%) nurses supported the hand hygiene behavior of patients ; of these, while 128 (97.7%) nurses assisted patient hand hygiene, 56 (42.7%) guided patient hand hygiene. Supportive behaviors of patient hand hygiene aimed at the cleanliness care (115 nurses) and the infection prevention for patients themselves (108 nurses) , etc. Regarding the suitable timing of patient hand hygiene assistance by nurses, they always assisted “when the patient’s hands are visibly contaminated” (61.7%) at the most, and “after interaction with visitors” (0.8%) at the least.　
 ［Discussion］Nurses’ supports for patient hand hygiene were unsatisfactory from the perspective to prevent the spread of health care-associated infection because their perceptions toward patient hand hygiene could be insufficient.

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 Purpose: To clarify the nursing skill characteristics required to initiate nurse-patient relationships based on the time series changes in verbal and nonverbal behaviors during the initial conversation with the patient.
 Methods: A 10-min role-playing session of an initial conversation with the same simulated patient was conducted by six nurses and six nursing students, and the time series changes in verbal and nonverbal behaviors with accuracy of 10 ms were extracted using the annotation software ELAN. The results were comparatively investigated.
 Results: Time series changes in speaking number and time, strength of claiming speech content, and number of physical movements showed a double-dip meta-complementarity in the nurses and a flat pattern in the nursing students. The simultaneous silence of the nurse complied with the patient’s silence, and the frequency of uttering meaningless words and unnecessary motion (filler) demonstrated a tendency to go along with the patient’s flow of ideas.
 Conclusion: It was suggested that nurses obtain patients’ attention by co-varying intonations using multiple channels and that during in-between silences, nurses should return to the basic supporting relationship to physically synchronize with patients’ motion.

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 In order to navigate a wheelchair over steps, a helper must depress a tipping lever to lift the front wheels. The present study investigated several tipping lever designs to clarify their ease of operation and the physical strain of people who help elderly people. These designs included three type of surfaces, and six locations (three lengths, two heights). Fifteen females in their 60s participated as wheelchair helpers, and two young males participated as wheelchair users. During locomotion, plantar pressure, posture angle, and surface electromyography were measured. After operation, the helpers subjectively evaluated the physical strain of the operation. The results indicate that both the cylindrical and flat surface levers covered with robber, as compared to the uncovered cylindrical lever, were more suitable based on subjective evaluation with regard to “ease of lifting” and “ease of depressing the lever,” as well as depression area. Regarding lever location, the longer tipping lever (over 40 mm at both heights) relatively improved the helper’s condition, according to their subjective evaluation. In addition, the pressure center of the plantar pressure was on the heel side, and decreased the electromyogram activity. Under conditions of low height, the hip and knee joints of the caretaker significantly expanded. On the other hand, the speed of the wheelchair and the ride comfort of the passenger did not significantly differ across all conditions. These findings suggest that subjective physical strain and electromyogram activity of wheelchair caretakers can be reduced by improved lever surface and length.

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 The purpose of this study was to clarify which of the two methods of folding the upper side of the sheet into a triangle (triangle method) and tying both upper sides of the sheet (tying method) is less likely to cause sheet slippage as a bed-making method for air mattresses. Forty-one nursing students conducted bed-making on air mattresses using the two methods, and daily living assistance was given to simulated patients on the beds to compare sheet slippage.
 The triangle method was resistant to sheet slippage for the air mattress overall, the center, foot side, right side, left side, and surface. It was only on the head side that the tying method was more resistant to sheet slippage. The triangle method is considered to be more resistant to sheet slippage than the tying method because the contact area between the sheets is large and the frictional force is large. In particular, the triangle method is considered to lead to a reduction in the risk of bedsores, since the central and foot side where the sacral region and calcaneus area, which are frequent sites for bedsores, are located are less prone to sheet slippage.

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 The purpose of this study is to take basic data on the measurement method of walking focused on the start of walking from signal and to verify its reproducibility. It also aims to consider the relationship between the walking data and fall risk factor. We measured safely on healthy adult group and elderly group, using “Walking measuring instrument” jointly developed by Miyazaki University and Sanwa New TEC Co., Ltd. As a result of calculating the number of Masri relationship from the measurement data of the elderly group, the walking data other than the first step grounding time were shown to have good reproducibility at one time measurement. The first step grounding time was generally good reproducibility in three times measurement. Each walking data was significantly different between the healthy adult group and the elderly group, showed similar results to the previous study of walking speed, stride, reaction time measured by the conventional measurement method. It was suggested that the walking data of this measurement method could evaluate fall risk factors such as a decrease in walking ability and a delay in reaction time.

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 Purpose: The purpose of this study was to examine whether the results of nursing technique research are being used in practice and in education, by investigating the actual state of the use of nursing techniques which are based on handed down knowledge or gained from experience. Method: A questionnaire survey on nursing skills - (1) techniques that have been proven by research, (2) unproven techniques, (3) techniques whose proof is doubtful-was conducted on 476 nurses and nurse educators, who had joined training workshops held by nursing associations, etc. Results: A total of 458 questionnaires were collected (96.2% response rate), of which 374 were valid (81.7% valid response rate). (1), e.g., a cold compress for IV infiltration, was used by 21.4%; (2), e.g., making a fist around the thumb in taking a blood sample, was used by 90.1%; (3), e.g., stool extraction before enema, was used by 27.5％. Conclusion: Techniques that have been substantiated by data were not being used, while unproven but handed down techniques and doubtful techniques were in use. This indicates that there is a gap between research results and their clinical and educational use. Thus, a current challenge to promoting the application of research outcomes is to enable easy access to them, and facilitate sharing.

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[in Japanese]

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 Previous research has shown that induration around sites of injection of haloperidol decanoate is caused by droplets of drug solution remaining within the underlying muscle for long periods, leading to development of an inflammatory reaction in the peripheral area. The inflammation is due to residual droplets of sesame oil used as a vehicle for the drug preparation. The aim of the present animal study, conducted in two parts, was to explore methods for prevention of this induration.
 StudyⅠ was performed to clarify an effective method for fine dispersal of drug solution within the muscle. Rats were divided into an exercise group, which were encouraged to bend and stretch the affected limb, a vibration group, and a massage group. It was found that exercise was most effective, resulting in maximum shrinkage of the oil spots.
 StudyⅡ was performed to clarify the time required for effective dispersal of drug solution within the muscle. Exercise for 60 s, 30 s and 15 s revealed that a longer period was more effective, although for practical purposes, 60 s was considered the limit for avoidance of fatigue. There were no significant differences in the blood drug concentration between the experimental groups and the control group. Exercise for 60 s was considered safe.
 On this basis, exercise for 60 s is considered to be effective for prevention of induration after intramuscular injection.

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 The purpose of this study was to assess how the act of repositioning a patient up in bed would affect the physical and psychological wellbeing of nurses and patients and identify influencing factors. Repositioning was performed in three approaches, namely (1) without using sliding sheets as assistive devices, (2) sliding sheets inserted and removed from the head side of the bed, and (3) sliding sheets inserted and removed from the lateral side. Physical and psychological burdens were assessed before, at the time of, and after sliding the patient. Subjects were ten nurses (average age 29.9±2.0) and another person acting as a patient (BMI 18.70). Measurements were made of the muscle activity of the nurse's erector spinae and the forward inclination angle of her torso as well as the muscle activity of the patient's sternocleidomastoid and the back bending angle of her neck. Subjective assessments were also made. Results revealed the use of assistive devices was effective in that it attracted a high overall rating from the subjects in their subjective assessment. It was also shown that the assistive devices could increase the physical burden depending on how they were used. The study suggested that the factors influencing the physical and psychological effects of repositioning were associated with the method of inserting and removing the assistive devices, the manner in which the patient's body was supported and how the nurse made use of her body parts in performing the task.

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 This study sought to determine the effect on sleep rhythm in persons with severe physical and intellectual disabilities who have sleep disorders by continuous application of hot compresses to both forearms. Intervention-based research was carried out from September to December 2015 with one subject with a semi-profound disability who has a sleep disorder causing irregular sleeping and waking patterns. Wet heat packs were applied to both forearms for 20 minutes every day for four weeks, and the time the subject spent asleep and awake, the nature of their sleep, their vital signs and their skin condition were compared before and after the intervention. The results indicated a significant decrease in drowsiness during the day and a significant increase in time spent awake. There were no abnormal findings in the subject’s vital signs or skin condition. These results indicate that the stimulation created by the wet heat of these heat compresses stimulates the core temperature of persons with semi-profound disabilities, positively affecting their sleep rhythms, and that it is safe to continuously apply wet heat-based stimulation by placing hot compresses on both forearms.

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 This study investigated the safety of hot compresses to the lumbar region on the skin of elderly people using skin barrier function and time-dependent changes in skin temperature. This study had a cross-over trial. Hot towels that were warmed with hot water at 60℃ and covered with a plastic bag (hot compress group), as well as dry towels, which were covered with a plastic bag (control group), were applied to the lumbar region of 8 elderly people (mean age : 73.0±3.5) who belong to a health circle for 15 minutes. In terms of transepidermal water loss (TEWL) and stratum corneum water content, which are evaluation indexes of skin barrier function, there were no significant differences between two groups and within each group at the start of compress and 15 minutes after its end. Comparison of changes in skin surface temperature and deep skin temperature with time revealed that, the hot compress group increased significantly more than control group. However, the deep skin temperature of the hot towel group fell below 38℃, and adverse events did not occur. Therefore, the hot compress of this study was suggested to be high safety for elderly people.

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 This study identified current trends of research regarding the effectiveness of venodilation techniques, focusing on experimental design, measurement methods, and venodilation effects for verification of the effects of venodilation in venipuncture. We conducted our literature search based on Cooper’s integrated literature review method. Using key search terms “venodilation,” “vasodilation AND venipuncture,” and “ (vasodilation AND peripheral) AND catheterization” to search the Japan Medical Abstract Society website, CINAHL, and PubMed, we analyzed 10 Japanese and six international reports. More than 80% of the reports described application of a tourniquet and local warming. Vein cross-sectional area and diameter increased, whereas vein depth decreased ; moreover, venipuncture success rate increased and needle insertion time was shortened by venodilation techniques. However, there were differences in methods among some reports, such as implementation time and tools, even when using the same venodilation techniques. Therefore, we conclude that is difficult to directly compare venodilation techniques among reports.

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 This review aimed to investigate psychomotor measurements and methods for evaluating nursing skills education, based on relevant literature both in Japan and worldwide over a ten-year period (2007-2016) . The electronic databases for the review included the Cumulative Index of Nursing and Allied Health Literature (CINAHL) and the Japan Medical Abstract Society (JMAS) . The search terms included “nursing skills,” “nursing students,” and “effect or effectiveness” in the CINAHL, and the equivalent terms in Japanese were adopted for searches in the JMAS. As a result, 15 domestic research articles (DR) and 21 international research articles (IR) were selected and analyzed. Many articles about “daily life support skills” (DR：33.3%, IR：0%) and the “medical examination and care support skills” (DL：53.3%, IR：71.4%) were analyzed. All psychomotor measurements in this review were classified using five evaluation criteria： “achievement,” “procedure,” “accuracy,” “quickness,” and “combination,” where “combination” referred to methods that combined multiple evaluation criteria. The measurement periods were classified into four phases： “pre,” “inter,” “post” and “long-term follow-up” for the intervention. It is essential to select the most appropriate or best combination of psychomotor measurements and to decide on adequate measurement periods to assess the effectiveness of the psychomotor domain in nursing skills education. These findings indicated that “long-term follow-up” test was an important aspect for evaluating skill retention and the improvement of nursing students.

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 This study aims to clarify the effect of partial bed bath using a disposable towel on the skin of elderly people. Both forearms of 27 community-dwelling elderly people aged 65 to 74 years were given a bed bath using a disposable towel and a cotton towel. The cleanliness, moisture content, pH, and temperatures of the skin were measured before and after the bed bath. In addition to these objective measurements, participants’ subjective feelings toward the towels were evaluated after the bed bath. The cleanliness and pH of the skin after the disposable-towel bed bath were almost equivalent to the measurements obtained after the cotton-towel bed bath. The moisture content of the skin was significantly higher after the disposable towel bed bath compared to the cotton-towel bed bath for 15 minutes after the bed bath (P＜0.01) . On the other hand, a greater decrease in skin temperature was observed after the disposable- towel bed bath (P＜0.01) .
 This might be attributed to the presence of more water on the skin surface. As for the subjective evaluation, the “softness” and “tactile feeling” of the disposable towel were more excellent than the cotton towel (P＜0.05) . These results suggest that water on the skin should be sufficiently wiped off because heat loss by vaporization after the bed bath was higher when using a disposable towel.

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 The aim of this study was to elucidate defecation method and fecal incontinence experiences and their impact on the self-esteem and self-efficacy of Japanese patients with chronic-phase spinal cord injury. In total, 114 individuals (92 males and 22 females) participated in this study. Their median age and duration after the injury were 47 (range, 8-80) and 14 (range, 1-55) years, respectively. The location of injuries included cervical (97) , thoracic (10) , and lumber (5) cords. We requested all subjects to complete a questionnaire that included self-efficacy and self-esteem scales by the World Wide Web or mail. While 96 subjects defecated using stool extraction, suppository, and enema, 85 subjects used artificial anus and experienced fecal incontinence (FI) . In the subjects with FI, the mean self-esteem scale (26.1±7.0) was significantly lower (P=0.027, independent t-test) than that in the subjects without FI (29.4±6.1) ; however, it was significantly higher (P=0.034) in the subjects using artificial anus (33.6±6.1) than in the others (26.8±6.9) . Based on the FI frequency, the mean self-esteem scale was 27.9±6.9 in the “experience several times in a month” group and was significantly lower than those in the “several times in a week” and “several times in a year” groups (P=0.042, ANOVA) . In contrast, the mean self-efficacy scale with FI (8.4±4.2) was significantly lower (P=0.045) than that of without FI (10.2±4.4) ; however, no significant difference was observed in terms of defecation methods. This study suggests that FI experience adversely affects self-esteem and self-efficacy ; however, using artificial anus exerts a positive impact on self-esteem. In fact, individuals adjust themselves to the defecation method they select.

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 This is a case study of a patient with severe Parkinson’s disease which made the patient bedridden. The patient had symptoms including sensations of heat, pain, and restlessness on both of her lower legs. The symptoms appeared to be those of restless legs syndrome (RLS) . The patient reported that those symptoms of RLS were felt stronger especially after receiving moisturizer application to the lower legs after bath. A preceding study reported that relaxation effect was observed by the application of the moisturizer at the speed of 3 to 5 cm per second. Therefore, in order to verify this effect, the moisturizer was applied at the speed of 3 to 5 cm per second to the lower legs of the patient. As a result, some major changes were reported concerning the sensations of heat, pain, and restlessness of the lower legs using the Visual Analog Scale. At the same time, muscle tension clearly decreased, and the range of motion of the joints of the lower legs improved slightly after the moisturizer application.
 This research did not serve as a fundamental solution to RLS, but the method used in this study can be applied as a new type of counseling or communication with the patients in clinical settings. Furthermore, since the reduction of heat, pain and restlessness was reported, this method can possibly contribute to the prevention of depression and anxiety, which are common comorbidities of RLS.

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