Some patients on complete bed rest have difficulties in self urination. However, nursing care to encourage spontaneous urination on the bed has not been established yet. This study compares the autonomic nerve activities by observing heart rate variability under different circumstances ; on urination in the restroom and on the bed, and also in spontaneous urination and non-urination on the bed. I have done spectral analysis of heart rate variability with 12 healthy adult women before, after and on urination for five minutes each. As a result, in urination in the restroom compared with before urination, HF (parasympathetic nerve index) did not change but LF/HF (sympathetic nerve index) rose significantly. When there was urination on the bed, HF rose significantly, and LF/HF did not change. When there was no urination on the bed, HF did not change, but LF/HF rose significantly. When there was urination on the bed compared with in the restroom, HF rose significantly. Moreover, when there was urination compared with no urination on the bed, at the time of urination, HF rose, and LF/HF fell significantly.

View full abstract

　To clarify subcutaneous tissue thickness at injection sites and analyze needle length required for intramuscular injection skills. Subcutaneous tissue thickness was measured at injection sites on gluteus medius and deltoid muscles using ultrasonography. Height, weight and body fat were measured along with subcutaneous tissue thickness at injection sites on deltoid muscle and back of the upper arm using skinfold calipers. Correlations between various measurements were analyzed. Subjects comprised 174 male and 156 female. Significant correlations were found between male and female (p＜.01), 18-64 years and ≥65 years (p＜.01, p＜.05) for the gluteus medius. Mean thickness at the deltoid was 0.59 ± 0.18 cm in male and 0.71±0.23 cm in female. Mean thickness at the ventrogluteal site was 0.79±0.31 cm in male 18-64 years, 0.58±0.28 in male ≥65 years, 1.05±0.41 cm in female 18-64 years, and 0.76±0.29 cm in female ≥65 years. Mean thickness at Clark' s site was 0.85±0.34 cm in male 18-64 years, 0.63±0.25 cm in male ≥65 years, 1.16±0.42 cm in female 18-64 years, and 0.92±0.43 cm in female ≥65 years. Mean thickness at upper quadrant of buttocks point was 1.05±0.43 cm in male 18-64 years, 0.68±0.30 cm in male ≥65 years, 1.41±0.48 cm in female 18-64 years, and 1.20±0.68 cm in female ≥65 years. Significant correlations were found between subcutaneous tissue thickness at injection sites on deltoid muscle by ultrasonography and subcutaneous tissue thickness at injection sites on deltoid muscle and at the back of the upper arm by skinfold caliper. Regression formula using these data were determined. Subcutaneous tissue thickness for intramuscular injection can be assessed using regression formulae.

View full abstract

[in Japanese]

View full abstract

　Fecal incontinence after digital extraction causes much distress and burden for those who receive home care and their family. The purpose of this study is to clarify techniques to prevent fecal incontinence after digital extraction that have not been documented but have been used by some practitioners, and to examine their effectiveness. We interviewed 4 nurses and a family caregiver regarding the techniques they use to prevent fecal incontinence and summarized it. Then home care nurses utilized the techniques documented in the summary in their practice, and whether the techniques were effective to prevent incontinence was examined. Data on the total of 68 digital extractions were collected from 12 clients and their home care nurses (n＝8). 1) Fecal incontinence did not decrease by using the model; 2) when there was the sign of “mucus discharge” at the end of digital extraction, the episodes of fecal incontinence was significantly fewer than the digital extractions without the sign; 3) the sign of “mucus discharge” was seen only when enema was used prior to the digital extraction; 4) when there was the sign of “feeling of rectum descending/closing,” the fecal incontinence tended to be fewer. Based on the findings, it was suggested that in order to prevent fecal incontinence nurses should not complete digital extraction before the mucus discharge appears if the enema is used. We need to collect more data to examine the effectiveness of the sign of “feeling of rectum descending/closing” as a sign to prevent fecal incontinence.

View full abstract

[in Japanese]

View full abstract