The aim of this study was to clarify the relevance sense of coherence（SOC）and psychological health has on the life of ostomates.The subjects were 208 members of A prefecture branch of Japanese Ostomy Association using the questionnaire about their life, SOC 13 and GHQ 12. We analyzed 121 of them(response rate 58.2％)and found that the postoperative burden like the difficulty of the stoma care,anxiety about future and life,and the progress after an operation itself had an effect on their Sense of Coherence and psychological health rather than their background either their life with his/her spouse,family or not. Moreover, a significant correlation was seen between SOC and GHQ and so,it suggested that psychological health was excellent when sense of coherence was high.

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Objective:To clarify the relationship in pH between bladder control pad top sheet and skin and effect of bacteria on the pH.
Methods:We measured the pH of top sheet and skin near the external urethral orifice and examined bacteriological property of top sheet at four time points； before urination,soon later,120-160-minute later,and 240-300-minute later.
Results:Both pH of top sheet and skin increased over time. Cases with high levels of top sheet pH showed strong activity of urease and exhibited Genus Proteus colonization.
Discussion:These results suggested the relationship between top sheet pH and skin pH. Increase of top sheet pH could be related to urease derived from bacteria in feces.

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[in Japanese]

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A nationwide survey was conducted on the stoma care at 373 home visit nursing stations in September 2007 and the current status is put together as follows.

1. Out of a total of the users,those who are on stoma care account for 3.2％ and the chances for home-visit nurses to experience stoma care were low level.
2. Sixty one percent of the target persons were late-stage old people,and many of the reasons for visit was low body functional capacity,cognitive deficit,poor ability of nursing care by care-givers,reflecting aging population and increase in growing number of aged family.
3. Supporting of self-care accounted for 17.5％,revealing the current situation that they leave hospitals before mastering the self-care.
4. The home visiting nurses feel that they are short of information,knowledge and skill,wanting the occasion of consultation with relevant organizations and enhancement of in struction by the hospitals from where stoma patients discharge.
5. In order to make regional alliances function effectively in the future,collaboration between medical institutions and home care facilities is needed.

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A survey was conducted of the directors of the Yamanashi Nursing Association Visiting Nurses Stations(stations)at 8 locations to assess their relations with medical institutions during ostomate support. Four out of 8 stations responded that communication before and after discharge of patients from medical institutions was inadequate. At 4 stations,directly witnessing device exchange by ostomates before discharge from hospital was possible,but only 1 station has a physician in attendance. With regard to the summary of the nursing reports,6 stations answered that it was inadequate. The problems in communicating with medical institutions included the contact person not being clearly indicated,differences of opinion between physicians and nurses at the same institution,and refusal to provide information due to privacy guidelines. We expected medical institutions to hold a pre-discharge conference,ensure the physician's attendance,clearly indicate who to contact,and assign appropriate personnel,as well as explaining how ostomates should judge the problems that must be reported. With regard to communication between medical institutions and visiting nurse stations,it is necessary to improve the understanding of their mutual responsibilities.

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Recently,due to shorter hospital stay,ostomates often require a visiting nurse because their stoma self-care skills are incomplete at the time of discharge. We investigated the difference in self-care capability of seven ostomates before and after discharge whom were introduced into homecare systems. After comparing the difference in care components between the visiting nurse and the medical institution,we assessed the inquiries received from the visiting nurse concerning the seven ostomates before and after discharge. As a result,less experienced ostomates tended to be dissatisfied with the care from the visiting nurse. On the other hand,even some of the more experienced ostomates were still excessively dependent on the visiting nurse when exchanging appliances. Therefore,we confirmed the importance of thorough communication of accurate information about the patients` capability of self-care and goals between the two care settings.

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We conducted a semi-structured interview to 12 home care nurses in order to reveal issues the nurses have and to improve QOL of patients with stomas who need home care nursing. We found that the nurses work with limited resources and with uncertain cooperation and expectation between cooperations/firms that deal with patients with stomas. lt was revealed that they work in an environment that has an unclear cooperation among hospitals,outpatient clinics,vendors,and manufactures and the nurses had difficulty using them.
It became apparent that it is necessary to create a cooperating system that provides home care nurses necessary assistance when a problem arises while taking care of such patients.

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[in Japanese]

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[in Japanese]

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