With the aim of clarifying the challenges and responses that psychiatric visiting nurses are facing in promoting collaboration with care managers in supporting older people with mental disorders, interviews were conducted involving 6 psychiatric visiting nurses from 3 psychiatric visiting nursing stations, and the obtained data were analyzed using a qualitative and inductive approach. As the results, the following 4 core-categories were extracted : [older people requiring both mental and physical care which has been provided by family members], [care managers’ lack of ability to support the lives of older people with mental disorders], [dilemma in which collaboration does not progress in the community], and [visiting nursing is a bridge between home care and disability support]. In the provision of psychiatric visiting nursing intervention for older people with physical care needs who have untreated psychiatric disorders and have been cared for only by their family members for many years, it was indicated that: the collaboration is difficult due to care managers’ lack of knowledge on patients with mental illness and mental disorders and skills to observe them ; that care managers do not understand the role of psychiatric visiting nurses ; that there are some issues related to long-term care insurance in promoting support ; and that psychiatric visiting nurses are considering to proactively promote collaboration among multiple professions.
To clarify an education status on the handling of excrement for outpatients receiving anticancer drugs and their family members, a survey using questionnaire on the education of the exposure prevention for the patients and their family was performed on 1,554 nurses engaged in 227 hospitals including 135 core cancer hospitals.
Among the 1,154 subjects, 756 subjects provided valid responses. Subjects who explained the precautions during the excretion or the handling of diapers, stoma, and linen with excrement were less than 40% for the patients and less than 25% for their family members. In all 5 items related to caution during excretion and 6 out of 8 items related to the handling of diapers, stoma, and linen, the frequency of explanations to family members was significantly lower than that of patients. More than 90% of the subjects needed exposure prevention education for patients and their family members. Free descriptions about the difficulty of exposure prevention education included “concerns about the degree, method, and content of preventive education”, “difficulty in changing the patient’s excretion habits”, “difficulty in responding to the characteristics of the patient and their family members” and “patients and family members’ hesitation to request special items”.
These results indicate that nurses are aware of the necessity of exposure prevention education for patients receiving outpatient chemotherapy and their family members, but the education provided to such patients and family members has been insufficient. Since the family members as well as the patients are affected by the exposure, education on the handling of excrement is necessary for both patients and their family members. In addition, it is important to consider the patients’ situation including living environment, their family background, and economy and be careful not to give excessive anxiety.
We examined the understanding and changing consciousness of genetic analyses for the general population and pharmacy staff to clarify whether genetic analyses affect the preventive awareness of lifestyle-related symptoms or diseases, regardless of knowledge level. The level of understanding of genetic analyses by pharmacy staff was significantly higher than that of the general population, suggesting a difference in the level of knowledge about genetic analyses between the general population and pharmacy staff. However, in the both groups, when they have a gene that associated with the symptoms or diseases, there are significantly fewer choices to “do nothing” than when the gene is unknown, and many respondents choose diet-related preventive measures. Therefore, regardless of the knowledge level of genetic analyses, these analyses for lifestyle-related symptoms or diseases may raise preventive awareness in subjects carrying the gene. Additionally, as a preventive measure for genetic possession, arteriosclerosis and cancer were “balanced diets,” and others were actions to reduce dietary components associated with the symptoms or diseases. Furthermore, as a preventive measure against genetic unknowns, it was demonstrated that the general population chose “diet” or “exercise” significantly more than the pharmacy staff.
To clarify wisdom in nursing in emergency nursing practice, semi-structured interviews were conducted with seven nurses engaged in tertiary emergency medical facilities. Narrative analysis was performed to clarify wisdom in nursing based on a classification of wisdom by Titchen et al., from epistemological and ontological perspectives. The themes of wisdom in nursing characterized by epistemological aspects included : [identifying abnormalities/sudden changes], [understanding the crises faced by patients], [becoming aware of the task of saving patients’ lives], and [detecting changes in patients’ pathological conditions] [grasp patients from the perspective of family members]. Wisdom in nursing characterized by ontological aspects addressed the following themes : [being the only person who can provide medical care immediately after a sudden change], [creating a starting point for collaborative work among medical professionals], [acting as a core person for team medicine], [providing a reliable basis for patient care], [becoming a reliable source of information], [supporting patients as a companion to overcome their current situation], and [maintaining the bond between a patient and his/her family]. Wisdom in nursing to manage sudden changes/emergencies also focused on patients’ and their families’ psychological and social backgrounds, in addition to saving the former’s lives, and it was used as a nurse-specific role in emergency teams.
Effect of educational intervention in increasing the glove wearing rate among nurses when drawing blood and administering intravenous injections was examined. An assessment using a questionnaire on the wearing of gloves in drawing blood and administering intravenous injections was conducted for 218 nurses. The reasons for not wearing gloves were classified into three factors : lack of awareness, technical procedures, and knowledge of research articles. For each factor, to improve the thinking processes and instill a sense of self-efficacy, educational intervention was performed using various andragogy methods such as group discussions and video e-learning systems. Similar assessments were conducted at 3 months and 1 year and 3 months after the educational intervention.
Prior to intervention, the glove wearing rates were 55.6% and 50.3% for drawing blood and administering intravenous injections, respectively. A dull sensation in the fingertips was the main cause of negative responses. After intervention, the respective glove wearing rates for phlebotomy and administration of intravenous injections significantly increased to 77.8% and 73.2% at 3 months and to 86.2% and 84.5% at 1 year and 3 months. In the negative responses, technical factors were the dominant response in both timelines. These results indicated that the andragogy educational methods used to improve the thinking processes and establish a sense of self-efficacy effectively motivated the nurses to wear gloves and establish glove wearing behavior.
This study was designed to evaluate the relationship between burnout and work-related stress among female nurses in a general hospital. A self-administered questionnaire survey on the related determinants was performed among 247 female nurses with the occupational career of one year and/or more (age : 36.8±11.5 years). Work-related stress was grasped mainly by using a new version of the Brief Job Stress Questionnaire (New BJSQ). Multiple logistic regression analysis was performed with the scores of emotional exhaustion, depersonalization and decreased personal accomplishment using Japanese version of Burnout Inventory scale created by Kubo and burnout scale using Japanese version of Pine’s Burnout Scale as the objective variable and the scores of work-related stress as explanation variable. In relation to occupational stress (work environment factors), score of emotional exhaustion was positively related to the scores of “quantitative work demand” and “emotional demands” (p<0.01), and was negatively related to the scores of “work aptitude”, “esteem reward” and “work-self balance (positive)” (p<0.01). Score of depersonalization was positively related to the scores of “emotional demands” and “role conflict” (p<0.01), and was negatively related to the scores of “work aptitude”, “support from family and friends”, “esteem reward” and “respect for individuals” (p<0.01). Score of decreased personal accomplishment was negatively related to the scores of “qualitative work demand”, “work control”, “work aptitude”, “role clarity”, “interactional justice” and “work-self balance (positive)” (p<0.05 or p<0.01). On the other hand, score of burnout was positively related to “qualitative work demand”, “interpersonal relations in the workplace” and “emotional demands” (p<0.01), and was negatively related to the scores of “meaning of work”, “role clarity”, “support from family and friends”, “job security” and “work-self balance (positive)” (p<0.05 or p<0.01). These results are quite different from the estimation based on the results of previous research with different occupational stress survey items, analytical method and occupations of subjects. Therefore, it is necessary to investigate further on the relationships between burnout and work-related stress among female nurses in the hospital.
Over-adaptation is a state in which individuals work self-sacrificially to meet the expectations from others, and is considered to be one of the causes of work stress. The purpose of the present study was to compare the effects of the over-adaptation on the stress response to those of stress-related personalities such as the type A behavior and the defensive pessimism. The subjects were 681 corporate employees (40.1±10.7 years old). Multiple regression analysis revealed that the over-adaptation was not related to the stress response and the satisfaction to a job after controlling for the effects of stress-related personalities. Furthermore, when the effects of stress-related personalities on the over-adaptation were examined, the over-adaptation were found to be related to stress-related personality, and its explanatory variance was greater than that of the satisfaction to a job and similar to that of the stress response. These results suggest that the over-adaptation measured may represent a state rather than a personality.
The impact of the pandemic of the novel coronavirus infection (COVID-19) has been significant for patients with intractable diseases, the elderly, and the psychiatric disabled (hereinafter referred to as those who need assistance), who have limitations in their daily lives and need constant support to live in the community. It is difficult to maintain physical distancing because they must take care of their personal care daily, which increases the risk of infection. Therefore, we interviewed the patients about the new lifestyle and innovations that are currently taking root due to COVID-19 measures. As a result, it was found that patients with intractable diseases need encouragement and innovations to prevent a decrease in exercise and leisure activities, and continued support for daily life as usual. For the elderly, it was found that they will need support so that they can continue to live together with their close friends in the local community. For the psychiatric disabled, it was found that they were concerned about their stress vulnerability due to loneliness, and that to establish a new lifestyle, it was necessary to repeatedly explain their behavior so that it would become a habit. These findings suggest that it is necessary to provide information and lifestyle guidance tailored to the characteristics of each patient in their own care environment.
The purpose of this study was to examine the influence processes of environmental factors such as work stress and psychological factors such as rationalization and optimistic attitude on the deterioration of lifestyle and the preservation of self-care in working diabetics. The participants for using data analysis were 592 (569 males and 23 females) working type 2 diabetics, whose ages were ranged from 40 to 65. The analysis of covariance structure was used to examine the influence processes of work stress and lifestyle on the implementation of diabetes self-care. The results showed that there were two influence processes to self-care. The first process is that work stress and stress responses inhibit the practice of self-care through the promotion of irregular diet. The second is that work stress and stress responses facilitate optimistic attitudes toward illness through encouraging rationalization and then optimistic attitudes inhibit the practice of self-care. These two inhibitive processes to self-care were consisted of the pathway by lifestyle and that by irrational cognitive copings.
To identify the relationship between professional identity and burnout of nurses working for university hospitals, a self-rating anonymous questionnaire survey was conducted in four participating university hospitals in the Kanto region in Japan with 2,926 nurses excluding nursing directors, midwives, and part-time nurses. The questionnaire is comprised of the Maslach Burnout Inventory Human Service Survey (MBI-HSS), the Professional Identity Scale for nurses, and a shortened version of the Three-Dimensional Commitment Scale. Responses from 1,452 nurses were analyzed. The age and length of clinical experience (mean±SD) were 32.53±9.56 years and 9.49±8.36 years, respectively. The total scores of the MBI-HSS, and the Professional Identity Scale for nurses were 11.93±2.68 and 61.92±8.40, respectively. A multiple regression analysis showed that burnout is related to the “professional identity” (β＝－0.257, p<0.01). This result shows that nurses with stronger professional identity are less likely to develop burnout. Respondents who had higher scores in professional identity were mainly nurses of higher age, longer clinical experience, having spouse and children, and working in the position of assistant head nurse or chief. These nurses attach a high value to the organizations they belong to, reporting that the “organization understand individual values”, and that “My hospital provides support for career advancement such as going on to higher education and research.”, “I am satisfied with the present salary”, and that “It is easy to get time off as I wish”. Their “emotional commitment”, “continuous commitment”, and “normative commitment” were high, and few of these nurses reported a “wish to leave their current workplace” or had a “wish to switch to a different occupation”. Developing nurses by referring to the characteristics of those with high professional identities will prevent their burnout.
Excessive consumption of phosphorus is one of the risk factors in the progression of kidney disease, whereas the effects of different dietary phosphate salts are unclear. In this study, we examined the effects of different dietary phosphate salts containing potassium dihydrogenphosphate (KH2PO4) and potassium tripolyphosphate (K5P3O10) on kidney function in unilateral nephrectomized (UNx) rats fed the normal dietary phosphorus concentration. Male UNx Sprague-Dawley rats were divided into two groups, and fed the diet containing KH2PO4 (UNx-KH) and K5P3O10 (UNx-KP) as dietary phosphate salts, respectively. The markers of kidney function, the serum urea nitrogen concentration, creatinine clearance, urinary creatinine, albumin, L-type fatty acid binding protein and N-acetyl-β-D-glucosaminidase activity were not significantly different between the groups. Serum phosphorus concentration was lower in UNx-KP than in UNx-KH. On the other hand, serum calcium, potassium, fibroblast growth factor 23 and parathyroid hormone concentration in the groups had no significant difference. These results suggest that KH2PO4 and K5P3O10 as dietary phosphate salts at the normal phosphorus levels had no different effects on kidney function in UNx rats.
To clarify the scope, types, and reporting criteria of accidents in local governments, we collected the references for “accident reporting procedures for long-term service providers” that were published on the website for prefectures, ordinance-designated cities, and core cities. Based on the content of each procedure, the accidents were classified into “scope,” “type,” and “reporting criteria.” A total of 104 procedures were collected. Most of the local governments that clearly wrote the “scope” in procedures indicated it as “pickup and drop-off, outpatient visit, and during a stay at the facility.” Regarding “type,” almost all local governments included both fatal accident and injury as accidents, and more than 60% of all local governments included tort and misconduct, infectious disease, and food poisoning as accidents. There was variation depending on whether the local governments asked for reports on “type,” including accidental aspiration or ingestion, foreign body ingestion, medication error, abuse and violence, property and house damage, missing person, fire, natural disaster, traffic accident, and complaint and litigation. These results suggest that it is necessary to consider the scope and reporting criteria of an accident in order to investigate its total number on a national scale.