Background and objective : Accompanying changes in social structure in China, patients started to seek for quality in nursing. This study is intended to evaluate the quality of nursing care by Chinese nurses using the Chinese version of QNCQ-NS developed in Japan. Subjects and Method : The investigation was conducted with the nurses working at three general hospitals in China using the QNCQ-NS prepared in Chinese translation. Result : As a result of factor analysis, 32 out of 40 items in the QNCQ-NS were selected and 7 factors were extracted from the 32 items. The Cronbach's α in the Chinese QNCQ-NS was 0.92 indicating a significant difference in the comparison of the mean scores by the occupational position. Conclusion : The Chinese version of QNCQ-NS was prepared and examined to confirm its reliability. As a result of factor analysis, a difference in the construct was shown. The mean total score of QNCQ-NS in the Chinese nurses differed significantly by the occupational position.

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Background and Purpose : In recent years, patients with hematological malignancies have tended to be treated by means of outpatient chemotherapy. The importance of the self-care of patients with hematological disease is pointed out. Self-efficacy has been suggested to be indispensable for self-care. The aim of this study was to identify factors that influence the self-efficacy of both cancer and non-cancer patients. Materials and Methods : The subjects of this study were 110 cancer patients and 90 non-cancer patients 20 of age and over attending the hematology clinic of 2 university hospitals who gave their consent in the study. The self-efficacy scale questionnaire was used for the survey. Results : The supportive emotional network score was significantly lower in the cancer patients than the non-cancer patients. The average self-efficacy score was 31.5±5.3 in the cancer patient group and 31.8±5.3 in the non-cancer patient group, and the difference was not significant. The average self-efficacy score was the lowest in the acute leukemia group. Interaction was found between sex and the self-efficacy scores of the 2 groups. There was significant difference in the level of performance status of the two groups. Patients in worse condition and with lower activity range levels had lower self-efficacy scores. Conclusions : The above results suggest that to increase the self-efficacy of patients with hematological diseases, relationship between the nurse and patient considering the patient's sex, general condition, etc. is necessary. The importance of emotional support for cancer patients also becomes clear.

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Purpose : To evaluate the learning effects of early exposure to clinical practice, we clarified the characteristics of the experiences described by students. Methods : Clinical practice reports by 27 students were analyzed, and 217 experiences extracted by the qualitative inductive technique were analyzed. Results : The extracted experiences were classified into 17 categories and combined into the following 7 categories : "experience of acquiring information and having impressions of and feelings toward the information", "experience of understanding information by referring to existing knowledge", "experience of understanding information by referring to existing knowledge and feelings", "experience of becoming doubts or becoming aware of problems by referring to existing knowledge", "experience of considering and inferring different situations based on both information and existing knowledge", "experience of expanding interest on nursing-based on information", and "experience of objectively observing oneself based on information". Conclusion : Nursing students' practices changed to nursing experience accompanied by various feelings through the understanding / verifying / doubting / inferring, and provided an opportunity to deepen their interest in nursing, their understanding of the clients, and self-understanding.

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Backgrand and Aims : The Nottingham Adjustment Scale are applied to measure psychological adjustment. The purpose of this study was to confirm the reliability and internal consistency of Nottingham Adjustment scale Japanese Version (NAS-J) on stroke survivors in Japan. Methods : The reliability was proved using test-retest procedure. A Self-rating questionnaire was mailed to 124 community dwelled stroke survivors twice with a 21-24 days interval. Forty-five stroke survivors who returned the first and the second questionnaire and answered every item completely, participated in this study. Spearman's correlation and Wilcoxon signed-ranks test were used to compare the NAS-J scores between the 1^st and 2^nd response. Cronbach's alpha was used to confirm its internal consistency. Results : Scores of the NAS-J between the 1^st and 2^nd response were correlated significantly (p‹0.05), which the coefficients were ranged from 0.41 to 0.79. No significant difference was found between the test and the retest. Cronbach's alpha in each domain ranged from 0.72 to 0.85 except at the domain "Locus of Control" (0.46). Conclusions : The results showed the reliability and the internal consistency of the NAS-J was generally good on stroke survivors in Japan.

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Background : We evaluated mid-term hemodynamics and clinical results of endoventricular circular patch plasty (Dor operation) for ischemic cardiomyopathy. Methods : Between January, 2000 and May, 2004, 22 consecutive patients with left ventricular (LV) aneurysm and ischemic cardiomyopathy after myocardial infarction underwent the Dor operation. Hemodynamics and clinical results of the Dor operation were analyzed periodically.Patients were divided two groups according to the preoperative left ventricular end-systolic volume index (LVESVI), which was less than 100 ml/m² as Group A and which was100 ml/m² or more as Group B. Results : Postopeartive New York Heart Association (NYHA) functional classfication improved in all survivors to class I or II. Postoperative ejection fraction (EF) increased and postoperative LV volume decreased significantly (p‹0.05) in all survivors.However, the LV volume 3 years after surgery re-enlarged in some cases in which preoperative LVESVI levels were more than 100ml/m², and LVEF deteriorated significantly (p‹0.05) compared with the postoperative data. Conclusions : As the postoperative LV volume re-enlarged and mitral regurgitation was observed in group B with LVESVI›100ml/m², careful follow up is necessary.

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Backgrounds : Pre-emptive analgesia is gaining support as a method of postoperative pain management. The present study aims to compare the pre-emptive analgesic effects of nonsteroidal anti-inflammatory drugs (NSAIDs) having different mechanisms of action, for relief of pain associated with extraction of impacted wisdom teeth. Methods : Thirty-three patients scheduled for extraction of impacted wisdom teeth were randomly administered one tablet each of any one of the following NSAIDs : zaltoprofen (selective cyclooxygenase (COX)-2 inhibitor with anti-bradykinin effect), loxoprofen sodium (COX-1 and -2 inhibitor) or etodolac (selective COX-2 inhibitor), 1 hour prior to the scheduled extraction. Postoperative pain was assessed on the basis of pain scores on the visual analogue scale (VAS), 6 hours after administration of the analgesic tablet. Results : Postoperative analgesia was not required in 2 of the 9 zaltoprofen patients and 3 of the 10 patients who received loxoprofen sodium.In addition, the VAS pain scores of patients in the zaltoprofen and loxoprofen sodium groups were significantly lower than those in patients who received etodolac. Conclusions : These results suggest that inhibition of COX-2 alone is insufficient for pre-emptive analgesia, NSAIDs acting on bradykinin, and both COX-1 and -2 being more effective pre-emptive analgesics for postoperative pain after extraction of impacted wisdom teeth.

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We reported on a woman with amyotrophic lateral sclerosis (ALS). She noticed weakness of left upper limb at age 73, and was diagnosed with ALS. She showed dysarthria and dysphagia later. Those symptoms worsened. She and her family didn't wish life-sustaining treatments. She complained of pain at left arm and other parts. We administered Codeine Phosphate as a palliative care. 44 days later, she died. According to guidelines by Japanese and American academy of Neurology, opioids are recommended for pain accompanied with ALS. However, strong opioids are likely to induce respiratory arrest in the patients with advanced ALS and losing weight. As for Japanese patients with ALS, we should consider administration of weak opioids, codeins.

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We report on an assessment and care of a patient who developed urgency urinary incontinence and functional urinary incontinence after a cerebral infarction. Urinary incontinence monitoring was performed for 3 days to assess the urinary incontinence care program, and the results showed 12-20 voidings a day, mean urine volumes of 76.3-87.5 ml, and 12-18 episodes of incontinence a day, and we identified urgency incontinence and functional incontinence associated with urinary frequency as sequelae of cerebral infarction. Care intervention consisted of drug therapy with an anticholinergic agent, behavioral therapy conducted by a nurse, and toilet activity training by the rehabilitation staff. In addition to overall recovery of activities of daily living (ADL), improvement in elimination activities was observed as a result of a rehabilitation team approach by a physician, nurse, physical therapist, and occupational therapist, and the urinary incontinence resolved.

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