Background & Aims : Immediately after undergoing breast cancer surgery, patients may usually have some psychological and physiological distress. Autogenic training (AT) is a complementary medicine and self-relaxation technique to relieve anxiety in patients. The aim of the study is to investigate the impact of AT on perioperative anxiety and pain in patients with breast cancer. Methods : Between July 2010 and March 2012, 60 patients who were diagnosed with breast cancer and scheduled for surgery were randomly assigned to the AT group or the control group. In the AT group, patients underwent 20 min of AT, three times a day within 3 days after surgery, and the control group received the usual care. The assessment was done based on the State Anxiety Inventory, Visual Analogue Pain Scale, heart rate variability, and analgesic requirement. Results : The AT group had a significantly decreased anxiety score during postoperative three days. Postoperative pain score was also significantly decreased, despite the fact that the two groups had received an equivalent amount of analgesics. No statistically significant difference was observed between the groups in their analgesic requirement. Conclusion : AT may be a useful non-pharmacological approach for relieving anxiety and pain immediately after breast cancer surgery.

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Objectives : Gum chewing might increase blood circulation of cerebral microvessels and might activate serotonergic neurons. We investigated the impact of gum chewing on mental health in patients with depression treated in the outpatient clinics of psychiatric hospitals. Methods : Between October, 2011 and November, 2011, 12 patients diagnosed with depression and treated regularly in the outpatient clinics of psychiatric hospitals located in rural area in Japan, were enrolled in the present study. Interventions of gum chewing for participants were approximately 3 minutes immediately after daily meal and usually 3 times per day for 7 days, following 7 days of non-intervention (control) period for taking the reference of individual mental health. All brain waves were recorded using a portable specific device with a single-channel electroencephalogram recording device. Changes in individual mental health were assessed by the 30-item general health questionnaire (GHQ-30). Results : A frequency of alpha waves significantly increased during 7 days of intervention period in each individual. Total GHQ-30 scores fluctuated during 14 days. Conclusions : According to the preliminary results in the present study, intervention of gum chewing for patients with depression may be of some roles in maintaining their mental health. Further objective assessment would be necessary to confirm the impact of gum chewing on mental health in patients with depression.

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Background & Aims : This study examined the effects of education, occupation, social networks and psychological factors on all-cause mortality in a middle-aged Japanese cohort. Methods : The cohort study (n : 11,565) was conducted from 1993 until 2011. The subjects were middle-aged males and females living in rural (n : 4,501 ; deaths : 669) and urban (n : 7,064 ; deaths : 1,190) areas in Gunma, Japan. Cox proportional hazards model was applied to investigate how various factors affect mortality risk. Results : In the age-adjusted model, higher educated rural males had significantly lower risks (junior high school : 1.00 ; high school : 0.76 ; junior college : 0.57), though rural females had a U-shaped risk pattern with the lowest significant risk (0.63) in the high school group. Also, males who were non-married or non-participated or heavily drinking or never exercised or BMI less than 18.5 or having chronic diseases or depression had significantly higher mortality risks. Current smoking was only one universal factor that was still significantly affected increased risk of mortality across both areas and genders. Conclusions : In the rural area, educational levels were related to mortality risk, but the risk patterns were different from genders. Males of poorer social networks had higher mortality risks.

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Purpose : To investigate the motives and burdens associated with health behaviors of first-time pregnant women, and to obtain resources for considering how to provide health instruction that complements health behaviors actually undertaken by pregnant women. Subjects and Methods : Subjects comprised 10 pregnant women in gestational weeks 30-34. Semi-structured interviews were conducted to gather data on motives and burdens associated with health behaviors of first-time pregnant women. Analysis was carried out following Berelson's content analysis. Results : The motives of and burdens associated with health behaviors of first-time pregnant women were categorized into the following seven categories: (1) motives related to interest and care concerning their bodies and daily life during pregnancy; (2) motives related to suggestions received from a medical professional, their husband, or a colleague; (3) motives related to their own body and their baby's health during and after birth; (4) motives related to noticing changes during the course of pregnancy; (5) motives related to the pregnancy experience of close relatives such as their mothers or grandmothers; (6) burdens due to work obligations preventing them from carrying out health behaviors during pregnancy ; and (7) burdens due to being unable to control changes in dietary habits or lifestyle rhythms. Conclusions : From these seven categories, it was apparent that most health behaviors carried out by pregnant women related to everyday physiological drives such as diet, activity and rest, and lifestyle rhythms. Health instruction for pregnant women should therefore take into account pregnant women's everyday lives and the interpersonal relationships that contribute to health behaviors, based on the understanding that these may constitute either motives or burdens, and such instruction must enable pregnant women to become aware of their own health during pregnancy.

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Purpose : This study is aimed at clarifying the characteristics of Taiwanese health and medical volunteers and to discuss the significance of the activities of such volunteers. Methods : The written materials obtained from the ICDF about the Taiwanese volunteers and the related articles were analyzed. Results : From 1996 till October 2012, Taiwan had dispatched 562 volunteers - 83 of them as medical volunteers, since 1999 - to twenty countries ; out of these four countries did not have diplomatic relations with Taiwan. 50.6% of them were engaged in Latin America and the Caribbean regions. 70 people of the medical volunteers were nurses. 21.4% of them provided nursing care at hospitals and 50.0% of them did community health activities. Volunteer nurses focused on health care mainly in Asia, Latin America and the Caribbean, while most of volunteer nurses were engaged in providing nursing care for diseases and injuries in Africa. Conclusion : Dispatch of volunteers was a significant diplomatic strategy for Taiwan. In Africa, nurse volunteers provided manpower at hospitals and promotion of community health is one of the challenges.

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This study was conducted to clarify the differences and commonalities in perceptions regarding husbands' supportiveness for their wives' satisfaction during pregnancy between husbands and wives with older children. This report also discusses the effect of nursing care that enhances the supportiveness provided by husbands during their wives' pregnancy. Semi-structured interviews were conducted with two multiparous couples during pregnancy. All interviews were transcribed and a qualitative inductive analysis was performed using Berelson's Content Analysis methods. The following five categories were identified regarding the husbands' supportiveness during their multiparous wives' pregnancy : [Increased consciousness of parenthood toward the unborn baby] ; [Empathy regarding wife's physical and mental health arising from the previous pregnancy and childbirth, and addition of a new baby] ; [Support with housework to show empathy for the multiparous wife] ; [Care of older children to show empathy for the multiparous wife] ; [Adjustment of roles in the parenting older children.] From the discussion about the common and different perceptions between multiparous couples, the following suggestion emerges. Nursing care should focus on enhancing the intimacy of a couple, strengthening the family system, increasing consciousness of parenthood toward an unborn baby, and adjusting the role in the parenting of older children.

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