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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【目　的】　初産婦が保健行動をとる際の動機, 負担を明らかにし, 妊婦の保健行動の実態に即した保健指導のあり方を検討する資料を得ることを目的とする.　【方　法】　妊娠30週～34週の妊婦10名を対象に, 初妊婦が保健行動をとる際の動機と負担について, 半構造化面接法によりデータを収集した. 分析はベレルソンの内容分析を使用した.　【結　果】　初産婦が保健行動をとる際の動機と負担について, (1)【妊娠中の身体と日常生活に関心をもって気を付けようとする動機】, (2)【医療従事者, 夫や会社の人に指摘を受けたことに関連した動機】, (3)【出産・出産後に関連した自分の体と胎児の健康に関連した動機】, (4)【妊娠経過の変調の気づきに関連した動機】, (5)【出産体験のある実母や祖母など身近な人から妊娠中の体験を聞いたことに関連した動機】, (6)【仕事が負担になり妊娠期の保健行動がとれない負担】, (7)【食習慣や生活リズムの変更が自分でコントロールできない負担】という7つのカテゴリーが得られた.　【結　語】　初産婦が保健行動をとる際の動機と負担について得られた7つのカテゴリーから, 妊婦の保健行動は, 食事, 動静, 生活リズムなど日常生活上の生理的欲求と関係する行動が多いことが明らかになった. 初産婦への保健指導では, 妊婦の日常生活と保健行動に関与する人間関係を考慮して, 保健行動をとる際の動機になること, 負担になることを把握し, 妊婦自身が妊娠期の健康を意識できるような指導が必要であると考える.

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【目　的】　台湾が派遣してきた医療ボランティアの特徴を明らかにするとともに, 看護ボランティアの活動の意義を考察する.　【方　法】　台湾の医療ボランティアについてICDFから入手した資料, 文献をもとに分析した.　【結　果】　1996年から2012年10月までに562名のボランティアが派遣され, 医療ボランティアは1999年から83名派遣されていた. 派遣国は国交のない4か国を含む20か国で, 中南米・カリブ地域が50.6％, 次いで大洋州, アジア, アフリカの順だった. 派遣された看護師は70名で, 活動内容は病院での看護活動21.4％, 地域保健活動50.0％等であった. アジアと中南米・カリブでは健康管理を中心とした活動が, アフリカでは, 疾病・負傷に対応する看護活動が主に行われていた.　【結　語】　台湾にとってボランティア派遣は外交手段として大きな意味を持っていた. アフリカへの看護ボランティア派遣は病院の人的補填として行われており, 地域保健の推進が今後の課題である.

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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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