Background & Aims : One of the roles of the nurse who comes into contact with a patient at the end of life is to attend to a person who, although living, faces imminent death. Purposeful touch is an example of an active support method. This means that the nurse's act of touching is intended to help the patient become more comfortable, even if only slightly, and has the objective of mentally and physically healing the patient. To date, no studies concerning how patients experience touch have been reported. The aim of the present study was to clarify the process of end-of-life cancer patients finding meaning in receiving touch intervention. Methods : The study participants comprised 12 end-of-life cancer patients who underwent touch intervention by nurses for 20 minutes, two or three times per week. A semi-structured interview was carried out following each intervention, and the results of the patients' responses were analyzed according to the modified grounded theory approach. Salivary secretory immunoglobulin A (s-IgA) concentration and a visual analogue scale (VAS) on comfort level were evaluated both before and after the series of planned interventions. Results : End-of-life cancer patients passively accepted touch intervention, and subsequently rated touch to have value. They were also given a boost of power to live in comfort, an emotion that occurs as a result of continuous touch intervention. Finally, they experienced a series of processes to surrender to touch. No significant differences were found in IgA concentration in saliva taken before and after the series of planned interventions. The VAS on comfort level after the series of interventions was significantly higher than that before the interventions. Conclusions : Continuous purposeful touch intervention may positively affect patients' psychological comfort. Furthermore, patients' intentions to allow themselves to undergo touch intervention by nurses might positively affect their will to survive.
Background & Aims : A comparative study between plasma diagnostic markers and oxidative stress-induced biomarkers localized differently in the liver has not been reported in non-alcohol fatty liver (NAFLD) and non-alcoholic steatohepatitis (NASH). Methods : Pathological observations by Hematoxylin and Eosin (HE) staining and immunostaining by specific antibodies against metallothionein (MT)-1/2 and -3, heme oxygenase -1(HO-1), adiponectin using biopsy samples and plasma diagnostic makers were determined in 37 cases. Results : The MT-1/2, HO-1 and adiponectin levels were all significantly reduced in the liver with NASH compared with NAFLD and control. MT-1/2 was most strongly stained in hepatocytes in the normal and NAFLD liver, while it was significantly reduced in NASH. Adiponectin was stained significantly less at blood vessels in NASH compared with NAFLD and controls. HO-1 was also stained significantly less in the Kupffer cells in NASH compared with NAFLD and controls. MT-3 was stained similarly among the three groups at blood vessel cells. Those biomarkers trended negatively with plasma liver injury biomarkers. Conclusions : The significantly reduced expression of oxidative stress-induced biomarkers in NASH may be associated with the degree of pathological damage. In particular, MT-1/2 appears to exert an important effect in hepatocytes against stress-induced damage in NASH.