Aims: To evaluate the reliability and validity of the Mongolian Version of the Spinal Cord Independence Measure (mSCIM).

Methods: Spinal cord independence measure III (SCIM III) was translated into Mongolian and data collected from 40 patients with spinal cord injury (SCI) were analysed. Reliability and validity were analysed in 30 patients, and the responsiveness was tested in 10 patients at admission to rehabilitation and discharge.

Results: Percent agreement and Kappa values between two raters were 83-100% and 0.70-1.00, respectively, in all mSCIM items. Intraclass correlations were shown to be above 0.99 within subscales and total score, and Cronbach’s alpha was above 0.75 aside from the respiration and sphincter subscale. The correlation between mSCIM and motor parts of the Functional Independence Measure (mFIM) was above 0.86 in each rater. The mSCIM showed more responsiveness to functional changes for patients at discharge than mFIM.

Conclusions: The SCIM III scale was translated into Mongolian, high inter-rater reliability and validity was shown. In addition, more sensitive to changes in function compared with mFIM. Furthermore, we justified the use of mSCIM in the field of rehabilitation, which might be easier for rehabilitation staff to use, because it is in their mother language.

Aim: This study aims to clarify the process leading mothers of one- to two-month-old infants to seek help from nursing professional and to contribute to the discussion of how best to support mothers in seeking help. Method: Semi-structured interviews were conducted with 10 primipara mothers of one- to two-month-old infants, and the data were analyzed qualitatively and inductively using the Modified Grounded Theory Approach. Results: The process by which these mothers seek help from nursing professional began with feeling “trivial concerns about their own child that arise regularly” during parenting. Parents fall into a “cycle amplifying parenting anxiety” and this process was impacted by “disappointment in the response of nursing professional”, “satisfaction with the response of nursing professional”, and an “affirmative attitude toward help-seeking and reassurance from hearing typical experiences of other mothers”. The process ultimately impacted the mothers’ “idea and decision to seek help from nursing professional” while their feelings about help-seeking spiraled back and forth. Conclusion: These results suggested that reducing barriers to help-seeking and establishing an environment where support is readily available even if barriers arise are important ways to assist mothers in seeking help from nursing professional.

Background & Aims: The purpose of this study was to gain insights into how patients experience involuntary admission under Japan’s system of psychiatric care. To this end, patients who had been involuntarily admitted and were scheduled for discharge were interviewed about their experiences at hospital admission to clarify the feelings of such patients’ experience on the day of admission.

Method: Semi-structured interviews were conducted among 12 inpatients who had been involuntary admitted to the hospital and consented to participate. The interview data was analysed qualitatively and descriptively.

Results: Feeling of involuntary admitted patients were summarised into five thematic categories: [Life/work commitments are bigger priorities than admission], [Surprise and anger at being deceived by family], [Recognising one’s emotionally driven behaviour], [Resigning to and accepting intangible exogenous forces], and [Unconvinced of explanation by health care professionals on admission].

Conclusion: Even after visiting to the hospital, patients remained clearly committed to their life/work, which were their bigger priorities than admission. The patients also felt that they had been deceived by their family. Issues regarding decision-making regarding hospitalization emerged. As they were aware of their own situation, they resigned to and accepted the inpatient treatment. As an initiative for outpatients at the time of non-voluntary hospitalisation, our results suggest that support is required for deciding treatment plans while sharing the opinions of both patients/family members and health care professionals while respecting what is important for the patients.

Aim: First-year medical students’ attitudes toward health care teams were compared between Sapporo Medical University and Gunma University, to evaluate the effect of the student placements in community health on the attitudinal change toward collaborative practice (CP).

Methods: The modified Attitudes Toward Health Care Teams Scale was used to measure the attitudes of medical students from Sapporo Medical University and Gunma University. The scale was subjected to exploratory factor analysis to examine the underlying constructs of the survey.

Results: The questionnaire was categorized into three subscales. The regression factor scores of “Quality of care delivery” were significantly reduced at both universities, while those for “Patient-centered care” trend toward an increase at both universities after subjects. Interestingly, there was no significant difference, with almost the same levels in all subscales, after the subjects between the two universities.

Conclusions: Medical students may rather expect high values of CP from the viewpoints of care providers at the entry level. The interprofessional education (IPE) program can contribute to their awareness of the values. Finally, the additive effects of community placement in the IPE program could not be revealed for only one year.

【目　的】　大学病院看護職のプリセプター役割遂行状況を把握し，役割遂行に関連する要因を明らかにする．

【対象と方法】　A大学病院看護職のプリセプター89名に自記式質問紙調査を実施した．調査内容は，①プリセプター役割自己評価尺度，②対象者の属性，③看護職の教育に関する知識，④プリセプターシップに関する要因であった．要因ごとに役割自己評価尺度の得点をMann-WhitneyのU検定，Kruskal-Wallis検定により比較した．

【結　果】　80名から回答を得た．下位尺度「指導計画に則った指導と評価の実施」の得点は看護師長・副看護師長の協力が得られている者が高かった．「新人指導以外の業務の計画的実施」の得点はアソシエーターとの良い関係性や看護師長・副看護師長・先輩の協力が得られている者が高かった．

【結　語】　大学病院看護職のプリセプター役割遂行には，アソシエーターとの良好な関係性とともに部署全体の新人教育への協力が必要であることが示された．

目　的：本研究の目的は，「病院看護職の在宅を見据えた看護活動尺度」の信頼性・妥当性を検討し，在宅を見据えた看護活動の実践に関連する要因を明らかにすることであった．方　法：群馬県内11病院の看護職を対象に2回実施した調査データを再分析し，尺度の信頼性・妥当性，および属性と各因子得点の関連を検討した．結　果：分析データは，2014年調査の1,568件と2018年調査の1,693件であった．尺度は【在宅生活の情報把握】【退院に向けた調整・指導】【社会資源の活用】【多職種協働】の4因子構造で，尺度全体の信頼性係数Cronbach’s αは0.96と高かった．訪問看護・在宅ケア研修受講は，4因子すべての因子得点と関連していた．また年齢および経験年数は，【社会資源の活用】と【多職種協働】の因子得点に関連していた．結　論：本尺度は，病院看護職の在宅を見据えた看護活動を包括的に評価する尺度として活用できることが示唆された．

Many surgeons separate pulmonary arteries and veins using vascular stapling devices. However, unexpected catastrophic incidents can occur using this method. We experienced a case of critical bleeding from a tear located near the distal site of the stump of the first branch (common branch to the anterior and apical segment) of the left main pulmonary artery, while the patient was waking from general anesthesia after surgical manipulation. Surgeons should leave a stump length equal to half the diameter of the pulmonary artery and closely observe the chest drainage during changes in blood pressure when waking patients from general anesthesia.

　症例は83歳の男性で，心窩部痛を主訴に当院を受診した．精査の結果，胆石性膵炎と診断され，経乳頭的に胆管チューブが留置された後に，遺残胆嚢結石に対して待機的に腹腔鏡下胆嚢摘出術が施行された．術中所見では，Calot三角や胆嚢頚部を中心とした組織硬化を認めたため，胆嚢底部からの肝床部剥離を先行した後に胆嚢動脈，胆嚢管を処理し，胆嚢を摘出した．摘出標本の肉眼所見では，胆嚢体部に長径13 mm大の乳頭状隆起性病変が指摘され，病理組織学的には異型の乏しい胆嚢上皮の乳頭状増生を認めたため，intracystic papillary neoplasm（ICPN）と診断した．ICPNはintraductal papillary neoplasm of bile ductの胆嚢内病変と考えられており，その疾患概念の認知度は低く報告例も限られている．また，前癌病変であるが故に，その多くは癌と併存して診断される．本症例のように偶発的に診断され，更には癌が併存しない例は非常に稀であり，文献的考察を加えて報告する．