Background & Aims: Anemia in women of reproductive age impairs health and well-being of generations. This study was undertaken to determine the prevalence, severity, and correlates of anemia in women of reproductive age at West Papua Province of Indonesia, also to discuss the burden of anemia in Papuan women. Methods: A community-based cross-sectional study was conducted on 221 women aged 15-49 years using structured questionnaires and body sample analysis. Results: An extremely high prevalence of 72.9％ anemia was found among women of reproductive age, associated with early-20s age, living area, low educational level, and Papua ethnic group. Conclusion: The ethnicity-particularly Papua with certain traditions and cultural beliefs related to lifestyle practices and sexual behaviors-might be a noteworthy risk factor of anemia, which needs to be considered for a future multifaceted approach to overcome the burden of anemia and improving the sexual and reproductive health and rights of women in Indonesia and worldwide.

Aims: This study was conducted with the following two purposes; 1) To identify and structure difficulties caused by communication based on the experiences of foreign patients who reside in Japan and whose native language was not Japanese when they visit a Japanese medical institution; 2) To examine communication means for providing proper medical care to foreign patients.

Methods: Semi-structured interviews were conducted with foreign residents. The data were analyzed using the Methodology for Conceptualization of Nursing.

Results: Of the eight core categories formed, “provision of health care services that neglect the importance of patient-centered communication”, “disparities in intercultural competence among health care providers”, “one-sided use of machine translation led by health care providers,” “lack of information about Japanese medical institutions and culture,” “overexpectations for Japanese health care,” and “structural problems of foreign community,” indicated the factors that caused problems to arise due to communication. “lack of awareness of the need for medical interpreters to receive appropriate health care,” and “the need of acquiring and maintaining professional medical interpreting skills to meet patient expectations” showed the problems and issues in expanding the use of medical interpreters.

Conclusions: The factors that cause difficulties in medical communication from the perspective of foreign patients were caused by both medical institutions and healthcare providers and foreign patients, but they were also caused by structural problems faced by the foreign community. Daily support to the foreign community is necessary for the provision of appropriate medical care to foreign residents. In addition, the active introduction of medical interpreters can be considered as a countermeasure for medical communication, but the following issues need to be addressed: (i) raising awareness of medical interpreters among foreign patients, (ii) proposing the proactive use of medical interpreters by health care providers, and (iii) acquiring and maintaining high interpreting skills of medical interpreters.

Background & Aims: Postnatal depression (PND) is a common illness that requires early intervention. However, women’s postpartum difficulties are often overlooked. This study aims to identify the risk factors of PND based on data obtained from general obstetrics in a maternity hospital. It also explores the usefulness of the Distress and Impact Thermometer (DIT) as a simple PND screening tool.

Methods: The sample comprised 423 women who had undergone parturition in a private hospital between January to June 2016. The participants were first assessed at a few days and then one month postpartum using self-administered questionnaires. The risk factors of PND were examined using logistic regression analysis while the DIT was assessed using the receiver operating characteristic (ROC) curve for PND.

Results: Depressive symptoms during early postpartum, psychiatric illness history, and primipara were significant risk factors for PND. Epidural delivery significantly reduced the risk of PND in women with early postpartum depressive symptoms. The PND detection test in the DIT had an area of 0.85 under the ROC curve.

Conclusions: Women with early postpartum depressive symptoms or a psychiatric illness history require continuous monitoring and support. Further, the DIT can be a useful screening tool for PND.

Background and purpose: Anastomosis for laparoscopic colectomy is generally performed extracorporeally. Exteriorization of the bowel involves wide dissection and mobilization of the bowel. Hemorrhage during retraction for resection and anastomosis may occur. To solve these problems, intracorporeal anastomosis is performed, but its efficacy is not clear. We compared intracorporeal anastomosis (IA) with extracorporeal anastomosis (EA) for laparoscopic colectomy performed in our department, and assessed its efficacy.

Methods: We retrospectively analyzed 160 patients who underwent laparoscopic colectomy in our department.

Results: Sixty-nine patients underwent IA and 91 underwent EA. More patients in the IA group had relatively early-stage cancer, and there were differences in the extent or number of lymph node dissections. The IA group had significantly less blood loss. The two groups showed no differences in operative time or frequency of postoperative complications such as intraabdominal abscesses. There were no differences in location of tumor recurrence.

Conclusion: The results suggest that IA in laparoscopic colectomy is a minimally invasive and potentially useful technique.

Background & aims: This study aimed to determine the prevalence of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) and to investigate the association between premenstrual symptoms and dysmenorrhea among college students in Mongolia. Methods: A descriptive cross-sectional design was used to examine 593 women attending the School of Nursing at the Mongolian National University of Medical Science. A final sample of 572 questionnaires was used for data analysis. In addition to collecting demographic characteristics, we used the Premenstrual Symptoms Questionnaire (PSQ) to measure the degree of severity of premenstrual symptoms. Data were analyzed using descriptive statistics, Fisher’s exact test, and Cochran-Armitage trend test. Results: The findings showed that the prevalence of moderate to severe PMS and PMDD among Mongolian college students was 23.8％ and 4.7％, respectively. The most frequent symptoms were “fatigue or lack of energy” (86.7％), “anger or irritability” (80.9％), “tearfulness” (76.2％), “difficulty concentrating” (75.3％), and “anxiety or tension” (73.4％). A statistically significant association was found between dysmenorrhea and the severity of PMS/PMDD. Conclusion: The prevalence rate of PMS and premenstrual symptoms among Mongolian female college students was comparably higher than in other countries, while the prevalence of PMDD was comparable among both Western and Asian participants.

Objective: To clarify how nurses coped with the challenges they faced in dealing with the family members of patients requiring end-of-life care in the fields of emergency and intensive care medicine.

Methods: Semi-structured interviews were conducted, using an interview guide, on 15 nurses working in emergency rooms and intensive care units. The contents of the interviews were qualitatively analyzed.

Results: The interview data were classified into the following 3 categories: [Seeking solutions for the challenges], [Measures to protect own feelings from getting involved], and [Increased motivation for the end-of-life care].

Discussion: Nurses have to deal with the responses and emotions of family members while keeping a distance, without getting personally involved with their tragic feelings. Support from colleagues is essential in managing these challenges, and it is considered necessary to deal with issues associated with end-of-life care as a whole department or a team. Furthermore, it is important to create opportunities for the nurses to share their thoughts and experiences and also educate them to elevate their level of motivation to providing support for family members of patients requiring end-of-life care.

Purpose: The aim of this study was to clarify the types of treatment-related lifestyles led by elderly cancer patients living in snowy regions.

Methods: Participants were eight elderly patients with esophageal cancer who were undergoing chemoradiotherapy at a designated cancer care hospital in a region with heavy snowfall. We conducted interview surveys with patients and their families, and carried out participant observation of their inpatient, outpatient, and home lifestyles. Data were collected and analyzed ethnographically.

Results: Elderly patients were found to have adopted treatment-related lifestyles according to a philosophy of incorporating the management of cancer as part of “typical life”. The two modes of living were living their“temporary life” in order to return to their “typical life”, during their inpatient life, which involved decisions concerning treatment lifestyle, and continuing to lead a “typical life” with cancer at their home after discharge.

Conclusions: It is important that nurses understand the “typical lives” of elderly cancer patients rooted in their local cultures. The findings of this study suggest that it is important to support patients’ “ability to eat and move” and self-care in order to incorporate a cancer-treatment lifestyle into their “typical lives”.

Objective: This study aimed to clarify levels of interpersonal stress related to smartphone addiction among health care college students.

Methods: An anonymous questionnaire was distributed to 320 third- and fourth-year students at a health care college. The survey comprised the following content: 1) smartphone usage time and frequently used apps; 2) The smartphone addiction scale - short version (SAS-SV); 3) the stress response scale (SRS-18); 4) the interpersonal stress coping scale - short version.

Results: 178 valid responses were analyzed. Fifty-seven respondents (32.0％) were dependent on smartphones. 57.0％ of respondents spent three or more hours per day using their smartphones. The most frequently used app was social media. There was a significant difference between the two groups (p<.001) in terms of the mean psychological stress response, 18.1 points in the dependent group and 10.9 points in the non-dependent group. The subscales of psychological stress response all scored significantly higher in the dependent group than in the independent group: depression/anxiety, displeasure/anger, and apathy. There was no significant difference in interpersonal stress coping between the dependent and non-dependent groups.

Discussion: Although interpersonal stress was not related to smartphone addiction, students with a tendency toward smartphone addiction had higher levels of psychological stress, highlighting the importance of learning methods to alleviate stress for students in this group.

Objective: This study aims to depict the involvement of assistant head nurse with mid-level nurses and the thoughts behind the involvement. Methods: Data were collected from five assistant head nurses through focus group interviews of their involvement with and thoughts about mid-level nurses and qualitatively descriptively analyzed. Results: Six categories were extracted as actual involvement: “consciously drawing out thoughts and feelings,” “making requests taking work content into consideration,” “supporting and encouraging,” “making use of high practical abilities,” “clearly communicating requests,” and “overcoming difficulties in the relationship.” Four categories were extracted as thoughts behind involvement: “considering the influence of the ability to act and the power to send messages,” “expecting for effects their efforts on colleagues,” “thoughts on how to provide instruction,” “understanding the position and thoughts of each party.” Conclusion: Assistant head nurses rely on the abilities of mid-level nurses, shown in how they pay attention to the thoughts of mid-level nurses, while involving themselves to prevent the power and influence of mid-level nurses leading to a negative direction.

Axillary lymphadenopathy is a local reaction to mRNA COVID-19 vaccination. A 19-year-old healthy woman presented with a mass in the axilla diagnosed by ultrasonography as a result of COVID-19 vaccine-induced hyperreactive lymphadenopathy. After two weeks, ultrasonography revealed that the lymph node had shrunk and that the blood flow signal in the hilum had disappeared. This case describes the typical course of isolated unilateral axillary lymphadenopathy after BNT162b2 COVID-19 vaccination. Short-term ultrasound is sufficient for monitoring unilateral axillary lymphadenopathy following recent COVID-19 vaccination, avoiding unnecessary radiation injury and axillary lymph node biopsies.

The subject, Ms. A, a woman in her 80s who lived alone, was evaluated as “Needs Care Level 1”. She felt anxious because she was concerned about accidentally starting a fire. She also found it difficult to reach her emergency contacts and keep track of visitors. To address these issues, she was provided support in the form of posters. These posters had eye-catching and calming designs and were hung in her living space. They gave Ms. A a sense of security. This is likely because (1) the posters were hung in a way that suited her living space, the flow of her movements, and her line of sight, and (2) the designs were chosen to match her preferences. We report this case with the hope that this intervention will be useful for other older adults who live alone.

Zinc deficiency is one of the causes of refractory eczema in breast-fed infants; however, such cases are similar to be food allergy manifestations. We encountered three siblings with zinc deficiency. The first child was diagnosed with and treated for zinc deficiency due to low zinc content in breast milk at four months of age; the treatment for the second child was started early. However, the third child was diagnosed with food allergies by the family doctor owing to a lack of disclosure of the family history of zinc deficiency by the mother. We reaffirmed the need to publicize the existence of reactions due to zinc deficiency and the importance of family history in siblings.

Objective: This study aimed to determine the efforts made toward classes and training sessions for acquiring nursing techniques in undergraduate nursing education and, thereby, gain insights into the challenges faced during nursing technique training.

Methods: The authors searched the Japan Medical Abstract Society website for articles from 2000 to 2020 with the following keywords: “undergraduate nursing education,” “nursing techniques,” “training,” “education,” “classes,” “fundamentals nursing science,” “adult nursing science,” “geriatric nursing science,” “infant nursing science,” “maternal nursing science,” “adult nursing science,” and “home nursing science (discussion).” A total of 34 articles were extracted for analysis.

Results: Of the 34 articles, 14 were regarding education programs utilizing videos, 5 were regarding fact-based education, and 4 were regarding e-learning programs, indicating that a wide variety of education methods were employed.

Conclusion: In nursing technique training in undergraduate nursing education, classes and training sessions utilizing videos were frequently adopted. In conventional programs, demonstration was the most prevalent method; however, with the increase in programs utilizing videos, various newly conceived ideas were being employed. To determine the most effective education program, it is essential to consider the pros and cons of each methodology.