The Kitakanto Medical Journal
Online ISSN : 1881-1191
Print ISSN : 1343-2826
ISSN-L : 1343-2826
Current issue
Displaying 1-15 of 15 articles from this issue
  • Yuki Ikeda, Noriko Hirasawa, Chikako Takabayashi
    2023 Volume 73 Issue 2 Pages 119-125
    Published: May 01, 2023
    Released on J-STAGE: June 05, 2023

    Purpose: To identify the difficulties faced by municipal public health nurses (PHNs) when collaborating with other professionals/institutions and the relationships between such difficulties and years of experience as a PHN.

    Methods: An anonymous questionnaire survey was sent to PHNs in 18 municipalities of a prefecture. The scores for 33 difficulties related to collaboration were tabulated, and the relationship between years of experience as a PHN and each difficulty was analyzed by calculating the Spearman correlation coefficient.

    Results: A total of 115 municipal PHNs were included in the analysis. Among the collaboration-related difficulties, the rates of answering “True for me” and “Somewhat true for me” were the highest for ‹high workload of PHNs›. The number of years of experience was negatively correlated with ‹being unsure of one’s role in collaboration›, ‹lack of knowledge on how to collaborate›, and ‹lack of confidence in one’s collaboration skills›.

    Discussion: The expanded duties of PHNs, changes in their practice, and their decentralized assignment may have been background factors associated with the collaboration-related difficulties. The negative correlations between the number of years of experience and some difficulties indicate the necessity of in-service education and support systems for inexperienced PHNs.

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  • Mutsumi Seki, Yayoi Kondou, Mamiko Konda, Yukari Yoshie
    2023 Volume 73 Issue 2 Pages 127-133
    Published: May 01, 2023
    Released on J-STAGE: June 05, 2023

    Purpose: To determine what the nursing students who practiced psychiatric home health care nursing were able to learn.

    Methods: Data were from the practice reports of 25 nursing students who practiced at a psychiatric home health care nursing station. Content analysis was performed using text mining.

    Results: Nursing students’ learning in psychiatric home health care nursing was in clusters of eight (8): “talk”-“listen,” “effort”-“acknowledge,” “place”-“create,” “home care patients”-“think,” “maintain+able”-“support,” “method”-“suggest,” “mental status”-“worsen”-“prevent.

    Conclusion: It is clear that the lessons learned in psychiatric home health care nursing practice are the importance of building trusting relationships, support for self-determination, support for daily living, specific methods of support for family members, and relapse prevention. In addition, it is necessary to secure opportunities to learn about multidisciplinary cooperation in the future.

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  • Ayumi Kyota, Maiko Senuma, Noriko Tsukagoshi, Aya Kiyohara, Shun Koike ...
    2023 Volume 73 Issue 2 Pages 135-142
    Published: May 01, 2023
    Released on J-STAGE: June 05, 2023

    Background & Aims: It is necessary to educate nurses to reduce the difficulty of communicating with patients at the terminal phase of cancer and to talk openly with patients. This study aimed to clarify (1) current status of education regarding communication, (2) the difficulties nurses face in communicating with terminally ill cancer patients, and (3) responses of certified nurse specialist in cancer nursing (CNSCN) when nurses consult about difficulties.

    Methods: A questionnaire survey and a semi-structured interview were conducted for CNSCNs. In the analysis, communication education was organized using Excel, and nurses’ difficulties and CNSCNs’ responses were analyzed qualitatively and inductively.

    Results: Consent and responses to the questionnaire were obtained from 12 out of 22 CNSCNs. All hospitals had some form of communication education. The following three categories were established based on the nurses’ difficulties: “confusion that they are not able to respond to the patients’ feelings despite having been able to listen to,” and “the psychology of nurses who cannot get into the feelings of patients,” etc.

    Conclusions: It is necessary to provide communication education that considers the attitude of nurses seeking correct answers out of their unwillingness to hurt themselves and the fear of communication out of their unwillingness to hurt patients.

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  • Yoshihiro Ono, Hiroyuki Takechi
    2023 Volume 73 Issue 2 Pages 143-148
    Published: May 01, 2023
    Released on J-STAGE: June 05, 2023

    Objective: To speculate the expansion and outbreak in the near future by analyzing the trend of recent spread of syphilis.

    Methods: Spread of syphilis was compared with the trend of other sexually transmitted infections. Effective reproduction numbers (ERN) were calculated using the notification numbers of syphilis in Gunma prefecture every month from 2017 to 2022 to speculate the spread of syphilis in the next three years.

    Results: Cases of syphilis are increasing noticeably. ERN was high in the summer and low in the winter every year. If ERN of 2022 continues after that, the cases of syphilis might increase by 1.4 times in 2023, by 1.6 times in 2024 and by 1.9 in 2025. If ERN of 2021 continues, it might increase by 2.4 times in 2023, by 6.7 times in 2024 and by 16.4 in 2025 consequently in Gunma prefecture.

    Discussion: In Japan, outbreak of syphilis is observed every 20 years. The next peak of an outbreak is supposed to come in 2027 or 2028. The results of this study support this speculation, and policies should be implemented to suppress the expansion and outbreak of syphilis.

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  • Kei Kawano, Yusuke Sawada, Takumi Nihei, Tomoyoshi Yamada, Daiki Aoyam ...
    2023 Volume 73 Issue 2 Pages 149-154
    Published: May 01, 2023
    Released on J-STAGE: June 05, 2023

    A female in her twenties who took 15 g of anhydrous caffeine in a suicide attempt, was transferred to our hospital. Ventricular fibrillation (VF) occurred upon arrival at our hospital, and cardiopulmonary resuscitation including veno-arterial extracorporeal membrane oxygenation (VA-ECMO) was performed. Blood tests showed marked acidosis and hypokalemia. She was admitted to the intensive care unit (ICU), and continuous hemodiafiltration (CHDF) and continuous intravenous administration of potassium were started. Return of spontaneous circulation and normal sinus rhythm were obtained 286 and 356 min after arrival at our hospital, respectively. Brain computed tomography performed on the 2nd hospital day showed loss of gray-white matter differentiation, and electroencephalography performed on the same day showed a flattening. On the 3rd hospital day, we informed her family about her severe prognosis because of hypoxic encephalopathy, and it was decided not to intervene further. She died on the 8th hospital day.

    It is important for physicians at hospitals that accept patients who ingested a lethal dose of caffeine to improve the environment to be able to respond to sudden changes in the patient’s general condition.

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  • A Case Report
    Shinji Takahashi, Shun Yamanaka, Yoichi Okuda, Akihiro Hara, Yuki Naka ...
    2023 Volume 73 Issue 2 Pages 155-158
    Published: May 01, 2023
    Released on J-STAGE: June 05, 2023

    The patient was a man in his 60s with an unremarkable medical history. He underwent radical surgery via anterior approach (mesh plug technique) for the right inguinal hernia. Ten hours postoperatively, a dome-shaped subcutaneous hematoma that was approximately 10 cm in diameter was observed from the wound to the anterior surface of the right iliac crest. Contrast-enhanced computed tomography showed extravascular leakage of contrast medium under the skin ventral to the aponeurosis of external abdominal oblique muscle. An emergency hemostatic surgery was performed on the same day to stop the bleeding. The source of bleeding was found to be the superficial epigastric artery, and active bleeding was observed intraoperatively. The patient was discharged from the hospital on the sixth postoperative day. A case of active bleeding of the superficial epigastric artery after inguinal hernia surgery that required reoperation has not been reported so far. Here, we report this as a very rare case.

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  • Makiko Hardy Yamada, Shigeru Saito
    2023 Volume 73 Issue 2 Pages 159-162
    Published: May 01, 2023
    Released on J-STAGE: June 05, 2023

    Background: Electrical injuries, particularly those caused by high voltage, are characterized by multi-organ damage, such as skin burns and cardiovascular, respiratory, nervous, and other system injury. In this case, due to precautions based on his professional experience and knowledge, an electrician could reduce the impact of an electrical injury, resulting in less skin injury, but could not avoid nervous system injury, presenting as visual disturbances, deafness and pain after high voltage electrification. We present his post-injury pain management using analgesic adjuvants.

    Case presentation: A 39-year-old male electrician experienced a 5000-volt electrical injury while working. He was able to avoid fatal injuries such as respiratory and cardiac arrest, and sustained no skin burns, but presented with visual disturbances, deafness, pain and paresthesia in both his upper extremities. Considering that the pain and paresthesia were caused by direct electrical damage to nerves, we prescribed analgesic adjuvants (mirogabalin, amitriptyline, clonazepam) as for neuropathic pain, with subsequent improvement in the pain and paresthesia.

    Conclusion: High-voltage injury is commonly associated with high morbidity and mortality. In this case, the electrical injury caused isolated nervous system injury. This report shows the efficacy of adjuvant analgesics for the treatment of nerve damage pain after electrical injury.

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  • Rio Sawabe, Hiroko Kondo
    2023 Volume 73 Issue 2 Pages 163-170
    Published: May 01, 2023
    Released on J-STAGE: June 05, 2023

    Objective: This study aimed to obtain suggestions on the development of a self-compassion training program for nurses.

    Methods: We used CINAHL and MEDLINE to identify overseas intervention studies, abstract of which contained the terms “self-compassion” and “nurse.” In addition, Igaku Chuo Zasshi and Google were used to identify intervention studies in Japan containing the term “self-compassion” in the abstract section.

    Results: Five overseas and eight domestic articles were identified. The overseas articles included three articles dealing with studies on programs called Self-Compassion for Healthcare Communities (SCHC), which do not involve meditation. The nurse participation rate increased as SCHC training hours were short. Short programs used the following methods to improve self-compassion as effective as long programs: Assigning no take-home work to consolidate learned knowledge; implementation of work at the time of trouble; reflection among trainees; and follow-up after completion of the training program. Meanwhile, program contents varied from a domestic article to another and domestic studies most commonly involved meditation.

    Discussion: Short programs are practical for nurses who have difficulty finding time for training. Program structures without meditation, during which participants often become sleepy, appear useful for busy nurses.

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