Background & Aims: Ice massage is used to stimulate the oral cavity and pharynx to improve the swallowing function; however, there is no specific device for this purpose. Therefore, we created an Ice Stick®, a special device for ice massage, and investigated whether it was more effective than the conventional massage method.

Methods: The subjects were 36 patients who were diagnosed with dysphagia. They were randomly divided into two groups: the Ice Stick® group and the conventional approach group. A 30-second repeated saliva-swallowing test was performed before and after ice massage, and the changes in the number of swallows and the latency of the first swallowing time were compared between the two groups.

Results: Both groups showed an increase in the number of swallows and a shortening of the latency of the first swallow after the ice massage. However, there were no significant differences in the change in the number of swallows or the latency.

Conclusion: Although we did not find that the Ice Stick® is more effective for dysphagia, the swallowing-enhancing effect of ice massage is certain, and as a dedicated device, the Ice stick® would contribute to the widespread use of ice massage on more occasions.

Background & Aims: For chemotherapy-induced peripheral neuropathy (CIPN), patients are expected to have knowledge and skills regarding their own medical care, and to independently self-manage their illness while coming to terms with life on their own. The purpose of this study is to clarify the subjective effects of self-monitoring intervention on CIPN and to examine effective support in this regard.

Methods: A total of 18 participants in the intervention group and 16 participants from the control group were analyzed. The data were analyzed qualitatively and inductively using the content analysis method.

Results: In the intervention group, new categories related to cognitive and coping behavior were formed after 9 weeks. These included “correct information promotes recognition of numbness” and “self-monitoring promotes coping behavior”. The subjective effects of the patients’ self-monitoring intervention for CIPN were positive perception of CIPN, acceptance of CIPN with a sense of foresight, promotion of coping behaviors, and increased self-efficacy.

Conclusions: The results suggest that self-monitoring intervention for chronic peripheral neuropathy is an effective nursing support for promoting cognitive behavior modification in patients.

Background & Aims: This study aimed to investigate cut-off values of clinical assessment tools in the decision-making on the use of physical restraints.

Methods: This study was a retrospective analysis of routine patient data in a sub-acute care ward in a general hospital. We analyzed data of patients who were aged 65 years and older admitted to a sub-acute care ward. Upon admission, the following variables were examined: the Short Physical Performance Battery, the Japanese version of the rapid dementia screening test, the admission Functional Independence Measure (FIM), the modified version of the Fall Risk Assessment Tool and the use of physical restraint for fall prevention. The factors determining physical restraint use were investigated using multivariate logistic regression analysis based on admission variables, and the cut-off value for predicting the use or non-use of restraints at admission was estimated.

Results: Of the 73 patients, 15 patients were restrained on admission. The FIM cognitive was the sole assessment tool that predicted the physical restraint use for fall prevention. The cut-off value for the FIM cognitive was 23 points.

Conclusion: This finding could make the decision-making process more visible and transparent to minimize physical restraint use.

Aims & Methods: The objective of this study was to examine the self-management behavior of cancer survivors with taste alterations, regarding their role as cooks. Fifteen gynecological or breast cancer survivors who experienced taste alterations due to outpatient chemotherapy and were responsible for preparing meals for their families participated in semi-structured interviews. The responses were analyzed using a qualitative inductive method.

Results: Self-management behaviors of survivors under the conditions mentioned above were divided into five categories: use ready-made products to avoid having to season food myself, try different methods of seasoning and tasting food, so I can cook on my own, cook the same as before sense of taste was impaired, cook with family cooperation; adjusting taste based on their feedback, and have family members take over the role of cooking.

Conclusions: Survivors with taste alterations try various ways to carry out their cooking role; they need specific information on methods for improving their taste issues as well as suggestions for cooking and recipes that will make it easier for them to eat. These findings suggest that it is important for nurses to provide specific advice and approve survivor self-management when taste alterations.

　症例は68歳の男性で1年半前に胃癌に対して腹腔鏡補助下幽門側胃切除術（Billroth-I法再建）を施行した．嘔吐，腹痛を主訴に当院を受診し，CTでair bubbleを含んだ楕円形の残渣が十二指腸に見られた．症状発症前に柿を摂取した経緯があったため柿胃石による腸閉塞を疑った．入院時のCTで胃石が空腸に移動しており腸閉塞を来していたため，イレウスチューブを留置しコーラによる溶解療法（以下コーラ療法）を5日間施行した．しかし，柿胃石の大きさに変化は認めず，コーラ注入時に腹痛を訴えるようになったため手術を施行した．腹腔鏡補助下で空腸を体腔外に挙上し胃石を摘出し，術後14日目で退院となった．近年柿胃石に対する腸閉塞症例にコーラ療法を行った報告が散見されるが，手術が必要となる報告も多くいまだ手術が第一選択と考えられる．コーラ療法は胃石の腸管圧迫による腸管壊死などの合併症もあるため，コーラ療法を施行する場合は手術の選択肢を常に念頭においておくことが肝要と思われる．

　症例は30歳代，男性．コオロギパウダーを含む食品を摂取した20分後から腹痛，嘔気，下痢の症状を自覚し，その後さらに全身の掻痒感および全身の皮膚の発赤が出現したため，同日救急外来を受診した．アナフィラキシーと診断したが，呼吸循環は安定していたためアドレナリンは用いず，救急外来で抗ヒスタミン薬を点滴投与したところ，症状は速やかに改善した．入院による経過観察を行ったが，その後の全身状態は安定しており，翌第2病日に退院とした．本症例では，ハウスダスト，ヤケヒョウダニおよびコナヒョウダニに対するアレルギーを確認したが，エビ・カニ等の甲殻類へのアレルギー反応は確認できなかった．

　近年，環境への配慮などから昆虫食は注目を集めており，コオロギもその1つである．しかしながら，コオロギはイエダニや甲殻類と共通のアレルゲンを含むため，これらに対してアレルギーを有する場合には，コオロギパウダーを含む食品の摂取に注意が必要である．

　対象者はA氏，80歳代，女性，要介護2．独居で生活しているが，服薬管理が不安で，誤薬が生じていた．特に週に1度服薬する薬剤は飲み忘れが多かった．A氏は難聴で視力も低下し，歩行時は手すりの使用が必要であった．そこで，A氏の目に留まりやすくした手作りの服薬カードを作成した．その後，骨折により，入院・介護施設への入所のためカードを使用することはなかったが，1年後に自宅復帰した．週に1度の内服については継続となり，自宅復帰後にカードを使用することになった．数か月たった現在も忘れずに服薬ができている．その要因として，服薬カードの色は自分が選択した事，カードの色と薬袋の色とのコントラストが明確でわかりやすい事が考えられる．

　68歳男性．心窩部痛を主訴に来院され，上部消化管内視鏡検査で胃体下部に3型腫瘍を指摘された．腹部造影CTでは，胃領域リンパ節に加え傍大動脈リンパ節に多数のリンパ節腫大が認められた．病理組織検査でHER2陽性であったため，S-1＋oxaliplatin＋trastuzumabによる全身化学療法を開始した．7コース施行後のPET-CTでは胃体下部にのみFDG集積を認め，領域リンパ節及び傍大動脈リンパ節へのFDG集積は認められなかった．Conversion Surgeryが可能と判断し9コース実施後に開腹幽門側胃切除術を行った．病理組織検査ではypT2, ypN0 (0/12), Ly0, V0, ypStage IBであった．術後の補助化学療法は施行せず現在まで術後9か月無再発である．切除不能進行胃癌の生存期間中央値は約15か月と予後不良であるが，Conversion SurgeryによりR0切除を達成した場合の長期生存例がいくつか報告されている．全身化学療法が著効しConversion SurgeryによりR0切除を達成した切除不能進行胃癌症例を経験したため，文献的考察を含めて報告する．