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.
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.
結 果：海外文献5件，国内文献8件が抽出された．海外文献のうち3件はSelf-Compassion for Healthcare Communities（SCHC）という瞑想を含まないプログラムの研究であった．研修時間の短いSCHCは，看護師の参加率が高かった．また学びを定着するためにホームワークを課さず，仕事で困難に遭遇した時にワークを実践する，研修者同士でリフレクションする，研修後フォローアップを行うという方法で，長時間プログラムと同様のセルフ・コンパッション改善の効果を得ていた．一方，国内文献は研究によりプログラム内容が異なり，瞑想が最も多く用いられていた．