CONTENTS

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The Sense of Burden Factors for Japanese Ward Nurses after COVID-19’s Transition to Class Ⅴ Infectious Diseases

Introduction and Purpose: Coronavirus disease (COVID-19) was treated as a new influenza type 2 infectious disease (Category Ⅱ infectious disease) in Japan until May 2023, after which it became a Category Ⅴ infectious disease. Although previous studies have revealed the burden on nurses during the Category Ⅱ infectious diseases stage, the burden after the transition to Category Ⅴ infectious diseases is unclear. This study aimed to clarify the factors contributing to the sense of burden among Japanese ward nurses after COVID-19 became a Category Ⅴ infectious disease. Methods: A cross-sectional online survey was conducted between February and April 2024 among nurses in hospital wards in the Kinki region of Japan using network sampling. A total of 740 QR-coded forms were distributed. Thirteen items were set as burden items related to COVID-19 based on previous studies, including staffing shortages, handling of unknown fever, and infection control at mealtime. These items, as well as participants’ basic attributes and personal lives, were investigated using the Likert method and open-ended questions. The association between the basic attributes and the items asking about the sense of burden was analyzed by t-test or χ2 test.　 Results: In total, 111 nurses (15.0%) responded to the survey. Five basic attributes (age, sex, years of nursing experience, position, and presence of COVID-19) and 13 burden-related items were analyzed. There were significant differences in the presence of COVID-19 infection and understaffing, nursing experience, position and handling of unknown fever, age, and mealtime infection prevention measures; however, no significant differences were found for all but four items. Discussion: Significant differences in the burden of COVID-19 may not have been found because it was not influenced by basic attributes. It is possible that other factors, such as hospital- and ward-specific infection control measures, rather than personal factors, play a role in the COVID-19 burden after the Class Ⅴ transition.departmental bulletin pape

Survey on Disaster Prevention Education for Outpatients as Perceived by Hospital Nursing Departments -Questionnaire survey of hospitals with more than 300 beds-

本研究は，300床以上の病院が外来患者に行っている災害に対する防災教育の現状を明らかにすることを目的とし，300床以上の病院の看護部の代表者を対象に郵送による無記名自記式質問紙調査を行った．基本属性，先行研究を参考に作成した病院で行われている防災対策の項目とその満足度，患者とその家族向けの防災に関する冊子の必要性を調査した．結果は項目ごとに記述統計で分布を明らかにし，災害拠点病院の指定，所在地，病床数，傷病者受け入れ経験，被災地への看護師派遣，被災経験，DMAT指定，救急指定と防災対策に関する調査項目でクロス集計を行いχ²乗検定で比較した．1356施設へ郵送し，364件の回答があり（回収率26.8％）345件を分析対象とした（有効回答率94.5％）．災害への備えの整備と防災教育の実施状況について，患者指導を行う看護職の育成，防災に関する患者向けの指導・説明の実施，防災教育に関する患者向けの研修・講習会の実施，備えの満足度に関する4項目で災害拠点病院の指定の有無で比較した際に有意差がみられた（p<.05）．しかし，全体を通して患者向けの防災に関する指導・説明，患者向けの防災に関する研修・講習会の実施は2割に満たず，看護部の災害への備えの満足度も低かった．災害時の病院の混乱を避けるために，入院中から退院後を視野に入れた継続的に防災教育を行う必要性が示唆された．また，防災に関する冊子の活用については既存のものの活用も視野に入れ，病院だけでなく行政など他機関と連携しながら対象者への直接的な指導の機会が求められる．The purpose of this study was to clarify the current status of disaster preparedness education for outpatients in hospitals with 300 or more beds. A self-administered, anonymous questionnaire survey was conducted by mail among representatives of nursing departments in hospitals with 300 or more beds. Based on previous studies, the survey examined basic attributes, disaster prevention measures implemented in hospitals, levels of satisfaction, and the need for a booklet on disaster prevention for patients and their families. The results were cross-tabulated with items related to Designation of disaster base hospitals, location, number of hospital beds, experience of accepting patients, dispatch of nurses to the disaster site, experience of the disaster, designation of DMAT, and designation of emergency services. and disaster prevention measures and compared using the χ² test. A total of 364 responses (collection rate: 26.8%) were received from 1356 facilities, and 345 responses (valid response rate: 94.5%) were included in the analysis. Significant differences were observed in four areas: training of nurses to provide patient guidance; instruction and explanation of disaster prevention for patients; training and seminars for patients on disaster prevention education; and satisfaction with preparedness (P<0.05). However, fewer than 20% of respondents reported providing guidelines on disaster preparedness to patients and conducted training/seminars on disaster preparedness. Overall satisfaction within the nursing department regarding disaster preparedness was low. These results suggest the necessity of continuous disaster preparedness education extending from the time of hospitalization to after discharge to avoid confusion in the event of a disaster. In addition, the use of existing pamphlets on disaster preparedness should be considered, and opportunities for direct instruction should be sought, both within the hospitals and in collaboration with external organizations such as the government agencies, should be considered.data pape

紀要投稿規程

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Study on patient's factors which influence the clinical condition and the detection process when being diagnosed as pulmonary tuberculosis.

日本の結核患者の年齢層は，今後ますます高齢者に偏っていく一方，時間経過とともに労働者層の占める割合は相対的に増加することが予測されてきたが，2023年時点においても15歳～39歳までの年齢層で喀痰塗抹陽性肺結核新登録患者は増加しており，若年層における早期発見の対策強化が求められる．本研究の目的は，発見時の病態，発見経路，および肺結核患者の特徴との関係を明らかにし，労働者に対する対策を検討することである．定期健康診断における結核の発見率は，常用勤労者で高く，男性では有空洞率が高かった．したがって，男性の年1回の健康診断は結核検診として有効であると考えられた．また，呼吸器症状を有していても定期健康診断まで受診しない人もいる傾向にあったことから，労働者に対しては，定期健康診断の徹底と症状が出たときの早期受診を促すような十分な対策が重要である．The age group of patients afflicted with tuberculosis（TB） in Japan will become increasingly skewed towards the very elderly in the future. It is important to achieve effective TB control for the working population due to the diversification of employment patterns. In a previous paper, the author analyzed the incidence of TB among foreign workers and reported on the importance of annual health checkups and health checkups at the time of employment. The purpose of this study was to clarify the relationship between the clinical conditions at the time of detection, the detection process, and the and the characteristics of patients with pulmonary TB, and to investigate the measures for workers. The detection rate of TB during regular health checkups was high among the routine workers, the cavitation rate was higher among the males. Therefore, annual health checkups in men were considered to be effective for TB screening. There was also a trend that some people have respiratory symptoms but do not consult a doctor until it is time for a regular health checkups. Therefore, it is important to take adequate measures to working men to encourage the thoroughness of regular health checkups and early visits to the doctor when symptomatic.departmental bulletin pape

目次

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Wishes for End-Of-Life-Care of Patients with Cancer

がんと診断された時点から最期まで最善の生を生きるためには，good death（死にゆく過程に対する考え方）も含めた視点をもつend-of-life-careが必要である．本人にとって最善の生とは何か，本人が望むこと或は本人らしく生きることはどの様な生活か，end-of-life-careに関する様々な想いを明らかにする必要があると考えた．研究目的：がんと診断された患者のend-of-life-careに関する様々な想いを明らかにする．研究デザイン：質的記述的研究 調査期間：2017年3～9月 調査参加者：近畿圏内の緩和ケア病棟・がん緩和ケア外来のある5病院とがん患者会2団体で，がんであることの説明を受けている人 調査内容：end-of-life-careに関する様々な想いを自由回答で記載を求めた．調査方法：自己記入式の調査票を配布，回収は個別返送及び留置法 分析方法：それぞれの記載された内容から1文脈1単位を記録単位として抽出した．得られた記録単位を意味内容が類似したものを集めてコードを作成し，さらに内容の類似性に基づきサブカテゴリー，カテゴリーに整理した．そしてスーパーバイスを受け，分析の信憑性を高める努力をした．倫理的配慮：摂南大学研究倫理審査委員会で審査を受け実施，調査票の回収をもって同意が得られたものとした．結果：155名に配布し，77名から回収（回収率49.7％），76名を分析対象とした（有効回答率98.7％）．その中で自由記述回答者は16名であった．分析した結果68のコード，8のサブカテゴリー，4つのカテゴリーを抽出した．文中のカテゴリーは『』サブカテゴリーは《》で示す．『寄り添える存在の必要性』は，《想いをわかり合える人の存在》《患者同士のコミュニケーション》の2つのサブカテゴリーで形成された．『先の見えない不安』は，《不安な気分》《がんになったことに対しての不安》の2つのサブカテゴリーで形成された．『適正な医療の提供』は，《医療者への想い》《疼痛(症状)コントロールの必要性》の2つのサブカテゴリーで形成された．『経済への支援』は，《高額な治療費》《就労への取り組み》の2つのサブカテゴリーで形成された．【結論】がん患者のend-of-life-careの想いは，『寄り添える存在の必要性』『先の見えない不安』『適正な医療の提供』『経済への支援』が見出された．To help patients with cancer live as they optimally wish from the time they are diagnosed with cancer till the end of their lives, nurses need to support the patients to become aware of what they wish and what kind of life is true to the feelings and wishes of the patients themselves． Objective： This study aims to understand a range of wishes for end-of-life-care of patients diagnosed with cancer under the premise that listening to patients with cancer and reflecting their wishes in the nursing improves end-of-life-care and helps them to live as they wish till the end of their lives, as a result of the improvement of the quality of nursing． Study design： A qualitative descriptive study． Survey period： From March to September, 2017． Study participants： Patients aged 20 and older who are conscious and lucid and diagnosed with cancer at one of the five hospitals with palliative care wards and/or palliative care outpatient clinics for cancer patients, two cancer patient groups, home-visit nursing agencies． Participating facilities： five hospitals and two cancer patient groups． The number of participants responded to open-ended questions： 16． Results： Analysis of the responses to the open-ended questions yielded 68 codes in 8 subcategories and 4 categories: ‘The need for supportive persons,’ ‘Anxiety and uncertainty about the future,’ ‘Provision of appropriate medical care,’ and ‘Economic concerns．’data pape

Effects of communication opportunities with individuals with disabilities through production tasks on medical sciences students: A report on the activities of the “Employment support cafe (3s Cafe)".

本学の医療系学生は，2022年度より地域の福祉事業所と連携し，本学キャンパス内で「就労支援カフェ（3s Cafe）」を協働運営している．この取り組みの目的は、新型コロナウイルス感染症の流行による多様なコミュニケーションの機会の喪失を補填することであり，学生が基本的なコミュニケーションスキルを実践できる環境を提供するものである．今回の地域交流会イベントに参加した学生らは，多面的コミュニケーションを通じて内省的な成長を経験した．今後も「就労支援カフェ （3s Cafe）」は，持続可能性を重視し，地域および本学の課題解決に向けた取り組みを推進していく．Since 2022, medical students at our university, in collaboration with local welfare offices, have been managing the “Employment support cafe (3s Cafe)” on our university campus. This initiative aims to compensate for the loss of diverse communication opportunities caused by the COVID-19 pandemic by providing students with a practical environment to apply basic communication skills. Through participation in regional exchange meetings, students engaged in multifaceted communication and experienced significant introspective growth. Prospectively, the “Employment support cafe (3s Cafe)” will continue to prioritize sustainability and promote initiatives aimed at addressing challenges faced by both our university and the surrounding community.repor

Information

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Changes in Pediatric End-of-Life Care Perspectives of Nursing University Students Before and After Attending the Lecture hearing the Experiences of the Parents Who Have Lost their Children.

目的：本研究は，子どもを亡くした親の体験を聴講する授業前後での，学生の小児エンドオブライフケア観の変化を明らかにする． 方法：子どもを病気で亡くした親から話を聴く授業前後で，学生の死生観尺度，および小児エンドオブライフケアの実践を想定した時の感情や信念をWilcoxonの符号付順位検定で分析し，「エンドオブライフケアに対する思い」の自由記述を質的に分析した． 結果：授業前後結果で有意差が認められたのは「死に逝く患者は自分にないものを教えてくれる」「死に逝く子どもとその家族と関わることは，辛くて耐えられない」「死の差し迫った子どもの家族には，声を掛けないほうがよい」「死の差し迫った子どもの家族にとって，看護師の影響は大きい」であった． 結論：子どもを亡くした親の体験を聴く授業により，学生は「子どもが精一杯生きることを助けたい」という思いに至り，小児エンドオブライフケアを具体化できることが示唆された．Purpose: This study will clarify the changes in pediatric end-of-life care perspectives of students of the nursing university before and after attending the lecture hearing the experience of the parents who have lost their children because of illness. Method: Analysis of the survey and the free writing of the students was performed after the lecture and compared it with those of before the lecture. Result: There were statistically significant differences in the student’s view on the following points after the lecture. “Care of the dying children and their families is unbearable to nurses”, “It is best to have nothing to say to the family of the dying child”, “Nurses can play essential roles in the terminal care of the children and their families”. Conclusion: The students suggests that students have got the clear vision on the pediatric end-of life care by hearing experiences of the parents who have lost their children.departmental bulletin pape