看護単位の教育担当者が役割遂行上直面する問題に関する研究

目的:看護単位の教育担当者が役割遂行上直面する問題を明らかにし,その特徴を考察することを目的とする.方法:全国の病院から無作為抽出した看護単位の教育担当者479名に質問紙を送付し,郵送法により回収した.そのうち,役割遂行上直面する問題があり自由回答式質問に回答した171名の記述をBerelson, B. の方法論を参考にした看護教育学における内容分析を用いて分析した.結果:看護単位の教育担当者が役割遂行上直面する問題を表す【看護単位全体で教育を行う体制の整備が難しい】【業務と並行しながら役割を遂行することが難しい】など,32カテゴリが形成された.結論:看護単位の教育担当者が役割遂行上直面する32の問題は〈看護単位の教育計画立案・運営に関する検討の不足〉〈スタッフ看護師や上司からの協力獲得に必要なコミュニケーションの不足〉など,6つの特徴を示した.Purpose : The aims of this study were to clarify the problems encountered by clinical nurse educators in nursing units in terms of role performance, and to discuss the characteristics of these problems. Methods : Questionnaires with open-ended responses were mailed to 479 clinical nurse educators in nursing units randomly selected from hospitals throughout Japan. All questionnaires were collected by mail. Among the educators that returned responses, 171 indicated that they had faced role performance problems. All descriptions were analyzed using content analysis. Results : Thirty-two categories of role performance problems encountered by clinical nurse educators in nursing units were extracted, including "Difficulty establishing a system to teach the entire nursing unit" and "Difficulty performing one's role alongside one's duties." Conclusions : The 32 role performance problems encountered by clinical nurse educators in nursing units had six characteristics, including "Insufficient examination of teaching planning and management in the nursing unit" and "Insufficient communication to obtain cooperation from staff nurses and their superiors."報

A case of Wartin\u27s tumor of the parotid gland found in a specimen extirpated on radical neck dissection for tongue carcinoma

近年, 腫瘍性病変の重複頻度は増加傾向にあるといわれている。本論文では舌癌の頸部郭清術後に病理組織学的検査でWarthin腫瘍の合併が確認された1症例について報告する。患者は56歳男性で, 舌の接触痛を主訴として来院した。口腔内診査では舌右側辺縁部に不整形の潰瘍がみられ, 潰瘍周囲は硬結を呈し, 右側頸部リンパ節に腫脹を触知した。舌生検で高分化型の扁平上皮癌と診断され, 術前化学療法の後, 舌部分切除術及び右側全頸部郭清術が施行された。手術標本では, 舌の筋層深部に達する扁平上皮癌及びリンパ節転移がみられた。術後7ヶ月に左側頸部リンパ節への転移が疑われ, 左側全頸部郭清術が施行された。摘出組織標本では舌扁平上皮癌のリンパ節転移とともに耳下腺部にWarthin腫瘍がみられた。口腔癌とWarthin腫瘍の重複症例については, 癌のリンパ節転移との鑑別が重要であると思われた。The incidence of multiple primary neoplastic lesions in the head and neck region has increased in recent years. This article presents a rare case of Warthin\u27s tumor of the parotid gland that was found in a specimen extirpated during radical neck dissection for tongue carcinoma. The patient, a 56-year-old man was admitted because of tenderness of the tongue. Physical examination showed an irregular-shaped indurated ulcer on the right lateral border of the tongue as well as swelling of the right cervical lymph nodes. Histological examination of a biopsy specimen of the tongue indicated a diagnosis of well-differentiated squamous cell carcinoma. After preoperative chemotherapy, the patient underwent partial resection of the tongue with radical neck dissection on the right side. Histologically, squamous cell carcinoma was found to invade the deep muscle layer of the tongue and metastasize to the cervical lymph nodes. Seven months after the operation, swelling of the left cervical lymph nodes was noticed. Radical neck dissection was performed on the left side. Histological examination of the surgical specimens showed Warthin\u27s tumor of the parotid gland as well as the metastasis of squamous cell carcinoma to the cervical lymph nodes Our findings indicate that it is important to distinguish Warthin\u27s tumor from nodal metastases from oral cancer in patients with tumors arising in different primary sites