Ward Chief Nurses' Perceptions and the Current Situation of Nurses' Career Development

目的：近畿，中国・四国地方の地域密着型病院の病棟看護師長のキャリアアップに対する認識と現状を明らかにする．方法：研究協力が得られた病棟看護師長187名に自記式質問紙調査を実施した．結果：101名（回収率54．0％）から回答が得られた．54名がスタッフに進学希望者がおり，それに対する思い・考えは【看護師個人の知識・スキルアップ・キャリアアップにつながる】【病棟・病院の看護の質向上が図れる】【病棟管理者としてスタッフの成長・キャリアアップを支援したい】の３つに分類された．支援はスタッフのキャリアプランの目標管理と学習への指導・助言，勤務調整・研修費などの体制支援を行っているが，スタッフのキャリアへの志向性が低い，人員不足・勤務業務調整が難しいなどの課題が明らかとなった．結論：病棟看護師長は，スタッフの成長と看護の質向上を期待し，キャリアアップへの課題に対する支援を模索していることが伺えた．Objective : To clarify the perceptions of ward chief nurses at community-based hospitals in the Kinki, Chugoku, and Shikoku regions, as well as the current situation regarding career development. Methods : We conducted a self-administered questionnaire survey of 187 ward chief nurses. Results : Responses were obtained from 101 chief nurses （response rate : 54.0%）. Of the respondents, 54 replied that their ward had staff members who desired more advanced education. Their thoughts/opinions about advanced education were classified as follows :［ it helps those nurses to advance their knowledge/skills/career］, ［it is helpful in improving the quality of nursing care in wards/hospitals］, and ［（they）, as ward managers, want to support staff members’ growth/career development］. Support provided to staff members included guidance/advice on goal management, learning for career development, and organizational support such as work shift adjustment and training fees. On the other hand, issues included staff members’ low career orientation, manpower shortages, and difficulties in work shift and duty adjustment. Conclusion : The ward chief nurses wanted to encourage staff members’ growth and qualitative improvements in nursing care and to explore support for career development issues

Validation of Optimum ROI Size for 123I-FP-CIT SPECT Imaging Using a 3D Mathematical Cylinder Phantom

Objective(s): The partial volume effect (PVE) of single-photon emission computedtomography (SPECT) on corpus striatum imaging is caused by the underestimation ofspecific binding ratio (SBR). A large ROI (region of interest) set using the Southamptonmethod is independent of PVE for SBR. The present study aimed to determinethe optimal ROI size with contrast and SBR for striatum images and validate theSouthampton method using a three-dimensional mathematical cylinder (3D-MAC)phantom.Methods: We used ROIs sizes of 27, 36, 44, 51, 61, 68, and 76 mm for targets withdiameters 40, 20, and 10 mm on reference and processed images reconstructed usingthe 3D-MAC phantom. Contrast values and SBR were compared with the theoreticalvalues to obtain the optimal ROI size.Results: The contrast values in the ROI with diameters of 51 (target: 40 mm indiameter) and 44 (target: 20 mm in diameter) mm matched the theoretical values.However, this value did not correspond with the 10-mm-diameter target. The SBRmatched the theoretical value with an ROI of > 44 mm in the 20-mm-diameter target;but, it was under- and overestimated under any other conditions.Conclusion: These results suggested that an ROI should be 4-2 folds larger thanthe target size without PVE, and that the Southampton method was remarkablyaccurate

Differential impact of multi-focus fan beam collimation with L-mode and conventional systems on the accuracy of myocardial perfusion imaging: Quantitative evaluation using phantoms

Introduction: A novel IQ-SPECTTM method has become widely used in clinical studies. The present study compares the quality of myocardial perfusion images (MPI) acquired using the IQ-SPECTTM (IQ-mode),conventional (180° apart: C-mode) and L-mode (90° apart: L-mode) systems. We assessed spatial resolution, image reproducibility and quantifiability using various physical phantoms. Materials and Methods: SPECT images were acquired using a dual-headed gamma camera with C-mode, L-mode, and IQ-mode acquisition systems from line source, pai and cardiac phantoms containing solutions of 99mTc. The line source phantom was placed in the center of the orbit and at ± 4.0, ± 8.0, ± 12.0, ± 16.0 and ± 20.0 cm off center. We examined quantifiability using the pai phantom comprising six chambers containing 0.0, 0.016, 0.03, 0.045, 0.062, and 0.074 MBq/mLof 99m-Tc and cross-calibrating the SPECT counts. Image resolution and reproducibility were quantified as myocardial wall thickness (MWT) and %uptake using polar maps. Results: The full width at half maximum (FWHM) of the IQ-mode in the center was increased by 11% as compared with C-mode, and FWHM in the periphery was increased 41% compared with FWHM at the center. Calibrated SPECT counts were essentially the same when quantified using IQ-and C-modes. IQ-SPECT images of MWT were significantly improved (P<0.001) over L-mode, and C-mode SPECT imaging with IQ-mode became increasingly inhomogeneous, both visually and quantitatively (C-mode vs. L-mode, ns; C-mode vs. IQ-mode, P<0.05). Conclusion: Myocardial perfusion images acquired by IQ-SPECT were comparable to those acquired by conventional and L-mode SPECT, but with significantly improved resolution and quality. Our results suggest that IQ-SPECT is the optimal technology for myocardial perfusion SPECT imaging

Validation of optimal cut-off frequency using a Butterworth filter in single photon emission computed tomography reconstruction for the target organ: Spatial domain and frequency domain

In single photon emission computed tomography (SPECT) images, we evaluated cut-off frequency using two methods: spatial domain method (normalized mean square error: NMSE) and frequency domain method (radius direction distribution function in the power spectrum: Pr (n)) and we calculated the optimal cut-off frequency of the Butterworth filter according to the nuclide and collimator used, and the target organ. The optimized cut-off frequencies (Fc) were determined for nuclides of 99m-Tc, 123-I, 201-Tl, and LEHR and LEGP collimators, and compared. The Pr (n) was used to evaluate the SPECT images for frequency domain analysis, and the NMSE method was used for the assessment of images in spatial domain. In the brain phantom for both of these methods of analysis, the optimal Fc varies depending on the nuclide and collimator. Fc in use for 99m-Tc is 0.802 [cycles/cm] with LEHR and 0.656 [cycles/cm] with LEGP. However, those in use for 123-I are 0.656 [cycles/cm] with LEHR. In the myocardial phantom, the appropriate Fc are 0.516 [cycles/cm] with LEHR, and 0.469 [cycles/cm] with LEGP in use of 99m-Tc. We concluded that the cut-off frequency of the Butterworth filter should be changed in reconstructing SPECT images according to the collimator, nuclide and target organs.我々は，脳ファントム及び心臓ファントムで周波数空間と実空間の評価でSPECT 画像における使用核種，コリメータ及び標的臓器のButterworthフィルタの最適遮断周波数の算出を試みた。周波数空間での評価は動径強度分布関数（Pr（n））を用い，実空間での評価はNMSE法を用いた。脳ファントムでは核種として99m-Tcと123-Iを用い，心臓ファントムでは99m-Tc及び201-Tlを使用した。また，コリメータはLEHR及びLEGPを使用した。脳ファントムでは99m-Tcにおける最適遮断周波数は，LEHRで0.802 [cycles/cm], LEGPで0.656 [cycles/cm] と変化した。しかし123-IではLEHRで0.656 [cycles/cm]であった。心臓ファントムでは99m-TcでLEHRは0.516 [cycles/cm], LEGPで0.469 [cycles/cm]と変化した。また，同様に201-Tlでも異なった遮断周波数が算出された。この結果から，SPECT画像再構成時でのButterworthフィルタの遮断周波数は，使用核種，コリメータ，標的臓器により変化させなければならない。原著Original Article