Factors related to the occurrence of phlebitis in acute phase stroke patients receiving intravenous nicardipine

This study investigated the incidence of phlebitis associated with continuous nicardipine infusion in patients with acute-phase stroke. To identify patient factors related to the occurrence of phlebitis, and considering blood pressure values during nicardipine administration, we retrospectively investigated the nursing and medical records of 301 patients who were hospitalized for stroke. Of these, 92 patients met the inclusion criteria and had data showing whether phlebitis had occurred. We confirmed that phlebitis occurred in 38 patients (41.3%). Factors found to be significantly related to phlebitis onset were Glasgow Coma Scale (GCS)-verbal (V; p = .020) and -motor (M; p = .007), level of consciousness (total GCS score [(p = .009)]), nicardipine administration time (p = .001), nicardipine dose (p = .000), mean nicardipine rate of administration (p = .000), nicardipine dilution rate (p = .000), mean arterial blood pressure at first insertion (p = .030), and difference in the diastolic blood pressure at first insertion (p = .032). Multiple logistic regression analysis indicated that nicardipine administration time (odds ratio: 1.042, 95% confidence interval: 1.023–1.062, p = .000) was a related factor. Results also suggested that a decreased level of consciousness after the stroke onset (V3 or below and M5 or below) is related to phlebitis occurrence. Patients with stroke having a lower level of consciousness (total GCS score of 12 or below), who are being administered continuous nicardipine infusion, may require more frequent and careful infusion management and needle insertion site observation. Because phlebitis onset occurs after 24 h of continuous infusion, peripheral insertion site catheter replacement should be performed within 24 h

job satisfaction in operating-room nurses

Purpose : The purpose of this study was to investigate the operating environment, degree of operating-room nurses’, and to clarify the job satisfaction, experience, and emotions categorized characteristics operating-room nurses. Method : The study surveyed 1177 operating-room nurses. For 38 questionnaire items, a 5-point Likert scale was applied regarding job satisfaction, workplace environment, experiences, and emotions. Classification was performed by cluster analysis based on operating-room nurses’ job satisfaction. Results : Results of cluster analysis were classified into five groups with unique characteristics based on factors such as age, years of nursing experience, years of operating-room nursing experience, workplace environment, experience, and emotion. Conclusion: Results suggest providing support tailored to characteristics of each of the five groups to optimize their job satisfaction

physical activity in heart failure patients

This study aimed that we were classification of physical activity in patients with heart failure categorized as New York Heart Association (NYHA) class I or II. We were a survey using a researcher- administered questionnaire, SF-8, the Specific Activity Scale (SAS), and the Scale to Measure Self-Care Behavior of Patients with Heart Disease. We included 70 patients who were treated in the Department of Cardiovascular Medicine at Hospital A. Regarding patient characteristics and clinical information after the cluster analysis, there were significant differences in the NYHA class (p = 0.001), BNP level (p = 0.012), self-management of medication adherence (p = 0.000), and exercise habits (p = 0.005). We summarized characteristics of each group as follows : Group A showed high tolerance to physical activity and near-perfect self-management; Group B showed moderate tolerance to physical activity but was not willing to commit to daily exercise and self-management; and Group C showed low tolerance to physical activity and often requested others to handle medication management. We needed that tolerance to physical activity and proposals for tailored instruction according to patient conditions, and needed that instructions tailored to the characteristics of heart failure patients in groups A–C

カンゴ ガクセイ ノ リスク カンセイ ソクテイ シャクド ノ カイハツ ト シンライセイ ダトウセイ ノ ケントウ

〔目的〕看護学生のリスク感性を把握するための測定尺度を開発し、その信頼性と妥当性を検討することである。 〔方法〕文献検討により独自に作成した質問紙にて一次調査を実施し、リスク感性予備尺度(44項目)を作成した。看護系大学在籍中の1～4年次生774名に外部基準尺度項目を含む質問紙調査を実施し、602名を分析対象とした探索的因子分析および確認的因子分析を行った。 〔結果〕看護学生のリスク感性は、【安全行動遂行力】、【リスク体験活用力】、【リスク情報獲得力】、【リスク回避準備力】、【リスク対応準備力】、【リスク察知観察力】の6下位尺度25項目から構成されたモデルで妥当な適合度が得られた。尺度のCronbachのα係数は、0.93であった。リスク感性得点と外部基準尺度との相関では、安全意識尺度の「安全への関心」、「安全への配慮」の2下位尺度得点との間にr=0.5(P<0.01)の中程度の正の相関が認められた。認知欲求尺度ではr=0.2～0.3(P<0.01)の弱い正の相関、失敗傾向尺度では、「衝動的失敗」と【安全行動遂行力】の下位尺度間にr=-0.23(P<0.01)の弱い負の相関が認められた。 〔考察〕本研究結果より、開発した尺度の内的一貫性、構成概念妥当性が確認されたが、基準関連妥当性の確認については課題が残った。開発した尺度は、看護学生が実習開始前に自身のリスク感性を自己評価し、安全に行動するために必要な学習目標を設定し、実習への準備状況を整えることに活用できる。〔Purpose〕we developed a scale for measuring risk sensitivity in nursing students and tested the reliability and validity of the scale. 〔Methods〕A primary survey was performed with a questionnaire originally created based on the literature and the results were used to create a preliminary risk sensitivity scale (44 items). A questionnaire survey including external reference scale items was then administered to 774 first to fourth year students enrolled in a nursing college. The responses from 602 students were subject to exploratory factor analysis and confirmatory factor analysis. 〔Results〕A high goodness of fit value was attained for a nursing student risk sensitivity model comprised of 25 items in six subscales: [ability to execute safety acts], [ability to use risk experiences], [ability to acquire risk information], [risk avoidance preparedness], [risk response preparedness] and [risk detecting and monitoring ability]. Cronbach's α coefficient for the scale was 0.93. Analysis of correlation between risk sensitivity score and the external reference scales showed a moderate positive correlation with the two subscale scores, “interest in safety" and “safety consideration", of a safety awareness scale, with r=0.5 (p<0.01). A weak positive correlation was observed with the Need for Cognition Scale, with r=0.2-0.3 (p<0.01) and a weak negative correlation was observed between the “impulsive errors" subscale of the error proneness scale and the [ability to execute safety acts] subscale, with r=-0.23 (p<0.01). 〔Discussion〕We cofirmed the internal consistency and construct validity of the developed scale, although the criterion‐related validity has yet to be determined. The developed scale can be used by nursing students to self‐assess their own risk sensitivity prior to the start of practical training so that they can set the necessary study goals to act safely and attain a state of preparedness for practical training

Disruption of a Novel NADH-Glutamate Synthase2 Gene Caused Marked Reduction in Spikelet Number of Rice

Inorganic ammonium ions are assimilated by a coupled reaction of glutamine synthetase and glutamate synthase (GOGAT). In rice, three genes encoding either ferredoxin (Fd)-GOGAT, NADH-GOGAT1, or NADH-GOGAT2, have been identified. OsNADH-GOGAT2, a newly identified gene, was expressed mainly in fully expanded leaf blades and leaf sheaths. Although the distinct expression profile to OsNADH-GOGAT1, which is mainly detected in root tips, developing leaf blades, and grains, was shown in our previous studies, physiological role of NADH-GOGAT2 is not yet known. Here, we isolated retrotransposon mediated-knockout mutants lacking OsNADH-GOGAT2. In rice grown under paddy field conditions, disruption of the OsNADH-GOGAT2 gene caused a remarkable decrease in spikelet number per panicle associated with a reductions in yield and whole plant biomass, when compared with wild-type (WT) plants. The total nitrogen contents in the senescing leaf blade of the mutants were approximately a half of the WT plants. Expression of this gene was mainly detected in phloem companion cells and phloem parenchyma cells associated with large vascular bundles in fully expanded leaf blades, when the promoter region fused with a β-glucuronidase gene was introduced into the WT rice. These results suggest that the NADH-GOGAT2 is important in the process of glutamine generation in senescing leaves for the remobilization of leaf nitrogen through phloem to the panicle during natural senescence. These results also indicate that other GOGATs, i.e., NADH-GOGAT1 and ferredoxin-GOGAT are not able to compensate the function of NADH-GOGAT2

片麻痺擬似体験後の看護学生のイメージの変化

看護学生の片麻痺疑似体験前後の片麻痺患者に対するイメージの変化を明らかにするため，学生が記載したレポートについて質的に内容分析を行い，比較した．対象は３年次看護学生のうち研究協力が得られた６５名であった．片麻痺擬似体験は，片麻痺患者を約２０分間体験した．片麻痺の設定は利き手側の上下肢とし，片麻痺患者役は日常生活動作を実施した． その結果，擬似体験後の片麻痺患者に対するイメージの記述数は増加し，イメージの内容がより具体的となった．体験後は「片麻痺患者は想像しにくい」の記述がなくなり，カテゴリーとして抽出されなかった．カテゴリーやサブカテゴリーは，体験前の否定的なイメージから，麻痺があっても可能なことはあるなど肯定的なイメージが増えた．また，学生は片麻痺患者の体験するストレスを実感することで，心理面に対する共感的イメージをもつことにつながった．さらに，擬似体験は，机上の学習では気づくことができない患者を想像する貴重な機会となっていた．In order to show the changes in the image that nursing students have regarding hemiplegic patients before and after simulated experiences of hemiplegia, a content analysis of the reports made by the students was qualitatively conducted, and comparisons were performed. The subjects were６５students in Junior year, all participants signed an informed consent. During the implementation of the simulated hemiplegic experiences, the students experienced becoming hemiplegic patients for approximately ２０ minutes. Hemiplegia was set for the upper and lower limbs on the side of the dominant hand, and students who took the part of hemiplegic patients experienced various activities associated with daily living. As a result, the number of descriptions of their image of hemiplegic patients after the simulated experiences increased, and the descriptions of such images were also more specific. After the experience, as their response “it is not easy to imagine what it is like for hemiplegic patients” was no longer observed, and thus it was not included as a category. The details of the image of the categories and the subcategories showed a more positive image, such as things that they can do in spite of their paralysis, compared to negative details before the experience. In addition, the students felt the stress that hemiplegic patients have, which resulted in them having a more empathetic image regarding psychological aspects. Furthermore, the simulated experiences provided a good opportunity todevelop an image of the patients, which cannot be obtained from reading books or articles

Medication-taking behavior in CI patients

Purpose : The aim of this study was to clarify the changes in medication-taking behavior and related factors over time in patients with initial mild cerebral infarction up to 12 months after onset. Methods : Thirtyone patients with initial mild cerebral infarction were surveyed a total of four times : on admission to hospital, 3 months after onset, 6 months after onset, and 12 months after onset. Patients were surveyed regarding medication compliance, awareness of taking medication, perceived behavioral control, lifestyle risk factors, and subjective norms. Results :Medication compliance improved over time from the time of admission, but no changes were seen in awareness of taking medication. A cluster analysis based on changes in medication compliance over time revealed a “Persistently high compliance group” and a “Persistently low compliance group” for medication compliance. The health locus of control in the “Persistently high compliance group” was perceived as the result of chance and fate. Conclusions : Assessing the current state of medication compliance and the health locus of control during hospitalization permitted an understanding of patient characteristics, and indicated a need for recurrence prevention education and medication guidance tailored to each patient’s cognitive and behavioral characteristics