A case study of the pancreatic cancer survivor evaluated from the salutogenic standpoint

膵癌の治療成績は不良であり, 現在においても, 膵頭部癌切除例の生存期間の中央値は12.3ヶ月, ５年生存率は13.0％と低値である. 浸潤性膵管癌は膵癌の大多数を占めるものであるが, 同診断により手術を受けたのち, 19年が経過したサバイバーに, 病気との向き合い方についてインタビューする機会を得た.１) 疾病の理解, ２) 病気に対する自分自身の構え, ３) 病気への対処行動と予防行動について, その語りを健康生成論的視点で分析したところ, 首尾一貫して健康のベクトルを健康軸に向けるよう, 自分はこれでは死なないと信じて, 病名告知がない状況で自ら文献を調べて疾患を理解し, 回復手段を考え, 便秘やガス貯留が無いように代替療法を取り入れるなど, 主体的かつ積極的に過ごしてきたことが分かった. また, 入院中の生活で感じたさまざまな不合理や, 職業的背景や価値観を尊重した対応がされなかった際に感じた疎外感については, 今後のケアで留意すべき示唆となった.\nThe prognosis of invasive ductal pancreatic cancer is not satisfactory even at present. The median survival is reportedly 12.3 months, and 5 year survival rate is as low as 13.0％ in patients who underwent pancreatoduodenectomy.We interviewed a pancreatic cancer patient who survived for more than 19 years following pancreatoduodenectomy, with regard to the way he coped with the disease. We have analyzed the interviewfrom a salutogenic standpoint such as 1) understanding of the disease, 2) his own preparedness, 3) manageability and preventive approach to the disease.As the result, we realized that he maintained a proactive and positive attitude : he had a strong sense of coherence to maintain his health, he believed that he would not die from the disease, he examined the literature to comprehend the disease (since informed consent had not been achieved sufficiently in those days), and he managed constipation and abdominal distension well by resistance training, special supplements and devised abdominal massage. Furthermore, he sometimes felt irrational and alienated during his hospitalization, because his value judgment fostered through his long career of journalist was not respected during his treatment. This should be given consideration in future

The ANQueSt (Asian Nurse Quality of Life Study) to compare quality of life and identify related variables: study protocol for a cross-sectional design

Background: Hospital-based nurses’ quality of life is affected by stress coping ability, job satisfaction, job stress, and social support. These relationships appear to be identical, even among different countries. Nevertheless, dynamic comparisons of quality of life in Asia are very limited. The Asian Nurse Quality of Life Study was designed to compare nurses’ quality of life across Asian countries and identify variables that are related to quality of life. Research design: A cross-sectional questionnaire survey design. Subject: Hospital based nurses are recruited from Japan, Singapore, Malaysia, Thailand, and Bhutan (Five Asian countries). The inclusion criteria for the research are: 1) being from an Asian country, 2) working at a teaching hospital, and 3) obtaining the nursing director’s agreement. Co-researchers from each country independently select particular research fields. Method: A cross-sectional survey is conducted across five Asian countries (Japan, Singapore, Malaysia, Thailand, and Bhutan). Quality of life (WHOQOL-BREF), job stress (National Institute of Occupational Safety and Health questionnaire), and demographic data are assessed. Quality of life is directly compared among the countries. Stepwise multivariate linear regression analysis is performed to identify variables related to quality of life. Survey duration: Survey duration is between October 2013 and August 2014

Discharge Support Initiatives and Self-evaluation by Ward Nurses in District A

Ａ県Ａ圏域の病院看護師の退院支援への取組みの現状や自己評価，退院支援に関する病棟看護師の役割認識等を調査し退院支援の実態を明らかにすることを目的に，Ａ圏域の総合病院４か所の病棟看護師400名を対象に質問紙調査を実施した（有効回答299名，有効回答率74.8%）．退院支援病棟評価では13項目中10項目において，70% 以上が「いつもできている」または「ときどきできている」と回答し，退院支援自己評価の尺度全体の得点± SD は20点満点中13.90±2.44と共に概ね高評価であったが，院内外他職種との連携，役割分担等に課題があることが推察された．また病棟看護師の役割として，患者・家族の意思決定支援を重要視している一方，療養環境や社会資源の調整まで病棟で完結しようとする認識が窺えた．今後，他職種との関わりやカンファレンスの持ち方，他職種との役割分担を再確認し，病棟における退院支援のあり方を整理する必要があると考える．This study aims to elucidate the state of discharge support by investigating initiatives for discharge support by hospital nurses, their self-evaluation, and their role awareness regarding discharge support in District A, Prefecture A. We conducted a questionnaire survey on 400 ward nurses at four general hospitals in District A. Of 299 respondents (valid response rate: 74.8%), by 10 item in 13 items of the discharge support ward evaluation, "It\u27s always done" or "It’s sometimes done" was answered more than 70 % , and the total score ± SD for discharge support self-evaluation was 13.32 ± 2.33, respectively, suggesting generally high scores for both. However, issues associated with items such as coordination with other professionals inside and outside of the hospital, and role allocation were noted. Although several subjects gave the highest priority to patient and family decision-making support in their role as a ward nurse, they most likely felt that they had to complete everything up to the recuperative environment and social resource adjustment at the ward. Furthermore, it appears imperative to reconfirm involvement and conferences with other professionals, the acquisition of assessment and communication methods for decision-making, and role allocation with other professionals to determine how to implement discharge support at wards