Actual conditions of sexuality and sexual perceptions among IBD patients in Japan

The aim of this study was to clarify the conditions of sexuality and sexual perceptions in patients with Inflammatory Bowel Disease (IBD). Patients at 15 self-help groups and 14 hospitals were surveyed using a self-administered questionnaire. The questions’ basic attributes included sex, age, type of disease (Ulcerative Colitis (UC) or Crohn’s Disease (CD)), and presence of stoma. The questions also included conditions such as frequency of sexual activity, and sexuality satisfaction index “SEXSI-IBD (Sexuality Satisfaction Index for IBD),” and sexual perceptions. A total of 195 valid responses from IBD patients was obtained and subjected to analysis. With regard to the frequency of sexual activity in terms of the number of occasions of sexual intercourse, “approximately once or twice a month” was given as most frequent response, but overall, the largest number of responses indicated “no physical contact and no sexual intercourse” and “physical contact but no sexual intercourse.” In the results of the SEXSI-IBD, the highest score was for the “importance of skin ship,” and the lowest scores were for “sexual communication” and “sexual difficulty.” As concerns sexual perceptions, 60.0% of the responding patients said sick and disabled people can generally engage in sexual activity, but as opposed to this, only 7.7% said they were able to discuss matters related to sexual activity with a healthcare professional, and 29.7% of participants said they believed healthcare professionals can conduct consultations on matters related to sexual activity. The frequency of sexual intercourse among IBD patients in Japan is low, and it was clear that in terms of the degree of satisfaction of sexuality, these problems necessitate emphasizing the importance of skin ship and support for sexual communications. With the exception of healthcare professionals’ reluctance to discuss sex problems, it is desirable to recognize the actual conditions of sexuality among IBD patients, and provide specific forms of support

ヨウジ ゼンキ ノ コドモ ガ ウケル サイケツ ニ ドウセキ スル ハハオヤ ノ ストレス

背景 近年,小児看護領域において急速にプレパレーションという概念が普及してきた.医療処置を受ける子どもにプレパレーションを提供し,その効果を最大に引き出すためには,子どもが最も信頼している母親の存在が重要である.しかし,我が国では,母親が同席し泣き叫ぶ子どもをみることで不安が増大する,また子どもは母親が助けてくれないことによって不審感をもつなどを理由に,同席を推奨する施設は少ない.目的 幼児前期の子どもの採血に同席した母親27名を対象に,唾液中アミラーゼ(AMY値),STAI(状態不安得点)の測定及び母親へのインタビューを行い,子どもが受ける採血に同席する母親のストレスを明らかにすることを本研究の目的とした.結果及び考察 AMY値と状態不安得点は採血前から10分後に有意に低下したが,採血前の状態不安得点は標準レベルであった.また,母親は採血に同席することについて【一緒が安心】と感じていた.子どもが不安や恐怖で泣くことがあっても,子どもの年齢や過去の経験から予測可能な子どもの反応であり,心の準備ができていたことから【泣くことの受容】に繋がったと考えられる.結論 子どもが受ける採血に同席した母親のAMY値と状態得点からは,これまで医療者の間で信じられてきた同席による母親の不安の増大は否定された.しかしながら,母親は採血時の姿勢について【抱っこの難しさ】も感じているため,単に同席を勧めるだけでなく,安全性の高い固定法や幼児期前期に有効なディストラクションを具体的に示し,母親が自信をもって採血に臨めるよう支援することが重要である.Background Mothers are the persons who are often the most trusted individual by their children and their presence is important when preparing children for medical treatment that can be invasive,painful or generally frightening.This concept is often referred to as "preparation" and is at the heart of caring for the parent and child; as both go through the procedure,one as the patient the other as comforter and safe trusted presence for the child.In Japan,however,few hospitals agree with the concept of preparation that believing mothers may become increasingly anxious as they see their children crying and children may mistrust their mothers for failing to help.This paper seeks to examine stress levels of mothers who are participating in a preparation procedure of drawing blood. Method 27 mothers of children aged 1-3 years who were present when blood samples were taken from their children,agreed to participate in the research project.Informed consent was given for this research by the participants A sample of saliva was taken pre and post procedure and examined for salivary amylase(AMY) levels which are stress indicators.An increase would indicate higher stress and a decrease would indicate lower stress.A State-Trait Anxiety Interview (STAI)was also performed per and post procedure a high score would indicate high anxiety.A low score would indicate low score. Findings Salivary AMY levels and STAI scores decreased significantly 10 min after the blood sampling compared with before,STAI scores before blood sampling were normal,and mothers also felt reassured if they were present while the blood was being drawn. Discussion Mothers felt reassured when they were present while the blood was being drawn.Even if children cried due to anxiety or fear,mothers considered this reaction predictable because of the child\u27s age and their own experience; because the mothers were prepared for it as a result,they were able to tolerate the crying remaining calm and giving reassurance to the child.These findings go against the widespread belief among medical professionals that mothers become more anxious if they are present during treatment.However,mothers also found it difficult to hold their children during the blood drawing,so in addition to recommending that they be present,physicians must assist mothers in facing blood sampling with confidence,by teaching them how to hold the child still in a safe manner and showing them effective ways of distracting infants

Comparison of perceptions of domestic elder abuse among healthcare workers based on the Knowledge-Attitude-Behavior (KAB) model.

It is generally agreed that healthcare workers are ideally positioned to recognize and diagnose cases of elder abuse. However, little is known about their knowledge and understanding of this issue. The objective of this study was to assess and compare the perceptions of different groups of healthcare workers toward elder abuse in Japan, using the Knowledge-Attitude-Behavior (KAB) model. Home-visit nurses, medical doctors, care managers, care workers, public health nurses, and social workers, with experience of dealing with elder abuse received self-administered questionnaire surveys that inquired regarding demographics, knowledge, attitudes, and behaviors regarding elder abuse. A total of 311 healthcare workers participated in this survey. To compare the differences among the groups, a one-way analysis of variance with a post-hoc Tukey's test, and a Kruskal-Wallis with post-hoc Steel-Dwass tests were used in accordance with data normality. Multiple linear regression analysis was conducted to explore variables that predicted the healthcare workers' perceptions, and covariance structure analysis was used to examine whether the KAB model can accurately predict healthcare workers' perceptions. Multiple comparisons showed significant differences in knowledge, attitudes, and behaviors regarding elder abuse among the abovementioned six groups. Age, sex, and years of work related to the care of elderly were extracted as significant determinants of healthcare workers' perceptions of elder abuse. The examination of the KAB model with covariance structure analysis yielded a model with strong goodness-of-fit. These findings emphasize the need to take effective measures to improve their perceptions as well as review the role of each healthcare worker so that they can be more concerned with and involved in the safeguarding of the elderly. Given the strong goodness-of-fit demonstrated by the KAB model, education of healthcare workers on both the knowledge of, and attitudes toward, elder abuse may help in improving healthcare workers' behavior in dealing with elder abuse

Changes in the Impacts of COVID-19 over Time on Families with Older Adults Living on Remote Islands in Japan: A Study in Family Ethnographic Research

Coronavirus disease 2019 (COVID-19) affected not only individuals but also families. The purpose of this study was to clarify the temporal changes in the impact of the COVID-19 pandemic on entire families with older adults susceptible to infection living on small islands in Japan over the duration of the pandemic. Family ethnographic research was conducted from 2021 to 2023, using the Concentric Sphere Family Environment Theory as the theoretical framework. Formal interviews were conducted with 20 families. In addition, data from informal interviews, participant observation and other sources were compiled into field notes. All data on the impact on the entire family were extracted and content analysis was conducted. Six categories (family internal environmental system, family system unit, micro system, macro system, supra system, and family chrono-environment system) and a total of 85 subcategories were extracted. The results show that COVID-19 exerted not only negative but also positive impacts on the entire family, and their temporal changes are clarified. The impact on families is believed to have been influenced by the family external environment, such as increases and decreases of infection cases or events that occurred outside the family. The knowledge acquired from these studies will help healthcare professionals in providing appropriate family support