高齢者看護学実習における学生の高齢患者の理解の実態

The purpose of this study was to clarify how the students understand the older patients based on Orem’s nursing theory in Geriatric Nursing Training. The participants were１７nursing students in third grade. The interview was carried out using semi-structured interview with students for how they felt older patients. As a result, two categories were extracted ; ［ they need limited care for deficient parts］and［they have toughness cultivated through their long life］. The students understood the older patients as having self-caring abilities and thought that limited care should be provided only for deficient parts of patients. Also, they understood older patients as having strength cultivated through their long life. It is necessary for teachers to assess the Self-care agency more severely for students to get hold of mature elements characteristic of older patients

再発転移後の肺がん患者が持つ見通し

This study aimed at clarifying prospects that lung cancer patients undergoing treatment after recurrence and metastasis have. The study method is based on the qualitative descriptive study design. A semi-structured interview was performed for １３ lung cancer patients undergoing treatment after recurrence and metastasis. As a result, the following five categories were extracted［; Since it is recurrence and metastasis, the death is coming to me］［, I am undergoing treatment so I’m alright now but I’ll die someday］［, Let a matter take its own course］［, My life will be going as before］and［I will be living as long as I receive treatment］. Characteristics of the above are that all of the patients are ready to accept death and they had more than two prospects. They were characteristic of patients after recurrence and metastasis that symptoms that remind them of repeated treatment and death appear and there is uncertainty for their future. The above results have suggested the need to capture the state of each prospect while confirming the prospects of lung cancer patients under treatment after recurrence and metastasis

Psychological Adjustment in Lung Cancer Patients

The purpose of study was to clarify the psychological adjustment and related factors in lung cancer patients with recurrence/metastasis after curative surgery. Forty-one with lung cancer who were informed of a recurrence/metastasis after curative surgery completed a questionnaire comprised of the Mental Adjustment to Cancer Scale (MAC), Psychological Adjustment scale for Cancer Survivors (PACS), and information pertaining to demographic variables. When healthcare providers intervene in patients with lung cancer that has recurred/metastasized after curative surgery, it is necessary to assess patients’ psychological adjustment based on demographic information, such as age, sex, marital status, and employment status, and to provide effective support promptly. Factors associated with psychological adjustment with recurrent/metastatic lung cancer after curative surgery were 1) female, 2) having a job, 3) over 65 years of age, 4) having a spouse, and 5) advanced-stage cancer. There was no difference in psychological adjustment between treatment and the period from cancer incidence to recurrence/metastatic

Crosstalk between the Rb Pathway and AKT Signaling Forms a Quiescence-Senescence Switch

SummaryCell-cycle arrest in quiescence and senescence is largely orchestrated by the retinoblastoma (Rb) tumor-suppressor pathway, but the mechanisms underlying the quiescence-senescence switch remain unclear. Here, we show that the crosstalk between the Rb-AKT-signaling pathways forms this switch by controlling the overlapping functions of FoxO3a and FoxM1 transcription factors in cultured fibroblasts. In the absence of mitogenic signals, although FoxM1 expression is repressed by the Rb pathway, FoxO3a prevents reactive oxygen species (ROS) production by maintaining SOD2 expression, leading to quiescence. However, if the Rb pathway is activated in the presence of mitogenic signals, FoxO3a is also inactivated by AKT, thus reducing SOD2 expression and consequently allowing ROS production. This situation elicits senescence through irreparable DNA damage. We demonstrate that this pathway operates in mouse liver, indicating that this machinery may contribute more broadly to tissue homeostasis in vivo

がん患者を支援する訪問看護師の困難感

This study aimed to identify difficulties of visiting nurses who provide assistance to home-based cancer patients requiring palliative care. In survey１, a questionnaire survey was conducted involving３０visiting nurses working for visiting nursing stations（valid response rate :９０％）, and the data were analyzed using descriptive statistics. In survey ２, a semi-structured interview based on an interview guide was conducted involving４visiting nurses working for visiting nursing stations, and the data were analyzed using a qualitative and inductive approach. The results of survey１showed that the visiting nurses were more likely to experience difficulties with the worsening of a patient’s health status and at the initiation of home-based care. They also experienced difficulties with understanding medical conditions of patients and their families, supporting decision-making, and cooperating with visiting physicians. Their level of understanding about the explanation given by physicians and the sense of value of patients and families were factors that affected such difficulties, and so, in order to resolve them, the importance of cooperating to secure medical and nursing personnel and creating a setting where they can share their knowledge of patients’ conditions and treatments was indicated. In survey ２, the following ６ categories were extracted as difficulties encountered by visiting nurses providing assistance to home-based cancer patients requiring palliative care :［dealing with the worsening of the disease］, ［predicting the end of life］, ［being unable to care for patients without cooperation］,［being involved with patients by understanding their life before illness］,［preparing a home care environment for a patient’s end-of-life］, and［limits of current work situations］. The findings suggest the need not only to provide palliative care knowledge for the prediction and understanding of illness, but also to establish a system that allows multiple medical providers to assess patients’ conditions, in order to deal with their difficulties

学生が捉えた手術見学実習体験の術後看護への影響

Aim：To clarify the effects of observing surgery during clinical adult nursing practicum on postoperative nursing from the perspective of students. Methods：Semi-structured interviews were conducted with１０students in their third year at a nursing college. The obtained data were qualitatively and inductively analyzed. Results：When observing surgery for the patients they were caring for, the students were aware of［the importance of observing and assessment with the influence of surgery and anesthesia taken into account］. Subsequently, they performed［postoperative pain management based on findings from the observation of actual surgical settings］, while providing various approaches, including［Approaches to the promotion of patients’ awareness of the current situation in order to prevent postoperative confusion and to protect safety］. Through this process, they developed［a sense of responsibility for nursing care inspired by patients・families’ coping behaviors］． Discussion：The experience of observing surgery during clinical training was suggested to help students develop practical insights for care to promote postoperative recovery and a sense of responsibility for nursing care inspired by patients・families’ coping behaviors

看護学生が理解するパワー構成要素

The purpose of this study was to analyze trends in nursing students' assessments of the 10 powers of self-care agency in Gerontological Nursing and to identify educational support for students. The subjects were the practice records of 66 third-year nursing students who completed Gerontological Nursing from September 2019 to February 2020. The results showed that they had a perspective of directing their attention to the patient's interest, will, motivation, and reasoning among 10 power items that all students were able to assess, and that they approached their care with a respectful attitude toward the patient's perceptions and intentions for self-care. In addition, it could be inferred that they understood self-care in terms of patients' behaviors and activities by appearance. Conversely, from the items that more than half of the students were unable to assess, it could be inferred that they were unable to assess how to apply self-care agency to the patient's prospect and lives in future

終末期がん患者を在宅で介護する家族のストレス・コーピング

To clarify stress coping in families caring for end-stage cancer patients with difficulty controlling pain at home, semi-structured interviews were conducted with family caregivers using home-visit nursing services, and the obtained data were qualitatively, inductively analyzed. Stress responses in these family caregivers were summarized into５categories, including :［ having no idea what to do with the patient suffering from pain］and［being unsure on how to consult with medical professionals about pain］. In addition,６categories, representing the characteristics of their stress coping, such as［discharging negative emotions through recreational activities and catharsis］and ［managing pain based on experience］, were created. Families caring for end-stage cancer patients with difficulty controlling pain at home experienced several types of stress, but it was suggested that they personally grew through the process by adopting various coping strategies

治療を中止したがん患者の回復への希望に対する看護師のジレンマ

In this study, the authors clarified experience of nurses with the dilemma toward the wish for recovery of cancer patients who discontinued treatment. An interview survey was performed for 14 nurses who had ever care cancer patients who discontinued their treatment. Experience of nurses with the dilemma toward the wish for recovery of cancer patients who discontinued treatment consisted of the following categories ;［ I am not able to respond to the patient’s wish though I want to］,［There is difference how to spend the time remained between the patient and me］,［I do not have a sufficient power to support the end of the patient’s life］,［I feel disconsolate being unable to realize the patient’s wish for recover］and［I’m a nurse. I never run from my patients］. The nurses with dilemma had experience in facing nursing cares driven by the sense of responsibility as a nurse while holding pain in their heart. Ethical problems may be underlying in this experience, and the need of team work, not individual responses, has been suggested. Therefore, support to reveal experience of nurses in daily nursing care is needed