Occupational stress and moderator factors -nurse-

2カ所の地方都市の公立病院で働く看護婦585名に職業性ストレスとモデレータ要因についての調査を行った。職業性ストレッサーとして、訴え率の高い項目は「労働の過重負担」であった。バリマックスによる因子分析を行ったところ①自己実現、②人間関係と対人責任、③意欲と理念の喪失、④仕事の負担、⑤サポート、⑥ライフイベントの6つの因子を抽出した。①自己実現、③意欲と理念の喪失、④仕事の負担の因子は、年齢が若い看護婦ほど否定し、年齢の上昇と共に肯定する傾向が見られた。反対に⑤サポート因子は年齢が若いほど肯定し、年齢の上昇と共に否定する傾向が見られた。すなわち、若い看護婦は、能力の発揮ができない、意欲が喪失する、仕事が負担であると感じており、年齢の上昇と共に能力の発揮ができる、意欲がある、仕事が負担ではないと感じていた。しかし、若い看護婦ほどサポートを多く得られており、年齢の上昇とともに減少していた。これらの結果より、職業性のストレスやモデレータは年齢あるいは経験年数により質や量が変化していた。Occupational stress and moderator factors were investigated in 585 nurses working in two pubric hospitals local cities. As occupational stresser "too hevey labor" was most frequent in complaiment items. The following factors were extracted by varimax analysis, ①self-expression, ②human-relation and personal reponsibility, ③lost ofwill and ideology, ④loaded labor, ⑤support, ⑥life-event. It was observed that ①self-expression, ③lost ofwill and ideology, ④loaded labor were denayed by younger nurses, but ⑤support was increased with age. Accordingly, younger nurses felt that they couldn't show their abilities, they lost their will, their duties were heavy, but along with age, they felt they could exhibit their abilities, willing to work, their burdens were not heavy. The younger the nurses, the more the supports were given, and they received fewer supports with age. In conclusion, quality and quantity of occupational stress and moderator change with age and occupational carrier

Daily VMA (vanillyl mandelic acid) variation in urine in relation of fatigue sensation, stress and life stile of nurses on night shift.

Daily VMA variation in urine in relation of fatigue sensation, stress and life stile of nurses on night shift. To evaluate exhaustion objectively in hospital nurses, daily variation of urinaly VMA (vanillyl mandelic acid) excretion was measured in hospital nurses working in daytime and nighttime and it's correlation with the data from Psychological Stress Response Scale (PSRS) test, the burn-out scale, quality and quantity of sleep and daily life stile recorded throughout 24 hours were studied. VMA level in urine showed circadian rhythmic movement, higher in daytime and lower in nighttime. During night shift, VMA in urine in nighttime showed slightly higher level than during day shift but in the subsequent daytime after night shift, VMA level was stillkeeping normal circadian rhythm, resuling flatness of daily fluctuation of VMA level. Dissatisfaction of sleep during daily fluctation of VMA level. Dissatisfaction of sleep during daytime was noticed. Correlation between VMA level in urine and sense of tiredness, stresses or burn-out scale were not carfied in this study because of shortage of samples but working conditions might affect biologicalresponse of exhaustion

The health and daily-life problem of the aged at homes for three months after discharge from the hospital

今後の継続看護・在宅看護を考えてゆく際の参考にするために、医療施設から自宅へ退院した高齢患者が3カ月経過後に、どのような健康上や日常生活上の問題点をもち、家庭や地域でどのような援助や支援を受けて生活しているかについて報告をする。総合病院に入院していた70歳以上の高齢者で自宅に退院する患者92名のうち、退院後3カ月経過後の時点で回答を得た70名（76.0％）について分析を行った。病状については約8割の者は特に問題を持っていない、しかし約2割の者は病状に悪化が見られた。現在困っていることは「健康上の問題」とした者は約3割であった。日常生活の自立状況では「仕事もできる」とする者が退院時の18.6％より、3カ月後は40.0％に増加しており、「生きがいがかなりある」とする者は退院時の34.3％より、3カ月後は45.7％に増加していた。しかし、回答が得られなかった22名（24.0％）の高齢者は、より重要な問題を包含している可能性があり、追跡をする必要がある。We report that for the guidance to consider future continuing-nursing and home-nursing, the elderly patient who living in homes for three months after discharged from the hospital, have what problems in their health and daily lives and what sort of supports they are receiving in their homes and from the vicinities. Analysis was done on the health and daily-life problems of 70 elderly who responded to a survey which was mailed, three months after discharged from the hospital, among 92 elderly more than 70 years old. 80% of them had no problems in their conditions, but in 20% conditions got worse. About 30% of them complained of the problem of health with respect to independence of daily life. Patients who were able to work increased from 18.6% to 40.0%, and the ptients who felt worth living increased from 34.3% to 45.7%. 22 elderly who hadn't answer seemed to have more severe problems however, further surveys are needed

The research on the problems of health care and living of the aged (Pursuing the cases of home treatment given to the elderly patients for one year after their discharge)

退院後の生活に目を向けた適切な退院指導がなされることは、高齢患者が安心して在宅療養を送る上で、重要な意味を持つ。そこで病院から在宅療養に移行した70歳以上の高齢者の抱える問題を4回に渡って1年間調査し、これまでに退院時、3ヵ月後、6ヵ月後の調査結果を報告した。本稿では1年を通じて回答のあった53名について健康と生活上の問題の変化を分析し、考察した。在宅療養に移行した高齢者の健康状態と生活上の問題は、ほぼ一致して退院後6ヵ月から1年後までに変化を認め、特に日常生活上の問題は著しく増加した。その原因として病状の悪化との関連が考えられた。また、高齢者の問題についての意識は、研究者の専門的な問題意識に比べて低かった。従って入院中に退院後の生活を予測することには限界があり、今後は退院指導の充実と伴に在宅サービスとの連携が重要であることを認めた。We planned to make emerge the problems felt by the elderly patients of 70 years and over given home treatment. As a means of our research, four times a year we sent a questinnaire to the aged who had been discharged. After collecting the answers of the questionnaires, we decided to focus on the 53 elderly patients who answered all four questionnaires, and then tried to make their problems emerge. The contents of the questionnaires were about their health care in a year and how their daily life changed. We can see that the condition of the elderly patients under home treatment and their living problems have changed almost without exceptions six months to a year after their discharge. Especially the number of the problems in their daily life increased remarkably. These results might be considered to be caused by the aggravation of their diseases. In addition, the elderly patients are not as conscious of their own problems as a specialist with a critical mind. Therefore, there is a limit to estimating the change in lifestyle of a discharged patient while they remain hospitalized. We consider it essential to get full discharge-care closely connected with home service for elderly patients

Dietary treatment for the aged (A study on dietary treatments for the aged conducted at the time of leaving hospital and on the results of interviews with discharged patients)

高齢者を対象とした退院指導の評価を行う目的で、70歳以上の外来通院患者を対象として、患者が受けた退院指導の内容、理解度、実践状況の3つの要素について分析を行った。その中から、特に食事指導に焦点をあて在宅療養の視点から退院指導の問題点を考察した。食事指導を受けて退院した患者の約半数は更に指導を希望していた。指示された指導が実践できない患者の理由は、(1)指導不足、(2)意欲の喚起不足、(3)協力者の知識不足が上げられた。患者が希望している指導の内容は、食事療法の指導だけでなく、治療食や老人に適した食事についてであった。特に、栄養価の高い食事への関心が高く、具体的な指導を希望していた。また、看護婦による、社会資源を活用すべきかどうか、訪問看護を適応すべきかどうかの判断が、退院に向けてのアセスメントの内容として問題となった。With the purpose of estimating the quality of care given to elderly patients who are about be discharged, we made an analysis of three main factors. The first is the details of discharge-care, secondly the degree to which the patient underdtands the type of care, and thirdly the care practice situation ; focusing on outpatients who are more than 70 years of age. Bringing meal treatment into focus, we examined the problems of discharge-care from the viewpoint of home treatment. About half of the discharged patients who were given meal treatment in the hospital hope to have further personal medical direction about their meals after being discharged. The reasons why the directed treatments couldn't be practiced by the patients were given as follows ; (a) deficiency of medical guidance, (b) insufficient encouragement of practice, (c) cooperator's having lack of knowledge about care of the aged. The details of medical treatments which the elderly patients want to be given are not only what is called meal treatment but also knowledge about food for patients and about appropriate meals for the aged. The patients seem to be highly interested in nutritious food and hope to have concrete advice for following a nutritious diet. Additionally, what is important in deciding the question of discharging is how to make good use of social resources by nurses and how to apply visiting nursing to be aged

Sutdies on Galvanic skin responce (GSR) in relation to psychological condition test for the students.

Psychological anxiety trend was studied by Galvanic skin responce (GSR) 60 students, 7 of male and 53 of female, in School of Health Sciences Tokushima University, and the results were compared with the data from State Anxiety Inventory (STAI) test and Self-rating Depression Scale (SDS) test. Compared GSR with STAI, initial responses of GSR showed postive relation to state anxiety in STAI test ; while compared GSR with SDS, both of spontaneous and initial responses showed reversed correlation. Although spontaneous and initial responce in GSR were more remarkably augmented in the female students than male students, these trends might not be caused only by sex difference because the test environment was not same in two groups. Based on these data, GSR is considered to represent objective indicator of psychological anxiety. However further basic data accumulations are needed in regard to some factors affecting the data such as sex of examiners or examinees and test environment

Research of the problems on the elderly patients at discharge from the hospital concerning their health and daily life at home

高齢者の退院指導及び在宅看護の在り方を検討した研究は少ない。そこで、高齢者の自宅院時に持つ健康上及び生活上の問題を明らかにすることを目的に、面接調査を行った。対象は、中・四国の3国立大学付属病院と1総合病院で退院許可のあった70歳以上の患者78名とした。調査内容は、退院時の患者の身体状態・日常生活動作・退院時の患者の状況・家族の状況・健康に対する意識や取り組みについてとした。その結果、(1)高齢の自宅退院患者の23.1％は、身体状態上継続看護が必要であった。(2)退院患者の20.5％が、退院後生活を自立する為に介助が必要であるとしていた。(3)退院患者の57.7％は心配事を持ち、50％は相談・指導を希望していた。(4)患者の世話人の42.3％は職業を持ち、27.3％は健康を害していた。(5)退院患者の73.1％は何らかの健康管理がなされ、84.7％は生きがいを持っていた。Now there are few researehes into the guidance which be done for the elderly patients at the time of leaving the hospital and into the ways of their home nursing care. Therefore, we did interview the elderly patients in order to make it clear what problems they have about their health and their life. In the three national university hospitals in Chugoku District and Shikoku District and one general hospial, we focussed on the 78 patients more than seventy years old who were allowed to leave the hospital. The purpose of our research is to know body condition and the situation of the patients leaving the hospital, activities of their daily life, the situation of their family and their consciousness and care about their health. After having done this research we conclude as follows, (1) 23.1 percent of all the patients need continuing nursing care from the viewpoint of their body condition after leaving the hospital. (2) 20.5 percent of all the patients need help from their family or others to support themselves at home. (3) 57.7 percent of all the patients have worries and 50 percent of them have a wish to consult with the doctors or the nurses and to be guided by them. (4) 42.3 percent of people who take care of patients have their own job and suffer from poor health. (5) 73.1 percent of all the patients who leaves the hospital were given some health care before entering the hospital and 84.7 percent of them seem to lead a life worth living

Coping mechanisms of Junior high school students who feel unwell

本研究は，子どもに対する健康教育の具体的方策の検討に係る基礎的資料として，中学生の体調不良自覚の実態を調査するとともに，自覚症状に対する対処行動の傾向を明らかにすることを目的とし，以下の方法で分析を行った． ２００３年に中学生８１４名を対象として，睡眠や食事に関する生活習慣及び，体調不良の自覚とその際の対処行動に関する，独自の質問紙調査を実施し，記述統計及び項目間の有意差の検定を行った． ８１４名中，８０８名から有効回答が得られた．回答者の約３～４割が「腹痛」「頭痛」「倦怠感」を日常よく経験しており，対処行動には，学年，性別，体調不良自覚の頻度，生活習慣の違いによる選択率の有意差が生じていた． 体調不良の症状を自覚した際，中学生では学年が進むとともに他者依存から離れ，自己の判断により，よいと思う方法を選択する傾向に変化していた．中学生の時期には，自分の対処行動に伴う結果が適切な対処行動の選択に影響するとともに，学校や家庭での健康教育を含めたその他の要因が対処行動に関する知識の習得に影響していると考えられる．また，対処行動の選択には男女差が顕著な項目があり，男子は自己判断で対処する傾向があり，女子では他者に伝える傾向と，対処行動として合理的で確実な方法を選択する傾向があった． 以上の結果と考察から，発育段階，性差，生活の背景などを視野に入れた包括的，個別的な健康教育や保健指導の必要性が示唆された．The purpose of this study is to investigate the characteristics of feeling unwell and the coping styles of Japanese junior high school students. A questionnaire survey of ８１４ junior high school students was conducted in ２００３． An original questionnaire was developed, consisting of questions relating to １） lifestyle, including sleeping and eating habits, and ２）the characteristics of feeling unwell and coping mechanisms. The data was analysed using descriptive statistics and ▯２ or Wilcoxon to investigate the relationship between variables. Eight hundred and eight（８０８）questionnaire were returned. About ３０-４０% of respondents experienced stomach ache, headache and fatigue on a daily basis. Their grade, gender, lifestyle and the frequency of feeling unwell were associated with their coping styles. As students got older, their coping style became more independent. Junior high school may be the time to develop an independent coping style based on their own experiences as well as health education at school and home. There was a strong relationship between the coping style and gender. Girls tend to use a more internal locus of control and self-judgment, whereas girls tell others and choose rational and reliable strategies for coping. The results indicate that comprehensive and individualized health education and guidance incorporating personal development, gender and lifestyle are needed. The study’s results provide basic information for the development of health education strategies for school children

Probrems and needs on elderly patients after discharge from hospital - Analysis from the interview records of their patients -

高齢者人口の増加に伴い慢性疾患をもつ老人が増え在宅医療の必要性が叫ばれているが、一旦入院すると症状が軽快しても自宅への退院は困難とする事例が多い。そこで、高齢者の在宅医療がスムーズに行われるための退院指導のあり方、継続看護の方向性を得るために患者が自宅退院を迎える時どのような問題を持ち、どのような援助を希望しているかを質問紙を用い面接調査した。70歳以上の患者が自宅へ退院する時の心配なこと、医療従事者に相談したいことは1、健康面で病気のこと、2、日常生活面で食事のことが多かった。退院後、困る事では1、健康面の事が多く、次いで2、日常生活面、3、精神面の順であった。援助の希望では1、日常生活面が最も多く次いで2、健康面、3、精神面であった。このような心配事、ニーズが退院後どのように変化しているのか調査中である。The population of the aged people with the chronic disease is increasing. It produces demands for the home health care. We focused on the home health care for the aged above 70 and interviewed with a questionnaire to them who were ready to discharge. We also have been investigating every three months how problems and needs were changing after discharge. In this paper, we report on results of this interview and discuss problems and needs they have to provide our better nursing care for them