Comparison in the views of life and death between nurses and docters of a University Hospital

医師と看護師の死生観とその影響要因の相違をふまえ，質の高い緩和ケアチームについて検討することを目的とした．A 大学病院に勤務する医師と看護師に死生観について質問紙調査を行った．平井らが開発した死生観尺度（▯＝０．８８，７因子２７項目）を用いた．有効回答は医師１２０名（医師群）と看護師３４７名（看護師群）であった。統計処理については危険率５％未満を有意差とした．分析にはSPSS１１．０J for Windows（SPSS社製）を用いた．倫理的配慮は倫理審査会の承認を得た後，対象者へは参加の自由とプライバシーの保護を保証した．①「死への恐怖・不安」と「人生の目的意識」の因子には群間で有意差は認められなかった．②「死後の世界観」，「解放としての死」，「死からの回避」，「死への関心」や「寿命観」の５因子において両群間で有意に看護師群の方が高かった．③年齢などの各要因と死生観尺度との関係は両群者ともに年齢と「寿命観」で有意差が認められた．④死を迎える時に，希望する場所と死生観尺度得点に有意差が認められた．医師と看護師の死生観は「死後の世界観」などの因子得点で有意差が認められ，緩和ケアチームを効果的に展開していくためには双方の死生観の理解と，ケアへの活用の必要性が示唆された．A high quality palliative care team has been examined considering the differences between doctors and nurses in their views of life and death and its influential factors. A survey has been conducted on doctors and nurses employed at A University Hospital in their views of life and death. “Rinroshiki Syakudo”, a scale developed by Hirai et al（▯＝０．８８，７ factors，２７ items）, has been used as a scale of their views. The results of １２０ doctors and ３４７ nurses were analyzed by t-test, and significant difference was defined as a risk below ５％. SPSS １１．０J for Windows（by SPSS）was used for the analysis. After an approval of an audit for an ethical consideration, participants were ensured their freedom to participate and privacy protection. １） No significant differences have been found in factors “death anxiety” and “life purpose” in scales of views of life and death ２） However ５ factors， “after life belief”， “death relief”，“death avoidance”， “death concern” and “supernatural belief” were significantly high in nurses. ３） There was also a significant difference between the age and their “supernatural belief” in both doctors and nurses. ４） There were also significant differences in “where they want to die” and the total score of the scale, when facing own death. There being differences in factors such as “afterlife belief” between doctors’ views and those of nurses, the result suggested the need to understand both of the views and reflect them to palliative care

Randomized clinical trial quantifying the effectiveness of a self-monitoring intervention in cancer patients with peripheral neuropathy: A quantitative study

Objective: The aim of this study was to quantitatively evaluate the efficacy of a self-monitoring intervention for the management of persistent chemotherapy-induced peripheral neuropathy (CIPN). Methods: A randomized controlled clinical trial was conducted on 65 outpatients receiving taxane or platinum-based anticancer drugs. Participants were assigned to the control group (CG; n ​= ​32) or the self-monitoring group (SMG; n ​= ​33) and followed for 6 weeks. Non-interveners were blinded. Participants in the intervention group self-monitored and recorded. The researchers provided feedback on the recorded symptoms and coping strategies once every 3 weeks. The efficacy of the 6-week self-monitoring intervention was assessed, using various measures, at baseline (T0), 3 weeks (T1), and 6 weeks (T2). Scores of CIPN, Functional Assessment of Cancer Therapy/Gynecologic Oncology Group-Neurotoxicity, Distress and Impact Thermometer, Self–Efficacy Scale for Advanced Cancer, and Functional Assessment of Cancer Therapy-General of both groups were compared. Safety behavior in daily life was also compared. The study was conducted from August 9, 2017 to March 30, 2020 in outpatient clinics at three hospitals. Analysis was conducted using the t-test, Mann–Whitney U test, χ2 test, and two-way repeated-measures analysis of variance (two-way RMANOVA). Results: No significant differences were noted between the two groups in the CIPN score, the Distress and Impact Thermometer score, and in safety behavior in daily life. The mean Self-Efficacy Scale for Advanced Cancer score at T1 differed between the two groups (CG mean ​± ​SD: 358.44 ​± ​109.90; SMG mean ​± ​SD: 421.21 ​± ​85.54), which was significantly higher in the SMG (P ​= ​0.012). Two-way RMANOVA revealed an interaction between the CG and SMG (F ​= ​5.689, P ​= ​0.004). Quality of life scores were higher in the SMG than in the CG at T0, T1, and T2. Two-way RMANOVA analysis showed an effect of the intervention (F ​= ​7.914, P ​= ​0.007). Conclusions: The self-monitoring intervention maintained the participants’ quality of life. This finding suggests its effectiveness in patients with peripheral neuropathy

看護学生の死生観に関する研究

この研究の目的は,看護学生の死生観に影響する要因を明らかにし,終末期教育に対する示唆を得ることである.対象者はA看護専門学校に通う看護学生113名であり,それらの対象に質問紙調査を行った.測定用具は平井らが開発した死生観尺度(α係数=0.88) 7因子27項目の臨老式尺度を用いた.回答が得られた学生94名をspss11.0j for windowsを用いて分析を行った.この研究は, A専門学校の校長の許可を得て,学生に成績に影響しないことを保証して行った.その結果は,次のようにまとめられた. 1. 死生観には,宗教,性格型,読書,映画,年齢,学年が影響していた. 2. 学生は,「死後の世界観」の得点が高く,「死からの回避」の得点が低かった. 3. 死生観に「身近な人の死」が影響していなかった. 4. 終末期教育において,講義や技術の教授のほかに死に関する書籍や映画を取り入れて生と死を討論できる教育を行っていく必要性が示唆された.The object of this study is to make clear the influential factors of nursing students' attitudes toward life and death and to make a suggestion in terminal care education. Subjects were 113 students of nursing school A, whom questionnaire surveys were conducted on. A scale of views of life and death developed by Hirai et al. (coefficient α=0.88) was used as a measurement scale. SPSS11.0j for Windows analyzed answers from 94 students whom answers were retrieved from. Approval to conduct the study was obtained from the school principal, and students were ensured that the survey would have no effect on their records at school. The results are as below: 1. Whether the student has a religion or not, personality type, whether the student has a habit of reading books or not, whether the student has a habit of watching movies or not, age, and the school year of the student were influential factors 2. The students had high scores in "afterlife belief" and low scores in "death avoidance" 3. "Death of close ones" had no influence on the students' views of life and death 4. It was suggested that the adoption of books and movies and discussion on life and death is necessary in terminal care education, aside from lectures and skill teaching