看護基礎教育における「安楽確保技術」の効果的な教授方法 : 「リラクセーション」「指圧」「マッサージ」に焦点をあてて

「リラクセーション」「指圧」「マッサージ」の学生教育に関する研究論文を分析し，効果的な教授方法および課 題を検討した．医学中央雑誌Web. 版Ver.5を用いて，2000年から2013年までの文献を検索し，17件を分析の対象と した． 　17の文献は，【学生への教育効果に関する研究】と【リラクセーション技法・技術に関する研究】の2つのカテゴ リーに分類され，以下のことが明らかになった．1．リラクセーション技法について教授することが必要である．2． 基礎看護技術演習を実施する初期にマッサージ・指圧に関する教育を実施することが有用と考える．3．リラクセー ション技法・技術演習の際，血圧，脈拍数測定など生理学的指標を実施することは科学的根拠を提示することに繋 がる．4．リラクセーション技法は多種類あり，その技法の特徴や対象となる患者の状態や個別性を考えて選択で きるように教授する．5．看護におけるリラクセーション技術としてのマッサージや指圧の目的，対象者，方法， 手順，禁忌，効果判定方法等について今後さらなる研究が必要と考える．The aims of this study are firstly analyzing methods of relaxation technique and secondly how to effectively educate students.　We investigated literature of Ichushi Web Ver.5 from 2000 to 2013. 　Seventeen articles of literature were found related to relaxation methods and about the effective education methods for students.　These 17 literature were categorized in two types.　One is the effective education methods for students, the other is the relaxation methodology how to relax patients and make them comfort. 　17 papers, which we have categorized and concluded are as follows. 　【1】 Education for students, related to relaxation, Shiatsu, and variable massage techniques has not yet been sufficiently taught, thus we must propose to educate wide variety of relaxation techniques. 　【2】 At the early stage of fundamental nursing practice, it will be necessary to teach the basics of massage and Shiatsu maneuvers. 　【3】 Physiological indices such as blood pressure, pulse rate and so on are essential for understanding the usefulness and scientific basis of these relaxation methods and prevent the unexpected hazards by such maneuvers. 　【4】 There exists wide variety of relaxation methods in the world, such as traditional oriental maneuvers and western methods, education to students must be based on not only physiological states and symptoms but also based on emotional state of patients. 　【5】 Nursing staffs should be aware of the purposes, methods and procedure of massage technique and Shiatsu.　It will be also important to assess the objective effectiveness and contraindications of these maneuvers. 　Further scientific and objective investigation should still be needed in these relaxation maneuvers

スペクトラルドメイン光干渉断層計による視神経乳頭および乳頭周囲組織の解剖学的特徴の検討

学位の種別:論文博士University of Tokyo(東京大学

看護職者の個人の内的属性の対人不安への影響

看護職者の個人の内的属性の対人不安への影響について調べた.調査対象は, 2つの公立総合病院に勤務する看護職者332名である.測定用具には, 対人不安意識尺度・多次元自我同一性尺度・自己没入尺度・共感的配慮尺度・孤独感の類型判別尺度・自己評価式抑うつ性尺度を使用した.対人不安を従属変数とし, 自我同一性・自己没入・共感的配慮・孤独感・抑うつ性を独立変数としてこれらの関係をみた.さらに, 調査対象の属性である性・年齢・看護経験年数・職階・看護教育背景・兄弟姉妹数・友人数等の違いによりこれらの関係がどのように異なるかを調べた.その結果, 自我同一性と対人不安との間に負の相関がみられ, 自己没入や抑うつ性は対人不安との間で正の相関を示した.また, 女性群に有意な相関がみられたが, 男性群には相関がみられなかった.年齢, 経験年数, 職階, 看護教育背景, 兄弟姉妹数, 友人数等の違いにより, 対人不安への影響の程度は異なっていた.一方, 共感的配慮や孤独感との間には有意な相関は認められなかった.The purpose of this study was to examine relationships between nurses\u27 negative self-awareness in interpersonal relationships and their internal attributions. A sample consisted of 332 nurses was examined. The instruments used were Negative self-awareness in Interpersonal relationships scale by Hayashi and Ogawa, Multidimensional ego identity scale by Tani, Self-preoccupation scale by Sakamoto, Japanese version of Empathy consideration scale of the sub-concepts of Interpersonal Reactivity Index by Davis, Loneliness Scale by Ochiai and Japanese version of Depression Scale by Zung. The scores of ego identity showed partial correlation coefficient with significant level of 0.1% to those of negative self-awareness in interpersonal relationships. The scores of self-preoccupation showed positively correlation with those of negative self-awareness in interpersonal relation-ships. The scores of depression showed partial correlation coefficient with significant level of 0.1% to those of negative self-awareness in interpersonal relationships. Also, the relation-ships between nurses\u27 negative self-awareness in interpersonal relationships and internal attribution is different by their gender, age, experience, career ladder, brother numbers and friends\u27 numbers etc

Identification of human Kir2.2 (KCNJ12) gene encoding functional inward rectifier potassium channel in both mammalian cells and Xenopus oocytes

AbstractArginine residue at position 285 (R285) in the intracellular C-terminal domain of inward rectifier potassium channel Kir2.2 is conserved in many species, but missing in previously reported human Kir2.2 sequences. We here identified the human Kir2.2 gene in normal individuals, which contained R285 in the deduced amino-acid sequence (hKir2.2/R285). All 30 individuals we examined were homozygous for Kir2.2/R285 gene. The hKir2.2/R285 was electrophysiologically functional in both mammalian cells and Xenopus oocytes. However, the hKir2.2 missing R285 was functional only in Xenopus oocytes, but not in mammalian cells. Thus, R285 in Kir2.2 is important for its functional expression in mammalian cells

Development of serum dexamethasone radioimmunoassay to corroborate Cushing's syndrome diagnosis

INTRODUCTION: The 1 mg dexamethasone suppression test (DxST) is widely used to screen Cushing's syndrome (CS) due to its high diagnostic accuracy. CS is an endocrine-metabolic disorder caused by hypercorticism, which is characterized by the absence of cortisol suppression in DxST. OBJECTIVE: To develop a radioimmunoassay (RIA) for the measurement of serum dexamethasone (Dx) to complement DxST. METHODS: Three rabbits were inoculated with dexamethasone-21-hemisuccinate-BSA in order to choose the best antibody. Serum Dx RIA was performed according to RE 899/2003 (Agência Nacional de Vigilância Sanitária [ANVISA]) regulations. Serum samples from 96 volunteers from Universidade Federal de São Paulo (UNIFESP) and Santa Casa de Misericórdia de São Paulo were analyzed, 67 of which were submitted to DxST and 29 were not. There were 12 patients with CS. RESULTS: The Dx antibody chosen showed good specificity. Intra- and interassay CV were < 20% with 93.8% accuracy and the lowest detection limit was 19.5 ng/dl. Serum Dx concentration was similar among both volunteers and CS patients (absence of cortisol suppression): 205 to 703 ng/dl and 174 to 661 ng/dl (95% CI), respectively. Values were undetectable among those that were not submitted to the test. Discussion: The anti-Dx antibody shows high specificity and reliability to quantify serum Dx in DxST. The Dx RIA presented reproducibility and reliability in the determination of serum Dx levels during DxST. CONCLUSION: The current RIA for serum Dx is accurate and reliable, which permits to establish a reference value range to substantiate DxST interpretation.INTRODUÇÃO: O teste de supressão com 1 mg de dexametasona (TSDx) é amplamente empregado no rastreamento da síndrome de Cushing (SC) dada sua elevada acurácia diagnóstica. A SC é um distúrbio endocrinometabólico resultante do hipercortisolismo crônico com característica de ausência de supressão do cortisol no TSDx. OBJETIVO: Desenvolver um radioimunoensaio (RIE) para a dosagem de dexametasona (Dx) no soro para complementar o TSDx. MÉTODOS: Foram imunizados três coelhos com o conjugado dexametasona-21-hemissuccinato-BSA para escolha do melhor anticorpo e o RIE foi desenvolvido de acordo com as recomendações da RE 899/2003 da Agência Nacional de Vigilância Sanitária (ANVISA). Analisamos 96 voluntários, sendo 67 submetidos ao TSDx e 29 não, e 12 pacientes com SC, estudados na Universidade Federal de São Paulo (UNIFESP) e na Santa Casa de Misericórdia de São Paulo. RESULTADOS: O anticorpo contra Dx selecionado mostrou boa especificidade, coeficiente de variação (CV%) intra e interensaio < 20%, exatidão de 93,8% e dose mínima detectada de 19,5 ng/dl. A concentração de Dx no soro foi semelhante nos voluntários e pacientes com SC (ausência/supressão do cortisol): 205 a 703 ng/dl e 174 a 661 ng/dl (intervalo de confiança [IC] 95%), respectivamente; os valores foram indetectáveis naqueles que não se submeteram ao teste. DISCUSSÃO: O anticorpo empregado apresenta boa afinidade e especificidade para quantificar a Dx no soro. O RIE mostrou reprodutibilidade e eficiência na determinação dos níveis séricos de Dx durante o TSDx. CONCLUSÃO: O presente RIE para a dosagem de Dx no soro é acurado e confiável, permitindo estabelecer uma faixa de referência de valores para subsidiar a interpretação do TSDx.Universidade Federal de São Paulo (UNIFESP)UNIFESPSciEL

Trisomy 9 Mosaicism Diagnosed In Utero

We present three cases of trisomy 9 mosaicism diagnosed by amniocentesis with ongoing pregnancies after referral to our center due to fetal abnormalities. Two cases were associated with severe fetal growth restriction (FGR), each of which resulted in an intrauterine fetal demise (IUFD) in the third trimester. The other case involved mild FGR with a congenital diaphragmatic hernia and resulted in a live birth with severe development delay. A major prenatal finding of trisomy 9 mosaicism is FGR. Fetuses with trisomy 9 mosaicism can rarely survive in the case of severe FGR

Knowledge and Demand for Information about Islet Transplantation in Patients with Type 1 Diabetes

This cross-sectional study based on self-administrated questionnaire was conducted to investigate knowledge, related factors, and sources of information regarding islet transplantation in patients with type 1 diabetes in Japan. Among 137 patients who provided valid responses, 67 (48.9%) knew about islet transplantation. Their main source of information was newspapers or magazines (56.7%) and television or radio (46.3%). However, 85.8% of patients preferred the attending physician as their source of information. Although more than half of the patients were correctly aware of issues related to islet transplantation, the following specific issues for islet transplantation were not understood or considered, and there was little knowledge of them: need for immunosuppressants, lifestyle and dietary adaptations, fewer bodily burdens, and complications. The experience of hypoglycaemia, a high level of academic background, frequent self-monitoring of blood glucose, and the use of continuous subcutaneous insulin infusion were related to higher knowledge about islet transplantation

Achievement levels of students on clinical nursing practice for chronic illness

実習目標の到達度及び実習目標間の関係を明らかにするために,74名の学生による実習目標の自己評価を分析した｡その結果,実習目標の到達度は,｢自己の看護観や自己成長を培う｣が最も高かった｡そして｢疾患の病態生理や検査･治療についての理解と看護援助｣｢セルフケアに向けた看護援助｣｢危機に直面している患者の看護援助｣などの看護実践面に関する目標が高値を示していた｡学生は目標に沿った看護を実践する中で,経験したひとつひとつのケアを意味づけたり,看護とは何かを探求していったと思われ,それが看護観の形成や自己成長につながっていったものと考えられた｡実習目標間の関係では,各実習目標との間に相関が見られ,それらは信頼性のある妥当な慢性期看護実習の目標であることが確認された｡This paper is designed to demonstrate the relationships between each objective and the students' achievement levels for the objectives of clinical nursing practice. Seventy four students evaluated their own achievement levels related to their clinical nursing practice. Evaluation scores for each objective were analyzed. The following results were obtained: The objective of cultivating the view of nursing and developing themselves had the highest score. Understanding the mechanism of disease, physical examination and treatment, and patient care, understanding nursing care toward patient's self care, and understanding nursing care for patient in crisis had high scores. The students, through their own nursing care, explored the meaning of each care (or each experience) and inquired about the nature of nursing. Their view of nursing and self development was formed from their own various experiences. Correlation among each objective was found. Each for clinical nursing practice has reliability and validity