新生児の“泣き”に対する看護学生の気づき

本研究の目的は，看護学生が新生児モデルを使用して育児疑似体験をすることによって学生にどのような気づきがあるのか明らかにすることである．演習としてA 大学医療技術短期大学部３年生の母性看護学実習期間中に，新生児モデルを使用して育児疑似体験を行った．その演習時に提出された学生のレポートの中で，新生児の“泣き”によって自分の感情がどう変化しどのような学びとなったかに関して記述してもらった．本研究の参加に同意した４０名の学生のレポートについて気づきに関する内容を質的に分析した．その結果【泣きからわき起こる不快な感情を味わう】【育児の難しさを実感する】【泣きの理由と意味付けを考える】【泣きに対処するための方策を考える】【世話をし泣き止むことで愛着を感じる】【自分の中に母性意識が芽生える】【母親の気持ちを考える】【周囲のサポートの必要性や重要性を感じる】の８つのカテゴリーが抽出された．８つのカテゴリーからは，新生児の泣きによる学生の感情の変化についての内容，泣きの演習を通じて母親理解が深まっていた内容，看護者としての役割についての内容が導きだされ，今後の実習指導に役立てることができると考えられた．The purpose of study was to clarify nursing student’s experience changes to a newborn infant crying through simulated nursing training using a newborn infant model in her awareness. Subjects were ３rd grade forty female students at three-year nursing college. A writing and oral request to participate in the study was made to the subjects by the researchers. Students reported that “how my emotion has changed”, and “what I have learned?” by this simulated nursing care experience. We analyzed the nursing students’ report after this nursing training using qualitative method. Analysis of qualitative data revealed eight categories of response, which were labeled : （１）‘stirring uncomfortable emotion’, （２）‘realization of child-care challenges and difficulties’, （３）‘consideration of meaning and reason to cry’, （４）‘thinking of strategy to cope with crying’, （５）‘maternal and emotional attachment’, （６）‘consciousness of maternal affection in herself’, （７）‘empathy for the feeling of mother’, （８）‘consideration of importance and need of support from others’. Nurse educators can facilitate more effective education to promote student’s technological competency for child and maternal care by knowing the contents of students’ self-awareness

Knowledge and risk perception of radiation for Japanese nursing students after the Fukushima Nuclear Power Plant disaster

Background: The Japanese have had three experiences of radiation disasters: the atomic bombs dropped on Hiroshima and Nagasaki in 1945, and the 2011 Fukushima Nuclear Power Plant disaster. The former two experiences have been covered in compulsory education programs. In light of these incidents, a strong fear of radiation has pervaded people of several generations. In such a situation, the role of nurses is important. When nurses treat residents, their attitudes change depending on how they understand and feel about radiation. The foundations of these attitudes are formed through student education. Hence, it is necessary to explore nursing students' understanding and risk perception of radiation, and the nature of radiation education received. Objectives: To assess the levels of understanding and risk perception of nursing students regarding radiation. Design: Cross-sectional survey. Methods: A questionnaire survey was administered to all students (74 first-year, 79 second-year, 65 third-year, and 69 fourth-year students) in the nursing department of a Japanese national university. The response rate was 84%. Respondents were asked to rate their level of understanding of 50 phrases chosen from two supplementary texts about radiation for elementary school students and for middle and high school students, prepared by the Japanese Ministry. Further, they were asked to rate their risk perception for 30 events, and to answer six questions about radiation. Results: It was found that knowledge about radiation among Japanese nursing students was poor, because sufficient radiation education had not been provided. Hence, they displayed a greater fear of X-rays as compared to American students and members of the League of Woman Voters. However, it was also found that an increase in understanding might decrease risk perception. Conclusions: It was concluded that nursing students require adequate education about radiation, in order to reduce their fear of X-rays and to mitigate their risk perception

A Scholarly Report of the Educational Visit to Florida Atlantic University with Scholars of Caring Concerning Programs of Community Caring in Nursing.

２０１７年３月に徳島大学と連携協定を締結しているフロリダアトランティック大学看護学部（以下，FAU）を訪問し，コミュニティにおけるケアリング活動に関する視察を行った． Community Health Center at West Gateは低所得層が多く住む地域において住民の保健・医療へのアクセスを確保するために，FAU が助成金を確保して設立し運営している施設である．Louis and AnneGreen Memory & Wellness Centerは，大学敷地内にFAUが助成金を得て設立し運営している認知症などの方への通所施設である．Head Lice solutionsは，教員が調査研究を行いながら協力して実施しているアタマジラミへの対策である．Light of The World Clinicは，寄付と専門職らがボランティアによって協力して運営されているクリニックであり，移民等の多い地域の人々への保健・医療を提供する施設であり，FAUの教員がボランティアのNurse Practitionerとして診察を行っていた． このような大学が運営したり協力しているコミュニティへの活動は，健康の不利益を生じている人々への不平等を取り除くための取り組みや，コミュニティで生じている問題への対応のための取り組みであった．大学が実践活動を行いながら，調査研究を推進し，さらに学生への実習施設としても活用され，非常に有用な取り組みであった．This report contains the goals and explanations for the educational visit to Florida Atlantic University（FAU）. The aim of this visit was to investigate the activities in the community that FAU faculty members were actively engaged. This visit was conducted in collaboration with the bilateral agreement between Tokushima University and Florida Atlantic University. Florida Atlantic University Christine E. Lynn College of Nursing has facilities that foster community involvement and caring within Palm Beach County in Florida. The Community Health Center at West Gate was established and operated by FAU particularly for lower-income families who live in the vicinity. These families have little access to health care systems and their only means of seeking health care is through this center. Another clinical practice setting is the Louis and Anne Green Memory & Wellness Center. It is a daycare facility for older persons particularly those with memory problems, and mental disturbances and/or dementia. The center was founded and is operated by FAU within the premises of the university. The Head Lice Solutions is a health care initiative that focuses on the treatment of head lice basically among children in schools. The center is supported by a member of the FAU faculty, who is an expert on head lice as a school nurse. The Light of The World Clinic provides health care to people in the area who have little access to care. A faculty member, who is also a nurse practitioner, runs a consulting room at this clinic. These activities are intended to benefit communities within the area of responsibility at the vicinity of Florida Atlantic University. FAU has their goal which is to eliminate inequalities among those who suffer from health disadvantages, and address health issues when they arise in the community. The university promotes the combination of research with practice, and the project is also used as an educational facility for students. Overall, these functions create benefits for students’ and residents’ health and well-being

THE UTILIZATION OF THE DIOHAT©

Aim：To evaluate the utilization of the Diabetes Oral Health Assessment Tool （DiOHAT©） for Nurses by Diabetes Nurse Specialists（DNSs）in the clinical settings. Methods ： A survey was done using self-administered questionnaire distributed to １３８ DNSs who signified continuing collaboration during the authors’ previous study. The DNSs answered the questionnaire after utilization of the DiOHAT© in the clinical settings. Results ： Forty-seven DNSs responded（３４．１％）. The data revealed that items on cooperation with dental professionals（e.g., “regular dental visits” （８８％）, etc.）were frequently utilized, but those about oral function and self-care（e.g.,“checking one’s mouth with a mirror” （４０％）and “use of supplementary tools” （４４％）, etc.）were rarely utilized. However, over ６０％ of DNSs evaluated the DiOHAT© utilization version on the “nursing-process” and “collecting-information” as “possible” or “possible if revised”. Non-utilization of the DiOHAT© were due to insufficient time, and insufficient knowledge and skill. Conclusion ： The results of the study revealed the need for DNSs to increase their knowledge and skill about the content and use of the DiOHAT© e.g. oral function, and self-care, and to examine the coordination and division of roles between DNSs and dental specialists to support the oral health care of patients with diabetes

Assessing the oral health

Aims : To compare assessment of the oral health conditions and behaviors of in-patients with diabetes using a clinical version of the Diabetes Oral Health Assessment Tool (C-DiOHAT©) with dental examinations. Methods : A cross-sectional design was used. A nurse assessed 60 in-patients using the C-DiOHAT© (a formatted questionnaire to assess four factors of patients’ oral health conditions and behaviors : oral health conditions, oral hygiene behaviors, sharing health information among patients and dental/medical professionals, and perception and knowledge of oral health) while a dentist examined their oral health conditions. Results : “Use of supplementary tools (e.g., interdental brush, dental floss)” in the item of C-DiOHAT© was significantly associated with dental examination of “the number of present teeth” and “no recommendation of further dental visit”. “Symptoms of gingival swelling” in the item of C-DiOHAT© was also significantly associated with “recommendation of dental visit”. “Knowledge of a relationship between periodontal disease and systemic disease including diabetes” was significantly associated with Community Periodontal Index. Conclusions : These results suggest that nurses should prioritize these assessment items to most quickly acquire useful information about patients’ oral health. It is important to encourage nurses to be interested in patients’ oral health by such small pile of clue

ORAL HEALTH AND SELF-EFFICACY

Background : Bidirectional relationships exist between diabetes and periodontal disease. Fostering timely oral health assessments of patients with diabetes, the modified diabetes oral health assessment tool (M-DiOHATⓒ) for nurses was studied. The DiOHATⓒ has four factors, namely oral health conditions, oral hygiene behaviors, perception and knowledge, and health record sharing. It was modified as the M-DiOHATⓒ scale. To change people's health behaviors, “efficacy beliefs" and “outcome expectancies" are important. However, no studies have been reported that addressed efficacy beliefs and outcome expectancies of oral health conditions and behaviors of patients with diabetes. Objective : To clarify the oral health conditions and behaviors of patients with diabetes using the M-DiOHATⓒ, and to describe their associations with the Self-Efficacy Scale for Self-Care (SESS)/the Outcome Expectancy Scale for Self-Care (OESS). Methods : Twenty-eight patients with diabetes participated in the study. Their personal characteristics were determined from the items of self-efficacy for brushing of the teeth (SE-B), self-efficacy for dental consultations (SE-DC), OESS that are comprised of three factors, namely, the social outcome expectancy (OE-Social), oral outcome expectancy (OE-Oral), and self-evaluative outcome expectancy (OE-Self), and the M-DiOHATⓒ. Results : Forty-three percent of patients had retained their expected number of present teeth, and 68% of them had dental problems. The scores of health record sharing were low, and patients who were under 65 years old had fewer “expected number of present teeth," and lower SE-B/oral health conditions scores than those patients aged over 65 years. The scores of oral hygiene behaviors were significantly correlated with the SE-B scores, SE-DC, OE-Oral, and OE-Self. However, the oral health conditions showed no correlation with SE-B, SE-DC, OESS. Conclusion : The findings suggest that nursing interventions to promote SE-B, SE-DC, and OESS could be effective in enhancing patients' oral hygiene behaviors. However, severity of patients' periodontal disease require different types of dental self-efficacy procedures

トクシマ ケンナイ ノ カンゴ ショクイン コウド ジンザイ イクセイ ケンシュウ スイシン ジギョウ ニオケル トクテイ コウイ ニ カカル ジッタイ チョウサ

The purpose of this survey was to determine nurse administrators and hospital directors’ perspectives about nurses’ abilities in performing specific medical practices in hospitals in Tokushima Prefecture. The nurse administrators and hospital directors of all hospitals （１１３ hospitals） in Tokushima Prefecture were invited to respond to a survey questionnaire by mail posted during the period between February and March of ２０１５. Responses were received from ４６ nurse administrators （response rate, ４１％） and ３８ hospital directors （response rate, ３４％）. The obtained data were analyzed using descriptive statistics and the narrative descriptions summarized. Majority of responses from nurse administrators and hospital directors were accepting that nurses have responsibilities for administering medicines such as tranquilizers, anti-anxiety and anticonvulsant drugs. This result was not affected by the size of the hospital, in which fifty four percent （５４％） of respondents were from hospitals with less than １００ beds. In Japan, only hospitals with １００ beds or more may have procedures involving highly invasive treatments. Because of this, many of the respondents answered “not applicable” to statements in the questionnaire which were related to invasive treatments. Recruitment of nurses, strategies to cope with accidents and education curriculum were important concerns of nurse administrators and hospital directors which remain to be answered in future investigations