新卒で訪問看護事業所へ就職した看護学生の意思決定過程

目的： 本研究は新卒で訪問看護事業所へ就職した看護学生の意思決定過程を明らかにすることを目的とした。方法： 新卒で訪問看護事業所に就職した看護師5名を対象とし半構造的面接を実施した。訪問看護事業所への就職に対する【心理的過程】、〈影響要因〉をカテゴリー化し、過程を図にまとめた。結果： 看護学生は【人の暮らしとその支援への興味】等をもとに〈新卒訪問看護を知る人からの情報提供〉等により【訪問看護事業所への就職に対する関心】を感じていた。【訪問看護事業所への就職に対する不安と迷い】を抱えながらも、〈新卒訪問看護師に直接話を聞く機会〉等を得ながら【目指す看護を実践できる道に進む決断】をした。採用決定後も不安と希望を抱きつつ【自分の決定を信じた】。考察： 看護学生への情報提供、教員や家族、友人からの助言、インターンシップへの参加は看護学生が訪問看護事業所への就職を検討する際に有効であると示唆された

Subjective Symptoms Linked to Sleep Duration: An Analysis from Japanese National Statistics

Background: There is a high prevalence of sleep disorders in Japan, and they are a factor in a decreased quality of life. The main objective of this study was to clarify the background factors of sleep disorders that affect sleep duration, such as subjective symptoms and working hours. Methods: We performed a cross-sectional study on the Japanese national statistics data. Answers from a household questionnaire were used to analyze risk factors for decreases in sleep duration. The subjects were a total of 3972 men and women aged 40–59 years, the age group that forms the core of the working population. For the analysis, a univariate analysis (contingency table) between sleep duration (two groups: sleep duration ≥ 6 h and <6 h) and 42 subjective symptoms was carried out. A multivariate analysis (binomial logistic regression) was conducted using sleep duration and subjective health assessment as objective variables, and odds ratios (ORs) adjusted for sex, working hours, and other factors were obtained. Results: The univariate analysis by subjective symptom showed significant ORs for eight symptoms, including poor sleep quality (OR: 2.24), constipation (OR: 2.24), and dizziness (OR: 1.77). In the multivariate analysis, the model with sleep duration as the objective variable showed significantly adjusted ORs for four variables, including constipation (1.72) and poor sleep quality (1.66). The model with subjective health assessment as the objective variable showed significantly adjusted ORs for eight variables, including dizziness (4.18), while poor sleep quality (1.45) was not significant. Conclusions: The present results suggest the presence of subjective symptoms that may be inferred to be related to decreases in sleep duration

Study of Factors to Increase the Usage Rate of Generic Drugs in Platelet Aggregation Inhibitors

To reduce pharmacy-related medical expenses, it is necessary to reduce drug costs. One way to achieve this is by increasing the usage rate of generic drugs. The purpose of this study was to identify platelet aggregation inhibitors (PAIs) that contribute to high drug costs and are sold as brand-name drugs in order to increase the usage rate of generic drugs, and to analyze the factors that affect the usage rate of generic drug. We conducted a cross-sectional study based on the National Database of Health Insurance Claims and Specific Health Checkups of Japan Open Data Japan (NODJ) of the Ministry of Health, Labor and Welfare and datasets containing related medical information from official statistical surveys such as the Basic Survey on Wage Structure. Monthly personal income in each prefecture were negatively correlated with outpatient out-of-hospital and outpatient in-hospital prescriptions of the PAIs clopidogrel (75 mg), cilostazol (50 mg), cilostazol (100 mg), and ticlopidine (100 mg), but not between monthly personal income and outpatient out-of-hospital prescription of ticlopidine (100 mg). For outpatient out-of-hospital prescriptions and outpatient in-hospital prescriptions, negative correlation was generally observed between the usage rate of generic drug and monthly personal income, except for ticlopidine (100 mg), which has the lowest price among the brand-name drugs. The usage rate of generic PAIs is negatively correlated with monthly personal income. Promoting the use of generic drugs among high-income earners might be necessary to further increase the usage rate of generic drug