The effects measurement of hand massage by the autonomic activity and psychological indicators

This study examined the effects of hand massage on autonomic activity, anxiety, relaxation and sense of affinity by performing it to healthy people before applying the technic in actual clinical practice. Findings were showed below : 1) the significant increase in the pNN50 and the significant decrease in the heart rate meant the intervention of massage increased the autonomic nervous activity, improved the parasympathetic nerve activity and reduced the sympathetic nerve activity. This means the subjects were considered to be in a state of relaxation. 2) Salivary α amylase has been reported as a possible indicator for sympathetic nerve activity. In this study, there was no significant difference in the salivary α amylase despite a decrease after massage. 3) State anxiety score is temporal situational reactions while being in the state of anxiety and this score decreased significantly after massage. 4) The level of willingness to communicate with other person and the sense of affinity toward the massage-performer had a positive change of 70 percent. From this, it can be considered that a comfortable physical contact between a patient and a nursing profession, who are in a supported-supportive relationship, leads to an effect of shortening the gap in their psychological distance

The relationship between psychological comfort space and self-esteem in people with mental disorders

The purpose of this study was to demonstrate a causal model of the sense of having psychological comfortable space that is call ‘ibasho’ in Japanese and self-esteem in people with mental disorders who had difficulty in social activities. The subjects were 248 schizophrenia patients who were living in the community and receiving day care treatment. Data were collected from December 2007 to April 2009 using the Scale for the Sense of ibasho for persons with mentally ill (SSI) and the Rosenberg Self-Esteem Scale (RSES), and analyzed for cross-validation of construct validity by conducting covariance structure analysis. A relationship between the sense of having comfortable space and self-esteem was investigated. Multiple indicator models of the sense of having psychological comfortable space and self-esteem were evaluated using structural equation modeling. Furthermore, the SSI scores were compared between the high- and low-self-esteem groups. The path coefficient from the sense of having comfortable space to self-esteem was significant (0.80). High-self-esteem group scored significantly higher in the SSI subscales, ‘the sense of recognizing my true self’ and ‘the sense of recognizing deep personto- person relationships’ than the low-self-esteem group. It was suggested that in order to help people with mental disorders improve self-esteem, it might be useful to support them in a way they can enhance the sense of having comfortable space

精神科看護の魅力

本研究の目的は，長期入院の精神障害者の退院支援のための精神科看護の魅力について文献検討により明らかにすることである．日本においては長期入院の精神障害者に対する積極的な退院支援が行われている．しかし，退院後の継続的な支援環境が整わないために，退院できない状況もあり，看護師は仕事への無力感を感じる場合も多い．それでもなお，精神障害者の退院支援に魅力を抱いている看護師がいる．したがって看護師らが退院支援に対して抱く魅力は何かを明らかにすることが長期入院の解決に対して重要である．文献検討の結果，長期入院の精神障害者の退院支援の魅力として（１）患者との相互作用のなかでの自己洞察と自らの人間的成長，（２）患者と看護師の関係発展過程から得られる患者の本質的な理解，（３）看護師が主体性を持って患者と関わることができるという特徴が示唆された．The purpose of this literature study is to clarify the fascination of positive programmed discharge support （PPDS）and psychiatric nursing for long-term inpatient with mental disorders. Long-term psychiatric hospitalization remains as a major problem in Japan. PPDS is performed to such inpatient with social hospitalization. Despite nurses’ efforts with the best intentions, some nurse feel powerless to work because patient cannot discharge from a hospital by reason that living environment after patient leaves hospital was not ready. Therefore, it is important to clarify nurses’ fascination for PPDS and their achievement motive to work to solve prolonged hospitalization. The result of literature review, it was suggested that fascination of psychiatric nursing have the following features : （１）nurse’s self-insight and personal growth in the interaction between patient and nurse, （２）intrinsically understanding of patient obtain from developmental process in the interaction between patient and nurse, and （３）psychiatric nurse is able to intervene to the patient independently

Development of the Anger Coping Behaviors Style Scale for High School Students

The reliability and validity of the Anger Coping Behaviors Style Scale for High School Students were examined in this study. In the analysis, we used the data of senior high school students in A Prefecture (n=3360) who had no missing values on the survey items. We extracted the following four factors using exploratory factor analysis: Support seeking, Situation analysis, Escape, and Violence. Then, we examined the factorial validity of the scale using confirmatory factor analysis, which indicated that an oblique factor model consisting of these four factors fitted the data（CFI: Comparative Fit Index=0.955, RMSEA: Root Mean Square Error of Approximation=0.070). The results of statistical analysis supported the reliability and validity of the Anger Coping Behaviors Style Scale for High School Students developed in this study

Tendency of long stay patients on a psychiatric ward : Analysis based on medical and nursing records

本研究は,A大学病院精神科に長期入院(90日以上)をしている患者に着目し,年齢や疾患名の傾向などの特徴を明らかにするとともに,これらの実態に照らした看護アプローチのあり方について検討することを目的とした｡対象は,2004年1月1日から12月31日までに入院した延べ229人のうち,90日以上入院した延べ56人である｡診療記録等から在院日数,年齢,性別,疾患名のリストを作成し,傾向を分析した｡90日以上の長期入院患者の平均在院日数は175.1±79.7日であり,年齢層は思春期から40歳台の壮年期までで全体の約7割を占めた｡性別は男性16人,女性40人で,疾患名別では,統合失調症9人(16.1%),うつ病12人(21.4%),摂食障害16人(28.6%),適応障害5人(8.9%),躁うつ病4人(7.1%),強迫性障害1人(1.8%),身体表現性障害1人(1.8%),その他8人(14.3%)であった｡疾患名別の平均在院日数は,摂食障害が214.1日,適応障害が199.6日,統合失調症が180.2日であり,躁うつ病が175.3日であった｡年齢,疾患名,性別による在院日数の差は有意でなかった｡ 摂食障害に代表されるように身体機能の回復に数か月の医学的アプローチが必要な疾患はあるが,これらの中には患者自身の課題解決にむけた支援や家族支援など,保健福祉的アプローチも必要であると思われ,今後,これら事例の経過を質的に分析し,在院日数を長期化させている要因を明らかにする必要がある。This fact-finding survey was carried out to identify attributes of long stay psychiatric patients to improve nursing intervention based on their actual experience in hospital. 56 subjects out of the 229 patients who were admitted to a psychiatric ward at a university teaching hospital during the year 2004 were found to be hospitalized more than 90 days (175.1 ± 79.7 days on average), and all of them agreed to be included in the study (16 males and 40 females). Data were collected from their medical and nursing records. Most of the participants ranged from teens to adults in their forties. They were mostly diagnosed as having depression, schizophrenia, eating disorder, bipolar affective disorder and adjustment disorder. The patients with eating disorder stayed longest (214.1 days on average). followed by patients with adjustment disorders and schizophrenia. It is assumed that, although certain types of disorder need months of medical interventions for restoring physical functions, patients with these disorders also need family and social support as well as nursing interventions to cope with their problems. The results suggest that qualitative studies should be needed to identify factors that necessitate a long stay and make the system more supportive and effective