Bioethics and the Experiences of Hansen’s Disease Survivors

Historically, Hansen’s disease patients suffered from discrimination because their physical features changed due to the bacterium Mycobacterium leprae (M. leprae) and made them “ugly” in the eyes of society. Former Japanese governments saw them as a national disgrace and forced them to reside in leprosaria. Since the law requiring isolation continued after the silver bullet was developed, survivors could not leave the leprosaria and return to society. Currently, survivors’ average age is 82 and they live in 13 national sanatoriums. When they pass away, the history of Hansen’s disease in Japan will end, so we must record their experiences. We conducted qualitative and inductive studies with survivors. In this chapter, we reconstruct them from the perspective of bioethics and propose several theories surrounding them: (1) How former leprosaria and medical administrations in Japan threatened bioethical principles; (2) the wisdom of aging survivors, who lived through extreme situations, and what real restoration of their rights might look like; and (3) the ethical dilemmas of how we will care for the survivors—who have multiple severe sequelae—until they all pass away. Finally, we will introduce our ethical nursing practices in relation to caring and understanding via holism

Images of nurses by senior high school students wishing to go on to the nursing course

本研究では、看護課程志望の高校生が看護職に対してどのようなイメージを持っているのか、看護教育機関の希望や将来の看護職種の希望は看護職に対するイメージと関係があるのかを明らかにしたいと考えた。岡山県下の全ての高校に在学中の看護課程志望高校生に対して、質問紙調査をおこなった。222名から回答が得られ、分析を行った結果、以下のことが明らかになった。1）看護課程志望高校生は看護職に対して非常に良いイメージを持っており、同時に労働条件の厳しさも理解していた。その良いイメージとは、看護職の持つ尊さや献身性に由来する自負心と、資格のもつ現実的利点であった。しかし、看護職の専門性を表す、高度な知識・判断・技術、生涯教育の必要性の認識は低かった。2）短大・大学を志望する高校生は、看護学校・准看護学校志望者に比べ、看護職は生涯教育を必要とするとイメージしていた。3）看護婦、保健婦、助産婦のどの職種を希望するかによって、看護職に対するイメージに違いがあった。A qusetionnaire survey was done by senior high school students wishing to go on to the nursing course in Okayama Prefecture, to know what images of nurses they had, what course for nursing education they wished to best for and what they would like nursing profession to be. Results of analysing data obtained from 222 students were as follows; 1. They had favorable images of nurses in high rates, although they also recognized the harsh working conditions. Those images were thought to be derived from the preciousness of nursing, devotion to people, and advantage of the license. But recognition of specialty of nursing indicated by items such as knowledge, judgement, skill and continuing education was low. 2. Necessity of continuing education was recognized by students wishing to go on to university or junior college better than students of vocational school of registered and assistant nurses. 3. Images of nurses were different by their choice of profession such as clinical nurses, public health nurses and midwives which they would like to be in the future

A new scale for student nurses to rate image of the elderly

Our prior scale for student nurses to rate image of the elderly is inadequate both in number of items used and in exaustiveness of possible images they have. This study attempts to construct a new rating scale by decreasing the number of the previous items and by incorporrating pertinent novel items. A new scale reported here consisits of 20 items, with 15 items being determined through a factor analysisi of the previous 38 items and 5 items being selected after a survey of relevant studies

日本における開発教育の主体形成論と実践構築に関する研究

早大学位記番号:新8310早稲田大

Changes of Student Nurses' views and Images of the Elderly before and after Practicing at Nursing Homes

A questionnaire survey was done by 76 third year-students of the nursing course before and after practicing at the two nursing homes in 1989. The same questions about their views and images of the aged person were given twice and compared. Question to image consists of 38 paired items respectively opposed to be rated on a seven-point scale. The results showed that their views and images had changed from idealistic to realistic as a result of their practices. These were some differences found in these changes by the home and the period of practice

Nursing students' perception of their acquired basic skills in nursing practices : a comparison between a new and an old curriculum

平成2年度改正の新カリキュラムで学んだ学生と旧カリキュラムで学んで学生間に、卒業時の基礎看護技術の到達度に違いがあるかを明らかにするために、看護技術の基本的要素、日常生活の援助技術、診療時の援助技術の49項目の到達度について、3年制課程の3年生に質問紙調査を行った。対象者全体では、到達度の上位10位以内に日常生活の援助技術項目の37％が含まれ、到達度の下位10位以内に診療時の援助技術項目の37％が含まれていた。新カリキュラム群と旧カリキュラム群の比較では、21項目に有意差があった。新カリキュラム群の高い15項目は日常生活の援助技術と看護技術の基本的要素に関するものが多く、旧カリキュラム群が高い6項目は診療時の援助技術が多かった。カリキュラム改正に関係なく、日常生活の援助技術の到達度は高く診療時の援助技術は低い傾向にあったが、カリキュラム改正後はその傾向が強まり、さらに看護技術の基本的要素の到達度はカリキュラム改正後に比較的高くなっていることが明らかになった。新カリキュラムでは臨地実習時間を削減しているが、基礎教育で重視する日常生活の援助技術と看護技術の基本的要素は習得できていると考えられる。A revision was made in a nursing curriculum in 1990. This study examined nursing students' perceived level of acquired 49 basic skills in nursing practices consisting of 11 basal elements of nursing skill, 19 skills in helping patients' daily activities, and 19 skills required in medical situations, comparing students receiving a new curriculum with those receiving an old one. Findings showed that in the rank ordering of all items from the best acquired to the least, collapsed across the two groups of students, 37% of the upper 10 items cocerned the skills in helping patients' daily activities, while 37% of the bottom 10 items concerned the skills required in medical situation. The students receiving the new curriculum perceived themselves better than those reseiving the old one for 15 items that were related with the basal elements of nursing skill and the skills in helping patients' daily activities, while the 6 items in the skills required in medical situations were perceived to be better acquired for the latter than the former students. The finding suggest that the new curriculum produced students who perceive themselves to be better achievers in the basic skills in nursing practices

Alopecia Diffusa while Using Interleukin-17 Inhibitors against Psoriasis Vulgaris

We report two cases of alopecia diffusa during the treatment of psoriasis vulgaris with interleukin (IL)-17 inhibitors. Psoriasis is one of the most common immune-mediated chronic skin diseases, strongly associated with IL-17A. Clinically, the monoclonal antibodies to IL-17A or its receptor, IL-17R, show a dramatic effect against psoriasis. Alopecia is also an IL-17-mediated autoimmune disease, and IL-17 inhibitors have been expected to be the gold standard for the treatment of alopecia; therefore, the complication of alopecia while using IL-17 may be regarded as an unexpected “paradoxical reaction.” T helper (Th)17 cells are not cytotoxic enough by themselves to undermine the hair follicle under normal circumstances, they need the coexistence of CD8+ cytotoxic Th1 cells. Th17 cells may be the initiator of the damage of the hair follicle, but CD8 T cells or more powerful Th1 cells are required as followers. The Th17/Th1 axis might convert into a Th1-dominant immune status using IL-17 inhibitors, and the destruction of the hair follicle might result in alopecia. An accumulation of cases is to be expected

The ideas about nursing course of senior high school teachers.

近年、4年制大学の増設をはじめとした看護課程における教育の変革が進められつつある。これは質の高い看護の人材を必要とする社会のニーズに応えたものである。著者らはこれらの看護課程に対する意見を、岡山県下の高校で進路指導をしている教師に尋ね、郵送による質問紙法を用いて33名の回答を得た。その結果、以下のことが分かった。1. 51.5％の教師は、看護大学が増えると進学希望者の関心は呼ぶとしており、36.4％は、学生数の一定の増加があるだろうとしている。また、36.4％は教師の立場から看護課程への進学を勧めやすくなると考えている。2. 高校の教師は看護婦不足の理由として労働条件の厳しさを指摘している。3. 高校教師は進路として看護課程を勧める理由を仕事の専門性と奉仕性を多くあげていた。これらは、高等教育化と看護職のイメージの改善の両方が必要であることを示唆している。Currently, improvement of nursing curriculum has been done in Japan, including the establishment of a four year course at universitiy, responding to the social needs for man-power for high quality nursing. A questionnaire survey by mail was done in 1993, to get ideas about the nursing course of high school teachers giving advice to students wishing to go on to university or college. Thirty three high school teachers out of a total of 76 schools in Okayama prefecture responded. The results were as follows; 1, Seventeen teachers (51.5%) answered that the increase of a four year course at university would be an incentive to students. Twelve teachers (36.4%) said that it might increase the number of students choosing the course. And also 12 teachers (36.4%) thought that they could recommend this course to students more easily than before. 2, They pointed out the harsh working conditions as the reason for a shortage of nursing manpower. 3, Their reasons why they recommend the nursing course to students were firstly the specialty and secondly devotion to people