ジシ イゾク ノ グリーフワーク オ ソクシン スル ミンカン シンコウ ノ ジッタイ

自死遺族のグリーフワークにおいて、青森県の特徴的な民間信仰である「イタコ」の、どのような支えが喪失による悲嘆を乗り越えることができたかを明らかにすることを目的に、イタコを利用したことのある自死遺族で1年以上経過した30歳代～70歳代の女性７名に聞き取り調査を行った。遺族は、イタコの口寄せによって自殺の理由を聞かされたことで、故人の人生に対する価値を見出すことができ癒された。また遺族は、【故人の生き様への共感】、さらに、【故人の加護や繋がりの実感】【相互の赦免の獲得】を経て、【生きることへの託宣】を得て、【心の浄化】ができた。The early detection of relapse in patients with schizophrenia is considered an important objective for psychiatric nurses doing home health visits. In this study, interview surveys of home health psychiatric nurses were conducted to elucidate what they watched for when monitoring these patients for signs of relapse. The results showed that when monitoring for deteriorating health, through experience, they had learned to watch for deviations from usual lifestyle patterns, worsening of patient pathological experience, loss of interest in treatment, and abnormal communication

Comparison of enlargement of the spinal canal after cervical laminoplasty: open-door type and double-door type

The purpose of this study was to compare the degree of enlargement of the spinal canal between two methods of cervical laminoplasty (open-door laminoplasty and double-door laminoplasty) and to determine their appropriate surgical indications based on the results. Tension-band laminoplasty (TBL, one method of open-door type) was performed in 33 patients and double-door laminoplasty (DDL) in 20 patients. The operation level ranged from C2 to C7 in all patients. The width of the spinal canal and the inclination angle of the lamina at the C5 and C6 levels were measured using a computer software program (Image J) and pre- and postoperative CT films. Concerning the degree of enlargement of the spinal canal, the mean expansion ratio at the C5 level was 148.9% in TBL and 148.2% in DDL, and there was no significant difference between them. However, at the C6 level, it was 159.0% in TBL and 140.3% in DDL, which was significantly larger in TBL than DDL (p < 0.05). The increase of inclination angle of the lamina was 11.0° in TBL and 19.0° in DDL at the C5 level, and 9.2° in TBL and 19.3° in DDL at the C6 level. At both the C5 and C6 levels, it was significantly larger in DDL than TBL (p < 0.0001). In conclusion, the appropriate surgical indications of TBL were considered to be (1) cervical spondylotic myelopathy (CSM) combined with hemilateral radiculopathy, (2) severe prominence of ossification of the posterior longitudinal ligament (OPLL), and (3) patients with tiny spinous processes who cannot undergo DDL. Those of DDL were considered to be (1) usual CSM, (2) small and slight prominence of OPLL, (3) CSM combined with bilateral radiculopathy, and (4) cervical canal stenosis combined with instability necessitating posterior spinal instrumentation surgery