Depression and Suicidal Behavior in the Elderly: A Literature Review

Depression and suicide are significant health problems in the United States and Japan, and suicide is still considered primarily a phenomenon of adolescence to middle age. However, it is also a significant problem in the elderly (65 years old and above). The purpose of this report was to review the literature relative to the depression and suicide in the elderly in the United States and Japan. Several important factors involved with elderly suicide were different between the 2 countries. While Americans suffer from psychological problems, Japanese more likely suffer from physiological problems. Cultural and religious backgrounds play an important role in the decision to commit suicide

Implementation of Work Sampling in an Acute Rehabilitation Unit: Assessing Nursing Efficiency

To establish appropriate staffing guidelines, roles, reduced labor costs and reduced cost per unit of service, i) identification of work with appropriate staff members, and ii) development and utilization of a patient acuity system were studied in an acute rehabilitation unit of a hospital in central Illinois. Acuity of patients (n = 127) was categoried by using assisting levels of minimal, moderate and maximal based on the Functional Independence Measure (FIM) score. The FIM score was reevaluated each week. In the 1st month, volume and time studies were done on all rehabilitation patients. In the 2nd month, roles of the registered nurse (RN) and the unlicensed assistive personnel (UPA) were clarified; and in the 3rd month, patients' acuity levels were reestablished and staffing management was adjusted. This system also clearly identified patients' acuity and the role of RNs and UPAs. Hours per unit of RN service was cut from 8.85 to 7.49 per 8 h shift. Cost per unit of service was decreased from $163.6 to$105.2. A total annual savings of $268,410 indicated a big financial impact on the unit with almost the same level of patient satisfaction as before. The results of the study suggest that the work sampling method for a management and organizational development program can be used to objectively assess work load of RNs as a first step

Depression and Suicidal Behavior in the Elderly: A Literature Review

Depression and suicide are significant health problems in the United States and Japan, and suicide is still considered primarily a phenomenon of adolescence to middle age. However, it is also a significant problem in the elderly (65 years old and above). The purpose of this report was to review the literature relative to the depression and suicide in the elderly in the United States and Japan. Several important factors involved with elderly suicide were different between the 2 countries. While Americans suffer from psychological problems, Japanese more likely suffer from physiological problems. Cultural and religious backgrounds play an important role in the decision to commit suicide

A Comparative Study on Medical Care for Children in Schools for the Handicapped in Japan and in the United States

We conducted a survey to document the number of students who needed medical care at schools for the handicapped in Osaka, Japan and in Dayton, Ohio, USA. The ratio of students who needed medical care was similar in both cities (10 to 15%). In Dayton, all schools had school nurses who administered medical care to those who needed it. In contrast, in Osaka, medical care was administered by people at various levels of medical training and knowledge

Implementation of Home Health Care Nursing Education in Japan

In Japan, the focus of health care has been shifted from hospital-based to community-based care. In nursing fields, home health care nursing is expected to well implemented. Although our society is facing a problem of care of the elderly population, the target patients of home health care nursing are children to the elderly. In home health care nursing education, geriatric nursing focuses on various nursing care techniques in home care settings rather than management skills and leadership. In 1997, the new home health care nursing curriculum was mandated by a committee appointed by the Japanese Government. How have nursing junior colleges incorporated the new curriculum? We expected that the new curriculum might cause changes in nursing lectures and clinical practicum, so-far run on the 3-year associate degree program in Japanese national junior colleges of nursing. We analyzed the results of the survey, with a discussion of current problems: Among 17 junior colleges studied, 4 (23.5%) had incorporated the new curriculum, and the rest had made a plan of implementation. The methods of implementations varied among the colleges probably due to the lack of a common definition. Among many problems recognized, the main were: i) shortage of faculty members who can be in charge, ii) problems related with clinical sites, iii) absence of common background among the faculty members and iv) limitation of lecture hours. Training of faculty members in this fields was an immediate concern to the colleges

The Necessity of Ethical Education for Clinical Nurses in Japan

In complex and diversified clinical settings, social needs for patients' rights are increasingly demanded. Although clinical nurses have not received systematic ethics education, they will face ethical problems on a daily basis. To solve these problems, we are required to offer ethics education to clinical nurses. We have conducted a seminar on ethics for clinical nurses at Tottori University Hospital. The purpose of this study is to clarify the current status of nursing ethics. Sixty-six clinical nurses attended this seminar from Tottori University Hospital. A questionnaire was used to collect data from 61 nurses. The following data were found: i) 56% had experience with ethical problems, ii) 49% have criteria for ethical judgment, iii) 83% answered that their understanding of ethics has deepened through this seminar and iv) almost all nurses who attended this seminar realized that nurses play an important role in advocating patients' self determination. Based on the results, we concluded that a seminar on nursing ethics provides opportunities for nurses to review his or her practice, to look back on their own nursing and to think about what ethical problems are. These findings also indicated the importance of continuing education on this problem for clinical nurses

Relationship Between the Quality of Life in Patients with Intractable Diseases and the Information Telecommunication Service

This study evaluated the relationship of the quality of life (QOL) of home-care patients having intractable diseases with motor disabilities and the use of information telecommunication services. The investigation was carried out primarily with a questionnaire and interviewing for those incapable of writing. From the answers, the 171 patients were divided into high- and low-QOL groups based on the mean (32.5) and the median (33.0) values. Using a 2-by-2 contingency table, the activities of daily living (ADL), depression score and accessibility of information telecommunication services were compared. Both groups showed significant differences in the QOL, ADL and depression scores. The study suggested that the QOL of home-care patients with intractable diseases were related to ADL and depression. If ADL and depression are maintained at an adequate level, patients can be engaged in outside activities, receive stimulation and increase their motivation. In providing information about subjects familiar to patients with intractable diseases, such sources as the circulating neighborhood newsboard (kairanban), newspapers and mass media are very useful to improve their QOL. Furthermore, devices that support their living should also be developed with regard to their private likes and dislikes