Analysis of Communication between Inpatient Children and Their Mothers - I -

We observed the communication between inpatient children and their mothers mainly at the scenes of "play", "drug administration", and "meal" and classified their communication state into 6 types to evaluate the mother-child relationship. The 6 types were such as, good response type (Type I), repair type (Type II) , good response discontinuation type (Type III), response setback type (Type IV), rejective ending type (Type V), rejectin type (Type VI). 1. Sixty-two communication scenes were evaluated in 10 mother-child pairs. 2. Concerning child\u27s words and behavior, attachment for their mothers was observed at 82.5% of the "play" scenes. However, both attachment and rejection were observed at similar percentages of "drug administration" or "meal" scenes . 3. Concerning mother\u27s responses, good responses were most frequently observed at play scenes (88.0%). At "meal" scenes, good responses, good response discontinuation, and rejection were observed. In "drug administration" scenes, no rejection was observed. 4. The mother-child communication was classified into 6 types according to mother\u27s responses. 5. Type I and II indicating good responses were most frequently observed (77.4% of the scenes) . Type V and VI indicating rejective responses were observed in 9.7% of the scenes. 6. In "play" and "drug administration" scenes, good com- munication types were frequently observed. In "meal" scenes, various types were present. 7. The frequency of the communication types indicating rejection was significantly lower in relatively aged mothers group than in young mothers. It is clinically important to clarify the association between mother-child communication types and the situation in which the mother and child are placed based on the results of this study. The participation-observation method used in this study is an effective method of evaluating the relationship between inpatient children and their mothers for appro- priate nursing support

Mothers\u27 Perceptions of the Sexual Development and Behavior of their Children and Persons with Autism in General

In order to ascertain and evaluate mothers\u27 perceptions of the sexual development and behavior of their children with autism, we conducted a questionnaire survey on participants in meetings held in Nagasaki. From among 172 persons who consented to participate in the survey and responded to the self-administered questionnaire, we selected 71 mothers of sons with autism (aged 6 years or over) as the study subjects. The questionnaire included items on children\u27s sexual behaviors, the appearance of secondary sexual characters/sexual development, the mothers\u27 perceptions of the children\u27s sexual development and behavior, and assessments of their own child and persons with autism in general with respect to masturbation, romantic relationships, and marriage. According to the severity of the children\u27s autism, subjects were classified into severe and non-severe groups and the above-mentioned items were compared between the two groups. No significant difference was observed between the two groups in terms of the age at first appearance of secondary sex characters; however, the age at which interest in the opposite sex was first shown was significantly earlier in the non-severe group (p = 0.031). Among 58 children aged 120 months or over, 29 (50.0%) were masturbating and the proportion of such children was significantly larger in the severe group (p = 0.014). Regarding problem sexual behavior, no significant difference was observed in the frequency of worried mothers between the two groups (p = 0.80), while "talking about sex in public" was more frequent in the non-severe group (p = 0.018). Approximately 80% of the mothers in both groups had positive views about masturbation both for their own child and for persons with autism in general; however, the proportion of mothers showing positive views about romantic relationships or marriage was significantly smaller in the severe group (p<0.0001). The present study demonstrated that mothers\u27 perceptions of sexual development and behavior in their children with autism vary according to the disease severity. This finding indicates the necessity for healthcare professionals to actively concern themselves with the mothers

乳房切断術患者の術後遠隔期におけるQOLに関する研究

根治的乳房切断術を受けた乳癌患者137例について，術後遠隔時のQOLをアンケート調査票を送付して行った．QOLの構成因子を患側上肢の機能障害，Activity　of　Daily　Life（以下ADL），State of　Daily　Life（以下SDL），就労状況，身体的活動意欲，精神的活動意欲，手術満足度，癌再発不安度，ボディ・イメージの変容とした．患側上肢の自覚症状として，腫脹32％，筋力低下25％，疼痛14％，可動域制限14％，知覚異常7％が認められた．ADLを各項目別に検討すると，過半数の例に何らかの支障を認めた．これら機能障害の高度な例では，身体的・精神的活動意欲などの他のQOL因子も有意に不良であった．SDLが術前と不変と回答した例は108例中79％であった．手術不満例は16％であり，上肢の高度機能障害例に多かった．癌再発不安は，65歳以上の高齢者群に比し，65歳未満の若年者群に有意に高く，長期経過例であっても不安は解消されていなかった．乳房喪失というボディ・イメージの変容に対して，大多数の症例がブラジャー，衣服の工夫を行っていた．　以上により種々の程度の上肢の機能障害に対し，各人に適合した補整具の開発やアフタケアを含めた指導や，癌再発不安などに対する継続的な看護が重要であると考えられた．We conducted a questionnaire survey to evaluate the long-term quality of life (QOL) in 137 patients with breast cancer who underwent radical mastectomy. QOL factors consist functional impairment in the upper limb on the affected side, activity of daily life (ADL), state of daily life (SDL), the status of postoperative rehabilitation, mental activities, physical activities, satisfaction of the surgery, anxiety for recurrence of cancer, cosmetic factor (changes in the body image). In the upper limb on the affected side, swelling was observed in 32％, decreased muscle strength in 25％, pain in 14％, limitation in the range of motion in 14％, and sensory impairment in 7％. However, evaluation of the items of the ADL questionnaire revealed specific disturbance in daily life in more than 50％ of respondents. Patients who showed marked functional impairment in this limb had other QOL factors, such as the desire to do mental and physical activiies which were also significantly poor. Of these patients, 108 (79％) replied that state of daily living (SDL) did not change after the survey. Sixteen percent of the patients were not satisfied with the results of their surgery, and they often noted marked functional impairment in the upper limb. Anxiety about recurrence of cancer was more in the middle aged group (65 years or more) than in the aged group (less than 65 old). Anxiety persisted even in patients showing a long survival without regard to aging. Against changes in the body image, ie., loss of the breast, most patients used prosthetic devices in a brassiere and clothes. These results suggested the need to develop prosthetic consultation for each patient, and instruction in post operative care to help prevent functional impairment in the upper limb, continuous nursing intervention to the anxiety about recurrence of cancer might be needed. to various level of the functional impairment in the upper limb

看護基礎教育における心肺蘇生法の習得状況-一次救命処置を中心として-

長崎大学医療技術短期大学部看護学科学生70名を対象に，救急蘇生訓練用人形を用いて，一次救命処置を中心とした心肺蘇生法の学内演習を行った．実技テスト，演習前後の客観テスト，学生の自己評価などをもとに学習効果および今後の課題を検討した．　実技テストでは，チェックリストにそって，各項目ごとに教官が評価した結果，ほとんどの項目で9割以上の学生が合格できた．客観テストでは演習後の平均点は高かったが，知識と技術の統合がされていない項目もあり，指導上の課題と考えられた．また，学生の自己評価では，人工呼吸法が「できなかった」とする学生が多く，気道の確保および維持，また吹き込みもかなり難しい技術であった．一次救命処置は緊急の現場で実践できなければ意昧のない技術であり，反復訓練による習得が必要であると考えられた．Nursing skill training for cardiopulmonary resuscitation as part of the basic life support was conducted in the school using dummies for training emergency resuscitation. This training was participated by 70 students of the Department of Nursing, the School of Allied Medical Sciences, Nagasaki University. The effectiveness of learning and practicing by the students and the problems were analyzed on the basis of their nursing practical test and objective tests before and after the skill exercise. In nursing practical skill test, the instructors evaluated each item on the check list, and more than 90% of the students passed the test for most of the items. In objective test, the average marks after the nursing skill exercise was high. However, knowledge and skill were not integrated in some items, leaving problems for the teaching procedure. In self-evaluation, many students "could not" perform artificial respiration, indicating that keeping airway and mouth-to-mouth ventilation were quite difficult. Basic life support is meaningless if one is unable to perform at an emergency circumstance. Acquisition of the skill by repeated training is considered essential

The relationship between physical signs of aging and social functioning in persons with Down syndrome in Japan

Background: In Japan, there have been no substantial studies of social function and physical aging in adults with Down syndrome. The aim of the present study was to examine social functions (movement, conversation, and daily living skills) and physical signs of aging in adults with Down syndrome in Japan, and to analyze the relationship between changes in social function and age.Methods: A cross-sectional survey of persons with Down syndrome who were 15 years of age or older (15-65 years old) was conducted. The survey was conducted in patients associations, institutes, group homes, and workplaces from July to December 2009. Primary caregivers, such as family members and institute staff, were asked to complete a questionnaire on the subjects’ living situation, movement ability, conversational skills, daily living skills, and 10 characteristics of physical aging at the time of the survey.Results: The total number of subjects was 315. Subjects’ movement ability, conversational ability, and daily living skills declined as a function of age. Canities (40.6%) were the most prevalent physical sign of aging, followed by missing teeth, hump back, and skin wrinkling. Further, physical aging was related to a decline in social functions (p < 0.001).Conclusion: The present study showed that adults with Down syndrome exhibit signs of physical aging earlier than do the general population, and that physical aging is associated with social functioning. Thus, the appearance of physical aging might indicate a decline in social functioning

Knowledge, experience, and potential risks of dating violence among Japanese university students: a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>The Domestic Violence Prevention Act came into effect in Japan in 2001, but covers only marriage partner violence and post-divorce partner violence, and does not recognize intimate partner violence (IPV). The present study was performed to determine the experience of harassment, both toward and from an intimate partner, and recognition of harassment as IPV among Japanese university students.</p> <p>Methods</p> <p>A self-administered questionnaire survey regarding the experience of harassment involving an intimate partner was conducted as a cross-sectional study among freshman students in a prefectural capital city in Japan.</p> <p>Results</p> <p>A total of 274 students participated in the present study. About half of the subjects (both male and female students) had experience of at least one episode of harassment toward or had been the recipient of harassment from an intimate partner. However, the study participants did not recognize verbal harassment, controlling activities of an intimate partner, and unprotected sexual intercourse as violence. Experience of attending a lecture/seminar about domestic violence and dating violence did not contribute to appropriate help-seeking behavior.</p> <p>Conclusions</p> <p>An educational program regarding harassment and violence prevention and appropriate help-seeking behavior should be provided in early adolescence to avoid IPV among youth.</p

入院中の小児と母親のコミュニケーション分析

大学病院に入院している小児と母親のコミュニケーションを分析した．８組の親子の56場面を観察し，母親の対応の仕方からコミュニケーションを６型に類型化した．Ⅰ型は良好型，Ⅱ型は修復型，Ⅲ型は対応良好中断型，Ⅳ型は対応頓挫型，Ⅴ型は拒否的終結型，Ⅵ型は拒否型とした．　その結果，Ⅰ型が73％みられ，どの親子でも良好な対応がみられた一方で，どの親子にも中断や拒否を示す対応もみられた．対象者の背景とコミュニケーション類型の関連がみられたのは母親の年齢だけであった．特徴的な２事例の分析では，一方がほとんど良好な対応であったのに対し，もう一方は良好な対応が少なく拒否型が多かった．　母親には小児の感情を受け止めるためのコミュニケーションに関する感性が求められており，そのための看護介入も必要であり，重要である．Communication between inpatient children and their mothers in an university hospital was analyzed. Fifty-six units of conversation of 8 mother-child pairs were recorded and units of conversation were classified into 6 types according to mother\u27s response; Type I good response, Type II repair, Type III good response discontinuation, Type IV response setback, Type V rejective ending, and Type VI rejection. Main results were as follows; 1) Communication types indicating good responses were observed in all the pairs, and Type I occupied 73%. 2) Types indicating interruption or rejection, however, were also observed in all the pairs. 3) Among background factors of the subjects, only mother\u27s age was associated with the communication types. Scenes of rejection were significantly less frequent in mothers aged 30 years or more. 4) There was large variation of proportion of types of conversation; most responses were good in one case, whereas most responses were rejective responses in another case. Mothers need to have sensitiveness concerning communication with their child and need to accept child\u27s feeling. Nursing intervention for enabling this appears to be necessary and important