マンセイ シッカン デ セイシン ショウジョウ オ テイスル カンジャ エノ チイキ セイシンカ イリョウ モデル ジギョウ オヨビ ソノ ヒョウカ : セイシン カンゴ センモン カンゴフ ト リエゾン チーム ノ ヤクワリ

The purpose of this study was to show the effectiveness of psychiatric liaison consultation team for the people with chronic illness in the general hospital. Psychiatric liaison consultation team was constructed by certified nurse specialist (CNS), psychiatrist, clinical psychologist, nurse and social worker. Case manager was CNS and team intervened to the patients according to the standard of intervention by team. Intervention had been implemented by CNS mainly. Thirty one patients who consented to this study were intervened by CNS and team between July of 2007 and Feb.2008. They had chronic illness which was SLE, cancer and other physical illness without mental illness. BPRS, GAF, and LSP were written by CNS at the time of baseline before intervention and at the end time of intervention. Furthermore patients wrote CES-D and SF-36 by themselves at the baseline and the end point of intervention. Those questionnaires were returned by mail. CSQ was written by patients at the end of intervention. Thirty one patients had high depression score at the baseline and after intervention depressive state was improved. And they had lower SF-36 compared with that of the people who had chronic illness in another study. Furthermore they needed to be supported psychosocially by CNS to prevent worse their symptom. And they had psychosocial needs and those needs should be intervened by interdisciplinary team. In conclusion, the role of CNS and interdisciplinary team were discussed in order to meet the patients\u27 needs and to prevent worse their symptom in the general hospitals

Current Ethical Issues and Future Challenges in Psychiatric Nursing : Based on the Pilot Test Outcome

The purpose of this study was to shed light on present ethical issues in Japanese psychiatric nursing and establish clearly what measures, educational programs, and guidelines are needed in order to improve the care and treatment of patients with mental disorders. Twenty Psychiatric Certified Nurse Specialists (CNSs) were interviewed on ethical issues. This study reports the results of this pilot test. The survey was conducted from October to December of 2012. After approval from the Kumamoto University Research Ethical Committee, objectives, methods, and guarantees of privacy were explained to the subjects and, with their agreement, interviews were conducted. Ethical issues faced by the CNSs fall into 5 categories: 1) As hospitalization lengthens, patient needs are less respected, 2 ) Conflict between patients and family regarding decisions, 3) Struggle in achieving agreement with doctors, 4) Difficulty in developing adequate treatment and care programs, and 5) The insular nature of hospitals. Furthermore, the CNSs resolved these ethical issues as follows: 1) By talking with ward supervisors to resolve ethical issues; 2 ) by proposing and implementing solutions; and 3) by considering ways to strengthen group performance. In Japan the length of stay among psychiatric patients is particularly long and this study shows the characteristics of Japanese psychiatric nursing. In addition this study shows that the family plays an important role in deciding on a patient\u27s discharge. But the CNSs have effective communications with related professionals to solve the problems. Based on these results we will develop an educational plan for psychiatric nurses and we need to clarify the role of psychiatric nurse and CNSs concerning those problems