Longitudinal study on factors affecting assertiveness among preceptors of novice nurses

Purpose: This study aims to understand the assertiveness of preceptors of novice nurses and factors affecting the assertiveness through a longitudinal perspective. Methods: Anonymous self-rating questionnaire surveys were administered to 1292 preceptors working in participating city and university hospitals across Japan (August, 2013 (baseline) and March, 2014 (second survey)). The surveys had question items from the Japanese version of the Rathus Assertiveness Schedule (J-RAS, 30 items), demographic details of the participants, evaluation of novice nurses by preceptors, instruction framework, selfevaluation of preceptors, working environment, and a burnout inventory (Japanese version of the Maslach Burnout InventoryHuman Services Survey, 22 items). Bivariate analyses (T-tests and one-way analysis of variance) were conducted using assertiveness of the second survey as the objective variable, and other items of the baseline survey as explanatory variables. Selecting variables with p values smaller than 0.2 obtained in the bivariate analysis as explanatory variables, a multiple linear regression analysis (Stepwise method) was conducted. For the analyses, we used a statistics analysis software, SPSS Statistic 22. Results: Choosing 836 valid respondents of the baseline survey as a cohort group, we repeated the survey 8 months after the baseline survey to identify the factors affecting the assertiveness of preceptors of novice nurses. Excluding 62 who had missing values in the question items for assertiveness, 472 participants who were followed were included in analyses. As the results, following factors were found to affect the assertiveness: thinking that ‘they make rapid decisions’, and that ‘they are valuable as others’. Further, participants who have higher total burnout scores had lower assertiveness. Adjusted coefficient of determination was 0.153. Discussion: It can be inferred that the assertiveness of preceptors is higher than that of novice nurses measured by the J-RAS used in this study, and lower than that of administrative nurses. The assertiveness of preceptors was higher among participants who evaluated themselves positively, thinking that ‘they make rapid decisions’, and that ‘they are valuable as others’. It was also found that higher ‘total burnout scores’ was a factor that lowers the assertiveness. These findings suggest that a positive self-evaluation improves assertiveness and helps to prevent burnou

Coping Behaviors and Collaboration among Staff of Multiple Occupation Classifications during Norovirus

In December 2012 a norovirus infection outbreak occurred in the Orthopedic Surgery Ward of Hospital A in Japan. This study aims to establish details of coping behaviors used by nurses, physicians, physiotherapists, and pharmacists of the facility, and examine the issues involved in infection control by team collaboration as well as the ways employed to deal with the infections. Participants in this study were thirty-seven medical professionals who were working in the Orthopedic Surgery Ward of Hospital A at the time the infection outbreak occurred, and who were still working there when the interviews were conducted. Interviews were conducted from January to April 2015, and the data from the interviews were analyzed using the “Trend Search 2008” text mining software. As a result of the analysis it was found that the nurses primarily communicated information by passing messages to the nurses who took over the duty at shift changes, but did not pass on the information to staff in other occupations or to the ward as a whole. The nurses clearly remembered that the ward was closed and it was a difficult experience, but did not remember details of the patients they were in charge of. The physicians clearly remembered individual patients they were in charge of, but they were not aware of the situation and state throughout the ward. The findings suggest that this difference is due to the differences in the occupational nature and sense of values of the staff involved. It is also found that physiotherapists did not feel a sense of crisis about the norovirus outbreak because they felt the patients in the ward appeared to be in better condition than patients in other wards, and that pharmacists lacked communication with staff in other occupations because they usually have heavy workloads. In concept mappings of physicians, physiotherapists, and pharmacists, the keyword places in the center of the maps, and is linked to and . Because the nurse plays a central role to report information among the four occupations, nurses should be aware of and assigned to play the role to coordinate team collaboration

主任看護師の立場にある実習指導者の実習指導に対する意識の特徴 自己教育力とその関連要因に焦点をあてて

主任看護師の立場にある実習指導者の実習指導に対する意識の特徴を、指導者の自己教育力とその関連要因に焦点を当て明らかにすることを目的に、関東甲信越・東海地域の300床以上の病院で看護学生の指導に当たる指導者を対象に質問紙調査を行い、主任看護師の立場にある233名(平均年齢40.5±6.4歳、平均実習指導経験5.9±5.0年)より有効回答を得た。その結果、主任看護師の立場にある指導者の自己教育力と最も強い関連が認められたのは「学生に大切にしている看護を語っている」で、その他「学生とよい関係を築けている」「指導者としての誇りをもっている」「看護実践に自信がある」「実施した看護を意味づけている」と有意な関連が認められた。また、自己教育力が高い者は、「実習指導に対するストレスを感じていない」ことが明らかになった

Synthetic study directed toward novel multi-linked heterocycles

金沢大学大学院自然科学研究科生理活性物質科学金沢大学薬学部2-Amino-4-(1-methylindol-3-yl)thiazole (11c) has a characteristic nucleophilic nature at the 5-position and add to the 4-position of acetylpyridinium acetate (13) producing 2-acetylamino-5-(1-acetyl-1,4-dihydropyridin-4-yl)-4-(1-methylindol-3-yl) thiazole (1c). Its structure was established by X-ray single crystallographic analysis. Applying the results, simple syntheses of the related tris- (1a-b and 2-8) and tetrakis-linked heterocycles (9) were achieved

Association between Optic Nerve Head Microcirculation and Macular Ganglion Cell Complex Thickness in Eyes with Untreated Normal Tension Glaucoma and a Hemifield Defect

Purpose. We evaluated the association between optic nerve head (ONH) microcirculation and macular ganglion cell complex (mGCC) thickness in patients with untreated normal tension glaucoma (NTG) and a hemifield defect. Methods. The medical records of 47 patients with untreated NTG were retrospectively reviewed. Laser speckle flowgraphy was used to obtain mean blur rate (MBR), a relative measure of blood flow. Average total deviation (TD), mGCC, and the circumpapillary retinal nerve fiber layer (cpRNFL) thickness were also analyzed. Results. All parameters corresponding to the defective hemifield were significantly lower than those corresponding to the normal hemifield. In the defective hemifield, MBR was correlated with TD, mGCC, and cpRNFL thickness. In the normal hemifield, MBR was only correlated with mGCC thickness, and multiple regression analysis showed that mGCC thickness was a significant contributing factor of the MBR. Conclusion. MBR was well correlated with mGCC thickness in eyes with untreated NTG and a hemifield defect. In the normal hemifield, mGCC thickness was a contributing factor of the MBR indicating that ONH circulatory dysfunction may be associated with retinal structural changes in the early stages of glaucoma. A reduction in ONH microcirculation may be an early indicator of the presence and progression of glaucoma

看護学臨地実習指導者自己教育力尺度を用いた実習指導者の自己教育力とその関連要因－職業的アイデンティティ・バーンアウトを含む関連要因の検討－

本研究は，看護学臨地実習指導者自己教育力尺度を用いて，看護学臨地実習指導者（以下指導者）の自己教 育力とその関連要因を明らかにすることを目的とした． 北海道・東北・中部・近畿地方の300 床以上の病院に勤務する指導者1692 人を対象として自記式質問紙 調査（ 郵送留置法）を 2019年 9 月～10 月に実施した． 目的変数である指導者の自己教育力と説明変数の2 変量解析において，有意差のみられた変数を抽出し， 重回帰分析（ステップワイズ法）を実施した（ｐ＜ 0.05）． 回収数は1435 部（回収率84.8%）であった．看護管理者を除く指導者で，自己教育力尺度に欠損がない 1018 部（有効回答率60.2%）を分析対象とした． 対象者の平均年齢37.1 ± 7.9 歳，平均臨床経験14.4±8.1 年，平均実習指導経験5.4±5.5 年であった．本 研究における指導者の自己教育力の平均は65.8±10.8 点であり，本研究のCronbachα 係数は0.91 であった． 重回帰分析の結果，自由度調整済み決定係数は0.55 であった．指導者の自己教育力に最も強く関連していた 変数は，看護師の職業的アイデンティティであった．さらに，学生をチームの一員として認めている， 実習目標 を達成できるように指導している，実習指導を振り返っている，学生に看護について語っているなどであった． 指導者の自己教育力に最も強く関連していた要因は，看護師の看護観の基盤となる職業的アイデンティティ であった．これは，指導者が学生に看護を意味づける上で，実習教育の質を左右する重要（安酸, 2015）な 要因であり，指導者の自己教育力の高さと強く関連していたことが明らかになった