Effect of preoperative physiothery on Surgery for lung cancer with limited respiratory function

Surgical outcome of lung cancer for the aged was evaluated, in particular, in the patients with obstructive ventilatory failure of less than 49 of FEV1.0. The survival rates in the patients with obstructive ventilatory failure after surgery was satisfactory as compared with non-obstructive ventilatory failure. Furthermore, postoperative hypoxemia and hypercapnia did not correlate with the degrees of obstructive ventilatory failure. The preoperative physicotherapy greatly contributed to improvement of preoperative obstructive ventilatory failure, which may help reduce postoperative pulmonary complications. Great enthusiasm has developed regarding cooperation of nursing care and patient\u27s volition for resuming their health to improve surgical result for the aged

Preference of middle-aged Japanese regarding place to receive end-of-life care: a case study of parents of nursing students

Objectives: This study was performed to assess the preference of middle-aged Japanese regarding end-of-life care. 　Methods: A structured, self-administered questionnaire survey regarding preference of place to receive end-of-life care was performed among parents of nursing school students by postal mail. 　Results: A total of 64 （61.5%） participants returned the questionnaire. Some of the major concerns regarding home-based end-of-life care were being a burden on their family and whether their family would accept care at home at the end of their life. The majority of the participants wanted more information regarding financial support system and availability of medical and care institutions and care support services to receive home-based end-of-life care, regardless of the extent of their pre-existing knowledge regarding end-of-life care, and participants with little or no prior knowledge of the end-of-life care were less likely to appreciate the importance of family support system. 　Conclusions: These results suggest that ignorance about end-of-life care produces a narrower range of choices and limits decision making regarding such care, even though most participants would prefer to receive end-of-life care at home

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 mental health status of children who have been evacuated or migrated from rural areas in Fukushima prefecture after the Fukushima daiichi nuclear power station accident: results from the Fukushima health management survey

Introduction: We evaluated the mental health status of children residing in Kawauchi village (Kawauchi), Fukushima Prefecture, after the 2011 accident at the Fukushima Daiichi Nuclear Power Station, based on the children's experience of the nuclear disaster. Methods: We conducted this cross-sectional study within the framework of the Fukushima Health Management Survey (FHMS);FHMS data on age, sex, exercise habits, sleeping times, experience of the nuclear disaster, and the "Strengths and Difficulties Questionnaire (SDQ)" scores for 156 children from Kawauchi in 2012 were collected. Groups with and without experience of the nuclear disaster - "nuclear disaster (+)" and "nuclear disaster (-)" - were also compared. Results: Our effective response was 93 (59.6%);the mean SDQ score was 11.4±6.8 among elementary school-aged participants and 12.4±6.8 among junior high school-aged ones. We statistically compared the Total Difficulties Scores (TDS) and sub-item scores of the SDQ between "elementary school" and "junior high school" or "nuclear disaster" (+) and (-). There was no significant difference between these items. Conclusions: We found indications of poor mental health among elementary and junior high school-aged children in the disaster area immediately following the accident, but no differences based on their experience of the nuclear disaster. These results indicate the possibility of triggering stress, separate to that from experiences related to the nuclear disaster, in children who lived in affected rural areas and were evacuated just after the nuclear disaster

Factors Associated with Nurses’ Intention to Leave Their Jobs after the Fukushima Daiichi Nuclear Power Plant Accident

We conducted a survey among nurses who were working at the Fukushima Medical University Hospital at the time of the Fukushima Daiichi Nuclear Power Plant accident to clarify the factors associated with their intention to leave their jobs during the radiation emergency. We asked 345 nurses (17 men and 328 women) about their intention to leave their jobs after the accident. We also asked about relevant factors including the participants\u27 demographic factors, living situation, working status, and knowledge of radiation health effects. We found that living with preschoolers (OR=1.87, 95%CI: 1.02-3.44, p=0.042), anxiety about life in Fukushima City after the accident (OR=5.55, 95%CI: 1.18-26.13, p=0.030), consideration of evacuation from Fukushima after the accident (OR=2.42, 95%CI: 1.45-4.06, p=0.001), consideration of the possible radiation health effects in children (OR=1.90, 95%CI: 1.02-3.44, p=0.042), and anxiety about relationships with colleagues in the hospital after the accident (OR=3.23, p=0.001) were independently associated with the nurses\u27 intention to leave their jobs after the accident. On the other hand, the percentage of nurses with knowledge on radiation health effects was relatively low among those who had the intention to leave the job and among those who did not have the intention to leave the job after the accident, with no significant differences between the two groups. Our results suggest the need for an education program for nurses regarding radiation health effects

Survey of awareness of radiation disasters among firefighters in a Japanese prefecture without nuclear power plants.

Japanese firefighting organisations are essentially run as village, town, or city units. The Great Hanshin Earthquake of 1995 led to the establishment of emergency support teams to ensure rapid action in response to disasters beyond the capacities of local fire departments. The 2011 Great East Japan Earthquake involved both a tsunami and a radiation disaster caused by a nuclear reactor meltdown, underscoring the need for responses in complex disasters. This study aimed to assess Nagasaki Prefecture firefighters' preparedness for, awareness of, and anxiety regarding radiation disaster response with the aim of elucidating the factors affecting individuals' decisions to accept or reject assignment to a radiation disaster response team. A questionnaire survey was carried out with 1,122 firefighters in three firefighting departments in Nagasaki Prefecture, which does not have nuclear power plants. In total, 920 questionnaires were returned, and the 784 that were valid were analysed. Among the participants, 39% replied that they would have no difficulty accepting assignment to a radiation disaster response team; most of them were under 30 years old and unmarried. This group also included significantly higher percentages of participants who were confident about radiation disaster response or, if anxious, believed things would turn out fine, as well as those who replied that they were able to use the necessary equipment. Furthermore, this group had significantly higher percentages of participants who replied that they would definitely participate in seminars and those who replied that their level of preparedness for radiation disasters was sufficient. The willingness to be assigned to a radiation disaster response team was linked to confidence about radiation disaster response and about handling materials and/or equipment. Therefore, it is considered that measures to increase firefighters' confidence regarding response to radiation disasters will be linked to more proactive measures if and when such disasters occur