A One-Message Question in a Structured Interview: Investigating Psychological Needs of Children and Adolescents with Eating Disorders Directed toward Their Mothers

The purpose of this study was to investigate the psychological needs of children and adolescents with eating disorders (ED) directed toward their mothers. Patients with ED have low self-assertion and various abnormal eating behaviors. Therefore, mothers face difficulty in understanding their children's psychological needs, and the mother-child relationship is sometimes strained. We developed a One-Message Question (OMQ)-structured interview. The OMQ was easy to answer, and it helped the patients with ED. We examined the relationship between psychological needs and illness phase of the children and adolescents, and we discuss the viability of implementing the OMQ in clinical settings. The subjects were 23 patients and their parents. Their parents were just asked about the patients' background. The mean age of the patients was 15.8 years, and the average age of ED onset was 13.5 years. The EDs were anorexia nervosa (n＝20) and bulimia nervosa (n＝3). The phases of patients' illness were identified as anorexic (n＝5), bulimic (n＝7), chronic (n＝3), and stable (n＝8). All subjects provided specific responses to the OMQ-structured interview. Data analyses revealed the following seven categories of patients' psychological needs directed toward their mothers:attachment, cooperation in meeting their goals, longing for love, changing attitude toward family members, respect for self-reliance, expression of apology, and expression of appreciation. These findings suggested that the OMQ-structured interview may prove useful for mothers to understand their children's psychological needs and may encourage positive interactions as a foundation for future recovery

Changes in Attitudes of Japanese Doctors toward Complementary and Alternative Medicine—Comparison of Surveys in 1999 and 2005 in Kyoto

We surveyed the attitudes of Japanese medical doctors toward complementary and alternative medicine (CAM) in 1999. It is supposed that the situation concerning CAM has been changing recently. The aim of the present study is to survey the attitude of doctors toward CAM again, and to examine changes in attitude over the last 6 years. The attitudes of medical doctors belonging to the Kyoto Medical Association toward CAM were surveyed by a structured, self-administered questionnaire in 1999 and 2005. The results showed that the doctors familiar with the term “CAM”, practicing CAM therapies, and attending meetings or training courses related with CAM, increased significantly from 1999 to 2005. The doctors who possessed knowledge of CAM also increased significantly from 1999 to 2005. Almost all doctors believed in the effectiveness of Kampo (Japanese traditional herbal medicine) and acupuncture. The number of doctors who believed in the effectiveness of aromatherapy and ayurveda increased significantly in 2005, compared with 1999. In the near future, 58% of doctors desired to practice CAM therapies. In conclusion, the numbers of doctors who practice CAM therapies, possess CAM knowledge and desire to practice such therapies have increased over the last 6 years in Japan

Importance and usefulness of evaluating self-esteem in children

Self-esteem is the "feeling of self-appreciation" and is an indispensable emotion for people to adapt to society and live their lives. For children, in particular, the environment in which they are raised contributes profoundly to the development of their self-esteem, which in turn helps them to adapt better to society. Various psychologists have provided definitions of self-esteem, and examined methods of objectively evaluating self-esteem. Questionnaire-style assessment methods for adult include Rosenberg Self-Esteem Scale and Janis-Field Feeling of Inadequacy Scale, and these for children include Coopersmith Self-Esteem Inventory, Pope's 5-Scale Test of Self-Esteem for children, and Kid- KINDL®. Other methods include Ziller Social Self-Esteem Scale and Implicit Association Test. The development of children's self-esteem is heavily influenced by their environment, that is, their homes, neighborhoods, and schools. Children with damaged self-esteem are at risk of developing psychological and social problems, which hinders recovery from low self-esteem. Thus, to recover low self-esteem, it is important for children to accumulate a series of successful experiences to create a positive concept of self. Evaluating children's self-esteem can be an effective method for understanding their past and present circumstances, and useful to treat for children with psychosomatic disorders

因果関係モデルによる腎移植レシピエントのQOLの分析

The purpose of this study is to analyze the structural relationship among the components of quality of life of kidney transplant recipients by using a causal model. The subjects were 329 recipients who had regular checks-up following transplantation in seven general hospitals in Tokyo, Gunma, Aichi, Okayama, and Hiroshima, and agreed to participate in this study. Ferrans and Powers's Quality of Life - Index Kidney Transplant version was used to measure perceived quality of life. The self-administered questionnaires were handed over to the subjects, who completed the instrument on the spot. After that, the answers were collected immediately. The factor analysis and the covariance structure analysis were used to make clear the structural relationship among the components of quality of life. The results of data analysis were as follows : (1) Five components of quality of life were extracted ; socio-economic functioning, family ties, emotional support, physical health, and peace & happiness. (2) The scores in the family ties dimension and the physical health dimension were higher than in the others, and the score in the socio-economic functioning dimension was the lowest. (3) The physical health showed the starting point in a causal model. (4) The physical health influenced the family ties and the socio-economic functioning. (5) The socio-economic functioning strongly influenced the peace & happiness and the emotional support. (6) The family ties influenced the socio-economic functioning, the emotional support, and the peace & happiness. Therefore, it was conceivable that it was particularly important to make approaches for the physical health, the family ties, and the socio-economic functioning dimensions to improve quality of life.本研究は，因果関係モデルによって，腎移植後レシピエントのQOLの構成要素間の関係を明らかにすることを目的としている。対象者は，東京，群馬，愛知，岡山，広島の7医療機関に外来通院中で，研究に同意が得られた329名の腎移植後のレシピエントである。レシピエントのQOLに関するデータは，Ferrans＆PowersのQuality of Life Index―Kidney Transplant versionの測定用具を用いて収集した。収集は外来受診時に行い，対象者に自己記入式質問紙を配布し，その場で記入してもらった後，直ちに回収した。データ分析は，QOLの構成要素と構成要素間の因果関係を明らかにするために，因子分析と共分散構造分析を行った。分析結果は以下の通りである。すなわち、(1)QOLの構成要素として，社会・経済的な機能，家族の絆，情緒的な支え，身体の健康，安らぎと幸福の5つが抽出された。(2)「家族の絆」と「身体の健康」についての得点が高く，「社会・経済的な機能」についての得点が最も低かった。(3)因果関係モデルにおいて，「身体的な健康」が原点となっていた。(4)「身体的な健康」は，「家族の絆」と「社会・経済的な機能」に影響を及ぼしていた。(5)「社会・経済的な機能」は，「安らぎと幸福」と「情緒的な支え」に強く影響を及ぼしていた。(6)「家族の絆」は，「社会・経済的な機能」，「情緒的な支え」，「安らぎと幸福」に影響を及ぼしていた。したがって、レシピエントのQOLを高めるために，「身体的な健康」，「家族の絆」，「社会・経済的な機能」の側面に働きかけていくことが特に重要であると考えられた

Analysis of Problems in Family Nursing at Intensive Care Unit of O University Hospital

O大学病院のICUにおける家族看護のあり方を検討するため,過去の記録から入室患者の特性と家族の状況を把握し,課題を明らかにした｡128例の看護記録を資料に,患者の入室理由,入室期間,転帰の状況を分類し,入室期間別の家族の言動等から,家族看護の必要性について検討した｡また,家族に対する看護実践を,家族に関する情報の記載の有無から評価した｡その結果,ICU入室患者の9%が死亡退院で,そのうち受け持ち看護師の決まっていない入室後3日以内に死を迎えた患者の家族へのフォローが充分に行えていなかったこと,また,14日以上の長期入室患者の家族には,全事例に家族に関する情報が 記載されており,看護師が家族の気持ちや疲労感,患者への回想などの語りを捉えていたことが明らかとなった｡今後は,短期間で死亡の転帰となった家族へのグリーフケアや,長期入室患者の家族に対する継続看護の評価が必要である。To study family cares at an intensive care unit (ICU) in O University Hospital, we clarified problems existing in the family cares by grasping patients' character and their family conditions in reference to patients' past records. On the basis of the nursing records of 128 patients, the patients were classified according to reasons for their stay in ICU, their staying period, and how they had left ICU to examine the necessity for family cares mainly from the point how families' sentiment and behaviors differed depending on patients' staying period in ICU. Nursing practice for family cares was evaluated in consideration of whether information about patients' families had been recorded or not. As a result, nine percents of the patients studied had left ICU by death and in case patients died within 3 days in ICU, no nurses in charge of them had been assigned to or no sufficient follow-up cares had been given to their families, while families' information of all the patients staying in ICU for more than 14 days was recorded, which indicated that nurses could share the information with patients' families to understand them. This research showed the importance not only of giving grief cares to the families who had lost their important person after a short stay in ICU, but also of evaluating continuous cares for families with patients in ICU for a long time, suggesting the need for some revision of the present care system to give mental as well as physical cares to both patients and their families regardless of staying period in ICU

Analysis of humidification of low-flow-oxygen therapy

低流量酸素吸入時の加湿について,アメリカのいくつかの学会が提唱するガイドラインでは,加湿には科学的根拠がないとしている｡このため,O大学医学部附属病院放射線部特殊検査室において,低流量酸素吸入時の加湿を廃止したが,廃止後,医療者や患者から加湿の要望が若干あった｡また,病院内の各部署から依頼をうける特殊検査室では,院内における加湿状況にばらつきがあり,明確な基準を確立する必要性を感じた｡我が国において,酸素加湿に対する基準やガイドラインは見当たらないため,国内外の文献をもとに,低流量酸素吸入時の加湿の必要性について考察した｡加湿の効果を,健常者や患者を対象として加湿の有無で比較調査した研究では,日本国内で酸素流量2L/分以下,アメリカで5L/分以下において自覚症状に有意差は認められず,加湿器を使用しなくても問題がないことが明らかにされていた｡日本国内で酸素流量を5L/分以下に設定して比較調査した研究は行われていなかった｡特記すべき点として,有意差は認められなかったものの,両群とも鼻･咽頭の乾燥感に関する訴えが多かったことが挙げられた｡これらの知見から,日本国内において,さらに酸素流量を増し,環境中の湿度を考慮した比較調査が必要であることと,鼻･咽頭の乾燥感への対策を考案することが,加湿の基準を確立する上で重要であると考える｡Guidelines proposed by several medical associations in the United States showed that there was no scientific evidence of the validity of humidification during the inhalation of low flow oxygen. Therefore we abolished the humidification in the division of special procedures of O University hospital. Afterwards, some medical staffs or patients requested humidification. Further there are patients from various departments where standardization of humidification is not identified. Thus we needed to standardize the humidification during the inhalation of oxygen in our division. We reviewed published reports regarding humidification during the inhalation of low flow oxygen because there were no standards or guidelines of the humidification in our country. As a result, we confirmed that there was no symptomatic difference during the inhalation of oxygen between with and without humidification if the flow volume was less than 2 L/min in our country, or equal and less than 5 L/min in foreign countries. On the other hand, we noticed that patients were likely to complain of dry sensation of nose and/or pharynx during the inhalation of oxygen with or without humidification. We think that reevaluation of necessity of humidification during higher volume of oxygen taking room humidity into consideration in our country the flow volume of oxygen depending on the change of its amount is now required. And it is important to. establish the way to prevent dry sensation during the inhalation of oxygen

A Japanese version of the stressors in nursing students (SINS) scale

© 2018 Chinese Nursing Association Objectives: To translate and study the factor structure of a Japanese version of the Stressors in Nursing Students scale. Methods: The Stressors in Nursing Students scale was translated into Japanese and administered to a large cohort (N = 1298) of female Japanese nursing students across five universities and across all four years of the nursing programme. The data were analysed using exploratory factor analysis. Results: Exploratory factor analysis revealed four factors: ‘Clinical’; ‘Conflict and confidence’; ‘Education’; and ‘Free time’. The relationship between the total score on the Stressors in Nursing Students scale and the demographic aspects of the sample was weak but there was a significant increase in the perception of stressors between first and second year students. Conclusions: There were similarities and differences between the perception of stressors by nursing students in Japan compared with, for example, the United Kingdom and China mainland. While a four-factor structure was found here, the distribution of items in the Stressors in Nursing Students scale differed from previous studies in the United Kingdom and China with the ‘Free time’ factor being unique to this study. Stress is an issue for nursing students and is related to the specific stressors they encounter in the process of their work and study. Findings can inform the development of strategies to reduce such stressors among nursing students in multiple, global contexts

A Study of Psycho-pathology and Treatment of Children with Phagophobia

Phagophobia is a disorder characterized by a conditioned excessive fear of eating and is initiated by an event such as vomiting or choking. During childhood, vomiting often occurs as a result of infection or overeating, and painful experiences bring about maladaptive eating behavior like food refusal. There have been few reports of phagophobia, and patients have sometimes been misdiagnosed with anorexia nervosa (AN). The objective of this study was to elucidate the psycho-pathology and current treatment of patients with phagophobia by analyzing case studies. We describe 6 cases with phagophobia. Patients with strong obsessions were refractory to treatment, indicating that evaluation of premorbid personality is crucial to the prognosis. It is important to classify this disorder according to psycho-pathology into "post-traumatic type" and "gain-from-illness type" to make a treatment plan. A solution focused approach is also effective for patients and their family. Paying close attention to these conditions and to the diagnostic concept referred as "hagophobia" is useful in achieving these aims

Oil-in-water emulsion lotion providing controlled release using 2-methacryloyloxyethyl phosphorylcholine n-butyl methacrylate copolymer as emulsifier

AbstractLotion is a useful vehicle for active ingredients used to treat skin disease because it can be applied to the scalp, can cover large areas of skin, and it is easy to spread due to low viscosity. An emulsion lotion (EL) containing 2-methacryloyloxyethyl phosphorylcholine n-butyl methacrylate copolymer (PMB) as an emulsifier that provides controlled-release was developed. Diphenhydramine (DPH) was used as a model drug. Formulation with 5% DPH, 5% soybean oil, and 4% PMB in water was emulsified using a high-pressure homogenizer. Polysorbate 80 (TO) was used instead of PMB for comparison. They were applied in vitro to Yucatan micropig intact or stripped skin at a practical dose (2μL/cm2). For stripped skin, penetration of DPH from 4% PMB EL was slower than that from 1% TO EL; results for intact skin were similar. The same phenomenon was observed with application to rabbit skin in vivo. When 4% PMB EL dried on the skin, it made a thin film matrix incorporating the oil phase, which controlled the release of DPH. The release rate could be controlled by the ratio of oil phase to PMB. The EL with PMB shows promise as a vehicle for long-acting treatment of skin diseases