Nursing Students' Learning and Evaluation of Exercises in Pre-Practice Simulation Exercises for Hospital Ward Practice : From the results of the Post-Implementation Questionnaire

看護学部2年生及び学士3年生を対象とした実習の一環として，実習前自己学習にて，病棟実習を想定したシミュレーション演習を行った。シミュレーション演習内容は，事前に学部2年生に希望調査を行い，また上級生のラーニングアシスタント作成による病棟で遭遇する事例集を活用した。自己学習終了時のアンケート結果より，参加者全員より「参加してよかった」という回答が得られた。また，演習内容に関しても，実習に向けた準備性が高まったとの回答が99％であり，「復習できた」，「新たな学びが得られた」といった評価が得られた。ウィズコロナ時代に向け，看護学生の看護実践能力育成に，更にシミュレーション演習が必要とされることから，今回の結果を踏まえ臨床実習をより想定できるよう内容を改善する必要があると考える。A simulation practice was conducted assuming hospital ward practice in self-study before practical training for second-year nursing students and third-year undergraduate students. A survey of second-year undergraduate students regarding the content of the simulation exercise was conducted in advance, and a collection of cases encountered in the hospital ward was created employing a learning assistant. Results of the questionnaire at the end of the self-study showed that all participants were pleased to participate in the program. Regarding the contents of the exercises, 99% of the respondents answered that they were more prepared for the practical training, and the participants responded that they were able to review the contents and that they could learn something new. During the COVID-19 era, when simulation exercises are required to develop the practical skills of nursing students, we appraise that it is necessary to improve the contents so that clinical training can be envisioned more based on the results of this study

Utilization of a Learning Assistant System to Support the Acquisition of Nursing Skills

本学では教育環境をより充実させるため，2017 年度よりラーニング・アシスタント(以下，LA)制度を導入した。著者らは看護技術を習得する科目において，LA 制度を活用している。本稿では，その実践について報告する。看護学部2 年生の必修科目「基礎看護技術論Ⅰ」にて, 12 名のLA が登録し，演習時の教育補助活動および自己学習支援活動を行った。自己学習支援活動は，のべ35 回(平均3.5 時間)実施された。活動を評価するため,履修者を対象に，2017 年5 月にWEB アンケートを行った。履修者85 名中79 名(92.9%)の回答を得た。うち, 77 名(97%)がLA 制度は「よい」と回答した。LA 制度は履修者から高評価を得ており，学習支援制度として有効であると示唆された。一方で，LA に聞きづらいという意見があり，LA の対応についてのオリエンテーション内容を改善する必要が明らかになった。The Learning Assistant (LA) system was introduced to our college in 2017. Here we report on the utilization of the LA system in subjects in order to learn nursing skills. An online questionnaire was administered to 85 students taking a Basic Nursing Skills class in May 2017. We received responses from 79 students (92.9%), of whom 77 (97%) reported that the LA support they received was positive. The LA system was highly praised by students and effective as a learning support system. However, the participants expressed the opinion that it was difficult to ask the learning assistants for help. This indicates a need to improve the LA system

Student Support with Learning Assistants at the College of Nursing during the COVID-19 Pandemic

本学では,2017 年度にラーニングアシスタント(以下，LA)制度が設置された。実習室小委員会でも,2018 年度より,学生の看護技術習得支援を目的に,LA を導入している。2020 年度は,新型コロナウイルス感染症拡大により,前期科目が在宅学習となった。そのため,LA による下級生支援活動はWeb にて実施され,LA28 名は,オンライン質問会開催や演習と実習に関するスライド作成などの活動を行った。LA活動についての下級生へのアンケートの結果,回答者の93％が「LA の活動は,在宅学習や大学生活の支援につながった」と回答した。コロナ禍においても,LA による下級生支援が可能であり,今後も,状況に応じた学習者支援が必要であることが示唆された。The learning assistant (LA) system was implemented in our college in 2017. In 2018, the Nursing Learning Lab room committee began offering the LA system to students to provide support for nursing skills practice. However, as a result of the rapid spread of the COVID-19 pandemic, students were required to study at home starting in early 2020. Therefore, a support service for students in the lower grades, conducted by the LA system, was implemented online. A total of 28 LAs created slides relating to "nursing exercises and clinical nursing training" and held online consultation meetings. A questionnaire regarding LA support was sent to students who use the LA service; 93% of respondents stated that "LA supported home study or university life." The LA system made it possible to support students in the lower grades during the COVID-19 pandemic. This study suggests that student support appropriate to the situation is required

Bereaved Family Members’ Perspectives of Good Death and Quality of End-of-Life Care for Malignant Pleural Mesothelioma Patients: A Cross-Sectional Study

Objective: This study investigated whether malignant pleural mesothelioma (MPM) patients achieved good deaths and good quality of end-of-life care compared with other cancer patients from the perspective of bereaved family members in Japan. Methods: This cross-sectional study was part of a larger study on the achievement of good deaths of MPM patients and the bereavement of their family members. Bereaved family members of MPM patients in Japan (n = 72) were surveyed. The Good Death Inventory (GDI) was used to assess the achievement of good death. The short version of the Care Evaluation Scale (CES) version 2 was used to assess the quality of end-of-life care. The GDI and CES scores of MPM patients were compared with those of a Japanese cancer population from a previous study. Results: MPM patients failed to achieve good deaths. Only 12.5% of the MPM patients were free from physical pain. The GDI scores of most of the MPM patients were significantly lower than those of the Japanese cancer population. The CES scores indicated a significantly poorer quality of end-of-life care for the MPM patients than the Japanese cancer population. The total GDI and CES scores were correlated (r = 0.55). Conclusions: The quality of end-of-life care for MPM patients remains poor. Moreover, MPM patients do not achieve good deaths from the perspective of their bereaved family members

Depression and Complicated Grief, and Associated Factors, of Bereaved Family Members of Patients Who Died of Malignant Pleural Mesothelioma in Japan

Objectives: we investigated the prevalence and associated factors of depression and complicated grief (CG) among bereaved family members of malignant pleural mesothelioma (MPM) patients in Japan. Methods: Bereaved family members of MPM patients (n = 72) were surveyed. The Japanese version of the Patient Health Questionnaire-9 (PHQ-9) and the Japanese version of the Brief Grief Questionnaire (BGQ) were used to assess depression and complicated grief (CG), respectively. Socio-economic factors, anger toward asbestos, care satisfaction, achievement of good death, and quality of end-of-life care were assessed in relation to depression and CG. Results: In the family members of MPM patients, the frequencies of depression and CG were 19.4% and 15.3%, respectively. The bereaved family members who were not compensated by the asbestos-related health-damage relief system (p = 0.018) and who felt the financial impacts of the patient’s MPM on the family (p = 0.006) had a higher likelihood of depression. The bereaved family members who were not satisfied with the care given when the patient became critical (p = 0.034), who were not compensated by the asbestos-related health-damage relief system (p = 0.020), who felt the financial impact of the patient’s MPM on the family (p = 0.016), and whose deceased relative underwent surgery (p = 0.030) had a higher likelihood of CG. Conclusions: For bereaved family members of MPM patients, routine screening for depression and CG and the provision of grief care are suggested. In addition, for family members of MPM patients, financial support, including the promotion of the asbestos-related health-damage relief system, and improved care for patients who undergo surgery and when patients become critical, are recommended