主成分分析によるストレングス志向の比較

The purpose of this study was to compare the strengths-oriented attitude among psychiatric nurses（PNs）, psychiatric social workers（PSWs）and occupational therapists（OTs）working at psychiatric hospitals using principal component analysis. Survey subjects were ８９９ PNs, １００ PSWs and ９０ OTs employed at １７ psychiatric hospitals in Japan who consented to participate in the study. The self-administered questionnaire was mailed and returned between from October ２０１３ to January ２０１４. The subjects’ strengths-oriented attitude was evaluated using the Strengths-Oriented Attitude Inventory（SOAI）developed by the authors based on the work by Rapp and Goscha. The loading of the primary ingredient of the SOAI was compared by Principal Component analysis among occupations. A common strengths-oriented attitude of PNs, PSWs, and OTs was the assessment for psychiatric inpatients’ social life, the ability to perform activities of daily life （ADL）, mental status, and taking care and therapeutic intervention. Especially, in the differences of characteristics depending on the specialty, PNs focus on physical health, PSWs emphasize economics and housing, and OTs emphasis on functional recovery of their ADL. Differences in strength-oriented attitudes have shown the commonality and specialty of each healthcare provider

チーム ケア アウトカム カンリ ケアリング トシテノ ギジュツテキ ノウリョク

The hospital evaluation and accreditation by Japan Council for Quality Health Care, and International Organization for Standardization （ISO）‐9001 have been playing an important role in standardizing general services of hospitals across the country in Japan. However, these cannot fulfill the patients and users’ needs in future societies. Hospitals in the future must provide unique services that are specific to each hospital in addition to standard services, i.e., it is necessary to develop medical services for which patients wish to stand in line and wait to receive them. Although hospital manuals and procedures are often considered the main parts of hospital evaluation, this poses a risk of making the service like robot. Health care providers ought to understand patients’ experience and convey an emphatic understanding to them with respectful words, so the patients can feel relieved and start to open their heart, contributing to establishing a favorable relationship. To develop such compassionate care services, the management of comprehensive outcomes, provision of interdisciplinary team care, and technological competency as caring were considered important

Rehabilitative Care by Humanoid Robots

Japan's declining birth rate and increasing aging population prompted intercessory efforts towards robot technologies in nursing practice for the elderly. Today, technological companies are developing robots that meet universal health care technology demands. While human caring focus on human-to-human relationships, but between humans and nonhumans, e.g. Humanoid Nursing Robot (HNRs)-to-human relationships, caring practices have not been forthcoming. When HNRs can support patients independently, capabilities much like being human will be required, including intelligence and skill competencies. Currently, Tanioka's research group is conducting clinical trials of humanoid robots equipped with applications using Pepper (manufactured by SOFTBANK CORPORATION), towards elderly care and rehabilitation at the Mifune Hospital, Kagawa prefecture. Care Prevention Gymnastics Exercises (Pepper-CPGE) was made by Xing Company, Japan. Therefore, this paper aims to describe the clinical trial outcomes based on the Transactive Relationship Theory of Nursing (TRETON) (Tanioka, 2017) emphasizing nursing engagement processes between HNRs and human persons. Observable effects include positive changes in relationships of patients, humanoid robots and healthcare providers. Emphasizing ethical concerns and human person safety as critical factors of care, and fears for divergent robot use are observed. Cooperative undertakings with various interdisciplinary activities mark the visioning of Japanese human caring ideas for an aging society

Balance of Autonomic Nervous Activity, Exercise, and Sleep Status in Older Adults : A Review of the Literature

While older people are frequently known to experience sleep disturbances, there are also many older people who have a good quality of sleep. However, little is known about the balance of autonomic nervous activity, exercise habits, and sleep status in healthy older adults. This study reviews the literature regarding balance of the autonomic nervous activity, exercise, and sleep in healthy older adults. Relevant articles were searched from electronic databases using the combination of the following keywords: “Autonomic nervous activity”, “sleep status”, “sleep”, “healthy older adults”, “aging”, “heart rate variability (HRV)” and “exercise”. Articles were included if they met inclusion criteria: (1) Published in English, (2) Article types: research and review articles, (3) Main outcome was related to the autonomic nervous activity, lifestyle, sleep, and/or healthy aging, and (4) Fully accessed. From 877 articles that were identified, 16 articles were included for review. Results showed that the autonomic nervous activity changes with increasing age, particularly a constant decline in cardiac vagal modulation due to the significant decrease in the nocturnal parasympathetic activity. In addition, the autonomic nervous activity was also related to sleep status and lifestyle, particularly the capability to exercise. In preparing older people toward a healthy aging, maintaining good sleep quality and exercise is suggested

Examining Factors Associated with Dynapenia/Sarcopenia in Patients with Schizophrenia : A Pilot Case-Control Study

Sedentary behavior in patients with schizophrenia causes muscle weakness, is associated with a higher risk of metabolic syndrome, and contributes to mortality risk. This pilot case-control study aims to examine the associated factors for dynapenia/sarcopenia in patients with schizophrenia. The participants were 30 healthy individuals (healthy group) and 30 patients with schizophrenia (patient group), who were matched for age and sex. Descriptive statistics, Welch’s t-test, cross-tabulations, adjusted residuals, Fisher’s exact probability test (extended), and/or odds ratios (ORs) were calculated. In this study, dynapenia was significantly more prevalent in patients with schizophrenia than in healthy individuals. Regarding body water, Pearson’s chi-square value was 4.41 (p = 0.04), and significantly more patients with dynapenia were below the normal range. In particular, body water and dynapenia showed a significant association, with an OR = 3.42 and 95% confidence interval [1.06, 11.09]. Notably, compared with participants of the healthy group, patients with schizophrenia were overweight, had less body water, and were at a higher risk for dynapenia. The impedance method and the digital grip dynamometer used in this study were simple and useful tools for evaluating muscle quality. To improve health conditions for patients with schizophrenia, additional attention should be paid to muscle weakness, nutritional status, and physical rehabilitation

Reflections on International Nurses Day : Current status, issues, and the future of nursing in Indonesia

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2D Video Analysis for Active shoulder ROM

Aging and its associated problems related to movement impacts the care of people with psychiatric disorders. This study sought to clarify the usefulness of 2D video analysis for evaluating shoulder range of motion (ROM) during upper limb exercises in patients with psychiatric disorders. Subjects (N=54) were patients with psychiatric disorders categorized as the following : having either a high or low activities of daily living (ADL) score using the Barthel Index ; experiencing shoulder ROM limitation, and whether or not compensatory movements were exhibited. Compensatory movement was also considered in patients with Parkinsonism, cerebrovascular disease, and cognitive dysfunction. Shoulder joint ROM was measured using a goniometer and active ROM was captured using ImageJ. No significant difference between passive ROM measured by a goniometer and active ROM measured by ImageJ considering disease groups, ADL level, and shoulder ROM limitation was found. Factoring in compensatory movements, however, significant differences were found between passive and active ROM : existence compensatory movement group, left side (z=-2.30, p=0.02) ; nonexistence compensatory movement group, right side (z=-2.63, p<0.001). Image-evaluating devices help assess ROM in patients with psychiatric disorders, enhancing the development of physical rehabilitation programs to regain critical ADL, sustaining self-care capabilities

Evaluation of a Remote-Controlled Drone System for Bedridden Patients Using Their Eyes Based on Clinical Experiment

With the aging of the population in Japan, the number of bedridden patients who need long-term care is increasing. The Japanese government has been promoting the creation of an environment that enables everyone, including bedridden patients, to enjoy travel, based on the principle of normalization. However, it is difficult for bedridden patients to enjoy the scenery of distant places and to talk with the local people because they need support from helpers to travel to distant places using travel agencies. Therefore, to enhance their quality of life (QOL), we developed a remote-controlled drone system, which involves using only the eyes. We believe that bedridden patients are able to operate the system’s drone in a distant place, to easily view the scenery of the distant place with a camera installed on the drone, and to talk with the local people. However, we have never evaluated whether actual bedridden patients can operate the drone in a distant place, to see the scenery, and to talk with the local people. In this paper, we presented clinical experimental results to verify the effectiveness of this drone system. Findings showed that, not only subjects with relatively high levels of independence in activities of daily living, but also bedridden subjects, could operate the drone at a distant place with only their eyes and communicate with others

ケアロボットのもたらす法的問題点

Our research group studies on care and rehabilitation using Care Robots（CRs）. Legal issues arising from these CRs are diverse. In this paper, we examined legal issues that should be considered in each stage ; manufacturing, processing, installation, use, deterioration, and disposal of CRs, and especially the cases where CRs as medical devices cause damage to patients. Thus, this paper pointed out the subjects as below : “Product Liability Act mainly and secondary general tort law in the manufacturing stage’’, “Defect liability in the processing stage’’, “General tort law in the installation stage”, “Obligation of security or faulty performance responsibility in the use stage” and “Personal Information Protection Law at the disposal stage”. In addition, we suggested the presumed issues that should be examined and indicated the direction of the way of thinking. This study will contribute to creating safety guidelines for the future use of CRs