1.Nursing practices in which nurses experienced a realization of spirituality and their thoughts at that time: a survey of nurses in one prefecture
Yoshiko Sakai ; Akiko Ohkubo ; Noriko Okamura ; Masako Abe ; Yukiko Toda
Palliative Care Research 2010;6(1):216-221
Purpose: The purpose of this research is to examine nursing practices in which nurses experienced a realization of spirituality and their thoughts at that time. Methods: A questionnaire was administered to nurses in four hospitals and one palliative care unit. Results: A total of 835 participants completed the questionnaire. Nearly 20% of nurses reported having spiritual experiences associated with their work, including realizations of the value of human life and patients' strength in facing death or living with illness. In addition, nurses achieved a sense of spirituality through transcendent occurrences related to life and death, such as premonitions. Nurses pondered providing care that transcends both mind and body after encountering difficulty in providing nursing care. Conclusion: Nurses' sensitivity to human life and death and transcendent occurrences may be a reflection of the unique features of Japanese spirituality. In order to enhance Japanese nurses' perceptions of spirituality, it is necessary to offer nursing education in spirituality related to each nurse's own experiences. Palliat Care Res 2011; 6(1): 216-221
2.Natural History of Chronic Intestinal Pseudo-obstruction and Need for Palliative Care
Kosuke TANAKA ; Hidenori OHKUBO ; Atsushi YAMAMOTO ; Kota TAKAHASHI ; Yuki KASAI ; Anna OZAKI ; Michihiro IWAKI ; Takashi KOBAYASHI ; Tsutomu YOSHIHARA ; Noboru MISAWA ; Akiko FUYUKI ; Shingo KATO ; Takuma HIGURASHI ; Kunihiro HOSONO ; Masato YONEDA ; Takeo KURIHASHI ; Masataka TAGURI ; Atsushi NAKAJIMA ; Kok-Ann GWEE ; Takaomi KESSOKU
Journal of Neurogastroenterology and Motility 2023;29(3):378-387
Background/Aims:
Natural history of chronic intestinal pseudo-obstruction (CIPO), a rare disease characterized by episodes of non-mechanical obstruction, is unclear in adults. This study evaluates the clinical course of CIPO and palliative care needs of patients.
Methods:
From October 2010 to September 2021, 74 patients who underwent cine MRI and had a definitive diagnosis of CIPO were prospectively included. We investigated disease etiology and outcomes, age at onset, nutritional status at consultation (body mass index and serum albumin), hydrogen breath test results, and total parenteral nutrition (TPN) during the disease course.
Results:
Forty-seven patients (64%) were women, with a mean age of 44 years at onset and 49 years at diagnosis. Primary CIPO was observed in 48 patients (65%). Secondary CIPO was observed in 26 cases (35%), of whom 18 (69%) had scleroderma. The mean body mass index, serum albumin level, and hydrogen breath test positivity rate were 17 kg/m2 , 3.8 mg/dL, and 60%, respectively. TPN and invasive decompression therapy were required by 23 (31%) and 18 (24%) patients, respectively. Intestinal sterilization was performed in 51 (69%) patients and was effective in 33 (65%); of these, 28 (85%) were taking metronidazole. Seven (9%) patients used opioids. There were 9 deaths (12%), including 5 (56%) from infection and 2 (22%) from suicide. Of the deaths, 6 (67%) and 4 (44%) underwent TPN management and decompression therapy, respectively. Fifty-one patients (69%) wanted palliative care.
Conclusion
CIPO is a rare, severe, and under-recognized disease. Standardization of treatment strategies, including palliative care and psychiatric interventions, is desired.