1.Review of Evaluation of Patients' Attitude According to Behavior Modification Stage at Time of Diabetes Educational Hospitalization and Various Parameters After They Were Discharged From Hospital
Ai YAMASHITA ; Akina KOIDE ; Etsuko MAJIMA ; Katsutosi KUBOTA ; Hitoshi ISHIGURO ; Masaru MATSUBARA ; Kazuhito SUZUKI ; Motoo HANANOUTI ; Takamichi MASUBUCHI ; Toshinori NIMURA
Journal of the Japanese Association of Rural Medicine 2014;63(4):634-643
Evaluation of the attitude of patients according to behavior modification stage when they were admitted to hospital for our diabetes educational program and various parameters after they discharged were reviewed. We examined the 106 people (53 males and 53 females, average age 66.0 years) who were admitted to our hospital for diabetes education during the period from October 2009 to February 2012. We examined HbA1c levels and measurements taken during the stay in hospital, and 1 month, 3 months, 6 months, 9 months, and 12 months after leaving hospital. Compared with the measured values in the hospital, HbA1c levels measured each month showed a significant improvement (p<0.05). By evaluation of the value according to behavior modification stage, we recognized a rebound tendency in precontemplation groups. The evaluation of patients’ attitude by occupation according to stage of behavior modification revealed a difference more than 2 stages by approximately 10%. From these result, it was speculated that the patient self-management skills made a significant impact on glycemic control after hospital discharge. Diabetes educational hospitalization is supported by team members who vary in specialty. It is expected that we can provide higher-quality medical care by each specialist and supporter with a good knowledge. Assessment difference of behavior modification stage may appears by each specialty staff member and by changes in physical condition and feeling of the patients. In addition, these causes may change further by difference in the way each specialist deals with the patients. Therefore, we considered it was important to share information and have the mutual confirmation of the evaluation. Now, team medical care is regarded as important. It was suggested that cooperation among the staff members would lead to better medical treatment, and to improvement in patients’ QOL.
2.Patient and family perceptions of palliative care units in Japan
Yujiro Kuroda ; Yumi Iwamitsu ; Keiko Todoroki ; Rika Ishiguro ; Asako Nobuto ; Mei Matsubara ; Shigemi Okazaki ; Yuji Yamada ; Hitoshi Miyaoka
Palliative Care Research 2012;7(1):306-313
Objectives: The purpose of this study was to examine common experiences among patients and primary family caregivers as they transition to hospice and palliative care units (PCU), with focus on the perspectives of cancer patients and their primary family caregivers. Methods: We conducted semi-structured interviews using a questionnaire with a purposive sample of 5 terminal cancer patients and 9 primary family members of patients who were admitted to the PCU from November 2005 to December 2006. The questionnaires consisted of questions about the PCU, and semi-structured interviews inquired about perceptions of the PCU. We analyzed interview contents from 14 participants (mean age ±SD; patients, 77.2±4.0 years; family members, 53.7±14.6) by summarizing content analysis. The Aiwa Hospital Institutional Review Board approved the present study. Results: Content analysis identified common perceptions about the PCU. Perceptions prior to the transition were summarized into 2 categories for patients and 5 categories for families, including general impressions of the PCU, PCU environment and equipment, treatment, cost, and other patients. After being admitted to the PCU, perceptions were summarized into 3 categories for patients and 7 categories for families, including general impressions of the PCU, PCU environment and equipment, treatment, staff, cost, other patients, and religion. Conclusion: Identification of these themes from patient and family perspectives suggested that patients transitioned to hospice with no particular impressions about the PCU, while families perceived the PCU as both “a place to relax” and “a place where one only waits to die” before entering the PCU. These results may aid in designing interventions that consider patient and family needs and desires during the transition to the PCU.