1.What Can We Do to Avoid Abuse of Aged Persons?
Hiromi KOBAYASHI ; Tatsuya SUGIMURA ; Chikako KATAYOSE ; Ryuta YAGI ; Kyoko MORI ; Yosuke NATSUME ; Chiharu AMANO
Journal of the Japanese Association of Rural Medicine 2016;65(2):188-195
Persons who are abused often have serious problems in a complicated life situation. We studied this issue and considered ways in which medical social workers (MSWs) handle these social problems. We collected data in 16 cases of elderly abuse that were managed by staff at our hospital from 2010 to 2013 and compared the characteristics in these cases with those of 23 cases of child abuse during the same period. Data analysis revealed 3 characteristics of abused persons: insufficient use of long-term care insurance service; mental disorder such as dementia or mental illness; and financial problems. Further detailed analysis found that intervention for elderly abuse cases was requested only in more difficult cases when abuse was easily identified by our staff. Therefore, staff’s awareness and motivation to become more involved in cases of elderly abuse may be low compared with cases of child abuse. Hospital staff are in a position where they should be able to readily identify maltreatment of aged persons. We need to develop a mechanism for the early detection of elderly abuse so staff can intervene easily in mild cases of elderly abuse, and ask for assistance from MSWs in more difficult cases. It is important to ensure that all employees have access to MSWs in the hospital.
2.Signs and symptoms associated with postsurgical dysfunctions among upper gastroesophageal cancer patients: an analysis of the published reports
Keiko Iino ; Shigeaki Watanuki ; Yurie Koyama ; Kyoko Suzuki ; Chihoko Wada ; Michiko Mori ; Miho Kurihara ; Kyoko Okada ; Chisato Ichikawa ; Hideo Uesugi ; Tomiko Ichihashi ; Yoko Hisabe ; Kaori Yagasaki ; Hiroko Komatsu
Palliative Care Research 2013;8(2):701-720
Purpose: The review of the published reports was performed with the aim of systematic collection and integration of information related to "signs and symptoms" along with their changes among patients after upper gastroesophageal surgeries. Methods: The PubMed and the Japanese healthcare literature database were searched by the following keywords:"gastric cancer" "esopha∗ cancer" "surgery" and "symptom" As a result, 37 articles related to gastric or esophagus cancer were identified. The data were extracted according to each sign and symptom, and were evaluated and discussed. Results and Conclution: Standardized instruments for gastrointestinal symptoms included evaluations about dysphagia, difficulty in swallowing, reflux etc. The incidence of signs and symptoms, or postsurgical recovery processes are different among individual patients. Healthcare professionals should support patients continuously and systematically so that patients can take appropriate health maintenance behavior according to their signs and symptoms.
3.Difficulties in daily life of post thoracic esophagectomy cancer patients after hospital discharge
Shigeaki Watanuki ; Keiko Iino ; Yurie Koyama ; Miho Kurihara ; Chisato Ichikawa ; Kyoko Okada ; Hideo Uesugi ; Chie Asanuma ; Hiroyuki Daiko ; Takeo Fujita ; Kyoko Suzuki ; Chihoko Wada ; Michiko Mori ; Yoko Hisabe ; Kaori Yagasaki ; Hiroko Komatsu
Palliative Care Research 2014;9(2):128-135
Purpose: This study aimed at identifying difficulties among post thoracic esophagectomy cancer patients during outpatient follow-up. Methods: Patients who had radical esophagectomy at a cancer center hospital in Japan were prospectively observed and were interviewed by a certified nurse assigned at esophageal surgical outpatient division. Their responses were documented in medical records and were analyzed by content analysis method. This study was approved by the study hospital's research ethics committee. Results: The data from 66 patients were obtained. Content analysis yielded 221 extracts, 25 categories, and 65 codes of difficulties, including: concerns or signs/symptoms associated with dietary intake, physical activity, and anxiety. Implications: The majority of post-thoracoabdominal esophagectomy patients experienced multiple dysfunctions and symptoms after discharge. The results underscore the significance of nurses' role in assessing and instructing patients to address these issues.
4.Content analysis of nurses' interventions for post thoracic esophagectomy cancer patients at the outpatient clinic
Keiko Iino ; Shigeaki Watanuki ; Yurie Koyama ; Miho Kurihara ; Chisato Ichikawa ; Kyoko Okada ; Hideo Uesugi ; Chie Asanuma ; Hiroyuki Daiko ; Takeo Fujita ; Kyoko Suzuki ; Chihoko Wada ; Michiko Mori ; Yoko Hisabe ; Kaori Yagasaki ; Hiroko Komatsu
Palliative Care Research 2014;9(3):110-117
Background: Patients having thoracic esophagectomy, a standardized treatment for esophageal cancer patients in Japan, are known to have various postsurgical signs and symptoms for a period of time. The current status of nursing interventions at outpatients need to be clarified. Purpose: This study aimed at identifying the nurses' interventions for cancer patients at the outpatient setting who previously had thoracic radical esophagectomy. Methods: Patients who had esophagectomy at a cancer center hospital in Japan were prospectively observed and interviewed by outpatient nurses between January 2009 and December 2010. Their documented responses in medical record were prospectively investigated and were qualitatively analyzed via content analysis method. This study was approved by the study hospital's research ethics committee. Results and discussion: The data analysis of nursing interventions for 66 patients yielded 372 extracts, 12 categories, and 74 codes. Nurses were assessing patients' signs and symptoms affected by postsurgical changes, and were utilizing patients' active self-monitoring skills. The results also showed the significance of facilitating postsurgical recovery in relation to nutritional intake and physical activity in patients' daily life. Implications: Based upon the study results, the development of a systematic program is underway, which facilitates esophageal cancer patients' postsurgical recovery.
5.Qualitative Study of Outpatients’ Eating-related Distress and Struggle in Cancer Center Hospital
Yasutaka Kimura ; Makiko Murase ; Tamae Hiramatu ; Mayumi Tsukagoshi ; Chihoko Wada ; Yoichi Shimizu ; Ayako Mori ; Miki Hosoya ; Kyoko Toju ; Yuko Shimizu ; Maki Obana ; Misae Maruguchi
Palliative Care Research 2017;12(2):239-249
Purpose: The purpose of this study was to clarify the state of eating -related distress and struggle in the daily lives of cancer outpatients in cancer center hospital. Methods: Cancer outpatients who consented to participate in the study filled out self-administered questionnaires regarding eating distress and the means of coping with them. The data were qualitatively analyzed via content analysis method. Results: Data from 176 patients who responded that they experienced eating difficulties were analyzed. A total of 222 codes were extracted for eating-related distress, and these were classified into five categories, which included eating-related symptoms accompanying the disease and its treatment, difficulties related to food preparation, and concerns about eating outside food. A total of 224 codes were extracted for eating-related struggle made by the patients, and these were classified into eight categories, which included adjusting eating methods to make food easier to eat, controlling one’s feelings when unable to eat certain foods, and adjustments related to food preparation. Conclusions: The study results suggested that cancer outpatients require care not only at early stages after treatment for eating-related symptoms but also related to food preparation and concerns when eating outside food.
6.Unmet needs for education and training among palliative care physicians in training: a qualitative study
Tomohiro Nishi ; Masanori Mori ; Sadahisa Matsumoto ; Kyoko Satou ; Junko Uemoto ; Shingo Miyamoto ; Tomofumi Miura ; Meiko Kuriya ; Kimiko Nakano ; Kazuki Satou ; Tatsunori Shimoi ; Keita Tagami ; Yuuta Esumi ; Daisuke Sakai ; Takahiro Kogawa ; Tatsuya Morita
Palliative Care Research 2013;8(2):184-191
Background: The demand for palliative care in Japan has risen over recent years, and training of palliative care physicians is an important problem. However, little is known about unmet needs for education and training systems as well as career development among young physicians who wish to specialize in palliative care. Purpose: To explore unmet needs among palliative care physicians in training. Method: We held group discussions in a forum for physicians of postgraduate year≦15, and analyzed their opinion on topics such as "what are unmet needs?" using theme analysis. Results: Forty physicians participated. Theme analysis revealed the following unmet needs among young physicians; "securing of manpower", "securing of quality of training programs/education", "improvement of network", "removal of many barriers to keeping on a palliative care physician", and "establishment of career models for a specialist". Conclusions: We should discuss solutions for the unmet needs to secure more palliative care physicians.
7.The Clinical Studies of the Protective Effects of Acupuncture on the Habitual Tonsilitis
Keishi Yoshikawa ; Kazushi Nisijo ; Kazuhiro Yazawa ; Hidetoshi Mori ; Tomomi Sakai ; Kozo Nemoto ; Kiyomi Gennai ; Kazuo Sasaki ; Akihiro Ogata ; Kyoko Oda ; Toshikazu Shima ; Kiyokazu Kubota ; Hiroshi Mineta ; Hideko Kamio ; Akemi Yamamoto
Journal of the Japan Society of Acupuncture and Moxibustion 1982;31(4):372-380
We administered electro-acupuncture with the purpose of preventing repeated attacks of repetitive tonsillities.
The majority of the 77 subjects were kindergarden and elementary shool children, who had high fiver more then 4 times a year.
The treatment method was as follows: 1Hz low frequency stimulation between Co 4 and lu 6 (and this bilateral) for 20 to 30 minutes.
The treatment interval was once a week, with 3 weeks constituting a treatment course.
And depending on the results of 1 course, the treatment was repeated or not. 53 patients followed 1 course, 24 patients followed 2 course.
The evaluaton of the results is based on a 1 year observation period.
RESULTS:
-9 patients (11.68%) didn't got any high fever.
-49 patients (63.63%) noticed a decrease of the high fever frequency [39 patients (50.64%) got less then 3 times a year a high fever.]
-19 patients (24.67%) didn't notice any effect [6 patients (7.79%) got tonsillectomy.]
This study showed the usefulness of acupuncture and as it's a general and easy to apply therapy, we can consider acupuncture as a first choice therapy for the prevention off repetitive tosillitis.
8.Evaluation of Publicity Activities to the COVID-19 Website for Community Pharmacists
Kazuaki MORI ; Hiroshi OKADA ; Shota SUZUKI ; Megumi YAMASHITA ; Kyoko MATSUZAWA ; Emiko IGARASHI
Japanese Journal of Drug Informatics 2021;23(3):143-147
Objective: The worldwide spread of the COVID-19 pandemic since 2020 led to a lack of information even at Japanese pharmacies, which are at the forefront of community medicine. Therefore, the Kyoto University Graduate School of Public Health Pharmacy Information Group has developed information materials related to COVID-19 for pharmacies0and released them on the COVID-19 countermeasure website, which was launched in haste. However, these days in the information society, the amount of information distributed is explosively expanding. Therefore, it is not possible to reach the target people just by publishing the countermeasure website. Therefore, we set up a public relations team to carry out publicity activities for pharmacists and analyzed the effectiveness of these activities by focusing on changes in the number of page views (PV) on the countermeasure website.Methods: PV and public relations(Facebook, industry media , e-mail) activities during the first 18 days(EARLY period), which is half of the total PV, and the remaining 164 days(MIDDLE period), covering 182 days from the day before the countermeasure website was opened. The changes in quantity were compared. Furthermore, we also compared the changes in the level of interest in the new coronavirus during the target period using Google Trends.Results: PV was remarkably large in the EARLY period, and the amount of public relations activity was generally concentrated in the EARLY period and PV. The number of searches for related words on Google Trends was almost the same as PV except for some. Conclusion: The study revealed the importance of establishing a pandemic countermeasure website for pharmacists at an appropriate time and conducting intensive public relations activities in the early stages.
9.Practical Training in Pharmaceutical Rehabilitation Services at Medical School Using Video and Reflection
Yuka SHIBAZAKI ; Satomi SHIBAZAKI ; Kohei KANEDA ; Kyoko ONISHI ; Tomoe SUGIYAMA ; Ryuichiro ARAKI ; Yuuki KAWAMURA ; Hiromasa SATOH ; Tohru KISHINO ; Yoshihito KOMINE ; Hitoshi KURABAYASHI ; Yumi YONEOKA ; Michio SHIIBASHI ; Keiichiro ISHIBASHI ; Shigehisa MORI
Medical Education 2021;52(3):227-233
At Saitama Medical University, practical training in pharmaceutical service and rehabilitation services is conducted. Due to the spread of COVID-19 infection in 2020, it was difficult for third-year medical students to practice in the actual medical field. For this reason, students have been provided a remote practical training in pharmaceutical service and rehabilitation services, such as watching videos of working situations and interviews for pharmacist, physical therapist, occupational therapist and speech therapist, group works using Zoom, and exchanging questions and answers with those professions. Although student’s levels of readiness were diverse, they could learn more deeply about the roles and perspectives they had not learned previously, compared to conventional practical training. In addition to this effect, the program provided more opportunities for students to deepen their learning. Therefore, in the future, we would like to consider implementing a training program that provides both virtual and onsite experiences.
10.Virtual Hospital Tour and Observership for First and Second-year Medical Students
Keiichiro ISHIBASHI ; Satomi SHIBAZAKI ; Tomoe SUGIYAMA ; Yumi YONEOKA ; Ryuichiro ARAKI ; Makiko UEMURA ; Kyoko ONISHI ; Yasuko YAMADA ; Yuuki KAWAMURA ; Kensuke NAKAHIRA ; Kohei KANEDA ; Yuka SHIBAZAKI ; Masafumi OYAMA ; Takeo TAKAHASHI ; Koji TOMORI ; Morihiro HIGASHI ; Michio SHIIBASHI ; Shigehisa MORI
Medical Education 2021;52(3):221-226
Students in all years, including those in lower years, were prohibited from coming to campus because of COVID-19, which began to spread in January 2020. However, we believed that a hospital tour and observership would be important practical training for first and second year medical students as part of the early exposure program, which aims to increase student motivation. Thus, we decided to conduct a virtual hospital tour and a virtual observation of medical doctors’ work. We used Zoom to conduct a virtual hospital tour for first-year students in June, and a virtual observation of physicians’ work for second-year students in December. Although this offered less of an opportunity to experience the reality of the clinic, there have been benefits in terms of increased learning content, fairness of learning opportunities delivered, and the promotion of independent learning. With regard to a “Hospital Tour” and the “Observation of Medical Doctors’ Work” , we believe that hybrid forms, which are able to skillfully combine the strengths of the two methods, would be effective.