This research was performed with the family assessment tool at critical and emergency care settings (CNS-FACE) as a standard tool at the ICU of Hospital A. It clarified changes in the awareness and practice of family support by staff in order to obtain clues to how to provide family support in the future.
  Initially, a briefing session was held to acquaint nurses with CNS-FACE. A total of 28 nurses assigned to the ICU were invited to the session. They were informed of the importance of using CNS-FACE to understand the family needs and coping. The staff members were requested to use CNS-FACE to obtain an objective assessment of patients' families selected at random by the nursing research members. Subsequently, questionnaires were distributed to investigate the changes in the nurses' awareness. Those who reported a change in relationship with the families after using CNS-FACE accounted for 100% of the nurses with one to three years' experience, 64% of the urses with four to six years' experience, and 50 % of the nurses with seven or more years' experience. An understanding of the 46 items in CNS-FACE was thought to lead to more positive intervention awareness. It was believed that this would result in a reduction in stress for nurses providing family nursing and to bring about a change in their awareness of family nursing, irrespective of their number of years of nursing experience. CNS-FACE gave the nurses with one to six years' experience with an objective understanding of needs and coping and changed their awareness of family nursing. A change of awareness was achieved by 50% of the nurses with seven or more years' experience. Over 60 % of the staff members recognized CNS-FACE to br effective for family nursing.

Methadone is a difficult medicine to assess the efficacy at an initial stage because the blood concentration of it varies greatly among individuals and it takes days to reach a steady state and cannot be increased for 7 days. Nevertheless, there are few reports of blood concentration together with effects after administration of methadone about Japanese cancer patients. In this study, we investigated changes in blood concentration and pain score (NRS), and factors that affect blood concentration. Dose per body weight was only correlated with blood concentration of methadone. In the effective cases, NRS decreased chronologically until the 7th day after treatment initiation, and significantly decreased from the 1st day compared to before treatment initiation, but in the ineffective cases, it tended to decrease until the 3rd day, but there was no change thereafter. The blood concentration increased to 110 ng/ml on the 7th day in the effective cases, and in the ineffective cases, it reached the concentration on the 3rd day. Thus there was no correlation between the blood concentration and the drug efficacy. The individual blood concentrations tended to increase slightly or decrease after the 3rd day, but in only one case, it continued to increase. From the above-mentioned, it was shown that the effect could be judged at an early stage, however, since there was a case in which the blood concentration continued to rise until the 7th day, it was considered that the early dose increase within 7 days after initiation should be performed carefully.