1.How Do Community Pharmacists Feel and Recognize the Acts of Touching Patients during Home Care?—The Legal Validity of Acts and the Pharmacist’s Feelings of Resistance—
Mami Kikuchi ; Takuya Tsujiuchi
Japanese Journal of Social Pharmacy 2015;34(2):81-96
A questionnaire-based survey was conducted to clarify how community pharmacists recognize the legal validity of acts that involve touching their patients and to determine if the pharmacists had personal feelings of resistance toward particular acts. The questionnaire was sent to 400 community pharmacies that practiced home care and 147 valid responses were analyzed. The survey suggested that there were many pharmacists who had no objection toward measuring vital signs, such as temperature and blood pressure. Additionally, they recognized that it was necessary for doctors, other professionals, and patients to recognize their ability to measure vital signs. The survey also suggested that there were strong feelings of resistance toward invasive acts, such as insertion of an enema tube or a suppository. It was considered that these feelings were due to insufficient knowledge and experience, as well as uneasiness with hygiene issues. The necessity to participate in a practical study session was emphasized. When pharmacists recognized a problem with the legality of an act, their feelings of resistance, particularly toward examining bedsores and applying ointment on them, tended to become strong. Therefore, it was suggested that pharmacists may be able to perform the acts without feelings of resistance if the legality of the acts was clarified. Based on these findings, it is necessary to find a suitable rationale for performing each act, so that pharmacists will be able to perform the acts that involve touching their patients without feelings of resistance.
2.Survey to Determine How Community Pharmacists Recognize the Necessity for and Frequency of Touching Patients during Home Care
Mami Kikuchi ; Takuya Tsujiuchi
Japanese Journal of Social Pharmacy 2016;35(1):10-22
A questionnaire-based survey was administered to determine how community pharmacists recognize the necessity for and frequency of touching their patients during care giving. The questionnaire was sent to 400 community pharmacies that practiced home care, and 147 valid responses were analyzed. The survey suggested that acts recognized by pharmacists to require touching were measuring vital signs and helping patients take oral medications. It was thought that pharmacists needed to help patients in taking oral medications and also needed to determine issues related to oral intake. The survey also indicated that the frequencies of measuring vital signs and applying plasters to patients were high. Measuring vital signs was considered routine work, and applying plasters to patients was considered occasional work. Many respondents stated the need for practical study sessions on measuring vital signs. The frequency of measuring vital signs has increased because pharmacists have increasingly recognized this need. Additionally, females tended to touch their patients more frequently than males. However, there was no relationship between the frequency of examining bedsores and applying ointments on them and gender because it was thought that knowledge and experience were more important. The recognition of necessity for touching their patients was high but the frequency was comparatively low, and there was a discrepancy between the recognition of necessity and frequency. It was suggested that practical study sessions on when patients should be touched should be a high priority.
4.Cooperation between Acupuncturists and Physicians Providing Palliative Care at Home Care Support Clinics
Tomoaki TAKANASHI ; Keiichi NISHIMURA ; Takuya TSUJIUCHI
Journal of the Japan Society of Acupuncture and Moxibustion 2014;64(4):196-203
[Objective]The purpose of this study was to clarify the current status of cooperation between acupuncturists and physicians providing palliative care at home care support clinics.
[Methods]We studied 297 home care support clinics that provide cancer palliative care in the home. We mailed a self-administered questionnaire to the physicians belonging to the clinics. The questionnaire was created to clarify the number of clinics that provide home palliative care, current status of cooperation with acupuncturists, and methods of information-sharing.
[Results]We received responses from 98 clinics (33.3%response rate). Of these, 14 clinics (14.3%) currently provide care for terminal cancer patients in cooperation with acupuncturists, 9clinics (9.2%) reported having done so in the past. Patient's conditions treated in cooperation with acupuncturists were things such as pain, hiccups, edema, ascites, and constipation. The benefits attributed to cooperation with acupuncturists included "relief of symptoms,""improved patient satisfaction,"and "improved patient motivation."Regarding the presence or absence of information-sharing with acupuncturists, 7clinics (50%) responded that they "always share," 7clinics (50%) responded that they "share depending on the situation,"and no clinic reported "does not share information."Regarding the prospect for cooperation with acupuncturists in providing home palliative care in the future, 9clinics (9.2%) responded that they "actively want to cooperate,"and 65 clinics (66.3%) stated that they would "think about cooperation in some circumstances."
[Conclusion]From this study, it was concluded that cooperation exists between acupuncturists and physicians in 14.3%of home care support clinics providing palliative care. In addition, the possibility that cooperative patient care provides not only symptom relief but also other benefits has been suggested. On the other hand, it is necessary for acupuncturists, as part of a healthcare team, to have access to patient information and the status of other treatments, so that the acupuncturists can be involved in the field of home palliative care. Furthermore, management should promote an environment for cooperating with professionals in other medical occupations, including physicians.
5.The survey of the practice of acupuncture and moxibustion therapy in medical institutions with a palliative care unit
Tomoaki Takanashi ; Keiichi Nishimura ; Jukai Maeda ; Takuya Tsujiuchi
Palliative Care Research 2015;10(1):329-333
Purpose:The purpose of this study was to clarify the practice of acupuncture and moxibustion in medical institutions with a palliative care unit. Methods:A selfadministered questionnaire was mailed to the physicians in charge of the ward or the chief nurses of 244 medical institutions with a palliative care unit. Results:Responses were obtained from 98 institutions. Among these, it was obvious that acupuncture and moxibustion therapy were performed in six institutions(6.1%). The conditions of patients treated with acupuncture and moxibustion were pain, fatigue, constipation, and displeasure. Regarding acupuncturists being concerned with a palliative care field, it was described that acupuncturists could have one of the important role in clinical field in palliative care. On the other hand, it was indicated that there were difficulties associated with the practice of acupuncture and moxibustion therapy in a hospital. Conclusion:Although acupuncture and moxibustion therapy are considered to have usefulness as a variety of care, to practice acupuncture and moxibustion therapy in a medical institution, it is necessary to examine create the practice system.