1.Relationship Between the Process of Deciding on a Course at a Medical University and Occupational Identity
Yukiko OCHIAI ; Yoko HONDA ; Yoshiyuki OCHIAI ; Kyoko FUJII ; Nobuhiro TSUKAMOTO ; Yukari OHASHI ; Noriko NONOMURA ; Junko KUROKI
Medical Education 2006;37(3):141-149
Medical university students were divided into 5 types according to the process they used to decide on a course when entering a university, and the relationship between the decision-making process and occupational identity after entering the university was examined. The largest number of students, approximately 50%, were of the “meeting” type, followed in descending order by the “early decision” type, the “changing during 4 years” type, the “deciding at the last moment” type, and the “avoidance” type. There were differences in the frequency of decision-making types among departments, including the nursing department, which showed a large number of students of the “early decision” type. We examined the relationship between the decision-making process and occupational identity after entering the university and found that students of the “early decision” type were stable after entering the university, whereas students of the “avoidance” type had the lowest scores on all 4 subscales of occupational identity. This tendency was seen during the 4 years of university, and the importance of deciding on a course when entering the university was indicated.
2.The burden of introducing the Japanese language version of the Liverpool Care Pathway(LCP-J)for dying patients in general wards and their families:experience of health care professionals in a university hospital
Yusuke Kanno ; Kazuki Sato ; Yoko Hayakawa ; Yoshie Takita ; Takashi Agatsuma ; Tomoko Chiba ; Kazuko Honda ; Hiroko Shibata ; Kazuko Yamauchi ; Shin Takahashi ; Akira Inoue ; Mitsunori Miyashita
Palliative Care Research 2015;10(1):318-323
The purpose of this study was to explore the burden of introducing LCP-J in two wards(medical oncology and respiratory medicine)in Tohoku University Hospital. We administered audit evaluations about dying cancer patients and interviewed 2 doctors and 8 nurses regarding LCP-J intervention. LCP-J was used for 22 patients(38%), and no significant difference in infusion, potent opioid analgesic and sedative medication within last 48 hours were seen between users and nonusers. Responses were categorized into[confirm directions about dying care among health care professionals], and[training in dying care in a structured way]as usefulness facets of the LCP-J, and[difficulty in assessment of dying],[burden of health care professionals], and[difficulty using LCP-J without knowledge and training in dying care]as burdens of the LCP-J. We explored the burden of LCP-J in general wards, and found that use of the LCP-J could need education in dying care and backup of the palliative care team.
3.Utility of Over-the-Scope Clipping for Closure of a Persistent Post-Percutaneous Endoscopic Gastrostomy Fistula under Long-Term Steroid Therapy.
Yoshihisa ARAO ; Yuichi SATO ; Satoru HASHIMOTO ; Hiroki HONDA ; Kazumi YOKO ; Masaaki TAKAMURA ; Ken ichi MIZUNO ; Masaaki KOBAYASHI
Clinical Endoscopy 2015;48(6):563-565
A 50-year-old woman had a percutaneous endoscopic gastrostomy (PEG) tube placed after surgery for pharyngeal cancer. After 21 months, the PEG tube was removed due to improvement of per-oral ingestion. She had taken prednisolone for 31 years for systemic lupus erythematosus. The post-PEG fistula did not close spontaneously. The cause of the fistula was slow wound healing and gastrostomy site inflammation due to long-term steroid therapy. We were able to close the fistula with an over-the-scope clipping (OTSC) system. This case suggests that OTSC is useful for closing persistent post-PEG fistulas in patients receiving long-term prednisolone therapy.
Eating
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Female
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Fibrosis
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Fistula*
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Gastrostomy*
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Humans
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Inflammation
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Lupus Erythematosus, Systemic
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Middle Aged
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Pharyngeal Neoplasms
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Prednisolone
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Steroids
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Wound Healing