Purpose : The objective of this qualitative study was to clarify rewarding and positive aspects of comprehensive community care practices by clinic nurses.
Methods : Semi-structured interviews were conducted for six nurses who had been working for more than five years at community-based clinics in the surrounding areas of Tokyo. Responses were analyzed using the Modified Grounded Theory Approach proposed by Kinoshita. Concept diagrams were drawn from the themes.
Results : Nurses regarded the integrated care of individual patients, their family and community as meaningful and rewarding because they were able to provide truly holistic care. They were also satisfied with “value of individual experiences of nurses”, “frontier spirit of community nurses providing pathless integrated care”, “appropriate work-life balance”, “independent position in the clinic” and “community-based team approach including medicine, health and welfare”.
Conclusion : Nurses felt easier providing their psychosocial intervention in a community-based clinic as part of a medical system. Nurses obtained rewards by using their holistic care ability. Since nurses and family physicians have similar perspectives with respect to patient-centered care, some nurses felt conflicts with their physicians, because patient-centeredness is not the only strength of such nurses.

BACKGROUND: Rosa damascena, a type of herb, has been used for wound healing in Eastern folk medicine. The goal of this study was to evaluate the effectiveness of rose placenta from R. damascena in a full-thickness wound model in mice. METHODS: Sixty six-week-old C57BL/6N mice were used. Full-thickness wounds were made with an 8-mm diameter punch. Two wounds were made on each side of the back, and wounds were assigned randomly to the control and experimental groups. Rose placenta (250 microg) was injected in the experimental group, and normal saline was injected in the control group. Wound sizes were measured with digital photography, and specimens were harvested. Immunohistochemical staining was performed to assess the expression of epidermal growth factor (EGF), vascular endothelial growth factor (VEGF), transforming growth factor-beta1 (TGF-beta1), and CD31. Vessel density was measured. Quantitative analysis using an enzyme-linked immunosorbent assay (ELISA) for EGF was performed. All evaluations were performed on postoperative days 0, 2, 4, 7, and 10. Statistical analyses were performed using the paired t-test. RESULTS: On days 4, 7, and 10, the wounds treated with rose placenta were significantly smaller. On day 2, VEGF and EGF expression increased in the experimental group. On days 7 and 10, TGF-beta1 expression decreased in the experimental group. On day 10, vessel density increased in the experimental group. The increase in EGF on day 2 was confirmed with ELISA. CONCLUSIONS: Rose placenta was found to be associated with improved wound healing in a mouse full-thickness wound model via increased EGF release. Rose placenta may potentially be a novel drug candidate for enhancing wound healing.
Animals ; Enzyme-Linked Immunosorbent Assay ; Epidermal Growth Factor ; Medicine, Traditional ; Mice* ; Photography ; Placenta* ; Rosa ; Transforming Growth Factor beta1 ; Vascular Endothelial Growth Factor A ; Wound Healing* ; Wounds and Injuries*