The present study aimed to clarify whether positive attitudes towards terminal patients among nursing students are a）promoted by palliative care lectures, and b）more prevalent among students with experience with a relative’s death or being present during their final moments. A survey was conducted using the Frommelt Attitude Toward Care of Dying Scale, Form B, Japanese version, and scores were compared for pre- and post-palliative care lectures and experience of being present during someone’s dying moments. Responses were obtained from 69 students. Scores for positivity toward care for terminal patients and awareness of patient- and family-centered care were significantly higher after the lectures（p＜0.0001）. No significant difference was observed between scores based on whether they had experience of being present during someone’s dying moments however, scores tended to be higher for students with these experiences. The present findings suggest that palliative care lectures including content related to terminal care are useful for promoting positive attitudes towards terminal patients among nursing students.

The persistence of attitudes toward terminal patients acquired by nursing students from lectures and class-based practical exercises is unclear. The present study investigated whether attitudes persist following palliative care education. Sixty-four nursing students taking a course in palliative care participated in a questionnaire survey using the Frommelt Attitude Toward Care of Dying Scale, Form B, Japanese version before, immediately after, and three months after lectures. The responses of 46 students were analyzed. Attitudes were more positive after lectures. At three months after lectures, both “I. Positivity towards care of dying patients” and “II. Awareness of care focused on the patient and their family” had returned to baseline. Students in this analysis included some who had experienced a relative’s death or who had been present during their dying moments. Despite their experience, three months after lectures there was no different from the students without such experience. Some more approaches are needed to influence the maintenance of a positive attitude toward terminal care.

Purpose: This study intended to clarify the lesson topics, lesson content and emotions that painfully saddened nursing students with experience of bereavement taking lectures on palliative care, as well as the emotional changes of these students and the support they expect from teachers. Methods: We conducted semi-structured interviews. Their emotions were analyzed following Krippendorff’s method. Results: Thirty-six nursing students participated in the study. Lesson topics and content included “the state and signs of loved ones near death,” and “general lessons.” Feelings and thoughts presented were “regret,” “remembering,” “emotional upset,” “feeling anxiety,” “feeling dissatisfied,” “experiencing a sense of discomfort”, and “empathizing with the people shown in the teaching material as well as their situations.” With the exception of one subject, all subjects experienced a positive change in their emotions. Regarding to the support, 20 people did not require additional support because of “nothing wrong” or “enough”. Conclusions: Teachers need to specifically explain support content and methods many times, and to face lessons with the strong desire to always support their students.

The purposes of this study were 1) to determine cardiac output and active limb blood flow responses to unilateral and bilateral dynamic handgrip exercises and 2) to investigate the effects of exercise intensity and a change in active muscle mass on the relationship between limb blood flow and cardiac output. Five physically active women performed dynamic handgrip exercises with the right hand (right handgrip exercise ; RHG), with the left hand (left handgrip exercise ; LHG), and bilaterally (bilateral handgrip exercise ; BHG) . Exercise intensities were 10%, 30% and 50% of the subjects' maximum voluntary contraction (MVC) and the exercise frequency was 60 contractions per minute. The 10%MVC exercise duration was 10 min, while the 30% and 50%MVC exercise conditions were performed to exhaustion. During exercise, stroke volume (SV) and heart rate (HR) were measured using Doppler ultrasound and electrocardiogram (ECG), respectively. Cardiac output (Q_sys) was calculated as the product of SV and HR. Blood flow to the forearm (Q_foream, ) was measured by venous occlusion plethysmography. Q_sys, did not differ significantly between RHG, LHG and BHG. However, SV was lower in BHG than in RHG and LHG. Reciprocally, HR was higher during BHG than RHG and LHG. The increase in the Q_forearm, was significantly lower during BHG than RHG and LHG exercise (p<0.05) .
These results suggest that Q_sys, does not differ between unilateral and bilateral handgrip exercise, despite the increase in active muscle mass. The unchanged Q_sys could be explained by the Q_forearm reduction during BHG. The Q_forearm was lower during BHG than during the unilateral handgrip exercises, possibly due to vasoconstriction induced by BHG exercise.

Objective: The aim of this study was to investigate the healthcare workers’ awareness and support regarding the sexuality of cancer patients, their families. Methods: A self-reported questionnaire survey was conducted on the healthcare workers in Shikoku Cancer Center on May 2014. Results: Four hundred and fifty-seven (84.9%) workers responded to the questionnaire. It was 29.8% who have communicated about sexual issues with patients and their families, 67.0% acknowledged the necessity of supporting them. In the group which had experience in communicating about sexual issues and participating in study meetings of sexuality, there were more healthcare workers who acknowledged the necessity of support significantly (aware group). In the aware group, the reasons why they hesitated and felt difficulty in communicating about sexual issues were that they had no chances to communicate with patients about sexual issues (93.5%), they didn’t know whether the patients needed intervention of healthcare workers (89.2%), they felt lack of their knowledge of support regarding sexuality (89.2%), and they felt lack of their skill of support regarding sexuality (88.9%). In the aware group, in order to get knowledge and information about sexuality, books and brochures which could be introduced to the patients and their families (96.4%) were considered to be most wanted. Conclusion: We have to make an effort so that all healthcare workers recognize the importance of the necessity of communicating about sexual issues with the patients, their families and their partners.

Objectives: The purpose of this study was to investigate current fact of cancer outpatients’ opioid pain management and its possible abusive applications and to establish corrective treatments by the palliative care team. Methods: Our palliative care team investigated cancer outpatients’ prescribed opioid clinical records for 4 months in 2014, and the result revealed inappropriate opioid use which could lead to further abuse or dependency. Through this the team recommended attending physicians viable options including decrease of opioid eventually leading to final withdrawal. Results: Among 67 cancer outpatients, the finding of inappropriate opioid use which could lead to further abuse or dependency was in 5 patients (7.4%). The details are as follows: (1) Three patients were treated with opioid analgesia for initial pain relief but the application continued in spite of recovering from a cancer which had been responsible to the pain. (2) Two patients were medicated with opioid for pain but further diagnosis revealed the disease which caused pain was benign. Four out of 5 patients were successfully withdrawn from opioids. Conclusion: In cancer outpatient settings, it can be overlooked or undetected inappropriate use of opioids which may lead to abuse or dependency without a team approach. To prevent opioid abuses, it is imperative to find the cause of pain as accurately as possible.

Objective：The aim of this study was to develop an 8-item Japanese Arthritis Self-Efficacy Scale (ASES-8J）and perform pilot testing of its face validity and internal consistency in patients with osteoarthritis of the knee.Methods：Translation of the ASES-8J from English into Japanese was performed via forward-translation, back-translation, review by the original developer, and production of the pre-final version. We calculated the mean and standard deviation and Cronbach's alpha coefficient to assess internal consistency. Face validity was assessed by reviewing the results of the pilot study and using in-depth questionnaires on the responders' understanding of the ASES-8J.Results：Forty-one patients with osteoarthritis of the knee participated in the pilot study, with 38 providing valid responses. The mean ± standard deviation was 5.7 ± 2.2. Cronbach's alpha coefficient was 0.96, indicating high internal consistency. Of the responders, 54.9％ stated that it the ASES-8J was very easy or easy to answer. The original developer reviewed ASES-8J to confirm its usefulness.Conclusion：The results indicate that ASES-8J is a useful tool to assess the self-efficacy of patients with osteoarthritis of the knee.

Objective：The aim of this study was to develop an 8-item Japanese Arthritis Self-Efficacy Scale (ASES-8J）and perform pilot testing of its face validity and internal consistency in patients with osteoarthritis of the knee.Methods：Translation of the ASES-8J from English into Japanese was performed via forward-translation, back-translation, review by the original developer, and production of the pre-final version. We calculated the mean and standard deviation and Cronbach's alpha coefficient to assess internal consistency. Face validity was assessed by reviewing the results of the pilot study and using in-depth questionnaires on the responders' understanding of the ASES-8J.Results：Forty-one patients with osteoarthritis of the knee participated in the pilot study, with 38 providing valid responses. The mean ± standard deviation was 5.7 ± 2.2. Cronbach's alpha coefficient was 0.96, indicating high internal consistency. Of the responders, 54.9％ stated that it the ASES-8J was very easy or easy to answer. The original developer reviewed ASES-8J to confirm its usefulness.Conclusion：The results indicate that ASES-8J is a useful tool to assess the self-efficacy of patients with osteoarthritis of the knee.