1.Present nursing practices and challenges for foreign pregnant and postpartum women at perinatal medical centers in Osaka, Japan
Chie KOH ; Takako CHIBA ; Sachiko NAKANE ; Yoko FUJIKAWA ; Yuki YOSHIDA ; Chieko DOI ; Kayo KIKUKAWA ; Naoko UTAGAWA ; Ruriko MIYASHITA ; Takayo MAEDA
Journal of International Health 2024;39(2):21-32
Introduction The number of foreign residents in Japan reached a record high in 2023 and is still increasing. Many foreign residents are in their 20s and 30s and of reproductive age. The study aim was to clarify the present nursing practices and challenges for foreign pregnant and postpartum women at perinatal medical centers in Osaka, which contains many foreign residents.Methods A self-administered questionnaire survey was conducted from October 1 to December 31, 2023. Questionnaires were sent to one representative of the obstetrics departments of 23 perinatal medical centers in Osaka that agreed to participate in the study.Results A total of eight facilities (34.8%) returned questionnaires. Regarding the current status of nursing care for foreign pregnant and postpartum women, medical interpreters were frequently used during pregnancy to explain about abnormalities and precautions (87.5%); during delivery to explain about emergency cesarean section (62.5%); and during the postpartum/newborn period to explain about maternal abnormalities and precautions after delivery and discharge (75.0%) and about neonatal abnormalities and precautions after discharge (75.0%). Interpreters such as family members and friends were most frequently used during hospitalization for delivery (87.5%). More than half of facilities used various types of multilingual materials, such as cards with explanatory illustrations, communication cards, and childcare support information.Conclusions Family and friends helped women to interpret medical information, and telephone interpretation and multilingual translation equipment were also used. Various multilingual materials were used to address linguistic issues, and cultural and religious considerations were implemented at all facilities. However, there is a lack of medical interpreters, particularly during the delivery period, and free multilingual resources are not being fully used.
2.Measurement of Blood Methadone Concentration and Investigation of the Possibility of Early Effect Assessment in Japanese Patients with Cancer Pain
Takeshi NAKAMURA ; Daisuke TANADA ; Saki OKAMURA ; Takae INUI ; Yoko DOI ; Hiroki MIYAWAKI ; Munetaka HIROSE ; Takeshi KIMURA ; Tadashi SHIMIZU ; Akito TANAKA ; Miyuki MABUCHI
Palliative Care Research 2021;16(3):231-239
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.