1.Evaluation of Projects Aimed at Nurturing Medical Professionals in the Region; Effects on "Medical Kids" Participants' Medical Career Aspirations
Yohei YAMADA ; Yuichi ANDO ; Motoki SATO ; Takuji KIMURA ; Nobutaro BAN ; Juichi SATO
Medical Education 2024;55(3):235-238
Since 2013, Nakatsugawa City has been holding a medical/nursing care work experience event called “Medical Kids,” aimed primarily at sixth-grade elementary school students to develop an interest in medical and nursing care and aspire to become medical/nursing care workers in the future. We investigated the current career paths of participants in this event 7 to 9 years after the event, and evaluated the impact of the event on their intentions to work in the medical and nursing care professions. A questionnaire survey was conducted in 2022 asking 43 participants of the event from 2013 to 2015 about their current career paths. The response rate was 81.4%, with 40% employed or pursuing higher education in the medical/nursing care field, and 64% of them stated that participating in the event was an opportunity for them to choose a career path. It turned out that this event was an opportunity for them to choose a future medical or nursing career.
2.“Standardization of Pre-Graduate Curriculum” in Kampo Medical Education”: Purpose and Background of the Establishment of the Japan Council for Kampo Medical Education
Shin TAKAYAMA ; Marie AMITANI ; Takahide MATSUDA ; Juichi SATO ; Masayuki KASHIMA ; Tomoaki ISHIGAMI
Kampo Medicine 2023;74(2):180-187
In 2015, the Japan Council for Kampo Medical Education was established to create a basic curriculum for Kampo medical education that could be implemented in medical schools nationwide. After conducting a needs assessment, we decided on a lecture time of 240 minutes. To set learning objectives, we formed groups for “history,” “examination methods and patterns,” “effects of Kampo medicine,” “clinical cases,” “acupuncture and moxibustion,” and “evaluation.” The teaching contents were incorporated. Then, model slides and lecture guides containing these teaching contents were created, and textbooks based on these contents were published in 2020. In 2021, these overall efforts and contents were made public nationwide, providing an opportunity for the introduction of this curriculum at each university.
3.The Details of Inpatient Cancer Rehabilitation Provided by Designated Cancer Hospitals in Japan
Takuya FUKUSHIMA ; Tetsuya TSUJI ; Jiro NAKANO ; Shun ISHII ; Shinsuke SUGIHARA ; Hiroshi SATO ; Juichi KAWAKAMI ; Hitoshi KAGAYA ; Akira TANUMA ; Ryuichi SEKINE ; Keita MORI ; Sadamoto ZENDA ; Akira KAWAI
Palliative Care Research 2023;18(2):143-152
Objective: This study aimed to clarify the details of inpatient cancer rehabilitation interventions provided by designated cancer hospitals in Japan. Methods: This questionnaire-based survey asked specialists regarding the outline of their facilities’ inpatient cancer rehabilitation, Dietz classification, disease, and intervention details. Results: Restorative interventions were the most common, and the most common cancer was lung cancer followed by colorectal cancer; hematologic malignancy; gastric cancer; and liver, gallbladder, and pancreatic cancer. Intervention proportions for colorectal and gastric cancer were significantly higher in general hospitals than in university hospitals and cancer centers; in contrast, those for hematological malignancy were significantly higher in university hospitals than in general hospitals. For bone and soft tissue sarcomas, intervention proportions in cancer centers were significantly higher than those in university and general hospitals; and for oral, pharyngeal, and laryngeal cancers, they were significantly higher in university hospitals and cancer centers than in general hospitals. The most common intervention was walking training, followed by resistance training, basic motor training, activities of daily living training, and respiratory rehabilitation. Respiratory rehabilitation was performed significantly more frequently in university and general hospitals than in cancer centers.Conclusion: The diseases had differed according to the characteristics of the facilities, and the interventions were considered accordingly. In future, it will be necessary to verify the effectiveness of inpatient cancer rehabilitation according to facility characteristics and to disseminate information on inpatient cancer rehabilitation.
4.Report of the 71st Annual Meeting of the Japan Society for Oriental Medicine Special Program 1-“Pre-and Post-Graduation Education of Kampo Medicine for the Next Generation”: Standard Lecture on Kampo Medicine
Shin TAKAYAMA ; Takahide MATSUDA ; Yoshihide YAKAZU ; Makoto ARAI ; Takao NAMIKI ; Keiko OGAWA ; Juichi SATO ; Tomoaki ISHIGAMI ; Go ITO ; Tadamichi MITSUMA
Kampo Medicine 2022;73(3):247-262
At the 71st Annual Meeting of the Japan Society for Oriental Medicine held in August 2021, we conducted a special program, “Pre-graduation and post-graduation Kampo medical education for the next generation,” focusing on Kampo medical education. We summarize and report a mock lecture on standard Kampo medicine conducted jointly with the Japan Council for Kampo Medical Education (JCKME) for the purpose of faculty development. The lecture contents were based on the “Basic Curriculum for Pre-Graduate Education in Kampo Medicine 2016” established by the JCKME, and the common model slides prepared by the JCKME were used. The lectures were pre-recorded for 240 minutes on the “History of Kampo medicine,” “basic theory of Kampo medicine,” “physical examination of Kampo medicine,” “composition and effects of typical Kampo medicines, effects and side effects of typical herbal medicines,” “usefulness of Kampo and clinical cases that were effective,” and “overview of acupuncture and moxibustion treatment,” and were delivered from seven days before to seven days after the annual meeting. This was the first nationwide educational activity for the general meeting of the society. These lectures were viewed 1,017 times nationwide, by medical students, educators, and members of the society.
5.Family Involvement by Japanese Family Physicians in Their Clinics: The Second Report of a Focus Group Discussion
Hiroaki TAKENAKA ; Tomio SUZUKI ; Jun DATE ; Tesshu KUSABA ; Juichi SATO ; Nobutaro BAN
An Official Journal of the Japan Primary Care Association 2019;42(1):40-46
Objective: To clarify the involvement of Japanese family physicians with patients and their families in their daily practice.Methods: Participants were Japanese family physicians with over one year of experience of full-time work in their clinics, and who were able to join the focus group discussions (FGD) and member checks. The study employed a qualitative research design with semi-structured FGD. Two analysts examined video recordings of the FGD, and the results were verified through member checks and external checks.Results: Eight physicians participated at first, but five of them dropped out because of job commitments or death. The involvement by Japanese family physicians consisted of three stages. The first stage was "the approach of repeated hypothesis testing and normalizing" as safety interventions. The second stage was "reevaluation of the family" utilizing family genograms, family conferences, and others. After exhausting all other efforts, they engaged in "accepting the one who comes to them" in collaboration with the patient and families. The outcomes included awareness of patients, their smiles due to feeling accepted, and their expressed emotions. They did not explicitly boast that they were able to engage with family members. In addition, they also needed case studies of instances of "failure." Conclusion: Japanese family physicians engaged in three-stage involvement with families.
6.How and When Do Japanese Family Physicians Assess Family in Their Clinics?: A Preliminary Initial Report from a Focus Group Discussion
Hiroaki TAKENAKA ; Tomio SUZUKI ; Jun DATE ; Tesshu KUSABA ; Hiromi TAMAKI ; Juichi SATO ; Nobutaro BAN
An Official Journal of the Japan Primary Care Association 2017;40(4):176-182
Objective: To clarify how and when Japanese family physicians assess families in their daily practice.Methods: Participants were Japanese family physicians with over one year of experience of full-time work in their clinics, and who were able to join the focus group discussions (FGD) and member checking. The study employed a qualitative research design with semi-structured FGD. Two analysts examined video recordings of the FGD, and the results were verified through member checking and the checking by external members.Results: Physicians assessed families naturally while examining patients for common cold, during vaccination, and during registration in the Japanese care insurance system.Additionally, the physicians assessed the families when they observed or suspected something strange regarding the patient and/or the family.Families were assessed based on how they spent their time during special Japanese events that the family members attended together (e.g., Bon festival or Japanese style New Year holidays), the patient's illness behavior in non-reserved outpatient clinics, and their communication patterns. Furthermore, the family photograph technique for family therapy was also used for assessment.Conclusion: Participants utilized skills of family therapy such as communication patterns and family photographs. They also employed unique skills such as assessment of the families' sharing time during traditional events, assessment of the patient's illness behavior, and general assessments regarding the Japanese care insurance system.
7.Endolymphatic Hydrops as a Clinical Condition in Traditional Oriental Medicine —Is an Endolymphatic Hydrops Condition the Same as Suidoku? Analysis of Endolymphatic Hydrops by Traditional C
Michitaka HOSHINO ; Xiaochen HU ; Juichi SATO ; Masaaki TERANISHI ; Tsutomu NAKASHIMA
Kampo Medicine 2016;67(3):251-256
Endolymphatic hydrops, regarded as a marker of Ménière's disease, can now be diagnosed using MRI. Since endolymphatic hydrops is considered a condition of fluid disturbance known as suidoku in Kampo medicine, Kampo preparations with a water flow smoothing ability are often used to treat endolymphatic hydrops. However, the hypothesis that endolymphatic hydrops is suidoku indication has not been fully tested. We used traditional Chinese medicine to diagnose patterns in 11 patients who had been diagnosed with endolymphatic hydrops using MRI. Additionally, we researched the literature regarding the condition of fluid disturbance and resulting vertigo. Of the 11 patients, seven showed disorder of fluid, eight showed kidney (traditional medicine, TM) disorder, and five showed liver (TM) disorder. According to the literature, the vertigo condition caused by fluid disturbance was described in the chapters “tanyinkesoubing and shuiqibing” in the “Jinguiyaolue”. Since no auditory symptom is mentioned in these chapters on vertigo, vertigo caused by fluid disturbance might differ from typical Ménière's disease with auditory symptoms. It is suggested that the patients with endolymphatic hydrops do not necessarily indicate suidoku and we should consider the states of kidney (TM) and liver (TM) disorders.
8.Knowing the Patient Better: How Facilitated Sharing of Diabetes Patients' Life Stories Enhances Patient-Physician Relationships but not Metabolic Control
Keiko Abe ; Hideki Wakabayashi ; Juichi Sato ; Nobutaro Ban
General Medicine 2010;11(2):79-86
BACKGROUND: The patient-physician relationship and patient self-management are important in controlling diabetes mellitus. This pilot study assessed the value of patients sharing their stories with physicians.
METHOD: Twelve patients and two physicians participated. Patients told their life stories to a co-medical interviewer, and these were transcribed and summarized in their medical charts. The physicians read the transcripts. The intervention was evaluated by questionnaire and interviews with the patients and physicians. Two coders qualitatively analyzed the interviews. Glycated haemoglobin (HbA1c) and body weight were examined before and six months after the intervention.
RESULTS: 75% of patients felt an improvement in the physician's empathy, advice and ability to share the patient's problems. Physicians reported an improved relationship with 40% of the patients. The patient interview identified: 1) facilitated self-reflection; 2) encouraged self-efficacy; 3) changed perceptions about health-care related behavior; and, 4) difficulties in changing behavior. However, improvement in HbA1c levels and body weight was not significant.
CONCLUSIONS: The patients were satisfied that sharing their stories improved self-reflection and self-efficacy, but found it difficult to adopt healthier options for managing their diabetes. Long-term study of whether improved physician communication skills will enhance outcomes is needed.
9.Knowing the Patient Better : How Facilitated Sharing of Diabetes Patients' Life Stories Enhances Patient-Physician Relationships but not Metabolic Control
Keiko Abe ; Hideki Wakabayashi ; Juichi Sato ; Nobutaro Ban
General Medicine 2010;11(2):79-86
BACKGROUND: The patient-physician relationship and patient self-management are important in controlling diabetes mellitus. This pilot study assessed the value of patients sharing their stories with physicians.
METHOD: Twelve patients and two physicians participated. Patients told their life stories to a co-medical interviewer, and these were transcribed and summarized in their medical charts. The physicians read the transcripts. The intervention was evaluated by questionnaire and interviews with the patients and physicians. Two coders qualitatively analyzed the interviews. Glycated haemoglobin (HbA1c) and body weight were examined before and six months after the intervention.
RESULTS: 75% of patients felt an improvement in the physician's empathy, advice and ability to share the patient's problems. Physicians reported an improved relationship with 40% of the patients. The patient interview identified: 1) facilitated self-reflection; 2) encouraged self-efficacy; 3) changed perceptions about health-care related behavior; and, 4) difficulties in changing behavior. However, improvement in HbA1c levels and body weight was not significant.
CONCLUSIONS: The patients were satisfied that sharing their stories improved self-reflection and self-efficacy, but found it difficult to adopt healthier options for managing their diabetes. Long-term study of whether improved physician communication skills will enhance outcomes is needed.


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