In order for pharmacists to be collaboratively involved with patients in pharmacotherapy, there is a need to improve patients’ understanding of pharmacists’ involvement in extended pharmacotherapy, i.e., their interpersonal work. This study explores the factors that affect patients’ perceptions of pharmacists’ interpersonal work. A survey on patients’ perceptions of pharmacists’ interpersonal work was conducted among 450 patients aged 20 years or older who visited a pharmacy. Logistic regression analysis was performed with low and high patient perceptions of pharmacists’ interpersonal work as the objective variables. Valid responses were obtained from 350 participants. More than half of the respondents did not understand the nature of the interpersonal work of pharmacists. Patients who were unaware of pharmacists checking for side effects were more prevalent than those who were unaware of other interpersonal work. Explanations from the family pharmacist (OR＝2.25, P＝0.033) and trust in the pharmacist (OR＝1.11, P＝0.001) had a positive influence on patients’ perceptions of the pharmacist’s interpersonal tasks. As pharmacy pharmacists are increasingly becoming more involved with patients’ drug treatment and to ensure safe drug treatment practices for patients, it is considered important for pharmacists to actively explain their involvement in drug treatment to patients. This will be conducive to building trusting relationships, and for pharmacists to fulfil their function as family pharmacists.

Team-based learning (TBL) is an educational method developed to cultivate the ability to solve problems by learning and applying knowledge on one's own, as well as the ability to make decisions, take responsibility, and collaborate by working on issues in small groups. TBL in Kampo medicine was held as a special program : active learning at the 71st Annual Meeting of the Japan Society for Oriental Medicine. A total of 57 students participated in the TBL session. The theme of the session was the common cold with the theory of yin and yang. According to the results of a questionnaire survey, the students answered that they were able to understand the flow of diagnosis in Kampo medicine, which was the goal of the course. As a bridge from classroom lectures to clinical practice, TBL in Kampo medicine was considered to be useful in Kampo medical education.

Objective : Parkinson’s disease (PD) is a disease treated by polytherapy. This time, the authors report the role of pharmacists in one of the few Parkinson’s disease facilities in Japan (https://sunwels.jp/pdhouse/; abbreviated as PD House), which was born from the voices of PD patients. Methods : The backgrounds of 52 patients admitted to the PD House and prescriptions for them were analyzed to mainly clarify: the percentages of patients aged 75 or over and those using 7 or more prescribed drugs; and frequently used drugs to be carefully administered to the elderly. The approaches provided by pharmacists through interprofessional collaboration were also analyzed. Results : The percentages of patients aged 75 or over and those receiving benefits for individuals requiring care were 71.2 and 92.3%, respectively. Those using 7 or more prescribed drugs accounted for 75.0%. In multidisciplinary collaboration, pharmacists were involved in not only pharmacotherapy but also nutritional evaluation of patients with severe nutritional disorders, proposal of appropriate nutritional therapy, understanding of swallowing function, and appropriate medication teaching. Conclusion : The actual situation of PD patients, where they used multiple drugs, and their backgrounds suggest that interprofessional collaboration is indispensable for PD treatment, and the roles of pharmacists were shown to be important.

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.

Introduction  In Japan, midwives have difficulty communicating non-Japanese speaking women. The study aims to explore the midwives’ experience in communicating with them during the perinatal period. Methods  The semi-structured interviews were conducted for five midwives who have had experienced perinatal care for non-Japanese women.Results  Four categories were emerged during the pregnancy of the women: «Midwives desire to provide accurate information when giving medical and health related explanations», «Means and methods of health guidance depend on the contents», «It is much easier to interact with clients if verbal communication means are available during the prenatal check-ups» and «It is difficult to communicate by telephone about signs of onset of labor without having verbal communication means». Five categories have emerged in the intrapartum period including «Appropriate means and continuous involvement make communication smoother during delivery», «Non-verbal communication measures are useful in providing intrapartum care and «In case of an emergency of mother and fetus, ability of mother’s understanding and selection of appropriate means of communication are critical». Four categories have emerged in the postpartum period including «Midwives can communicate with non-verbal means for the health guidance» and «Midwives feel helpless when they cannot communicate verbally during the postpartum follow-ups». One thematic category «Midwives genuinely desire to provide quality communication despite the differences in language and culture»has emerged from over all period.Conclusions  It is important to prepare linguistic communication measures which help midwives to accurately communicate with their clients during the perinatal periods.

Abstract: We report a case of intractable pain in a patient with amyotrophic lateral sclerosis (ALS) that was successfully managed by administering a fentanyl transdermal patch. Case: A 75-year-old man was diagnosed with ALS in 2013 after he became aware of difficulty in walking and systemic pain since 2010. In 2019, he underwent gastrostomy and tracheostomy, and intractable generalized pain necessitated the administration of morphine hydrochloride six times a day; however, it could not provide adequate pain relief. Later, morphine was replaced with a fentanyl patch under a very strict safe-monitored setting and the pain became bearable. Discussion: Although high-level evidence is lacking, pain experts have reported the effectiveness of morphine for intractable pain in patients with ALS. Frequent short-acting morphine dosing is often burdensome due to the complexity of its administration and it also causes end-of-dose pain. A fentanyl patch may possibly improve these drawbacks.

This study investigated the difficulties that single caregivers face while providing home health care for a parent while continuing to work. Semi-structured interviews were conducted with 9 single caregivers who balanced working while providing home health care for more than 3 months for a parent discharged from the hospital. The interview contents were inductively analyzed. One core category with 2 factors was extracted, revealing the characteristics of difficulties that single caregivers face while balancing work and providing home health care. The factor [psychological stress associated with care] had the categories [opportunity to provide care] and [an environment where there is no one to take over caregiving. The factor [care reporting system of persons experienced in providing care] had the categories [presence of a person to talk to about troubles] and [areas to watch and respite system]. For single caregivers providing home health care for a parent for 3 months while continuing to work, the care burden was found to increase over time. The presence of a person whom they could talk to when they experienced difficulties influenced their ability both to provide care and to continue working. Establishing a system that allows for cooperation between medical institutions, the workplace, and society is necessary so that single caregivers can more easily provide care for a parent while continuing to work.

BACKGROUND/AIMS: To compare the diagnostic yield of 20-gauge forward-bevel core biopsy needle (CBN) and 22-gauge needle for endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) of solid pancreatic masses. METHODS: The use of 20-gauge CBN was prospectively evaluated for 50 patients who underwent EUS-FNA from June 2016 to December 2016. Data were compared with those obtained by a retrospective study of 50 consecutive patients who underwent EUS-FNA using standard 22-gauge needles between December 2016 and April 2017. At least two punctures were performed for each patient; the sample from the first pass was used for cytology with or without histology and that from the second pass was used for histology. Sample quantity was evaluated using the sample obtained from the second pass. RESULTS: There was no significant difference in the diagnostic accuracy rate between the first and second passes (20-gauge CBN: 96% [48/50]; standard 22-gauge needle: 88% [44/50]). Samples >10× power fields in length were obtained from 90% (43/48) and 60% (30/50) of patients using the 20-gauge CBN and standard 22-gauge needle, respectively (p=0.01). Technical failure occurred for two patients with the 20-gauge CBN. CONCLUSIONS: Diagnostic accuracy of the 20-gauge CBN was comparable to that of the 22-gauge needle. However, two passes with the 20-gauge CBN yielded a correct diagnosis for 100% of patients when technically feasible. Moreover, the 20-gauge CBN yielded core tissue for 90% patients, which was a performance superior to that of the 22-gauge needle.
Biopsy ; Biopsy, Fine-Needle ; Diagnosis ; Endoscopic Ultrasound-Guided Fine Needle Aspiration ; Humans ; Needles ; Pancreas ; Prospective Studies ; Punctures ; Retrospective Studies ; Ultrasonography

Objective: This study aimed to clarify outpatient nurses' awareness of their support for the decision-making of newly diagnosed cancer patients undergoing surgical therapy.Methods: Semi-structured interviews were conducted with eight outpatient nurses from two hospitals, and transcribed data were analyzed qualitatively.Results: The following four categories of outpatient nurses' awareness were extracted: "Difficult environment for supporting decision-making", "Identifying a patient in need of support", "Collaborating at the organizational level", and "Supporting the patient until a satisfying decision is made". Although the nurses recognized the need to support cancer patients' decision-making when undergoing surgical therapy, they were obliged to prioritize other duties and found it difficult to adequately provide the support needed. Although it was difficult, nurses tried to identify patients requiring support during their routine work, and to assist them until a satisfying decision was made by collaborating with colleagues at the organizational level.Conclusion: In order for outpatient nurses to more effectively support cancer patients' decision-making, it is necessary to allocate an adequate number of personnel, secure interview spaces, and provide training for nurses to improve their skills in decision-making support, in addition to implementing the necessary organizational changes.