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application/pdf, 本研究では、わが国における心肺蘇生指導に関する研究の動向を概観し、心疾患患者の家族を対象とした心肺蘇生指導の現状と課題を明らかにすることを目的に文献検討を行った。, 文献検索は、医学中央雑誌Web（Ver.5）を使用し、1980年〜2020年までに公表された国内の原著論文を対象とし、キーワードを「心臓マッサージ」「心停止」「胸骨圧迫」「心肺蘇生」に「家族」を掛け合わせて検索した。結果446文献が抽出され、重複文献や心肺蘇生指導に関連のないものを除外し、107文献を対象文献とし、研究内容別に分類した。さらに研究内容別に分類したなかで、看護師が心疾患患者の家族を対象とした心肺蘇生指導について報告している10文献を最終分析対象とし、現状と課題を整理した。その結果、心疾患患者の家族を対象とした心肺蘇生指導は、講習会形式で実施されていたものが多かった。受講前の患者の家族は不安を抱えていたが、受講後は急変時の対応について理解を深めることができていた。一方で、一度の講習では習得が困難なため再受講を希望する家族もいた。, 家族は心肺蘇生指導をうけることで不安の軽減につながっていた。今後の課題として、繰り返し受講できるシステムづくりが必要だということが示唆された。, We conducted a literature review to outline trends in research on cardiopulmonary resuscitation (CPR) guidance, and to clarify the current status and challenges of such guidance for families of patients with heart disease in Japan., We searched for original Japanese research studies that had been published between 1980 and 2020，and are available in the Ichushi Web (Ver. 5) database, using the following keywords: “cardiac massage”, “cardiac arrest”, “sternal compressions”, “cardiopulmonary resuscitation” and “family”. As a result, 446 studies were extracted and after excluding duplicate papers and those not related to CPR guidance, we classified 107 studies based on the topics. Furthermore, we finally adopted 10 studies that discuss CPR guidance for families of patients with heart disease provided to clarify the current status and challenges of such guidance. We found that the CPR guidance for families had been provided in a workshop style in many cases. The families had been anxious before participation, but the workshops deepened their understanding of measures to manage sudden changes., Families' anxiety was reduced by receiving CPR guidance. As a future challenge, the necessity of establishing a system that enables families to regularly participate in CPR workshops was suggested.

術後の健康回復の促進に向けた看護ケアの基礎的資料を得るため,超音波診断装置(周波数は7.5MHz)を用いて,開腹による胃あるいは大腸手術を受けた患者を対象に,手術経過に伴う下肢の筋組織厚および皮下脂肪厚の変化を明らかにした.術前,術後離床日,術後10日目,術後20日目の合計4回,下肢の大腿直筋上,大腿二頭筋上,長指伸筋上,ヒラメ筋上にプローブを当て,組織厚を測定した.開腹による胃または大腸手術を行なった患者のうち,合計4回の測定結果が得られた16名を分析対象とした.4箇所の測定部位の筋組織厚および皮下脂肪厚をそれぞれ合計し,筋組織厚総和および皮下脂肪厚総和を算出し,術前値との比較を行なった.その結果,下肢の筋組織厚総和は,術後離床日,術後10日目,術後20日目に有意な減少を認めた.一方,下肢の皮下脂肪厚総和は,術後には有意な減少を認めず,ほとんど変化しないことが明らかになった.胃手術群と大腸手術群の比較においては,胃手術群は,術後10日目から術後20日目にさらに減少し,回復の傾向を示さなかったが,大腸手術群は,術後10日目から術後20日目に下肢の筋組織厚が回復の傾向を示した.よって,開腹術後患者,特に胃手術患者に対して,より細やかな看護観察と栄養評価,および食事摂取量を増やす看護介入の必要性が示唆された., In order to obtain basic data for use in postoperative nursing care intended to promote the recovery of patients after surgery, the authors examined postoperative changes in lower limb muscular tissue thickness and subcutaneous fat thickness by ultrasonography (7.5 MHz) in patients who underwent open surgery of the stomach or large intestine. The ultrasound probe was placed on the skin above the following muscles: quadriceps femoris, biceps femoris muscle, extensor digitorum longus, and soleus. Measurements were taken on 4 occasions: before surgery, and on the 1st, 10th and 20th day after postoperative mobilization. Of all patients who underwent open surgery of the stomach or large intestine, 16 patients were selected for analysis and ultrasonic measurements. Muscular tissue and subcutaneous fat thicknesses at each of the four sites of measurement were totaled to yield measures of total muscular tissue and total subcutaneous fat. Postoperative and preoperative parameters were then compared. The total lower limb muscular tissue thickness at each of the 4 postoperative measurement points was significantly less than the preoperative thickness, whereas the total lower limb subcutaneous fat thickness showed no significant decrease after surgery and remained almost unchanged from the preoperative value. Comparing patients undergoing different types of surgery, leg muscular tissue thickness showed a tendency to recover on the 10th and 20th day after surgery in the colorectal surgery group, while the gastric surgery group showed further decreases in this parameter on the 10th and 20th day, with no trend towards recovery evident over the timeframe investigated. These results suggest the necessity of active nursing intervention for patients after open gastric surgery.G2