Search

Objective: Early walking post-surgery is vital to prevent surgical complications and enhance recovery. This study aimed to investigate the factors that affect the number of steps taken after leaving the bed by patients following gynecological surgery using a “walking diary” and clinical outcomes.Methods: Data collected from the walking diary included the target number of steps and general condition of 95 gynecological patients who underwent laparoscopy or laparotomy following clinical pathways. We analyzed the data using logistic regression.Results: The average number of steps on the first postoperative day of laparoscopy and laparotomy was 878 and 250 steps respectively, and increased to 2,525 and 1,023 steps, respectively, on the second postoperative day. The target number of steps and motivation at the time of waking up increased significantly with the postoperative course, and pain decreased significantly. The amount of bleeding and laparotomy were factors that inhibited the number of steps taken. Additionally, the larger the target number of steps on the two days after surgery, the greater the steps taken may be promoted. The surgical invasiveness of the procedure was a factor that influenced the number of steps taken.Conclusions: Patients who set a higher target number of steps for themselves took a higher number of steps in practice. They were presented with a guideline for the target number of steps for patients post-surgery: around 900 on post-operative day 1 (POD 1) and 2500 in POD 2. Improving postoperative symptoms might aid patients’ feeling of recovery, and reviewing the walking diary may enhance their motivation for walking as well as self-efficacy.

Objective : In this study, we analyzed a sample of nursing students, focusing on their self-directed learning experiences as they completed a program comprising specialized exercises and examinations and clinical training. Through this, we aimed to identify means of improving nurses’ self-directed learning skills during nursing education. Methods : Sixty-six third-year university students underwent a six-week adult-nursing training involving participatory-type simulated-patient (SP) exercises and objective structured clinical examinations (OSCEs), during which they maintained portfolios in which they noted their experiences and thoughts as they engaged in this education. We analyzed, through qualitative induction, the written data in these portfolios. We followed this by cross-sectionally integrating, using a chronological perspective, experiences reported by the same sample in previous research, consequently clarifying the structure of the students’ self-directed learning. Results : The students’ self-directed learning experiences during the adult-nursing training were divided into six classifications. Comparison of self-directed learning in participatory-type SP exercises, OSCE, and training, respectively, showed that few students applied their experience of the SP and OCSE exercises in training. However, during training they showed a strong ability to independently perform reviews of challenges that arose in actual practice and to engage in collaboration. They also showed increased desire to perform nursing. Conclusions : As the exercises and practice were not conducted consecutively, external experiences may have affected the continuity of the education, and hindered the students’ ability to maintain a sense of continuous development. Thus, encouraging students to regularly review their education may enhance their self-directed learning skills.

The purpose of this study was to clarify how Japanese nurse managers (i.e., “shunin”) or higher-ranked positions self-rate their nursing management competencies and to identify factors associated with their ability to develop staff. Data were collected using a questionnaire based on the 41-item Management Index for Nurses. This index assesses the competencies related to six components of nursing management: planning, motivating staff, developing staff, communication, organization, and ensuring safety. The total possible score is 205 points. The mean percentage score for each component was calculated based on the responses from 118 participants (107 women; mean age = 44.1 ± 7.0 years). Results showed that the mean percentage score for competencies related to ensuring safety was, by far, the highest (71.8%), and the lowest was for competencies related to organization (47.6%). Principal factors found to be associated with participants’ ability to develop staff were “gathering and using information” (a subscale of “educational background and interests”) and “supportiveness of the work environment”. These results suggest that, to improve nurse managers’ competencies related to their ability to develop staff, hospitals need to establish continuing education systems that offer nurse managers convenient educational opportunities in management science, either on-site or at a higher education institution; and develop an in-house support system that enables managers to obtain counseling when practical management concerns cause them stress.

With a view toward developing Simulated Patient Exercises (SPE) together with local residents, we aimed to ascertain the role that instructors should play, and the coordination they should undertake to achieve this goal. We interviewed local residents in their 60s and 70s who participated in the participatory SPE program of Tokai University’s Adult Nursing Department. We asked the residents about what they gained from, and how they felt about, their experience in the program, and about the kind of support they need to play their role effectively. From the interview data and qualitative inductive analysis, we derived four themes describing the residents’ experiences: “Self-encouragement and growth”, “hardships as a Simulated Patient”, “efforts to improve the training of simulated patients”, and “wishes for nursing students”. Many of the statements described hardships the residents faced as Simulated Patients, including their nervousness and the burden of learning their role. On the other hand, we also heard many positive statements about how the residents felt encouraged and achieved growth through the experience. For example, in serving as simulated patients, the residents were encouraged by a sense of pride at how they were helping to train nursing students who will in the future help them and their family members, and they felt inspired by the students’ earnestness and their cordial learning attitudes, as well as by the camaraderie with fellow Simulated Patients. These positive statements illustrate the value of local residents participating in the program, and they explain why the residents continued to participate.