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Purpose : The purpose of this study was to investigate the operating environment, degree of operating-room nurses’, and to clarify the job satisfaction, experience, and emotions categorized characteristics operating-room nurses. Method : The study surveyed 1177 operating-room nurses. For 38 questionnaire items, a 5-point Likert scale was applied regarding job satisfaction, workplace environment, experiences, and emotions. Classification was performed by cluster analysis based on operating-room nurses’ job satisfaction. Results : Results of cluster analysis were classified into five groups with unique characteristics based on factors such as age, years of nursing experience, years of operating-room nursing experience, workplace environment, experience, and emotion. Conclusion: Results suggest providing support tailored to characteristics of each of the five groups to optimize their job satisfaction.

This study aimed that we were classification of physical activity in patients with heart failure categorized as New York Heart Association (NYHA) class I or II. We were a survey using a researcher- administered questionnaire, SF-8, the Specific Activity Scale (SAS), and the Scale to Measure Self-Care Behavior of Patients with Heart Disease. We included 70 patients who were treated in the Department of Cardiovascular Medicine at Hospital A. Regarding patient characteristics and clinical information after the cluster analysis, there were significant differences in the NYHA class (p = 0.001), BNP level (p = 0.012), self-management of medication adherence (p = 0.000), and exercise habits (p = 0.005). We summarized characteristics of each group as follows : Group A showed high tolerance to physical activity and near-perfect self-management; Group B showed moderate tolerance to physical activity but was not willing to commit to daily exercise and self-management; and Group C showed low tolerance to physical activity and often requested others to handle medication management. We needed that tolerance to physical activity and proposals for tailored instruction according to patient conditions, and needed that instructions tailored to the characteristics of heart failure patients in groups A–C.

This study investigated the incidence of phlebitis associated with continuous nicardipine infusion in patients with acute-phase stroke. To identify patient factors related to the occurrence of phlebitis, and considering blood pressure values during nicardipine administration, we retrospectively investigated the nursing and medical records of 301 patients who were hospitalized for stroke. Of these, 92 patients met the inclusion criteria and had data showing whether phlebitis had occurred. We confirmed that phlebitis occurred in 38 patients (41.3%). Factors found to be significantly related to phlebitis onset were Glasgow Coma Scale (GCS)-verbal (V; p = .020) and -motor (M; p = .007), level of consciousness (total GCS score [(p = .009)]), nicardipine administration time (p = .001), nicardipine dose (p = .000), mean nicardipine rate of administration (p = .000), nicardipine dilution rate (p = .000), mean arterial blood pressure at first insertion (p = .030), and difference in the diastolic blood pressure at first insertion (p = .032). Multiple logistic regression analysis indicated that nicardipine administration time (odds ratio: 1.042, 95% confidence interval: 1.023–1.062, p = .000) was a related factor. Results also suggested that a decreased level of consciousness after the stroke onset (V3 or below and M5 or below) is related to phlebitis occurrence. Patients with stroke having a lower level of consciousness (total GCS score of 12 or below), who are being administered continuous nicardipine infusion, may require more frequent and careful infusion management and needle insertion site observation. Because phlebitis onset occurs after 24 h of continuous infusion, peripheral insertion site catheter replacement should be performed within 24 h.

[Purpose] The purpose of this study was to clarify the factors associated with the uncertainty patients with mild stroke experience regarding their illness. [Method] The participants in the study included stroke patients who had suffered a stroke but were able to communicate without cognitive impairment in an outpatient clinic or who were being hospitalized in a stroke care unit (SCU) or ward. Uncertainty regarding their illness was investigated using the Universal Uncertainty in Illness Scale (UUIS) (26 item, 6 subscale measurement scale, with scores ranging from 26–130) and Health-Related Quality of Life (QOL) SF-8 (8 item, 5–6 level Likert system) questionnaire. Data extracted from medical records included patient age, sex, type of stroke, time since onset, overlapping diseases, presence or absence of recurrent stroke, the National Institutes of Health Stroke Scale (NIHSS), ADL assessments using the Barthel Index (BI), and the presence or absence of family members living in the same house. For the analysis, Spearman rank correlation coefficients were calculated for the correlation between UISS and SF-8 in stroke patients after analyzing basic statistics. Comparisons of UUIS scores based on age, stroke type, BMI, time since onset, stroke severity (NIHSS), and ADL (BI) between the three groups were performed using the Kruskal-Wallis test, and comparisons between the two groups based on sex, the presence or absence of overlapping diseases, the presence or absence of stroke recurrence, the presence or absence of stroke sequelae, and the presence or absence of cohabitating families were performed using the Mann-Whitney test. Subsequently, multiple regressions with UUIS as an independent variable were performed on factors that showed significant differences in order to explore the factors related to UUIS. Approval was obtained from the Institutional Review Board of Tokushima University Hospital (Approval number 3134-1). [Results] Responses were obtained from 146 stroke patients. The mean age was 65.9 years (SD 13.9), 82 were men (56.2%), 64 were women (43.8%), 38 were acute phase patients (26.0%), 39 were recovery phase patients (26.7%) and 69 were maintenance phase patients (47.3%). The mean UUIS score in stroke patients was 72.0 (SD 23.1) and was high, at 82.0 (SD 23.3), in acute phase patients, in particular. In addition, significant differences in UUIS were seen based on age (p = .031), stroke type (p = .031), time since onset (p = .006), the presence or absence of stroke sequelae (p = .013), stroke severity (NIHSS) (p = .000), and ADL (BI) (p = .001). In multiple regression analyses, stroke severity, time since onset, and age were associated with stroke patient uncertainty (R2 = .221). [Conclusions] Stroke patients were characterized by uncertainty based on age, stroke type, time since onset, stroke severity (NIHSS), and ADL (BI). In particular, the uncertainty of acute phase stroke patients was higher compared to other chronic diseases due to time since onset, stroke severity (NIHSS), and ADL (BI). The three factors of stroke severity, time since onset, and age were associated with stroke uncertainty. In patients with high stroke severity (NIHSS 2 or higher), there was an indication that careful explanation and supplementation of information regarding the disease was required and that complicated information, such as disorders caused by the stroke and treatments, should be carefully explained to those 75 years and older (older people) as well as patients who experienced disease onset within less than 1 month.

Epidemiological investigations have shown that consumption of soybeans or soy foods reduces the risk of the development of cardiovascular disease, cancer and osteoporosis. The aim of this study was to determine the associations between different soy foods and inflammatory markers, including high-sensitivity C-reactive protein (hs-CRP), interleukin (IL)-6, and IL-18, in Japanese workers. The cross-sectional study included 1,426 Japanese workers (1,053 men and 373 women) aged 20 to 64 years. Intake of 12 soy foods was estimated by a validated food frequency questionnaire. Associations of total soy foods, fermented soy food, non-fermented soy food, soy isoflavone with hs-CRP, IL-6, and IL-18 levels were examined by general linear model regression analysis. We found that total fermented soy food intake was inversely associated with multivariable-adjusted geometric concentration of IL-6 in men (Q1 : 1.03 pg/mL, Q5 : 0.94 pg/mL ; P for trend = 0.031). Furthermore, it was shown that IL-6 concentrations were inversely associated with miso intake (β= -0.068 ; p = 0.034) and soy sauce intake in men (β= -0.074 ; p = 0.018). This study suggests that intake of total fermented soy food, miso and soy sauce be associated with IL-6 concentrations in Japanese men.

Purpose : The aim of this study was to clarify the changes in medication-taking behavior and related factors over time in patients with initial mild cerebral infarction up to 12 months after onset. Methods : Thirtyone patients with initial mild cerebral infarction were surveyed a total of four times : on admission to hospital, 3 months after onset, 6 months after onset, and 12 months after onset. Patients were surveyed regarding medication compliance, awareness of taking medication, perceived behavioral control, lifestyle risk factors, and subjective norms. Results :Medication compliance improved over time from the time of admission, but no changes were seen in awareness of taking medication. A cluster analysis based on changes in medication compliance over time revealed a “Persistently high compliance group” and a “Persistently low compliance group” for medication compliance. The health locus of control in the “Persistently high compliance group” was perceived as the result of chance and fate. Conclusions : Assessing the current state of medication compliance and the health locus of control during hospitalization permitted an understanding of patient characteristics, and indicated a need for recurrence prevention education and medication guidance tailored to each patient’s cognitive and behavioral characteristics.

The present study investigated the factors contributing to the loss of upper and lower extremity muscle mass in three elderly stroke patients with right hemiplegia in whom our rehabilitation program could not be performed at １‐２ weeks after onset. The results revealed common factors such as prolonged accurate microinjection of hypotensive agents, severe hemiplegia（Brunnstrom stage I or Ⅱ）, diarrhea and delayed initiation of tube feeding at ３ to ８ days after onset. With regard to individual differences, while all patients were recovering in bed, the degree of decrease in muscle mass varied among patients because they moved their extremities differently.

The present study measured lower extremity muscle mass using DXA （Dual energy X-ray Absorptiometry） in order to verify the effectiveness of intervention with a series of movements, including lying hip raise exercise with bent knees pointing upwards, among bedridden patients with post-stroke hemiplegia in the acute post-stroke period. Subjects in the intervention group were required to perform １０ repetitions of a series of back-lying exercises once a day with researchers, in addition to the exercises performed by those in a control group. The first measurement of muscle mass was conducted at three to five days after onset, and the second measurement was conducted seven days after the first. Muscle mass in the lower extremities was reduced by approximately ６００g （decrease rate ： ９％）on the paralyzed side and by ２８０g on the non-paralyzed side（decrease rate： ５％）in one week in the Brunnstrom stage ≤ II subgroup（site of measurement : lower extremities） （n＝８） of the control group （n＝２３）. The decrease in muscle mass in the Brunnstrom stage ≤ II subgroup （n＝４） of the intervention group （n＝１５） was approximately ２６０g on the paralyzed side （decrease rate ： ５％） and approximately ２８０g （decrease rate ： ５％）on the non-paralyzed side. Thus, muscle mass decreased on both sides, and this occurred regardless of degree of paralysis. Comparison of the Brunnstrom stage ≥ III subgroups between the control and intervention groups also confirmed that the decease in muscle mass was smaller in the latter group. Thus, it was confirmed that back-lying exercises combining lower extremity movements, including hip raises with bent knees pointing upwards, prevented the decrease in lower extremity muscle mass on the paralyzed side in post-stroke patients. The present study also suggests that these exercise movements can be applied to preventive care for bedridden patients with other severe diseases.

The present study analyzed１６patients who were bedridden for one week immediately after onset of post-stroke hemiplegia. We used DXA（dual energy X-ray absorptiometry）to determine changes in muscle mass in the lower extremities on both paralyzed and non-paralyzed sides. The first measurement was conducted ３ to ５ days after the onset, and the second measurement was conducted ７ days after the first. Muscle mass in the lower extremities was reduced by approximately ６００g （９％） on the paralyzed side with and by ２００g on the non-paralyzed side （３％） in the Brunnstrom stage≤II group （n＝５）. Although the decrease of muscle mass in the Brunnstrom stage≥III group（n＝１１, relatively slight degree of functional motion impairment）was not significant, a decrease of approximately ３００g （decrease rate ： ５％）was observed on the paralyzed side and approximately １００g （decrease rate ： １．５％）was seen on the non-paralyzed side. Hence, muscle mass declined on both sides, and this occurred regardless of degree of paralysis. The findings suggested that conventional range of motion exercises, functional position maintenance, and postural changes are inadequate to prevent disuse muscle atrophy in post-stroke patients ; thus, it is necessary to develop a new rehabilitation program which adopts different exercises such as trunk motion, even for patients in the acute stage after stoke onset.

In order to verify the accuracy of the thickness of the rectus femoris muscle and overlying subcutaneous fat as assessed by ultrasound, experiments were conducted on １０ healthy subjects aged over ３０ years to assess the following： １） concordance of measurements made by two different observers； ２） concordance of repeated measurements made by the same observer ; and ３） concordance of repeated measurements made by the same observer with and without an imaging aid（ultrasound gel block）. Between two observers with varying experience in ultrasound, no significant difference in measured muscle thickness was observed ; however, there was a significant difference in subcutaneous fat thickness. When measurements were made by the same observer on two separate days, a significant positive correlation was evident for muscle and subcutaneous fat thickness between the first and second tests. While use of the imaging aid was associated with higher concordance of measurements between the first and second tests, the measurements themselves were affected. Although ultrasonic measurement of tissue thickness requires further investigation to minimize intra-observer error and examine correlations with other imaging techniques, the accuracy of the measurements in the present study suggests that clinical application may be possible.

In order to establish an objective and convenient technique to assess postoperative recovery following laparotomy, in particular activities of daily living, we measured the thickness of muscle tissues by ultrasound sonography. In the present study, the following four muscular compartments were selected: rectus femoris, biceps femoris, extensor digitorum longus, and soleus. These account for a large portion of the systemic skeletal musculature and are important for locomotion. Subjects were 28 patients who underwent moderately invasive surgery for stomach or colon cancer. The results showed that muscle thickness decreased significantly in all four compartments. Rectus femoris exhibited the greatest reduction in thickness and was most affected by short-term or long-term recumbency. Furthermore, for soleus, the tendency was that the longer the recumbency, the greater the wasting. These findings suggest that, of the four areas of the lower limb, rectus femoris is most affected by short-term recumbency and is most suited for objectively assessing postoperative recovery. The results of the present study suggest that it would be effective to design a recovery program focused on maintaining the femoral extensor muscles, which are most affected by short-term recumbency following laparotomy., 広島保健学学会 特別講演

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

Learning objectives Background Imaging findings OR Procedure details Conclusion Personal Information References, Learning objectives: # To learn the role of DWI in offering additional information for diagnosing female pelvic tumors. #To investigate the usefulness of long TE-DWI ( TE=200ms ) in tumor...

Through the present study, combination of field data and satellite image are proved to be useful for spatial-temporal estimation of sea environment data and have high estimation accuracy regardless of restricted quantity of sample date., 本研究では、ハードデータ（現地測定データ）とソフトデータ（衛星画像データ）をリモートセンシング学、地球統計学という地球情報学的手法により解析し、かつ組み合わせを図り、量と分布が限られた情報から海域環境の詳細な時空間変化の抽出を試み、環境変化の影響因子の特定とメカニズムの解明への貢献を目的とする。代表的な閉鎖性海域である有明海を研究対象に選んだ。また、海洋環境として、「海面温度」、「水質」、「沿岸域堆積物」の3つに注目する。