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Division of Nursing, University Hospital, Kyoto Prefectural University of Medicine, School of Nursing, Kyoto Prefectural University of Medicine, Introduction: Warm compresses are one of the nursing techniques clinically used to improve patients’ comfort and promote the treatment efficacy. Here the effects of eye masks（EM）, heated eye masks（HEM）, and aroma-scented heated eye masks（AHEM）and their potential as a nursing technique to provide comfort were studied.Materials and Methods: Participants in this study were 42 healthcare professionals（female, 20‒60 years of age）, who voluntarily consented to participate. They participated in all three interventions with EM, HEM, and AHEM at an interval of at least 1 week between interventions. Indicators used were low frequency to high frequency ratio（LF/HF）, blood flow, axillary temperature, pulse rate, blood pressure, the salivary α-amylase activity（SAA）, and the Profile of Mood States Second Edition（POMS）.Results: Of 42 participants in total, 32 were included in the analyses. Their mean age was 46.8 years. The blood flow and axillary temperature values significantly increased and the LF/HF values and the pulse rates significantly decreased after the use of EM, HEM, or AHEM. The POMS Total Mood Disturbance（TMD）score and scores for six POMS subscales significantly decreased after the use of EM, HEM, or HEM.Comparisons among the three groups showed differences in LF/HF. Scores for subscales of POMS also differed among the three groups.Conclusion: These results suggest that the use of EM, HEM, or AHEM intervention is safe with no major body burden. Parasympathetic nerves may be dominant after the EM, HEM, or AHEM interventions The TMD score improved after the EM, HEM, or AHEM intervention. The data suggest that the AHEM use is particularly effective in alleviating depression, dejection, and confusion after the intervention. These findings indicates that the EM, HEM, or AHEM use holds potential as a nursing technique to provide comfort.

京都府立医科大学医学部看護学科, 京都府立医科大学附属病院看護部, 京都府立医科大学看護実践キャリア開発センター, 京都府立医科大学附属病院地域医療推進部, School of Nursing, Kyoto Prefectural University of Medicine, Department of Nursing, University Hospital Kyoto Prefectural University of Medicine, Kyoto Prefectural University of Medicine, Career Development Center for Nursing, Promotion Division of Regional Medicine, University Hospital Kyoto Prefectural University of Medicine, 本研究の目的は、「緩和ケア実践看護師養成コース（以下Aコース）」「在宅緩和ケア推進看護師養成コース（以下Bコース）」を受講した修了者とその上司への調査からプログラム評価および看護実践への活用状況を指標にしてプログラムを評価することである。【方法】平成27～31年度の間に京都府立医科大学看護実践キャリア開発センターが開催する「緩和ケアを推進する看護師教育プログラム」のAコースまたはBコースを受講した修了者25名のうち、調査時点で受講時と同じ施設・病院で就労を継続している21名（Aコース14名、Bコース7名）、とその上司21名（Aコース14名、Bコース7名）を研究対象者とした。修了生の施設・病院に質問紙を郵送し、令和3年7月～8月に無記名の自記式質問紙調査を行った。調査項目は、基本属性、カリキュラムについて、教育目標について、受講内容の適切性について、学習内容の臨床での活用について、とした。なお所属する大学の医学倫理審査委員会の承認を得て実施した（ERB-E-444）。【結果】回答者は、Aコース修了者9名、Aコース上司7名、Bコース修了者5名、Bコース上司3名であった。受講した修了者の評価においては、プログラムの内容についてAコースの8割以上が、Bコースの全員が（とても・まあまあ）適切としている。自己能力の発揮状況について、Aコースは4～6割、Bコースについては4～8割ができているとしている。 上司からの評価では、両コースとも受講した講義・演習・実習が7割程度現在の看護実践に役立っていると答えた。期待される能力については両コースとも8割以上が現在の看護活動に活きていると答えた。【結論】平成27年度から開始された「緩和ケアを推進する看護師教育プログラム」に対して、受講した修了者とその上司に，研修が有用であったかを問うたところ、受講した修了者はプログラムの内容が看護の実践で活かされていると実感していることが明らかとなった。さらに、上司は、受講した修了者が研修を踏まえた看護実践ができていると評価していることが明らかになった。修了者、上司の評価からプログラムの効果を評価することができた。

京都府立医科大学医学部看護学科, 京都府立医科大学附属病院看護部, School of Nursing, Kyoto Prefectural University of Medicine, Division of Nursing, University Hospital, Kyoto Prefectural University of Medicine, 『The Health Action Process Approach（HAPA）理論を用いた新人看護師の手指衛生認知尺度』の改良及び行動変数との関連について検討することを目的に追試研究を行った．新人看護師128名中，111名の有効回答（86.7％）を得た. 探索的因子分析にて原版より1因子少ないが，主要な【セルフエフィカシー】，【意思】，【コーピングプランニング】，【アクションプランニング】の4因子構造を確認した．項目数は17項目となった．各因子のCronbach のα係数は，それぞれ.90, .92, .88, .83 であった．確証的因子分析では，GFI=0.815, AGFI=0.750, CFI=0.922, RMSEA=0.091 であった． 手指衛生の行動変数である，日勤勤務帯における1患者1日あたりの擦式アルコール手指消毒薬使用量と尺度との関連では，因子【意思】及び【アクションプランニング】との相関係数がrs = .32, .30 であった． 本追試において，原版とほぼ同様の因子構造を持つ軽微な改良版が示された．行動変数との関連もうかがわれたことから，『The Health Action Process Approach（HAPA）理論を用いた新人看護師の手指衛生認知尺度』は，手指衛生行動を反映する可能性のある認知尺度であると考える.

Background: Warm compresses are one of the nursing techniques clinically used to improve patients’ comfort and promote the treatment efficacy. Here the effects of eye masks (EM), heated eye masks (HEM), and aroma-scented heated eye masks (AHEM) and their potential as a nursing technique to provide comfort were studied.Methods: Participants in this study were 42 healthcare professionals (female, 20–60 years of age), who voluntarily consented to participate. They participated in all three interventions with EM, HEM, and AHEM at an interval of at least 1 week between interventions. Indicators used were low frequency to high frequency ratio (LF/HF), blood flow, axillary temperature, pulse rate, blood pressure, the salivary α-amylase activity (SAA), and the Profile of Mood States Second Edition (POMS).Results: Of 42 participants in total, 32 were included in the analysis. Their mean age was 46.8 years. The blood flow and axillary temperature values significantly increased and the LF/HF values and the pulse rates significantly decreased after the use of EM, HEM, or AHEM. The POMS Total Mood Disturbance (TMD) score and scores for six POMS subscales significantly decreased after the use of EM, HEM, or AHEM.Comparisons among the three groups showed differences in LF/HF. Scores for subscales of POMS also differed among the three groups.Conclusions: These results suggest that the use of EM, HEM, or AHEM intervention is safe with no major body burden. Parasympathetic nerves may be dominant after the EM, HEM, or AHEM interventions The TMD score improved after the EM, HEM, or AHEM intervention. The data suggest that the AHEM use is particularly effective in alleviating depression, dejection, and confusion after the intervention. These findings indicates that the EM, HEM, or AHEM use holds potential as a nursing technique to provide comfort.Trial registration: UMIN Clinical Trials Registry (UMIN000018409Trial registration number: UMIN-CTR R000021207Date of registration: 07/24/2015

Objective Delirium and subsyndromal delirium in critically ill patients are important determinants of long-term functional disability and cognitive impairment. However, few outcome studies on sub-syndromal delirium have been reported. Thus, this study aimed to evaluate the incidence of delirium and sub-syndromal delirium as well as the risk factors and progression to delirium. Design A prospective cohort study. Setting Six bed medical and surgical intensive care unit in Otsu Municipal Hospital in Japan. Methods Delirium and sub syndromal delirium were evaluated using the Intensive Care Delirium Screening Checklist scores and the demographic data of the patients recorded. Statistical analyses were conducted using the Mann–Whitney U test and chi-square test for comparison. We also compared groups using multivariate analyses. Results Of the 380 patients who were screened, 15.8% and 33.9% had delirium or sub syndromal delirium, respectively and 9.5% of patients progressed from a state of sub syndromal delirium to delirium. Older age, predisposing cognitive impairment, blood transfusion, higher Acute Physiology and Chronic Health Evaluation II (APACHE II) score, low red blood cell count and high C-reactive protein levels were the risk factors highly associated with subsyndromal delirium symptoms. Older age, acute admission, steroid use, the utilisation of restraints and lower PaO2 were the determinants of progression to delirium. Conclusions A high incidence of sub syndromal delirium was observed in critically ill patients. Patient with sub syndromal delirium must be promptly identified and treated due to the risk of progression to delirium.

Objective In palliative care hospitals in Japan, mechanical bathing is conducted to maintain cleanliness. However, the physiological and psychological influence of mechanical bathing on patients has not been sufficiently studied. The objective of this study was to assess, using physiological and psychological indices, the effects of mechanical bathing care for patients in the terminal stage of cancer. Methods Mechanical bathing was performed using a Marine Court SB7000 in a supine or semi-seated position. The heart rate variability analysis method was used to measure autonomic nervous system function. The patients' state of anxiety was assessed using the State-Trait Anxiety Inventory (STAI), a psychological index, and patients' verbal responses were also collected after mechanical bathing. Results Twenty-four patients were enrolled in this study. Their sympathetic and parasympathetic nervous activity did not differ before and after bathing. A significant difference was found between pre- and post-bathing anxiety, as evaluated by STAI (P < 0.0001). In the patient's verbal responses that was collected, the most frequently mentioned descriptors were 'comfortable' and 'relaxed'. Patients were more relaxed after mechanical bathing according to STAI evaluation and their verbal responses. Conclusions The findings suggest that the method of bathing used in this study is safe and pain-relieving for terminal stage cancer patients. It is thus possible to provide safe and comfortable care for terminal stage cancer patients using mechanical baths.

Objective: To clarify the physical and psychological effects of head massage performed in the supine position using Ayurveda-based techniques (head treatment). Design: Twenty-four healthy female students were included in the study. Using a crossover study design, the same participants were enrolled in both the head treatment intervention group and control group. There was an interval of 1 week or more between measurements. Outcome measures: The physiologic indices measured included blood pressure and heart rate fluctuations (high frequency and low frequency/high frequency). The psychological markers measured included liveliness, depression, and boredom using the visual analogue scale method. State anxiety was measured using the State-Trait Anxiety Inventory method. Results: The parasympathetic nerve activity increased immediately after head treatment. Upon completion of head treatment, the parasympathetic nerve predominance tended to gradually ease. Head treatment boosted freshness and relieved anxiety. Conclusions: The results suggest that head treatment has a relaxing and refreshing effect and may be used to provide comfort.

基礎看護学実習における効果的な実習展開方法を明らかにすることを目的に,実習目標の達成度と実習目標に関連する要因を検討した.1)実習目標の達成度は,高い順に「健康障害とそれに伴う生活の変化の理解」,ついで「日常生活援助の実施と評価」,「看護上の問題の明確化・看護計画の立案」であった.2)実習中の悩み体験は約9割,実習環境に関連した困難点は約3割の学生があったとしていた.その具体的な内容は,患者との関係作りや患者とのコミュニケーション,自分の知識や技術の不足,援助の方法,実習日程や実習記録,自己の性格や行動傾向に関する内容であった.3)「日常生活援助の評価」の行動目標は実習中の悩み体験と,「適切な情報収集の実施」の行動目標は実習環境に関連した困難点と有意に関連していた.4)「健康障害とそれに伴う生活の変化の理解」と「看護上の問題の明確化・看護計画の立案」の実習目標は,患者とのコミュニケーションの達成度と有意に関連していた.以上のことから,実習指導においては,実習中の悩みや困難点になりうる患者-看護学生関係に着目し,患者と良好な関係が成立するようコミュニケーションを中心とした支援が必要であることがわかった.また,学習課題や実習日程の検討の必要性が明らかとなった.

看護継続教育における看護理論を用いた事例検討の学習効果を明らかにすることを目的として,病院の院内研修を受講した看護師を対象に研修終了後のレポートを分析した.その結果,看護師は,看護理論を用いて看護実践を省察することで,新たな視点から患者や看護の方向性を捉えることができていた.臨床現場を経験してから帰納的に看護理論を学ぶことの有効性と,看護のキャリア形成への効果も示された., To clarify the learning effect of a case study using nursing theories in continuing nursing education, we analyzed reports submitted by nurses who had participated in in-service education after their completion of the training. From the analysis, we found that the nurses had successfully identified trends in patients and future directions for nursing from a new perspective by reviewing their nursing practice with reference to nursing theories. Some reports indicated the effectiveness of the inductive approach of learning nursing theories after experiencing the job sites and the effects of the career development on nursing.

Fundamental nursing practice, the first step of clinical practice, is important for nursing students to facilitate their early, gradual introduction to clinical practice. As part of this fundamental nursing practice, first-year students have been exposed to nursing practice on one day in June for the past 4 years. Factors related to the effects of this early exposure of students to fundamental nursing practice on their learning and levels of satisfaction with this style of clinical practice were investigated based on their self-evaluation. 1) Students' relevant experiences before entering the college included admission to a hospital (31.6%) and one-day nursing experience (48.8%). 2) Nursing roles they had successfully observed included monitoring/recording/reporting, understanding the patient, daily life support, ensuring security and safety, environmental adjustment, respecting the patient's independence, empathizing with the patient, assistance during treatment, mental support, cooperating with other professions, and guiding the patient. 3) The achievement levels of the practice goals "to observe the site of nursing practice" (p