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Purpose: This study analyzed the influence of walking ability and physical condition on fatigue and anxiety at hospital discharge in patients receiving hematopoietic stem cell transplantation (HSCT). Method: A total of 25 subjects were assessed after receiving HSCT until discharge. The Japanese Cancer Fatigue Scale and the State-Trait Anxiety Inventory were used to assess fatigue and anxiety. Relationships of fatigue and anxiety status respective to walking ability variables: leg muscle strength (knee extension, ankle plantar flexion and ankle dorsiflexion strength) and average number of daily steps, and physical condition variables (food intake, febrile days, body mass index, and serum albumin) were examined with correlations and stepwise multiple regression analysis. Results: Subjects with later achievement of adequate food intake after HSCT (β = 0.62) and weaker knee extension strength per body mass at discharge (β = -0.42) reported higher fatigue (adjusted R 2 = 0.53, p = 0.00). Knee extension strength per body mass at discharge was correlated with an average step-count from 51 to 80 days after HSCT (r = 0.51, p = 0.01). In subjects whose Body Mass Index was above 23.5, weaker ankle dorsiflexion strength per body mass prior to transplantation reported higher fatigue at discharge (adjusted R 2 = 0.97, p = 0.00). Subjects with later achievement of food intake after HSCT (β = 0.59) and more days with fever reported higher anxiety (adjusted R 2 = 0.47, p = 0.00). Conclusion: Post-HSCT fatigue was affected by a delay in adequate food intake and diminished muscle strength. The results of this study show the importance of encouraging walking for maintaining muscle endurance. © 2011 Elsevier Ltd. Source

Okubo N.,St. Lukes College of Nursing
Journal of Neuroscience Nursing | Year: 2011

The purpose of this research was to document and compare the before and after levels of consciousness of patients with prolonged consciousness disturbance (PCD) who sat for a specified length of time in a specially designed backless chair (Suwarou-Kun). Three patients were selected as participants using the PCD criteria described by Jennet and Plum in 1972. The Kohnan Vegetative Score (henceforth referred to as the Kohnan PCD Scale) and electroencephalography (EEG) measurements, together with direct observation of subtle changes, were used to record each participant's overt behavior and autonomic responses. A single-case observation/intervention time series design was used in this study. Length of exposure to the intervention and mean exposure time per session were as follows: case 1, 65 days and 30 minutes; case 2, 36 days and 11 minutes; and case 3, 43 days and 36 minutes. The Wilcoxon's rank sum test was used to analyze the pair of Kohnan PCD Scale and EEG scores collected before and at the midway point of each intervention session. Because more than two variables were being measured, the data were reanalyzed using repeated-measure analysis of variance. In cases 2 and 3, there were significant differences in the Kohnan PCD Scale and EEG scores during the ''sitting without back support position'' (SB) intervention period as well as at the midway point of each session (p G .05) compared with the measurements taken before the intervention. In all three cases, there also were subtle changes during the intervention, for example, eye movement, finger or thumb movement, strength of voice, and salivation. Alpha and beta waves were greater after the introduction of the SB intervention and preceded the behavioral response changes. The SB intervention resulted in at least some improvement in the level of consciousness for each participant. It remains an open question, however, whether longer exposure would have brought about further change. The SB intervention is costly in terms of human time and effort, and its beneficial effects beyond those measured in this study will require additional research. © 2011 American Association of Neuroscience Nurses. Source

Kamei T.,St. Lukes College of Nursing
Japan Journal of Nursing Science | Year: 2013

Aim: This paper discusses how nurses can utilize information and communication technology (ICT) to provide care to patients with chronic diseases who are receiving home care, with particular focus on the development, basic principles, research trends, recent evidence, and future direction of telenursing and telehealth in Japan and overseas. Methods: This review was based on a published work database search. Results: Telenursing and telehealth use telecommunications technology to provide nursing care to patients living at a distance from healthcare facilities. This system is based on patient-nurse interaction and can provide timely health guidance to patients in any area of residence. Because of the increase in the rate of non-communicable diseases, the World Health Organization established and adopted a resolution (WHA58.28) to promote the e-health program, which uses ICT. This strategy, which was introduced throughout the world from the 1990s up to 2000, was used for the healthcare of patients with chronic diseases and pregnant women and was implemented through cooperation with various professionals. A telenursing practice model has been reported along with the principles involved in its implementation. Conclusion: Telenursing and telehealth are effective in decreasing the costs borne by patients, decreasing the number of outpatient and emergency room visits, shortening hospital stays, improving health-related quality of life, and decreasing the cost of health care. © 2013 Japan Academy of Nursing Science. Source

Asai H.,St. Lukes College of Nursing
Japan Journal of Nursing Science | Year: 2011

Aim: To identify the predictors of nurses' family-centered care (FCC) practises in neonatal intensive care units (NICUs) in Japan. Methods: A quantitative cross-sectional survey was conducted by administrating a self-reported questionnaire to 30 nurse managers and 710 staff nurses in 30 NICUs in Japan. A facility-level questionnaire, including items about the philosophy, policies, and environment of the NICU, was administered to the nurse managers. The Japanese version of the Measure of Processes of Care for Service Providers and the Japanese version of the Measure of Beliefs about Participation in Family-Centered Service were administered to the staff nurses to assess their practise of FCC and their beliefs about FCC, respectively. The data were analyzed with descriptive statistics and multiple regression analyses. Results: Self-efficacy, neonatal care experience, FCC principles, and a 24h parental visiting policy were significant predictors of the practise of FCC. Moreover, neonatal care experience, nursing support for the family to participate in the child's care, and visits by siblings were significantly associated with nurses' self-efficacy to implement FCC. Conclusion: Nurses' self-efficacy and hospital policies, including family visitation and participation in the child's care, were associated with nurses' FCC practises. These results suggest that educational programs to promote nurses' self-efficacy are essential and that organizational support is a key component in implementing FCC. © 2010 Japan Academy of Nursing Science. Source

Setoyama Y.,St. Lukes College of Nursing
Journal of medical Internet research | Year: 2011

Web 2.0 has improved interactions among peers on the Internet, especially for the many online patient communities that have emerged over the past decades. Online communities are said to be particularly beneficial peer support resources for patients with breast cancer. However, most studies of online patient communities have focused on those members who post actively (posters), even though there are many members who participate without posting (lurkers). In addition, little attention has been paid to the usage of online communities among non-English-speaking patients. The present study explored the differences in peer support received by lurkers and posters in online breast cancer communities. It also examined the effects of such support on both groups' mental health. We conducted an exploratory, descriptive, cross-sectional, Web-based survey among members of four Japanese online breast cancer communities. In an online questionnaire, we asked questions regarding sociodemographics, disease-related characteristics, mental health, participation in online communities, and peer support received from those communities. Of the 465 people who accessed the questionnaire, 253 completed it. Of the respondents, 113/220 (51.4%) were lurkers. There was no significant difference between lurkers and posters with regard to sociodemographic variables. About half of the posters had been given a diagnosis of breast cancer less than a year previously, which was a significantly shorter period than that of the lurkers (P = .02). The 5 support functions extracted by factor analysis were the same for both posters and lurkers. These were emotional support/helper therapy, emotional expression, conflict, advice, and insight/universality. When the support scores were calculated, insight/universality scored highest for both posters and lurkers, with scores that were not significantly different between the two groups. Among the 5 support scores, emotional support/helper therapy and emotional expression were significantly higher among posters. For posters, emotional support/helper therapy and advice were negatively correlated with the anxiety subscale of the Hospital Anxiety and Depression Scale. Emotional expression, advice, and insight/universality were negatively correlated with the anxiety subscale for lurkers. We found that posters felt they received more benefits from online communities than lurkers did, including emotional support, helping other patients, and expressing their emotions. Yet even lurkers were found to gain a certain amount of peer support through online communities, especially with regard to advice and insight/universality. The results demonstrate that participation in online communities--even as a lurker--may be beneficial to breast cancer patients' mental health. Source

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