ABSTRACT
This study aimed to clarify whether a regional palliative care intervention program, the OPTIM project, increased home hospice utilization, and explore the potential association between the home hospice utilization and the hospital staff's perceptions on home care. A questionnaire survey was conducted involving 154 physicians and 469 nurses. The rate of patients who made the transition to home-based care increased 967% in A Hospital, 295% in B Hospital, and 221% in C Hospital in 2010 compared to 2007, which was assumed to be 100. Staff of a hospital where many patients made the transition to home-based care were more likely to agree with the following statements concerning home care perspectives: “I started to consider that even cancer patients can be treated at home until the last moment of their life”, “I usually ask patients whether they wish to receive home-based care”, “We decided on coping strategies for sudden changes in the course of disease and a place to contact in advance”, and “I started to simplify treatment procedures, such as prescriptions during hospitalization for patients and their families to prepare for home-based care“.
ABSTRACT
There are many published studies on postoperative deep venous thrombosis (DVT) which can develop after hip joint arthroplasty, but very few reports are available on the incidence of thigh DVT following or thopedic treatment of transcervical fractures. In this study, therefore, we tried to find out a screening method just right for the early detection of clots that develop in the deep femoral veins after treatment of the feactures in the neck of femurs. Between March and September 1999, a total of 24 patients were operated on for fractures on the cervix of thighbone in our hospital. Of the total, 19 were recruited for this study. The five cases were excluded because some of them were on medication that could affect the coagulation/ fibrinogenolysis factors and some were under management of other departments. After surgery, a series of blood biochemical tests were performed, and changes in the partial pressure of arterial blood oxygen and D-dimer (??) level were examined with the passage of time. In the cases which were suspected to have thrombosis in the veins in the lower extremities by ultrasonography performed six to 18 days after surgery, definitive diagnosis was made by the aid of venography. DVT was found in three in the 19 cases. Routine blood biochemical tests and measurements of oxygen partial pressure in the artery were not so much helpful as were expected in the early detection of thrombosis, whereas measurements of D-dimer levels were considered useful because the levels were well over 20μg/ml one week after surgery in the positive-DVT cases.