ABSTRACT
Introduction: We aimed to clarify the characteristics of the activities of nurses who provide end-of-life care to users of small-sized multifunctional in-home care services (SMICS) and consider effective end-of-life care for elderly persons who use SMICS.Methods: Semi-structured interviews were conducted with 16 nurses who belonged to SMICSs, and the results were analyzed qualitatively and inductively.Results: The nurses provided four core categories of support: "support so that the elderly person and their family can spend a better end-of-life period together while maintaining their everyday lifestyle," "support so that the family and care staff can deal with the elderly person's dying process," "support so that the elderly person or their family can clarify where and how they want to spend their end-of-life and fulfillment of their wishes," and "provision of medical care suitable for the wishes of the elderly person or their family and disease conditions." Conclusion: The results indicated that nurses supported the elderly and their families by clarifying the care they desire and to support the elderly person, their family, and those who assist them in daily living. In addition, nurses should help not only toward maintenance of daily living but also adapt the medical system so that the elderly person can spend their end-of-life period in a familiar place.
ABSTRACT
<p><b>Introduction: </b>The University of Tsukuba has a one-week in-home care course combining a problem-based learning style tutorial and lectures in the comprehensive community-based learning curriculum for 2<sup>nd</sup> year students. This study aimed to investigate what medical students are learning concretely from this course.</p><p><b>Methods: </b>We performed a qualitative date analysis of the contents of all 111 student course reports written in the free description using a modified Steps Coding and Theorization method employing the framework of patient-centered clinical method (PCCM).</p><p><b>Results: </b>Medical students learned with keen interest based on their experiences and in the framework of PCCM such as 'Exploring health, disease and the illness experience', 'Understanding the whole person'. These processes led to the awareness of responsibility as a physician.</p><p><b>Conclusion: </b>The in-home care course in the classroom may provide medical students with an opportunity to become aware of their responsibility as a physician.</p>
ABSTRACT
<b>Purpose</b>: The present study was conducted to elucidate the gap in awareness of experience of care management and the actual work of being responsible for this field by spotlighting on the attributes of of case managers and who are in charge of care management of terminal cancer patients at home.<br><b>Methods</b>: Anonymous individual style questionnaire investigation was conducted against a target of 443 care managers.<br><b>Results</b>: 70.3% had experience being in charge of terminal cancer patients and there was a significant difference in that this was found in those of more than 5 years of experience and among those of full timer status. As for experience in regard to those with or without experience being in charge by basic type of job, there was not much significant difference.<br>As for awareness regarding being in charge of terminal cancer patients, those who felt “I want to avoid it”, remained in 25% and found more in non-fulltimers (P<0.05). As for those who thought that “health care providers are more suited to be in charge”, this was found in 70% of health care providers and 40% in welfare related individuls (P<0.05) and a significant difference was noted. As for awareness of “should not depend on specific profession and should be done fairly among professions and which was found in 80% of those who have less than 5 years among care support specialist profession and hence compared to those with more than 5 years, it was many, and a significant gap was found. Regarding need of education and training about care management of terminal cancer patients, 95% agreed there is.<br><b>Conclusion</b>: Approximately 70% of all had experience with terminal cancer patients and particularly, among those with over 5 years as care support specialist, it became clear that full timers were in charge. However, about awareness of being in charge of care management, it became clear that there was an positive attitude toward who takes in charge without being restricting to specific individuals and not selecting by number of years of experince as care managers nor by basic job types. Therefore, it can be concluded that opportunity for education and training about care management of terminal cancer patients and consolidating education environment for self training is important.
ABSTRACT
This study is to evaluate the decubitus ulcer healing effect of occlusive dressing with hydrocolloid and traditional dry dressing for home care nursing clients. Study design was quasi-experimental pre-post test design. Control group(15 person) was treated decubitus wound with traditional dry gauze dressing, and experimental group(17 persons) was treated decubitus ulcer with occlusive dressing with hydrocolloid and calcium alginate(17 persons). Study period was from 8/1/97 to 12/31/97. Subject subjects was 17 males and 15 females with 2nd phase over decubitus ulcer aged 30 to 70 who have been registered as home care nursing clients in Nurse's Association in Seoul city. Outcome variables were stages, size of decubitus ulcer, pain at dressing time and exudate amount. Study result as follows. Occlusive dressing with hydrocolloid was superior to traditional gauze dressing decreasing ulcer size and phase, and shortening treatment period. Dressing change of occlusive dressing was easier than that of traditional gauze dressing. In conclusion, occlusive dressing was recommended to treat decubitus ulcer in home care patients even if hydrocolloid is expensive to gauze dressing because of treatment effect and easiness of dressing.