RESUMEN
A working group, established by the Japanese Board-certified Physiatrist Association to examine the necessary functions for an electronic medical record keeping system for rehabilitation, created a functional evaluation system for electronic medical record keeping in kaifukuki rehabilitation wards. The group conducted a survey to determine how electronic medical records are actually being used in kaifukuki rehabilitation wards. Methods : The group sent questionnaires to 153 hospitals with kaifukuki rehabilitation wards by mail. The questions included the period of usage, how satisfied they were with their system, and a self-evaluation form for their electronic medical record functional evaluation. They asked the respondents to evaluate each item from 1 to 5 points. Results : The group received answers from 82 institutions, with a valid answer rate of 53.6% in total. The median of the electronic record functional evaluation was 60.5 points. The points given varied from 1 to 5 in all items. Conclusion : It was determined that electronic medical records are equipped with a minimum of functions for rehabilitation, but also that there are great functional differences among institutions.
RESUMEN
The factors that influence the risk of accidents during the replacement of gastrostomy catheters remain unknown and therefore have not yet been thoroughly investigated. We conducted a nationwide questionnaire survey of 415 rehabilitation-training facilities for the replacement of gastrostomy catheters. We received 221 valid responses. Among the catheter replacement methods submitted, the bumper button replacement method was the most widely chosen, comprising 40% of the valid responses. The measures used to prevent accidental erroneous catheterization included examination of the stomach contents, endoscopic examination of the stomach, and the detection of insufflation sounds, although these measures varied widely among the facilities. Fifty-one out of the 221 facilities that responded to the survey experienced various mishaps, of which 20 were due to erroneous catheterization. In approximately 40% of the facilities, there was no operative manual for the replacement nor was the patient's consent taken before performing the procedure. This investigation elucidates the risks involved in the replacement of gastrostomy catheters. This survey also suggests that the methods used for catheter replacement should be re-examined to prevent accidents during the replacement.
RESUMEN
We report a 47-year-old right-handed male patient with pure word deafness after suffering an intracerebral hemorrhage. He had been working as a high school teacher before the onset of his stroke. He was emergently admitted to our hospital due to left putaminal hemorrhage and treated conservatively after admission. The patient's neurological findings showed that although his auditory comprehension was severely impaired, he was still able to communicate using written language. Pure-tone audiometry didn't detect any sensorineural hearing impairment. After the diagnosis of pure word deafness was clinically made, we educated the patient and his family, as well as the associated medical staff at our department, about this condition so that they could understand his pathological situation. In addition, we introduced a rehabilitation program for lip-reading and showed him a technique for using articulatory voice production in usual conversation. As a result of our attempts, he developed the ability to communicate using lip-reading skills after 2 months of rehabilitation and successfully returned to his previous work because of the communicative competence he acquired. We also make some proposals for helping other patients with auditory agnosia to return not only to their regular daily activities but also to return to gainful employment, as patients with this condition seem to have special difficulties benefiting from the present welfare service system in Japan.