RESUMO
Our ward encounters many cases (approximately 80 every year) requiring end-of-life care. The experiences of nurses, as well as of patients’ families and friends, vary widely and nurses appear to be anxious about providing mortuary care, known as Angel care. There is no standardized manual, and therefore medical care professionals need to optimize good Angel care practices in order to alleviate nurses’ anxiety around the issue. We administered a questionnaire regarding the situation of Angel care to 208 ward nurses in our hospital and extracted difficulties in providing Angel care reported by the 173 respondents. Less than 5% of nurses, regardless of length of nursing experience, experienced no anxiety. Nurses found it difficult to conduct basic technical procedures: 51.7% had difficulties in closing the deceased patient’s mouth and 40.2% had difficulties judging whether the results of mortuary makeup resemble antemortem appearance. Ninety-five percent of nurses wished to study Angel care in the future should learning materials be available. In conclusion, more than half of nurses were anxious about providing Angel care regardless of length of their nursing experience and number of cases handled. Nurses are greatly interested in Angel care and wish to learn more if learning materials are made available.
RESUMO
Exercise therapy as well as diet therapy, is fundamental in the treatment of diabetes mellitus, however, its methods and effects of long term physical exercise therapy has not yet been clarified.<BR>The present study has been designed to evaluate the effects of physical exercise therapy in diabetic patients with fasting hyperglycemia. Ten non-insulin dependent diabetic patients participated in a 6-month physical exercise program consisting of 30 min, of jogging performed 3 times per week (Exercise group) . The exercise intensity represented 40% of estimated Vo<SUB>2</SUB>max.<BR>The following results were obtained:<BR>1. More significant improvement of glucose tolerance and plasma insulin response to glucose load was observed in exercise group as compared with the patients treated with mild caloric restriction alone (Diet group, N=15) .<BR>2. The significant increase in plasma HDL-cholesterol and HDL-cholesterol/total cholesterol ratio was observed only in exercise group.<BR>3. The reduction of body weight in exercise group was significantly greater than that in diet group.<BR>4. The physical exercise also resulted in an improvement of cardiovascular adaptaion to exercise.<BR>5. Improvement of symptoms in daily life activity was also found after physical exercise therapy. However, some medical troubles such as hypoglycemia, muscle pain and arthralgia were found during observation period.<BR>In conclusion, physical exercise therapy is useful as an adjunct to diet to improve metabolic control in patients with diabetes mellitus. And for effective exercise therapy, exercise program must be individualized, and motivation is stimulated by team including physician, trainer, nurse and dietitian.