Attitudes and Barriers of Physicians toward Palliative Care in Critical Care Setting:Qualitative Content Analysis Using Open-ended Data from Nationwide Self-administrated Questionnaire Survey in Japan

Purpose: Palliative care implementation should take into account the perceptions and acceptability of healthcare providers. This study aimed to identify physicians’ perceptions of palliative care and barriers to palliative care practice in the critical care setting. Methods: A nationwide, self-administered questionnaire was distributed to physicians working in intensive care units, and free-text data were qualitatively analyzed. Results: The questionnaire was sent to 873 respondents, and 436 responded (50% response rate). Of these, 95 (11%) who responded to the open-ended sections were included in the analysis. Conclusion: Japanese physicians working in ICUs recognized that palliative care was their role and practiced it as part of their usual care. They felt, however, that the practice was difficult and not sufficient. Barriers to practice included the lack of human resources and availability of palliative care teams, and the lack of uniformity in the perception of palliative care in the critical care setting.

Survey of Students’ Attitudes Toward Identifying Diseases That Can Be Effectively Prevented Using Genetic Analysis and the Effect of the Act of Answering a Multiple-Choice Questionnaire on the Improvement in the Knowledge of Disease Prevention / 社会薬学

A survey of pharmacy students’ and liberal arts students’ attitudes toward identifying diseases that can be effectively prevented using genetic analysis was performed using a multiple-choice questionnaire. We defined the diseases that can be prevented using genetic analysis and found that, for these diseases, the rate of selecting “do nothing” by people with disease-related genes was significantly lower than that of people for whom the genetic influence was unknown. We found that the nine conditions that we investigated (i.e., obesity, high blood pressure, diabetes, hypercholesterolemia, hypocholesterolemia, hypertriglyceridemia, arteriosclerosis, cancer, and liver disease) are diseases that can be effectively prevented using genetic analysis for all students. We also observed that the most common answer for disease prevention was related to dietary changes (including drinking restrictions). In conclusion, through our unique questionnaire, we identified various diseases that can be effectively prevented using genetic analysis. However, it was found that the act of answering a multiple-choice questionnaire does not improve knowledge of disease prevention measures. Therefore, we propose that, after the questionnaire, it is important to distribute written material that explains the cause of life-style-related diseases and their prevention in order to foster knowledge about disease prevention.

Making of the Condition Change Scenario Programs Aiming at Problem-based Learning using a Patient Simulator and Enforcement of the Workshop / 社会薬学

We developed a program to generate scenarios of pathological changes for problem-based learning (PBL) in a physical assessment workshop using the patient simulator, "Physiko^®”. With these programs, PBL-style case experiencing also became possible by actually performing physical assessment on “Physiko^®” using a stethoscope while presenting information such as the patient background. The results of a survey conducted during the physical assessment workshop showed that participants were significantly interested in simulation-based education. However, the results also revealed a lack of understanding of technical terms used in physical assessment, suggesting the need to urgently facilitate not only the acquisition of basic skills to monitor vital signs but also that of symptomatology knowledge in order to understand technical terms and pathological characteristics.

A survey of awareness and knowledge of human papillomavirus vaccination in schoolgirls and their parents / 日本プライマリ・ケア連合学会誌

<b>Objective</b> : To investigate the knowledge of cervical cancer and human papillomavirus (HPV) vaccination amongst vaccinated schoolgirls and their parents.<br><b>Methods</b> : All schoolgirls age range 12 to 18 years who received HPV vaccination and their parents, answered a questionnaire concerning the knowledge of HPV, cervical cancer, and vaccine provision at nine primary care clinics in Gifu Prefecture, Japan.<br><b>Results</b> : A total of 66 schoolgirls and 57 parents completed the questionnaire. A large proportion of the schoolgirls received information from their schools and their families regarding HPV. Many parents derived information about HPV from their local governments, television commercials, and their children's schools. Half of the schoolgirls were concerned about their decision to receive the HPV vaccination. Fifteen percent of them were hesitant to receive the vaccination because of the fear of pain. However, none of them were concerned about possible infertility or miscarriage. Fifteen percent of the schoolgirls and fifty-four percent of the parents acknowledged that cervical cancer is caused by HPV. Forty-one percent of the schoolgirls and seventy-nine percent of the parents reported that cervical cancer is a sexually transmitted infection. Twenty-one percent of the schoolgirls and sixty-three percent of the parents knew that a medical examination exists for detection of cervical cancer, whereas seventy-one percent of the former and ninety percent of the latter reported that the schoolgirls should receive an appropriate medical examination.<br><b>Conclusion</b> : Currently, schoolgirls' knowledge of the HPV vaccine in the Gifu area of Japan is inadequate and therefore, it is imperative to provide better healthcare education.

Support of physical therapy education in health sciences university of Mongolia / Монголын Анагаах Ухаан

Purpose: To do the support of physical therapy education in Health Sciences University of Mongolia (HSUM), the attitude survey concerning rehabilitation and physical therapy was done to the students. The purpose of this study was to examine the effect and the problem in the future of support of education in Mongolia. Method: The support of physical therapy education was begun in HSUM in July 2007, and the special lecture and practice to the specialized subjects were done in March 2009. In addition, the attitude survey concerning rehabilita¬tion and physical therapy was done to the students in Department of Physical Therapy. RESULTS: Curriculums of Department of Physical Therapy were 136 units, and special lectures and practices of Gunma University were nine subjects, 18 units. In the third grader and the fourth grader that attended the lectures of the specialized subjects, the understanding level concerning rehabilitation and physical therapy were high. Conclusion: It is though that it came to be able to do the multipronged idea because not only physical therapy but also the understanding of another occupational category increased as effect of the support of education. It is future tasks to clarify the understanding level of the contents and skills of physical therapy.

Activities and attitudes of standardized patients in the objective structured clinical examination: The second report of a nationwide survey / 医学教育

The role of standardized patients (SPs) has developed rapidly over the last10years because of medical education curriculum reform and the introduction of the objective structured clinical examination (OSCE). As the participation of SPs in medical education has increased, the anxieties and frustrations of SPs have also increased. We believe that an understanding of the attitudes of SPs would improve the quality of their activities. The purpose of this survey was to study the activities and psychological needs of Japanese SPs in the OSCE.<BR>1) The response rate to the nationwide survey was62% (332of532SPs).<BR>2) Role-playing and group discussion were the most common training methods, and the length of training varied from 0 to 40 hours.<BR>3) The factors that SPs felt difficult were judging how much to respond in their performances (73%) and maintaining consistent standards in evaluating examinees (66%).<BR>4) Our results suggest that SPs require more training and that the number of SP educators should be increased.

An Attitude Survey for Nursing Care Managers on Acupuncture and Moxibustion Therapy in Nursing Care Plans / 全日本鍼灸学会雑誌

[Purpose]To investigate the present use of medical expenses for acupuncture and moxibustion, and judo and massage therapies under the health insurance system in contracted nursing care plans prepared by nursing care managers.<BR>[Methods]The subjects were 75 nursing care service providers who were registered in a certain municipally (B City) with an aging index of 27.7%. We investigated the experience and use of medical expenses for acupuncture and moxibustion therapy through a mail survey. The survey period was from July 10 to July 31 in 2006. The collection rate was 57.3%(43out of 75 nursing care service providers). We used simple adding, the Kruskal-Wallis test, factor analysis (principal factor method) and path analysis.<BR>[Results]In simple adding, there were 3,535 total care receivers, 11.5%of the total aged population in B City. Users who took acupuncture and moxibustion therapy were 2.5%of the total care receivers in nursing care plans. However, 10 people could not take acupuncture and moxibustion therapy due to their economic conditions. Nine out of 41 nursing care service providers (22.0%) had users who could not take acupuncture and moxibustion therapy because their healthcare facilities would not sign the written informed consent. In factor analysis (principal factor analysis), "experience and recognition of acupuncture and moxibustion therapy using medical expenses"was extracted as the first principal component. In pass analysis, it can be explained that nursing care managers who planned acupuncture and moxibustion therapy using medical expenses had recognized that the therapy would maintain the capabilities for activities of daily living (ADL) and quality of life (QOL) of the users.<BR>[Conclusion]When nursing care managers planned acupuncture and moxibustion therapy for maintenance of ADL and QOL in their care services using medical expenses, they were considered to have recognized that the therapy would keep the users'ADL and QOL.

Relationships between the attitude on moxibustion treatment and moxa weight-Investigation of students and visitors to the school- / 全日本鍼灸学会雑誌

[Purpose] People have various mental images of moxibustion treatment. The purpose of this study was to investigate relationships between weight of moxa and perceptions of moxibustion treatment.<br>[Methods] We administered a questionnaire survey on moxibustion to 75 new students and visitors to this college. Furthermore, we instructed subjects to make a moxa as they imagined it would be used in moxibustion treatment, then measured these moxa.<br>[Result] The questionnaire survey had many replies indicating that moxibustion is associated with images of “hot”, “scar remains”, and “effective”.<br>Comparing the weights of moxa made by people with moxibustion experience to those made by people with no moxibustion experience, moxa was lighter for the experienced group than for the inexperienced group.<br>Furthermore, when weight of moxa was compared based on images of moxibustion, only moxa of the group with positive images of moxibustion tended to be light.<br>[Conclusion] Image size of the moxa appears to be connected with impressions and experiences of moxibustion treatment.