Lower-limb warming improves sleep quality in elderly people living in nursing homes.

Sleep disturbances are common in older people. This study was conducted to examine the effects of a hot pack, which was used to warm the lower limbs, on the sleep of elderly people living in a nursing home. This is a prospective cohort involving seven elderly women. Subjects aged 74-93 years old were treated by warming the lower limbs for 40 minutes using hot packs every night over 8 weeks. A hot pack made of a dense polymer and warmed in a microwave oven was used as a warming device. In the first and last week, the subjects were required to wear an activity monitor to determine their sleep-awake status. During the second to ninth week, they received limb-warming treatment by a hot pack heated to 42ºC for 40 min every night. Surface skin temperature data were collected by thermographic measurement. As a result, lower-limb warming by a hot pack significantly improved the quality of sleep in the subjects. During warming, the surface temperature of the hands and face rose by approximately 0.5-1.5ºC. This study showed that lower-limb warming with a hot pack reduced sleep latency and wake episodes after sleep onset; thus, improving the quality of sleep in elderly people living in a nursing home.

Efficacy of complete decongestive therapy (CDT) on edematous rat limb after lymphadenectomy demonstrated by real time lymphatic fluid tracing.

Although complete decongestive therapy (CDT) is considered to reduce the volume of lymphedema, there is no concrete evidence to sustain its efficacy. The purpose of the present study was to find new evidence of CDT based on visualizing the changes of lymph fluid accumulating in an edematous limb using indocyanine green (ICG) fluorescent lymphography in real time.Twelve lymphedema rats were divided randomly into two groups. On the first day, ICG was injected into an edematous limb of rats, and no-intervention and CDT was applied to groups 1 and 2, respectively, for two weeks. ICG lymphography and circumferential measurements were done every two days in each two-week observation. The results indicates that a fluorescent flow to the ipsilateral axillary fossa was identified in all rats. In addition, network-like and dermal backflow patterns were observed in the lower legs and thighs. While manual lymph drainage was applied in the CDT group, the flow moved more rapidly through this pathway than that in the no-intervention group. An area of high-intensity fluorescent signals concentrated around the injection sites diminished in the CDT group more than that in the no-intervention-group after two weeks. Circumferential lengths of the edematous limbs were longer than the non-edematous limbs in both groups 1 and 2 on the day of ICG injection. The no-intervention group 1 showed no significance differences during 14 days, whereas the CDT group 2 exhibited very significant differences. These results suggest that CDT has beneficial effects in lymphedema treatment.

Needs of ambulatory patients with cancer who visited outpatient units in Japanese hospitals.

PURPOSE/OBJECTIVES: To document the domains and properties of the self-reported needs of ambulatory patients with cancer. DESIGN: Descriptive. SETTING: Outpatient units in three general hospitals in Japan. SAMPLE: 139 ambulatory patients with cancer. METHODS: The data were collected using questionnaires. Five theoretical groups, which were composed of 30 items, were extracted empirically as domains. Alpha coefficients for each domain ranged from 0.70-0.89. Relationships between each domain and other variables and among the domains themselves were examined. MAIN RESEARCH VARIABLES: Expressed needs of ambulatory patients with cancer, their backgrounds, medical and treatment characteristics, and physical functioning. FINDINGS: All domains for patient needs, except for healthcare needs, were negatively correlated with the level of their physical function. Emotional, physical, and functional needs were positively correlated with the frequency of visiting an outpatient unit. Compared with other needs, adaptation needs were greater for patients who were employed or within three months of discharge. Among patients with one of three cancer sites (i.e., breast, stomach, and colorectal cancers), the needs for individualized care were the lowest for patients with colorectal cancer and highest for patients with breast cancer. CONCLUSIONS: From the needs that ambulatory patients with cancer expressed, five domains were derived. Those domains had relationships with other variables. IMPLICATIONS FOR NURSING: The findings shed light on a segment of ambulatory cancer nursing and may be useful when developing and testing programs needed in the future.