Ikuko Miyawaki

Computer-supported indirect-form lifestyle-modification support program using Lifestyle Intervention Support Software for Diabetes Prevention (LISS-DP) for people with a family history of type 2 diabetes in a medical checkup setting: A randomized controlled trial

AIMS To investigate the effect of a computer-supported indirect-form lifestyle-modification program using Lifestyle Intervention Support Software for Diabetes Prevention (LISS-DP), as a clinically feasible strategy for primary prevention, on diet and physical activity habits in adults with a family history of type 2 diabetes. METHODS This was a two-arm, randomized controlled trial: (1) lifestyle intervention (LI) group (n=70); (2) control (n=71). Healthy adults aged 30-60 years with a history of type 2 diabetes among their first-degree relatives were recruited. LI group received three times of lifestyle intervention using LISS-DP during six-month intervention period via mail. RESULTS Lifestyle intervention group showed significantly greater decrease in energy intake six months after baseline, compared to control (-118.31 and -24.79 kcal/day, respectively, p=0.0099, Cohens d=0.22), though the difference disappeared 1 year after from baseline. No difference was found in physical activity energy expenditure. CONCLUSIONS A computer-based, non-face-to-face lifestyle intervention was effective on dietary habits, only during the intervention period. Further examination of the long-term effects of such intervention and physical activity is required.

Development of an evaluation scale for self-management behavior related to physical activity of patients with coronary heart disease

Background: To provide patients with effective self-management education that takes their lifestyle into account, medical personnel need to provide education and evaluation of self-management behaviors which patients can apply to their daily life. Aim: This study aimed to assess the reliability and validity of the evaluation scale for self-management behavior related to physical activity of patients with coronary heart disease (ES-SMBPA-CHD). Methods and results: Outpatients with coronary heart disease (n = 76) completed a self-administered questionnaire supported by a previous study of ours. The ES-SMBPA-CHD was divided into two domains, the first dealing with self-management behavior to enhance physical activity in daily life and the second with behavior to maintain the level of physical activity. Factor analysis showed that the first part comprised four factors and the second five. The ES-SMBPA-CHD was associated with the International Physical Activity Questionnaire (IPAQ) subscales and activity energy expenditure (measured by Lifecorder EX). Cronbach’s α coefficient was between 0.71 and 0.90. The intraclass test–retest correlation coefficient of the subscale was between 0.75 and 0.93. Conclusions: The ES-SMBPA-CHD is reasonably reliable and valid and is expected to prove useful for the assessment of patients’ self-management behavior and for individualized instruction.

A study of the relationships between self-evaluation of physical condition and perception of difficulties of life in ulcerative colitis patients.

This study was conducted to elucidate factors that influence the self-evaluation of physical condition and perception of difficulties of life in ulcerative colitis patients. A survey and clinical examination were carried out in 171 outpatients with ulcerative colitis. Self-evaluation of physical condition was assessed according to a five-grade system. Perception of difficulties of life was assessed using a scale developed by the authors and others. Physical condition of patients was assessed according to their disease state, disease symptoms, and nutritional state. Additional related factors such as mental condition, demographic attributes, and psychosocial states were also investigated. Multiple regression analyses was used to assess the relationships among variables and showed that perception of difficulties of life and disease symptoms were the main explanatory factors for the self-evaluation of physical condition. Perception of difficulties of life was comprised of physical and mental conditions, the latter being further influenced by the patients’ psychosocial state.

Cues for Nursing Diagnosis of Ineffective Self-management of Fluid and Dietary Restrictions in Dialysis Therapy in Japan

PURPOSE We aimed to identify the cues of expert nurses and validate the cue information on the defining characteristics for a nursing diagnosis of ineffective self-management of fluid and dietary restrictions in dialysis therapy in Japan. METHODS We used qualitative interviews and two-round Delphi studies. FINDINGS The expert nurses regarded four signs of unmaintained fluid and dietary restrictions as major defining characteristics and nine other cues as minor defining characteristics. CONCLUSIONS Expert nurses in dialysis therapy regard symptoms of health behavior as major cues for nursing diagnosis of ineffective self-management of fluid and dietary restrictions in dialysis therapy. IMPLICATIONS FOR NURSING PRACTICE Verification of the clinical validity and development of a specific, clinically useful database on nursing diagnoses are required.

Becoming Interprofessional at Kobe University

The importance of collaborative practice and its education have been widely reported globally and nationally. At a local level, staff members’ experiences in the field after a natural disaster and their clinical work contributed significantly to the development of an interprofessional education/learning (IPE/L) program at Kobe University. From the first pilot classes in 2002, an IPE program evolved. This program is now fully integrated into the 4-year undergraduate curriculum at the Faculty of Health Sciences and into the 6-year curriculum of the School of Medicine. Student learning in this IPE/L program is interactive, experientially based, and predominantly conducted in interprofessional group settings.

P-250 Quality of Life and Mood Disturbance During the First Year of Patients with Implantable Cardioverter Defibrillators

Method: (1) A total of 43 patients with CHF treated at home for 2 years were enrolled in the study from among 115 patients admitted to the CCU of A Hospital due to acute CHF. Patients were treated with drugs, moved to an internal medicine ward, and then discharged. (2) The SF-36 questionnaire was used to measure health-related QOL at discharge and at 1 year (1 year) and 2 years after discharge (2 years). Self-care activities of patients were observed at the same time QOL was measured. Result: (1) At 1 year and 2 years, seven (physical functioning, bodily pain, general health perception, vitality, social functioning, role-emotional, and mental health) of the eight SF-36 subscales were significantly lower than the scores at discharge. (2) Self-care items related to regular exercise and abstaining from smoking were improved at 2 years. Until now, it was thought that QOL in patients with CHF gradually deteriorated after discharge due to repeated hospital admissions. In the present study, patients with CHF practiced self-care activities at home for 2 years after discharge; however, QOL in these patients at 2 years was not improved compared to QOL at discharge. Patients’ self-care activities should be more closely studied in order to identify practices that can effectively improve QOL in patients with CHF receiving at-home care.