Kiyoko Kanda

Bathing before sleep in the young and in the elderly.

Abstract In this study we investigated the effects of bathing on the quality of sleep in 30 elderly people (ages 65–83 years) and in 30 young people (ages 17–22 years) in their homes. Room temperature did not vary significantly during the nights that data were acquired, ranging from 8 to 12°C. After bathing and at the beginning of sleep, the mean (SE) rectal temperatures of the young and the elderly were 37.8 (0.08) and 37.5 (0.07)°C, respectively, and were higher by 0.7 (0.13) and 0.6 (0.07)°C, respectively, than when the subjects had not bathed. At the beginning of the sleep after bathing in the young subjects, skin temperature was 32.5 (0.24) and 1.5 (0.34)°C higher than when those subjects had not bathed. In the elderly, however, there were no significant differences in skin temperature with and without prior bathing because they used electric blankets during sleep. After bathing, the young people reported “warmth” in their hands and/or legs, while the elderly more often reported “good sleep” or “quickness of falling asleep”. During the first 3 h of sleep, body movements were less frequent after bathing for both the young and the elderly subjects. The results suggest that a bath before sleep enhances the quality of sleep, particularly in the elderly.

Development and Validation of a Chemotherapy-Induced Taste Alteration Scale

PURPOSE/OBJECTIVES To develop an instrument to assess the specific symptoms of chemotherapy-induced taste alterations. DESIGN Cross-sectional study. SETTING Two outpatient chemotherapy centers in Kanto, Japan. SAMPLE Convenience sample of 214 adult patients with chemotherapy-induced taste alterations. METHODS Items on the chemotherapy-induced taste alteration scale (CiTAS) were developed by a qualitative study of patients with taste alterations, and the content validity of each item was assessed by a panel of specialized oncology nurses. Data were analyzed for item consistency using Cronbach alpha and construct validity using factor analysis. MAIN RESEARCH VARIABLES Taste alterations, symptoms of discomfort, and impact of taste alterations on daily life. FINDINGS An 18-item scale was developed with four dimensions identified through factor analysis: decline in basic taste, discomfort, phantogeusia and parageusia, and general taste alterations. The scale demonstrated excellent reliability (Cronbach alpha = 0.9) and test-retest reliability (r = 0.94, p < 0.001, n = 28), as well as good validity, which was indicated by its strong correlation with a visual analog scale of the impact of taste alterations on daily life (r = 0.62, p < 0.001) and by negative correlations with Short Form-8 quality-of-life measures (physical component summary, r = -0.33; mental component summary, r = -0.47). CONCLUSIONS The CiTAS enabled valid, reliable measurement of specific symptoms of chemotherapy-induced taste alterations. The CiTAS has potential as a clinical tool and also could be used as a measure of chemotherapy-induced taste alterations in future studies. KNOWLEDGE TRANSLATION The CiTAS may help evaluate the effectiveness of interventions to reduce the symptoms of taste alterations, such as administering zinc and self-care strategies.

Salient features and outline of the joint Japanese guidelines for safe handling of cancer chemotherapy drugs

The purpose of this paper is to introduce the outline and describe the salient features of the “Joint Guidelines for Safe Handling of Cancer Chemotherapy Drugs” (hereinafter, “Guideline”), which were published in July 2015. The purpose of this Guideline is to provide guidance to protect against occupational exposure to hazardous drugs (HDs) to all medical personnel involved in cancer chemotherapy, including physicians, pharmacists, and nurses and home health-care providers. The Guideline was developed according to the Medical Information Network Distribution Service guidance for developing clinical practice guidelines, with reference to five authoritative guidelines used worldwide. PubMed, Cumulative Index to Nursing and Allied Health Literature, Ichushi-Web, and Cochrane Central Register of Controlled Trials were used for a systematic search of the literature. Eight clinical questions (CQs) were eventually established, and the strength of recommendation for each CQ is presented based on 867 references. The salient features of the Guideline are that it was jointly developed by three societies (Japanese Society of Cancer Nursing, Japanese Society of Medical Oncology, and Japanese Society of Pharmaceutical Oncology), contains descriptions including the definition of HDs and the concept of hierarchy of controls, and addresses exposure control measures during handling of chemotherapy drugs. Our future task is to collect additional evidence for the recommended exposure control measures and to assess whether publication of the Guideline has led to adherence of measures to prevent occupational exposure.

The validity and reliability of the Korean version of the Cancer-chemotherapy Concerns Rating Scale

OBJECTIVE The Cancer-chemotherapy Concerns Rating Scale was developed in Japan for outpatients undergoing chemotherapy, and its validity and reliability have been reported. The purpose of the study was to test the reliability and validity of the Korean version of the Cancer-chemotherapy Concerns Rating Scale. METHODS The questionnaire was filled out by 199 cancer patients, who were currently undergoing outpatient chemotherapy. The data were analyzed using exploratory factor analysis with Promax Rotation to determine the factor construct validity. The reliability of the Cancer-chemotherapy Concerns Rating Scale was investigated by Cronbachs alpha and the Spearman Brown coefficient. RESULTS Four factors were obtained and the overall structure was similar to that of the Japanese version; reorganization of daily life, self-existence, disease progress, and social and economic concerns. Cronbachs alpha for the total scale was 0.91 and the Spearman Brown coefficient was 0.85. CONCLUSIONS We found that the Korean version of the Cancer-chemotherapy Concerns Rating Scale could be clinically useful. It could provide health-care providers with information useful to understand the psychological state of patients undergoing outpatient chemotherapy.

Nursing care for terminal cancer patients preferring to receive care at home-A study of care support with a focus on primary caregivers-

【目的】本研究は，終末期下顎がんの維持透析患者と家族への支援のあり方を，渡辺式家族アセスメントモデルを参考に検討する．【方法】家族ストレス対処理論，家族システム理論などに理論的基盤をおいている渡辺式家族アセスメントモデルを参考に，「問題の明確化」「援助方針の明確化」「援助目標の明確化」「家族のニーズと援助者の役割の明確化」を明確にした後，支援方針の設定と家族支援を検討し実施した．【結果】モデルを参考にアセスメントし，支援方針と家族支援を検討した結果，死亡前日まで在宅で療養を継続できた．【まとめ】末期がん患者とその家族の看護を行っていく上で，アセスメントモデルを活用することは，患者家族の問題点を明確にし，看護援助の方向性が導き出される．また，終末期患者の看護は患者への援助のみならず，家族内の状況を踏まえた上で家族自身が対処行動を取れ，家族内部の相互作用を高めるための援助が重要である．

Issues Concerning Lymphedema Care for Post-Operative Cancer Patients

【目 的】 手術療法を受けたがん患者のリンパ浮腫ケアに対して看護師が認識している課題を明らかにする. 【対象と方法】 全国136施設でリンパ浮腫ケアに最も関係する看護師が回答したケアに関する質問紙のうち, 自由記述項目に記載のあった77名の記述内容を分析の対象とした. 分析は, 内容分析の手法を参考に質的記述的に行った. 【結 果】 手術療法を受けたがん患者のリンパ浮腫ケアにおける課題は『ケア提供者および当事者に対する教育的支援の不足』, 『施設におけるケア環境整備の不足』, 『地域におけるケアを推進する社会資源・地域連携の不足』, 『予防から発症後のケア方法の未確立』の4カテゴリーが形成された. 【結 語】 看護師が認識しているリンパ浮腫ケアの課題から, 施設, 地域, 社会が相互に連携し, ケア環境整備に向けて協働する必要性が示唆された.

Building Process of Familial Cure Life for a Child of Cancer Survivor Through a Narrative from their Parents

【背景・目的】 小児がん経験者の子どもを持つ両親の語りから夫婦および家族における療養生活構築のプロセスを理解し, 看護への示唆を得る. 【対象と方法】 発病から5年を経過した小児がん経験者Aちゃんの両親それぞれの語りを当事者の視点でストーリーを記述し, 出来事の意味を解釈した. 【結 果】 父親と母親は, 共通の目標を持って子どもの病気と向かい合い, 祖父母の多大な支援を受けて家族が親密性を高めながら療養生活を構築していた. 子どもの病気を乗り越えた父親, 母親は共通して自己成長を自覚し, 人生において子どもの病気が必要な出来事であったと肯定的に意味づけていた. 【結 語】 小児がん患者の家族が安定した療養生活を構築していくためには, 父親と母親が支えあう関係を維持できるような援助と, 効果的なソーシャルサポートが活用できるような援助が必要であることが示唆された.