Mitsuko Ushikubo

Benefits of off-campus education for students in the health sciences: a text-mining analysis

BackgroundIn Japan, few community-based approaches have been adopted in health-care professional education, and the appropriate content for such approaches has not been clarified. In establishing community-based education for health-care professionals, clarification of its learning effects is required. A community-based educational program was started in 2009 in the health sciences course at Gunma University, and one of the main elements in this program is conducting classes outside school. The purpose of this study was to investigate using text-analysis methods how the off-campus program affects students.MethodsIn all, 116 self-assessment worksheets submitted by students after participating in the off-campus classes were decomposed into words. The extracted words were carefully selected from the perspective of contained meaning or content. With the selected terms, the relations to each word were analyzed by means of cluster analysis.ResultsCluster analysis was used to select and divide 32 extracted words into four clusters: cluster 1—“actually/direct,” “learn/watch/hear,” “how,” “experience/participation,” “local residents,” “atmosphere in community-based clinical care settings,” “favorable,” “communication/conversation,” and “study”; cluster 2—“work of staff member” and “role”; cluster 3—“interaction/communication,” “understanding,” “feel,” “significant/important/necessity,” and “think”; and cluster 4—“community,” “confusing,” “enjoyable,” “proactive,” “knowledge,” “academic knowledge,” and “class.”ConclusionsThe students who participated in the program achieved different types of learning through the off-campus classes. They also had a positive impression of the community-based experience and interaction with the local residents, which is considered a favorable outcome. Off-campus programs could be a useful educational approach for students in health sciences.

Comparison Between Home and Hospital as the Place of Death for Individuals With Amyotrophic Lateral Sclerosis in the Last Stages of Illness

Introduction: Healthcare providers need to better understand the end-of-life situations of in-home amyotrophic lateral sclerosis (ALS) patients to support their desires about where to die and to allow peaceful death. Purpose: To clarify the situations of individuals with ALS in the last stages of illness according to the place of death as reported by home care nurses. Methods: Minimum structured interviews were conducted with 14 home care nurses, and data regarding 14 ALS patients who died were collected. Results: Six patients died at home, and eight died at the hospital. Many sudden deaths were observed among the patients who died at home, whereas pneumonia was often the cause of death in the hospital. Conclusion: Providing family education and ensuring the availability of local family physicians are vital to meeting a patients desire to die at home. Home care nursing should be introduced in the early stage after diagnosis to provide support to patients for timely decision-making.  

Circumstances and Challenges in Home Care-oriented Hospital Nurse Training: Using Group Interviews for Nurses Who Engage in Hospital Nursing Administration

Objective: This study aimed to clarify the circumstances and challenges in home care-oriented hospital nurse training on the basis of results of hospital nurse self-evaluations of nursing activities implemented in preparation for home care. Methods: Group interviews were conducted with 13 nurses at 9 different hospitals, and the results were qualitatively and inductively analyzed. Results and Discussion : Six categories for actual nursing activities implemented in preparation for home care were extracted. These categories were “I leave home care to other medical professionals,” “No form of inter-hospital cooperation has been established,” “There is disparity in cooperation with home-visiting nurses,” “Social resources are not being used due to a lack of knowledge,” “Able to develop a perspective of home care through workshop participation, years of experience, and interest,” and “Competency is lacking despite knowledge of home care.” Home care was apparently not being utilized by hospital nurses due to a lack of knowledge of social resources and a lack of interdisciplinary cooperation. Conclusions: Challenges in nurse training implemented in preparation for home care included compensating for the lack of practical knowledge of social resources and devising a duty system and inter-facility exchanges to allow nurses to build experience in other areas and departments. The results of this study suggested the need 群馬大学大学院保健学研究科 著者連絡先:牛久保美津子 群馬大学大学院保健学研究科看護学講座[〒371-8514 群馬県前橋市昭和町 3-39-22] email: ushi2@gunma-u.ac.jp (受付日:2016 年 8 月 18 日,採用日:2016 年 11 月 15 日) C2017 日本プライマリ・ケア連合学会