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Open Journal of Nursing 2012年第2期2卷 34-35页

作者： miwa yamamoto Department of Nursing Kyoto Koka Women’s University Kyoto Japan

Purpose: This study sought to clarify the relationship between a nurse’s exposure to elderly relatives and their perspective in using restraints on the elderly in health care situations. Methods: We approached nursing staff supervisors at 17 general hospital wards and explained the objectives of the study. Supervisors at 14 hospitals agreed to participate, giving us a sampling pool of 1929 nurses. We used a chi square test to compare nurses who had spent time with elderly relatives and those who had not on several variables related to using restraints on elderly patients. Results and Conclusion: This study found that nurses who live with elderly family members were significantly more likely to believe that restraints cause diseases (including chronic diseases) based on a chi square test (p < 0.05). Therefore it would be important that essential was the experiences of individuals with elderly family members when making programs of decreasing nurse’s dilemma to restraining the elderly.

关键词： Ethical Dilemmas Restraints Female Nurses Care for Their Relatives

Dilemmas Faced by Nurses Regarding the Physical Restraint of Elderly Patients with Dementia in Japan

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International Journal of Clinical Medicine 2011年第5期2卷 599-603页

作者： miwa yamamoto Department of Nursing Faculty of Nursing and Rehabilitation Aino University

This study aimed to clarify the dilemma of nurses working in general wards who face the ethical dilemma of restraining older people with dementia in Midwestern Japan. The study used the questionnaire method with an independently prepared questionnaire. The questionnaire was designed to ensure privacy and anonymity. The privacy and anonymity of study participants was assured. Of the 340 survey questionnaires distributed, 291 (85.6%) completed surveys were eligible number (12 additional surveys were returned without answers). An explanatory factor analysis revealed four dilemma factors among 15 items investigated (KMO value 0.84). These were: factor 1: “Execution of treatment and security,” α = 0.91;factor 2: “approach in the nursing of older people with dementia,” α = 0.93;factor 3: “A cooperative relationship in nursing of older people with dementia,” α = 0.87;and factor 4: “Priorities in nursing,” α = 0.81. The cumulative contribution ratio was 79.1%. We suggest that the program would enable nurses to cope with these dilemmas.

关键词： Dilemma Physical Restraint Elderly patients Dementia Nurse

Culturally Sensitive Medical Care and Nursing Support: A Study of the Concerns of Foreign Visitors to Japan

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Open Journal of Nursing 2019年第3期9卷 329-346页

作者： Yuki Murase miwa yamamoto Graduate school of Medical Sciences Tottori University Yonago Japan Department of Adult and Elderly Nursing School of Health Science Tottori University Faculty of Medicine Yonago Japan

Background: Considering the development of international transportation in modern societies, nursing care needs to be sensitive to the cultures and customs of patients from other countries. The purpose of this study is to determine, from the perspective of culturally sensitive nursing support, the cultural practices that foreigners consider important when they visit a Japanese hospital for check-ups or hospitalization. Methods: A survey was completed by 110 foreign participants at a shrine in Kyoto City. The purpose of the survey was to evaluate the concerns of foreign visitors regarding Japanese medical providers, caused by cultural differences such as customs of daily life. The statistical analyses were performed using descriptive statistics as well as cross-tabulation, chi-square, and Fisher’s exact tests. Results: After grouping participants by continent, the top concerns observed in all groups about visiting a Japanese hospital were accessibility to and cost of medical care. First, as for medical facilities, participants from North and South America (North and South American) and Europe (Europeans) were significantly more concerned than those in Asia (Asians) (P P P P P Conclusion: Nurses need opportunities to learn and understand differences in cultures. If nurses have opportunities to learn cultural differences as well as to experience caring for foreign patients, their competencies in culturally sensitive nursing support will improve over time. It can be said that this is an issue not only in Japan but also in all other countries.

关键词： Cultural Care Cultural Differences Foreign Visitors Nursing Support Understand Different Cultures

Factor Analysis of Acute Ward Nurses’ Concepts of Life and Death

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Open Journal of Nursing 2018年第9期8卷 629-639页

作者： Yusuke Sakurai miwa yamamoto Nara Medical University Basic Nursing Science Nara Japan Department of Adult and Elderly Nursing School of Health Sciences Faculty of Medicine Tottori University Yonago Japan

Background: The Ministry of Public Management, Home Affairs, Posts and Telecommunications announced that the proportion of elderly people aged 65 or over in the total population of Japan reached a record high of 26.7% in the present Japan. Aims: This paper aimed to clarify from acute ward nurses’ concepts of life and death in Japan. Methods: Questionnaires were distributed to 720 nurses working in acute care hospital A in the Kansai area in Japan. Distribution destinations were all wards except for operating rooms and outpatient clinics. We initially classified the 27 items from Hirai et al.’s death and life scale into the initial seven factors (via promax rotation). Operational Definition: In my analysis, I relied considerably on the seven-point Likert scale of the Concept of life and death. Ethical Considerations: The present study was approved by the Tottori University Ethics Review Committee (1603 A 156). Results: The initial factor analysis revealed that 10 of the 27 items were inadequate. Thus, a second analysis was conducted on the remaining 17 items. The KMO analysis produced a value of 0.8. A Bartlett’s test produced a significant result (p Consideration: The first factor comprised all subscales except for the “death avoidance” subscale, which fit better within the fourth factor. These factors included “A comprehensive view of life and death” “Sharing the fate of death and liberation” “Death fear, anxiety, and avoidance”, and “Liberation from life and a world after death”.

关键词： Anxiety Attitude to Death Fear Nurses Thanatology

Ethical Dilemma Factor in Regarding Physical Restraints to Elderly of Female Nurses with the Living Together Experience

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International Journal of Clinical Medicine 2012年第5期3卷 328-334页

作者： miwa yamamoto Shizue Mizuno Masako Aota Department of Nursing Kyoto Koka Women’s University Kyoto Japan Department of Nursing Meiji Univesity of Intergrative Medicine Kyoto Japan

Purpose: The aim of this study was to illuminate the connotation of “dilemma” regarding the use of physical restraint on elderly patients as represented by female nurses working in general wards at community hospitals who also live with elderly adults at home. Method: The study used the questionnaire method with an independently prepared questionnaire. Participants: The objective of the study was explained to the persons in charge of nursing in the selected 17 hospitals, and 1929. Finally, this study of participants were 524 female nurses working in general 54 wards (excluding the emergency wards of psychiatry, pediatrics, obstetrics, outpatients, operating rooms, and intensive care units) at community hospitals who also live with elderly adults at home. Results and conclusions: Cronbach’s overall coefficient for the 20 items of dilemma was high (0.78) and the factor analysis extracted four dilemma factors as having a characteristic value of 1 (Kaiser-Meyer-Olkin measure value = 0.81) with a cumulative contribution ratio of 64.5%. The high Cronbach’s for these items (0.86, 0.88, 0.87 and 0.81) confirmed the internal consistencies. With respect to the dilemma where nurses working in general wards at community hospitals who also live with elderly adults at home are faced with the physical restraint of elderly persons, four factors in the clarification of the dilemma were extracted: accomplishment of medical-treatment and accident prevention, characteristic features in nursing for elderly patients with dementia, healthcare professional relationship in nursing for elderly patients with dementia, and priorities on the accident prevention for elderly patients with dementia. Therefore, the construction of four systems to cope with these dilemmas is suggested. These systems would enable practising nurses to: (i) institution of policies to encourage discussion between nurses and other medical staff to reach consensus on treatment;(ii) allocating elderly care specialists to w

关键词： Ethical Dilemma Factor Physical Restraint The Living Under with Elderly People Experience

Development of ethical dilemma scale Japanese nurse faced physical restraints to elderly patients with dementia

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Open Journal of Nursing 2013年第2期3卷 202-208页

作者： miwa yamamoto Masako Nakamura Shigeru Sakuraba Department of Nursing Kyoto Koka Women’s University Kyoto Japan

Purpose: This study aimed to develop an ethical dilemma scale for nurses faced with the use of physical restraint when caring for elderly patients with dementia. Methods: We used a previously established 20-item dilemma scale. The objective and method of the study were explained to the head of nursing at 17 selected hospitals, and 121 nurses working in the general wards of 14 hospitals (excluding emergency department wards of psychiatry, pediatrics, obstetrics, outpatients, operating rooms and intensive care units) who agreed to participate were enrolled in 2000. Seventy-six nurses from one of the hospitals were selected after eight years (2008) to provide a comparison. Ethical considerations: The study was conducted with the approval of the ethics committee at Meiji University of Integrative Medicine. Results and discussion: Four factors were compared between 2000 and 2008: “execution of treatment and security”, “characteristic features in nursing of elderly patients with dementia”, “cooperative relationship in nursing”, and “priorities in nursing”. The cumulative contribution ratio was 65.3% (KMO = 0.77, p = 0.000) in 2000 and 72.5% (KMO = 0.78, p = 0.000) in 2008. Therefore, the scale dilemma nurse faced physical restraints to elderly patients with dementia in Japan was developed 4 facoters from 17-delremmas items of 20 items.

关键词： Ethical Dilemma Scale Japanese Nurse Physical Restraints Elderly Patients with Dementia

Relationship between Cognition and Activities of Daily Living in Elderly Women with Mild Cognitive Impairment in Japan

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International Journal of Clinical Medicine 2012年第4期3卷 251-253页

作者： miwa yamamoto Kyoko Izumi Yoko Aso Kyoto Koka Women’s University Department of Nursing Kyoto Japan Osaka prefecture University College of Health and Human Science Osaka Japan Osaka university Graduate School of Medicine Division of Health Sciences Osaka Japan

Purpose: This study aims to examine the relationship between cognition and ADL in elderly women with MIC. Methods: Cognitive function was assessed using a 4-item instrument screening for dementia. Each item was scaled from 1 to 4. The Katz Index was used to Participants (N = 680) were asked to return the completed questionnaire in the sealed envelope provided. The study received approval from the human subject’s ethics committee at Osaka University. Results and Conclusion: Participants’ mean age was 78.2 ± 6.5 years old. The age range of participants was 65 to 97 years old. Associations were not statistically significant between cognitive function and family structure. However, associations were significant for ADL items involving excretory failure (OR = 3.5, p = 0.000 in 2004, OR = 2.9, p = 0.000 in 2005;P < 0.05) using a logistic regression analysis adjusted for age. Therefore, we recommend that nurses work to educate the public about treatment-adjusted dementia in the community, teaching family members or caretakers to observe the ADL of the elderly, being watchful for unusual excretory habits, extra clothes, or the smell of elderly persons’ dirty clothing.

关键词： Woman’s Elderly Cognitive Function ADL Community

Measuring the Cognitive Impact of Laughter on Elderly People with Mild Cognitive Impairment in Japan

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International Journal of Clinical Medicine 2012年第6期3卷 459-460页

作者： miwa yamamoto Shizue Mizuno Masako Aota Yoko Murakami Aino University Osaka Japan Department of Nursing Kyoto Koka Women’s University Kyoto Japan Meiji University of Integrative Medicine Kyoto Japan

Objective: To evaluate the effect of laughter on cognition in elderly with mild cognitive impairment (MCI) through an appropriately designed intervention. Methods: The intervention involved watching a Japanese comedy routine (Manzai) for approximately twenty minutes, once a week for ten weeks. Participants were asked to paint, as a simple exercise, in addition to watching the show. Twenty-seven patients with MCI from the convalescent ward of a general hospital in the Kansai region of Japan. We measured cognition by evaluating five cognitive function domains before (baseline) and after the intervention. We used the Wilcoxon signed rank test, a distribution-free method, to compare baseline and post-intervention data. Ethical Consideration: Participants were given a document explaining the study. Only those who officially agreed to participate were enrolled. Results: Mean age of patients was 85.0 ± 2.8 years;average education was 8.6 ± 2.8 years. Three cognitive function domains had significantly different average scores after the intervention: 1) Exercise: 44.4 ± 8.9 points at baseline, 36.3 ± 10.2 post-intervention (p = 0.014);2) Word memory: 40.6 ± 7.2 at baseline, 43.1 ± 8.8 post-intervention (p = 0.002);and 3) Animal name recollection: 35.3 ± 8.4 at baseline, 38.1 ± 9.0 post-intervention (p = 0.003). Discussion: The intervention led to significantly higher cognitive scores in exercise, word memory, and animal name recollection domains, suggesting that interventions focused on laughter and simple exercise may improve cognition in elderly patients with MCI.

关键词： Cognitive Impact Laugh Elderly People Mild Cognitive Impairment

Survey on the Use of Information and Communication Technology Tools in Educating Caregivers of Elderly People with Dementia —Analysis from Ichushi and PubMed

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Open Journal of Nursing 2014年第5期4卷 375-378页

作者： miwa yamamoto Noriko Adachi Yasuko Maekawa Tomoharu Nakashima Shigeru Sakuraba Kyoto Koka Women’s University Kyoto Japan Osaka Prefecture University Osaka Japan Tottori University Yonago Japan

This study aimed to clarify the use of computer simulations in educating caregivers of elderly people with dementia. Thesaurus words in articles indexed in Ichushi and PubMed were analyzed using commercially available “Trend Search” text-mining software developed by FUJITSU. The analysis maps relational words in the articles, with line size and distance between words showing the strength of the relation. For ethical purposes, articles were anonymized for analysis. The search was conducted using the query phrases “elderly people with dementia AND simulation”, and retrieved four articles from Ichushi (2007-2010) and 16 from PubMed (1992-2012). The search results revealed that little research has been done on this subject, and highlighted opportunities to further investigate the use of ICT tools in educating caregivers of elderly people with dementia.

关键词： Survey Elderly People with Dementia ICT Tools

Identification of activity stop locations in GPS trajectories by density-based clustering method combined with support vector machines

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Journal of Modern Transportation 2015年第3期23卷 202-213页

作者： Lei Gong Hitomi Sato Toshiyuki yamamoto Tomio miwa Takayuki Morikawa Department of Civil Engineering Nagoya University Institute of Innovation for Future Society Nagoya University EcoTopia Science Institute Nagoya University

The identification of activity locations in con- tinuous GPS trajectories is an essential preliminary step in obtaining person trip data and for activity-based trans- portation demand forecasting. In this research, a two-step methodology for identifying activity stop locations is pro- posed. In the first step, an improved density-based spatial clustering of applications with noise （DBSCAN） algorithm identifies stop points and moving points; then in the second step, the support vector machines （SVMs） method distin- guishes activity stops from non-activity stops among the identified stop points. A time sequence constraint and a direction change constraint are applied as improvements to DBSCAN （yielding an improved algorithm known as C-DBSCAN）. Then three major features are extracted for use in the SVMs method： stop duration, mean distance to the centroid of a cluster of points at a stop location, and the shorter of distances from current location to home and to the workplace. The proposed methodology was tested using GPS data collected from mobile phones in the Nagoya area of Japan. The C-DBSCAN algorithm achieves an accuracy of 90 % in identifying stop points in the first step, while the SVMs method is 96 % accurate in distin- guishing the locations of activity stops from non-activity stops in the second step. Compared to other variants of DBSCAN used to identify activity locations from GPS trajectories, this two-step method is generally superior.

关键词： Activity Stop · Non-activity stop · Stopidentification · DBSCAN· Support vector machines