The Success of Healthcare Providers Who Fought the Epidemic of the Meiji Era in Mizunami City, Gifu Prefecture, Japan

Introduction: Knowing an epidemic existed in Mizunami city and knowing the healthcare provided to overcome the disease may give hints on how the epidemic was handled. Aim: To examine the literature on the epidemic that occurred in the Meiji era and the contributions of healthcare providers who were active in the history of Mizunami city. Method: This is a historical study, mainly using literature. In collaboration with the Mizunami City Board of Education, we searched for materials stored by Mizunami city. In addition, with the cooperation of the local residents of the healthcare providers who were active in Mizunami city, we collected materials in reference to our purpose. Result: The outbreak of the epidemic near Mizunami city was seen as a fight against smallpox. In addition, cholera, dysentery, Spanish flu, and typhoid fever also occurred. Vaccinations were carried out in the Tono region. Healthcare providers who were active in the Meiji era include six doctors and two midwives. Discussion: In the future, it will be necessary to provide more in-depth evidence through surveys, such as interviews with the cooperation of relatives of the active healthcare providers. Conclusion: In the Meiji era, in the vicinity of Mizunami city, doctors and midwives actively fought against epidemics, such as smallpox and other infectious diseases.

An Exploration of the Relationship between Maternal and Child Factors Contributing to Child Abuse

Background: There are many reports in the mass media and scientific literature about child abuse caused by parents. Medical practitioners also are concerned about child abuse and need to grapple with the prevention and early detection of child abuse when working in medical facilities. Aim: The aim of this descriptive study was to explore the relationship between maternal and child factors contributing to child abuse. Methods: A sample of 50 multiparas (mothers with more than 1 child) in a 48-bed postpartum hospital unit in Okinawa prefecture were asked to fill out an anonymous questionnaire regarding the relationship between mothers and their first child in September, 2007. The questionnaire contained 30 items of physical punishment that are quoted from “The Handbook of Correspondence to Child Abuse” (Ministry of Health, Labor and welfare in Japan), 24 items relating to maternal factors and 22 items to child factors, plus items related to mothers’ satisfaction with the health guidance given in the hospital. Data were analyzed using JMP (ver. 14.2;SAS Institute Inc., Cary, NC, U.S.). The significance level was set at 0.05. Results: Forty-one (82%) questionnaires were analyzed. Of the 41 valid responses, 19 mothers reported abusing their children. Child factors contributing to the abuse included the first child’s regression to infantile behavior, bullying younger brothers or sisters and being rough and violent to their friends. The significant maternal factor leading to abuse was the belief that mothers were irritated by their child. Conclusion: A first child’s developmental difficulties had a significant relationship with the harsh punishment by their mothers. The mothers need to understand their child’s developmental behavior and provide a favorable environment for nurturing young children.

The Impact of Repeated Death Conference Participation on Nurses’ Terminal Care and Nursing in Death Conference Using the Death Conference Nursing Self-Assessment Sheet

Background: Increasing the number of DC (Death Conference) experiences, nurses are expected to improve the quality of nurses’ terminal care and developing nursing minds. Therefore, there is a need for further evidence on the impact of repeated DC experiences on nurses’ terminal care. Aim: This study aims to clarify the impact of repeated DC experiences on nurses’ terminal care and nursing in DC using the prepared Death Conference Nursing Self-Assessment Sheet. Method: The study is approved by the Ethics Review Board of St. Mary’s College, Chukyo Gakuin University, and the hospital where the survey was conducted. This study was an observational and cross-sectional study using an anonymous, self-completed questionnaire composed of the newly created Death Conference Nursing Self-Assessment Sheet. Its evaluation items in the Death Conference Nursing Self-Assessment sheet consist of four categories (Cooperation, Future direction of nursing, Specific measures for nursing, and Feeling of the nurse) and 14 questions. The questionnaires were conducted on 144 nurses in the ER, ICU, and Palliative Care Ward (Hospice Ward) in a general hospital in Japan. For analysis, JMP ver.14.2 was used to perform Fisher’s exact test, Wilcoxon/Mann Whitney test, univariate, and multivariate logistic regression analysis. Results: Thirty-four participants (23.6%) who answered the number of DC experiences were included in the final analysis. Seventeen nurses had DC experiences, and 17 had no experience. There were significant differences in all of the above categories impacting nurses’ terminal care and nursing in DC. Conclusion: Repeated DC affected nurses’ terminal care and nursing in DC using the Death Conference Nursing Self-Assessment Sheet. In the future, verification of the reliability, validity of the questionnaire, and more evidence of the way of terminal concerns by raising the quality of DC for developing nursing minds will be needed.

Relationship between Female Sexual Function and Depression or Anxiety in Japan

Background: Sexual dysfunction is sexual complaints or disorders. There are various causes, but the onset leads to deterioration of relationships and quality of life with partners. There is still a deep-rooted awareness that sexuality is a secret in Japan. Aim: This study aims to clarify the relationship between female sexual function and depression or anxiety. Method: Four hundred and fifty-eight Japanese healthy women who worked in four randomly selected medical institutions in Okinawa Prefecture in Japan from March to May 2012 were asked to agree to a consent form of their own free will and participate in self-reported questionnaires. For their evaluation, the Female Sexual Function Index (FSFI;Rosen et al. 2000, which includes the six domains of desire, arousal, lubrication, orgasm, pain, and satisfaction) and the Kessler Psychological Distress Scale (K6;Kessler, 2002, which includes the following six items: felt nervous, hopeless, restless or fidgety, worthless, depressed, and felt that everything was an effort) was used. Moreover, participants’ characteristics showed age, marriage, menopause, annual income, and drinking. In addition, JMP16.2 and R 4.2.0 was used to perform Pearson’s chi-square test, Fisher’s exact test, Mann-Whitney U test, Kruskal-Wallis test, Steel-Dwass test, Spearman’s Rank-Order Correlation, and Cronbach’s alpha. This study was approved by the university and the medical institutional review board (IRB). Results: 178 women were included in the final analysis, and the median (IQR, interquartile range) was 39 (32 - 48) years old, and the mean ± SD (standard deviation) was 40.2 ± 10.4 years old. The median (IQR) and mean ± SD of FSFI Total Score were 22.0 (9.3 - 26.6) and 19.2 ± 9.6. The median (IQR) and the mean ± SD of K6 Total Score were 3 (0 - 7) and 4.2 ± 4.5. 16% of all women with a K6 Total Score of 10 and more, and 5% of all women with a K6 Total Score of 13 and more considered a serious mental illness. There was no clear association between female sexual function and depression or anxiety in all health worker participants between FSFI Total Score and K6 Total Score by Spearman’s Rank-Order Correlation Coefficient (ρ). However, there was a moderate correlation between the K6 Total Score and the FSFI Total Score in health worker participants with a K6 Total Score of 11 or more (n =19, ρ = ?0.62, P = 0.005). Moreover, there was a weak correlation between them in both married and drinking women or married and non-menopausal women. In the Mann-Whitney U test where few participants had morbid depression, significant relationships were found in the association between a sexual function with high depression or anxiety, whereas the low group had a K6 cut-off value of 11. Conclusion: Female sexual morbidity for high depression or anxiety should be managed with interventions. Especially, the intervention for decreasing female sexual function in the K6 Total Score of 11 or more will be needed, and a randomized study is required for more evidence.

International Exchanges by College Nursing Students: “International Comparisons of Awareness and Challenges”

Aim: The aim of this study was to determine the extent of awareness of international exchanges among college nursing students in Japan and other countries and to identify strategies to improve awareness. Method: This is an integrative literature review, consisting of scientific articles published on “Ichushi-Web,” an Internet-based retrieval service by the Japan Medical Abstracts Society (JAMAS) and Google Scholar for domestic documents and, PubMed, Medline, Cochrane library and Google Scholar for foreign documents. We employed search parameters for “the years from 2000 to 2017” in combination with “international educational exchange”, “schools, nursing”, “students, nursing”, “program evaluation”, and “awareness.” Result: The data were extracted from seven documents among a review of 29 retrieved domestic documents written in Japanese, and another seven documents among a review of 111 retrieved foreign documents written in English. All documents from Japan were reports of quantitative studies, and most documents from other countries were qualitative studies. The data from Japanese research reports were classified into four perspectives: interest in international exchange, need to participate in international exchange, understanding of different cultures and awareness of foreign settlers. The data from research reports from other countries were classified into three perspectives: understanding of different cultures, improving expertise in nursing, and awareness of the international community. Conclusions: Strategies that will enhance students’ understanding of diverse cultures are needed to increase their awareness of international exchanges.

Relationship between Death Conference Experiences and Nurses’ Terminal Care

Background: The experiences of death conference (DC) are regarded as improving the quality of nurses’ terminal care and developing nursing minds. Few studies in Japan clarify quantitatively how nurses’ participation in DC is related to nurses’ terminal care. Aim: This study aims to clarify the relationship between DC experiences and nurses’ terminal care using the prepared Terminal Care Nursing Self-Assessment Sheet. Method: The study is approved by the Ethics Review Board of St. Mary’s College, and the hospital where the survey was conducted. This study was an observational and cross-sectional study using an anonymous, self-completed questionnaire composed of the newly created Terminal Care Nursing Self-Assessment Sheet. Its evaluation items consist of six categories (Reflection, Cooperation, Response to patients, Response to patients’ family, Specific measures for nursing, and Feelings of the nurse), and 14 questions. The questionnaires were conducted for 144 nurses in the ER, ICU, and Palliative Care Ward (Hospice Ward) in a general hospital in Japan. For analysis, JMP ver.14.2 was used to perform a Chi-square test, Wilcoxon/Mann Whitney test, univariate, and multivariate logistic regression analysis. Results: One hundred thirty-nine participants (97%) were included in the final analysis. Forty-three nurses had DC experiences, and 96 had no experience. The median number (IQR;interquartile range) of DC experiences was 5.5 (2 - 22.5). There were significant differences in five of the above categories;however, there was no significant association in the five questions of the nurse’s stress on response to patients and patients’ family and specific measures for nursing regarding postmortem treatment for patients between DC experiences and Nurses’ terminal care. Conclusion: DC that looks back on terminal care has significance as an opportunity to consider the way of terminal concerns and direction of future care. It is required to raise the quality of DC for focusing on reducing nurses’ stress on terminal care and anxiety about postmortem treatment for patients.

Literature Review on the Significance of Death Conferences for Nurses in Japan

Aim: To identify evidence in the literature on the significance of death conferences for nurses. Method: This is an integrative literature review, consisting of scientific articles published on “Ichushi-Web”, an Internet-based retrieval service by the Japan Medical Abstracts Society (JAMAS), PubMed, Medline, Cochrane library, and Google Scholar for ‘the whole year,’ combining the keywords “death conference”, “nurse”, and “KJ method”. The significance of death conferences was reviewed by comparison of prior qualitative studies analyzed by the KJ method. Result: Seven studies, all from Japanese, were identified. The significance of death conferences showed “refraction”, “cooperation”, “directionality of nursing”, “caring for patient”, “caring for family”, “specific methods of nursing”, and “feelings of nurses”. Conclusion: The significance of death conferences is considered to be the effect on nurses for amelioration in the quality of patient and family care, development of human relations, and growth as a nurse. The quality of death conferences should be enhanced based on the guidelines for its clear definition.

Acquisition of Knowledge and Skills about Delivery by Self-Evaluation of Midwifery Students Using the Labor and Delivery Assistance Evaluation Sheets

Aim: This study aims to clarify the current state of advancement of knowledge and skills in the educational process from self-assessments by midwifery student labor and delivery assistance evaluation sheets. Method: Metrology is an observational and retrospective study. Self-assessments in labor and delivery assistance evaluation sheets of midwifery students registered in an advanced midwifery course at Nursing College A from Apr. 2017 to Mar. 2018 were analyzed retrospectively. The end-points were every score of six classifications: health checkups and assessments of women who give birth, preparations for labor and delivery assistance, delivery assistance in the parturient second stage, delivery assistance in the parturient third and fourth stages, midwifery process, and the training manner. Moreover, they also included the scores of 64 evaluation items belonging to any of the six classifications and a comprehensive evaluation score in which students judged the acquisition of all knowledge and skills of delivery assistance. In addition, although not on the evaluation sheet, the average score of all 64 evaluation items was also included. The evaluation criteria were five levels, from one to five. The end-points were examined by comparing the experiences of delivery assistances in two periods of Results: 80 among 91 evaluation sheets from eight out of nine students were analyzed. The average score of all 64 evaluation items, every score of the six classifications, and the comprehensive evaluation score was significantly elevated in the experience periods of 6 ≤ times (P Conclusion: Training in adaptation and enforcement of amniotomy and assistance skills for lacerations sutures will be needed in future educational challenges. Self-assessment scores by midwifery students in labor and delivery assistance evaluation sheets were significantly elevated in the experience periods of 6 ≤ times.