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 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.

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.