Relationships of youth risk behaviors with norm-consciousness and resilience among Japanese high school students

The purpose of this study was to examine the influences of norm-consciousness and resilience on the prevention of youth risk behaviors among Japanese high school students. Data of a national survey, Japan Youth Risk Behavior Survey 2011, was used for this analysis. The subjects were 9778 students (5027 males, 4751 females) in grades 10-12 in 102 schools randomly selected from among high schools throughout Japan. When multiple regression analysis was carried out using four subdomains of norm-consciousness and three subdomains of resilience as the independent variables and nine risk behaviors as the dependent variables, the subdomains of norm-consciousness showed significant positive standardized partial regression coefficients for eight risk behaviors for both males and females. In particular, “current alcohol use” and “ever had sexual intercourse” showed the largest standardized partial regression coefficients for the norm-consciousness in school, and “current cigarette use” showed that for the norm-consciousness in community. The subdomains of resilience showed significant positive standardized partial regression coefficients for five risk behaviors for males and for six those for females. The results of this study suggest that the norm-consciousness is an important protective factor to comprehensively prevent risk behaviors among Japanese adolescents. It is expected to be effective to enhance the norm-consciousness particularly in school and community. In addition, resilience should also be emphasized as a factor to prevent specific risk behaviors.

Nurses’ Perception of Privacy in the NICU and GCU: A Qualitative Descriptive Study

Purpose: The purpose of this study was to identify the perceptions that determine the nursing practices of nurses working in NICU and GCU to protect the privacy of the affected children and their families, and the perceptions that arise in relation to their practices. Further to obtain information on current issues and future suggestions for nursing practice. Method: Semi-structured interviews were conducted with six nurses of Clinical Ladder I or higher currently working in the NICU and GCU, and content analysis was conducted. Result: The study identified five categories, 16 subcategories, and 63 codes: “keeping in mind to act in accordance with the characteristics of the NICU and GCU”, “trying to secure a space only for the affected children and families depending on the situation”, “feeling the need for consideration for the affected children and families”, “feeling puzzled and frustrated through the relationship with families”, “having a dilemma between the environment they want to realize for the affected children and families and the fact that it cannot be realized”. Conclusion: In considering nursing care in NICU and GCU, including consideration for privacy, the need to reflect on daily nursing care and share it with other staff members was suggested.

Comparison of Fitness Tracking Using Three Different Smartwatches during Free Activities in Daily Life

Background: Young women of reproductive age experience various physiological changes, which they measure and track using various devices, including fitness trackers and smartwatches. However, fitness tracking assessment methods are ambiguous because they may differ from model to model. Objective: This study aimed to compare the stress level, heart rate, sleep time, number of steps, and distance traveled, which were calculated using fitness tracking methods for daily-life free activity installed in various smartwatches. Materials and Methodology: Healthy women in their 20s to 30s were recruited for this study, which was conducted from December 2021 to June 2022. The finalized participants wore three different smartwatch models (Mi smartband 6, vivosmart®4, and Band 6) simultaneously on their person for 48 hours and performed their daily activities and recorded them on an hour-based activity chart. Each smartwatch’s measured data (e.g., age, height, weight, and oral medications) were extracted into five datasets: heart rate, stress level, number of steps, distance, and sleep time. Data analyses were conducted using Spearman’s rank correlation coefficient ρ (for comparing heart rates) and Bland-Altman plots (for assessing heart rate agreement). The smartwatches’ fitness trackers were compared using the mean absolute percentage error. Results: The correlation coefficient showed that vivosmart®4 and Band 6 had a higher heart rate agreement (ρ = 0.684). The Bland-Altman plots showed high agreement between Band 6, Mi smartband 6, and vivosmart®4. The heart rate measurement method used under free movement was found to be consistent. The examined smartwatches were able to measure heart rate at the same level even under daily-life free movements. Conclusion: Several different smartwatches’ calculated measured values for heart rate had a high agreement. The smartwatches provided accurate heart rate measurements under daily-life free movement conditions. Furthermore, the calculation methods for stress level were found to differ in the fitness tracking of all the smartwatches. .

Effectiveness of an Educational Intervention for Postpartum Depression in a Pre-Parent Classroom

The global incidence of postpartum depression is estimated at approximately 10% - 20%. A lack of partner support is a key factor associated with perinatal depression. This study examined the effects of an educational intervention that provided information for the prevention and early detection of postpartum depression to first-time mothers and fathers who participated in a “First-Time Parent Class.” The study was utilized quasi-experimental research, conducted first with the control group and followed by an assessment of the intervention group. Mothers were assessed using the Edinburgh Postpartum Depression Scale and the Japan Child and Family Research Institute Child-Rearing Support Questionnaire. Fathers’ assessments were conducted using the Japan Child and Family Research Institute Child-Rearing Support Questionnaire for Fathers and were based on responses to questions regarding their coping strategies. Data were obtained from 158 data (72 interventions, 86 controls) couples analyzed. No significant difference was found between mothers’ child-rearing difficulty and depression score rates in the first month after childbirth. There was a difference among fathers in the control group and those in the intervention group regarding their responses to maternal depression: the “consult family” (p = 0.035), “consult friends” (p = 0.033), and “consult the city health center” (p = 0.047) variables were higher in the intervention group;however, the effect size was small. Providing first-time parents with information during pregnancy to prevent and detect postpartum depression will deepen parents’ understanding and help them cope with postpartum depression.

Literature Review on Support for Children and Families Experiencing Parental Bereavement

Purpose: This study aimed to understand the actual nursing support in a wide perspective by reviewing overseas literature on support for children who have experienced parental bereavement and their families. The goal was to identify future challenges in nursing support in clinical practice in Japan. Method: Literature searchable as of May 2023 was retrieved using PubMed, resulting in 11 relevant articles. Result: The results revealed the following: 1) For support provided to children, 13 codes were condensed into 5 subcategories and 4 categories. 2) For support provided to families, 36 codes were condensed into 11 subcategories and 4 categories. Conclusion: Open communication was found to be essential for supporting children and their families who have experienced parental bereavement. Moreover, involvement of multiple professions facilitated the provision of specialized support to address diverse needs of children and families, playing a crucial role in overcoming grief. Additionally, the effectiveness of support systems for bereaved families highlighted the need for nursing professionals in Japan to gain knowledge through learning opportunities and to establish a multi-disciplinary approach to support, thus indicating future challenges in nursing support.

Influence of Kupffer cells and platelets on ischemia-reperfusion injury in mild steatotic liver

AIM: To investigate the effect of mild steatotic liver on ischemia-reperfusion injury by focusing on Kupffer cells (KCs) and platelets. METHODS: Wistar rats were divided into a normal liver group (N group) and a mild steatotic liver group (S group) induced by feeding a choline-deficient diet for 2 wk. Both groups were subjected to 20 min of warm ischemia followed by 120 min of reperfusion. The number of labeled KCs and platelets in sinusoids and the blood perfusion in sinusoids were observed by intravital microscopy (IVM), which was performed at 30, 60 and 120 min after reperfusion. To evaluate serum alanine aminotransferase as a marker of liver deterioration, blood samples were taken at the same time as IVM.RESULTS: In the S group, the number of platelets adhering to KCs decreased significantly compared with the N group (120 after reperfusion; 2.9±1.1 cells/acinus vs 4.8±1.2 cells/acinus, P<0.01). The number of KCs in sinusoids was significantly less in the S group than in the N group throughout the observation periods (before ischemia, 19.6±3.3 cells/acinus vs 28.2±4.1 cells/acinus, P<0.01 and 120 min after reperfusion, 29.0±4.3 cells/acinus vs 40.2±3.3 cells/acinus, P<0.01). The blood perfusion of sinusoids 120 min after reperfusion was maintained in the S group more than in the N group. Furthermore, elevation of serum alanine aminotransferase was lower in the S group than in the N group 120 min after reperfusion (99.7±19.8 IU/L vs 166.3±61.1 IU/L, P=0.041), and histological impairment of hepatocyte structure was prevented in the S group. CONCLUSION: Ischemia-reperfusion injury in mild steatotic liver was attenuated compared with normal liver due to the decreased number of KCs and the reduction of the KC-platelet interaction.

Antithrombin reduces reperfusion-induced hepatic metastasis of colon cancer cells

瞄准：检验是否反凝血酵素(在) 能阻止导致的肝的 ischemia/reperfusion (I/R ) 由禁止肿瘤的肝的转移在老鼠的 E-selectin 的坏死因素(TNF )-alpha-induced 表示。方法：肝的 I/R 被夹钳门静脉和肝的动脉的左分支在老鼠和老鼠导致。癌症房间 intrasplenically 被注射。变形小瘤的数字被依靠在 I/R 以后的白天 7。在肝的织物，浆液纤维蛋白原降级产品和肝的织物的 TNF-alpha 和 E-selectin mRNA 6-keto-PGF (1alpha ) 铺平， PGI2 的稳定的代谢物，被测量。结果：在肿瘤房间的肝的转移和在受到肝的 I/R 的动物的 TNF-alpha 和 E-selectin 的肝的织物 mRNA 层次的禁止的增加。Argatroban，一个凝血酵素禁止者，没压制任何这些变化。在并且 argatroban 禁止了 I/R-induced 凝结畸形。6-keto-PGF (1alpha ) 的肝的织物层次的 I/R-induced 增加显著地被提高由在。有消炎痛的预告的处理完全颠倒了效果在。OP-2507 的管理，稳定的 PGI2 类似于那些的模拟、显示出的效果在在这个模型。在受到肝的 I/R 的先天的在缺乏的老鼠的肝的转移显著地与在野类型的老鼠观察了那相比被增加。管理在显著地在先天的在缺乏的老鼠减少了肝的转移的数字。结论：在由通过 PGI2 的内皮生产的增加禁止 E-selectin 的 TNF-alpha-induced 表示的结肠癌房间的力量还原剂 I/R-induced 肝的转移。这些调查结果也提起可能性如果在肝肿瘤的切除术期间管理了，在力量阻止肿瘤房间的肝的转移。

Family empowerment and quality of life of parents raising children with Developmental Disabilities in 78 Japanese families

Objectives: The families of these children experience distress both at the time of diagnosis and afterward.A top priority is to understand family empowerment,family function,and family members' quality of life (QoL) and to effectively support these families in Japan.The objective of this study was to assess the actual conditions of families living with children having DDs and to explore the factors associated with family empowerment and parents' QoL.Methods: We surveyed ninety-three parents (78 mothers,15 fathers) from 78 families which lived with children with DDs in the capital region of Japan.We assessed two main outcomes using the Japanese versions of the following instruments: Family Empowerment Scale (FES),World Health Organization Quality of Life 26 (WHOQOL26),and other six outcomes.Correlation and multiple regression analyses were conducted.Results: No medication,cooperation with child rearing,assistance from a developmental support center,solved problems related to child rearing,and higher scores in Problem Solving contributed to higher FES scores.Higher WHOQOL26 scores were related to being a full-time housewife,higher self-esteem,no developmental support,a broad emotional support network,higher scores in Problem Solving and Role Function,and lower scores in Affective Reaction and General Function.Conclusions: We revealed that family empowerment and QoL of parents rearing children with DDs in Japan were affected by various subscales of family function and other family attributes.Effective interventions for improving family empowerment and QoL should be researched in the future.

Self-assessed health and its aspects in the case of Mongolia

Self health assessment is a simple indicator that is widely used for measuring an individual’s perception of his or her overall health. Many studies have been conducted by way of showing which particular aspects should be included in health self assessment, especially in developed world. In the developing world, however, very few studies have examined self health assessment. The aim of this study was to identify particular aspects and associations in self health assessment and differences between subgroups in Ulaanbaatar, Mongolia. The area sampling approach and Kish tables were used for selecting respondents. Total 500 respondents were surveyed by paper-based questionnaires. Spearman’s analysis and multiple logistic regression analysis were used to show relations between variables. Sociodemographic status, such as age and gender, proved to be important in self health assessment. Other factors affecting self health assessment included the number of family members, daily life and lifestyles, social environment, community motivation, and utilization of health services. Women, the elderly, or people with less-than- normal access to information suffer from poor self-assessed health. People who are socially inactive and who have poor living conditions are less likely to use health care services and are likely to assess their health as “poor.” In order to reduce the poor self-assessed health status it is important to address disparities in socioeconomic factors, such as age, gender, employment, and residential area. In addition, more attention should be paid to community and health services, as well as to health promotion and empowerment activities, including income-generation activities. Further research is also needed, however, for better understanding of about the local people and their health-related issues.

Assessment of Quality of Life, Family Function and Family Empowerment for Families Who Provide Home Care for a Child with Severe Motor and Intellectual Disabilities in Japan

Background: About 70% of Japanese children with severe motor and intellectual disabilities (SMID) live at home, and the number is increasing. Family members have an enormous burden of daily physical care for these children. A top priority is to understand quality of life (QoL), family function, and family empowerment to effectively support these families. We aimed to assess current living situations of families with a SMID child, and to reveal the relationships between QoL, family function, and family empowerment. Methods: Sixty-five family members from 34 families with a SMID child participated in this study. We assessed 5 parameters using the Japanese versions of the following instruments: World Health Organization Quality of Life 26 (WHOQOL26), Kinder Lebensqualitats Fragebogen (KINDL), Family Assessment Device (FAD), Family Adaptability and Cohesion Evaluation Scale KG-4 (FACESKG-4), and Family Empowerment Scale (FES). Correlation and multiple regression analyses were conducted;QoL score was the objective variable. Results: Participants included 54 parents (34 mothers, 20 fathers) and 11 siblings. The mean age of SMID children was 10.4 ± 5.03 years. Twenty-two children needed multiple types of medical care. The mean age of parents and siblings was 41.5 ± 6.16 years and 15.5 ± 2.35 years, respectively. The mean QoL score (3.28 ± 0.5) was similar to the Japanese average. The mean KINDL score (77.2 ± 12.1) was higher than those of previous studies. The mean FAD score was 1.97 ± 0.32. For FACEKG-4, the score of adaptability was correlated with WHOQOL score (r = 0.459, p < 0.05). The mean score of FES was 113.6 ± 14. As the result of multiple regression analysis, lower family FAD scores ([sb] = ?0.61, p < 0.01) indicated higher family function and greater age of participants (sb = 0.495, p < 0.01) was correlated with higher WHOQOL scores (F = 15.208, p < 0.01). Conclusions: Our results indicated that the individual QoL depended on the age of participants (equals the years of experience caring for a SMID child) and the recognition of family function as a whole. Thus, to improve family members’ QoL, we should focus on individuals and also approach the family as a whole.

Impact of Adjuvant Radiotherapy and Reversibility of Neurogenic Bladder on Bladder Storage Function and Impact of Urethral Resistance on Bladder Emptying Function after Radical Hysterectomy

Purpose: To clarify which patients need careful neurourological management after abdominal radical hysterectomy (RH) by investigating the effects of adjuvant radiotherapy and reversibility of neurogenic bladder (NB) on the storage function as well as the effects of urethral resistance on the emptying function. Methods: Data from sixty-two patients referred to our NB clinic after RH were retrospectively reviewed. Findings of urodynamic studies performed at 3 (UDS-1) and 12 (UDS-2) months after treatment were compared, and logistic analysis was used to calculate the odds ratio (OR) of the effects of radiotherapy and irreversible NB on decreased bladder capacity and decreased compliance. Irreversible NB was defined as the need for clean intermittent catheterization at the last follow-up. Results: At the median follow-up period of 41 months, 60% of the patients continued to require clean intermittent catheterization. Of patients with irreversible NB and radiotherapy, 80% had decreased bladder capacity and decreased compliance at UDS-2. For decreased bladder capacity and decreased compliance, ORs of adjuvant radiotherapy at UDS-2 were 38.42 (p Conclusions: Careful neurourological follow-up after RH is mandatory for patients who undergo adjuvant radiotherapy and have irreversible NB with impaired urethral relaxation.

The effect of core stability exercise on the reaction time of deep trunk muscles

This study aimed to clarify the immediate effect that trunk muscle exercise has on muscle reaction time, and to clarify the effect of 2-week exercise on muscle reaction time. The study showed that as for immediate effects, the muscle reaction time was significantly shortened in the TrA/OI (transversus abdominis muscle/obliquus internus muscle) of two exercise groups. However, the immediate effect seen before the 2-week trunk muscle exercise intervention disappeared after the intervention. In addition, trunk muscle exercise intervention for 2 weeks significantly shortened the muscle reaction time of TrA/OI in one exercise group. Furthermore, shortening of the muscle reaction time was also observed in the MF (multifidus muscle) of both exercise groups. The factors affecting the muscle reaction time of TrA observed in this study were considered to be an improvement of neuromuscular function by the central nervous system. It was also considered that 2-week exercise intervention has a lower value after 2 weeks due to an improvement of neuromuscular function by the central nervous system, and an immediate effect could not be obtained with the same exercise as at the time of intervention.

Association of Television Watching Practices of Mothers on Overweight and Obesity of Their Under-5 Offspring in Urban Bangladesh

Childhood overweight and obesity, is an emerging public health concern in developing countries like Bangladesh. However, regular television watching by child’s mother and its impact on excess weight gain or overweight and obesity to their offspring is not reported elsewhere. The aim of the present analysis was to determine the socio-demographic characteristics among overweight and obese children based on those mothers who watch television regularly and compare this finding with malnourished and well-nourished under-5 children. A total of 20,800 under-5 children were enrolled during 1996 to 2012 in the Diarrheal Disease Surveillance System (DDSS) of Dhaka Hospital of International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b). Mean weight-for-age z-score (–1.61 vs. –2.30;mean difference: ?0.69;p < 0.001), height-for-age z-score (–1.42 vs. –1.99;–0.57;<0.001), weight-for-height z-score (–1.59 vs. –1.07;–0.53;<0.001), BMI-for-age z-score (–1.09 vs. –1.61, –0.52;<0.001) differed significantly between the children whose mother did and did not watch television regularly. Under-5 children whose mother watched television regularly (2%) compared to those who did not (1%), had 2.28 [(95% CI-1.61 - 3.24) p < 0.001] times increased odds of being overweight and obese. Television watching of mothers is associated with childhood overweight and obesity and is one of the most public health concerns in Bangladesh. These changes may be in part of better socio-economic condition, changes in life style behaviour and dietary pattern.

Empirical Study on the Empowerment of Families Raising Children with Severe Motor and Intellectual Disabilities in Japan: The Association with Positive Feelings towards Child Rearing

Background: “Children with severe motor and intellectual disabilities” refers to children with markedly limited activity due to severe overlapping of physical and intellectual disabilities. The physical and mental burden placed on families raising severely disabled children, particularly the primary caregivers, is great in home settings. For families to effectively utilize services and over-come child rearing problems, the families themselves need the “strength” to cooperate with others for the purpose of raising a severely disabled child. The ultimate goal of family support is to enable such families to achieve satisfaction and self-growth in child rearing. Methods: We used a questionnaire to survey 75 primary caregivers to empirically elucidate the empowerment and positive feelings towards child rearing of families raising children with severe motor and intellectual disabilities and the related factors. The t-test and Spearman’s rank correlation coefficient were used to examine the association with bivariates. A multiple regression analysis was conducted for empowerment and positive feelings. Results: Results revealed that life events, livelihood, awareness of social support and the child’s sleep problems were factors related to empowerment. Of these, awareness of social support from outside of the family was found to contribute the most to empowerment. Furthermore, improvement and maintenance of positive feelings towards child rearing reaffirmed the existence of empowerment in addition to reducing negative feelings towards child rearing and ensuring social support. Conclusions: Raising children with severe motor and intellectual disabilities requires specialist knowledge and skills. Support from professionals to empower the entire family is therefore important in order to strengthen positive feelings towards child rearing.

Investigation of Temperature Dependence of Polymer Gels for Use with Scanning Magnetic Resonance Imaging

Polymer gels are three-dimensional dosimetric tools. The purpose of the present study was to investigate the temperature dependence of polymer gels during scanning Magnetic Resonance Imaging. Prepared gels were irradiated with a 6MV X-ray beam at intensities ranging from 0 to 20 Gy in order to investigate their dose-R2 and dose-R1 responses. Irradiated gels were evaluated from 1.5-T magnetic resonance R2 and R1 images for each 5°C change in temperature from 5°C to 41°C, and then the four-field box technique irradiation plan was used to deliver a total dose of 4 Gy using the same beam weight in each direction to the prepared gels. The profile of the dose map generated from the four-field irradiated gel data at 20°C was then compared with the planned data. The dose-R2 response curve was linear up to 20 Gy at 20°C, with a slope of 1.17 Gy-1&dot;s-1. The slopes of the fitted curves of the dose-R2 decreased as gel temperature increased. The slopes of the dose-R1 curves were more parallel than the slopes of the dose-R2 curves between 5 and 41°C. The difference in the full width of half maximum of the gel profile data obtained using the four-field box technique at 20°C and the planned data were below 5% on average. The dose map from the irradiated gels obtained using the dose-R2 curve was the same as that from the planned data under the same temperature conditions. Measurement of difference between various temperatures is significant with dose accuracy. It is suitable to evaluate the gel dosimeter under the thermal equilibrium condition, MRI room temperature from the point of view of the stability of the irradiated gels.

Roles and Hopes of Family Members Living with SMID Children in Japan

The number of children with Severe Motor and Intellectual Disabilities (SMID) receiving medical treatment/recovering at home is rising yearly. Although benefits of this care are emphasized, the stress and duties of family members in the household are extremely great, especially because Japan is becoming a society of nuclear families. In this study, we described the lifestyles of nuclear families providing in-home medical care for children with SMID, focusing on family members’ roles. Roles of mothers, fathers, and siblings of children with SMID were summarized from semi-structured inter-views. As a result, for “the roles of each family member living with a child with SMID”, mothers had five roles, fathers seven, and siblings five. For “the hopes of each family member living with a child with SMID”, parents desired the whole family collaboration in care for children with SMID, and as caregivers, parents’ common thoughts included wanting siblings in order to help care for the child with SMID and wanting siblings to treasure their own lives. Siblings wanted their mother to have some time for rest and expected their fathers to have two main roles. They also expected their grandparents and other siblings to fulfill roles.

Preventing Pregnant Women’s Exposure to Secondhand Smoke: Development and Suitability Assessment of an Educational Comic Booklet

Aim: The aim of this mixed methods research was to develop an educational comic booklet to prevent pregnant women’s exposure to secondhand smoke. Methods: We assessed the suitability of the comic booklet by measuring participant response to content, literacy demand, graphics, layout and typography, learning stimulation, motivation, and cultural appropriateness. The participants were 17 Indonesians living in Japan who were recruited through Respondent-Driven-Sampling and met all criteria for the survey. Means and standard deviations were used to determine the suitability of the educational comic. Results: About 80% of participants rated the comic as “superior” on a rating scale with options of “superior”, “adequate”, “not suitable”, or “not applicable”. The most successful aspects of the comic were content and cultural appropriateness, as it provided clear contents and the graphics showed realistic Indonesian smoking behavior. The least successful aspect of the comic was the literacy demand because there were long sentences using difficult words. Conclusions: The results of this study may be used to conduct a randomized controlled trial using this comic booklet with some modifications.

A Three-Dimensional Biomechanical Analysis of KOSHIWARI Exercise

The koshiwari(Sumo Squat)is a traditional exercise used for basic training for sumo wrestling,the national sport of Japan.This study compares and analyzes the kinetics and kinematics of the koshiwari and squat with wide-stance(WSQ)to provide insight related to the mechanical features of the koshiwari.Optical three-dimensional automatic analysis instruments were used to measure movements of 11 men during exercises.A force platform was used to measure floor reactions.Two movements were analyzed:koshiwari and WSQ.The koshiwari and WSQ were compared as analytical objectives,using paired t-tests corresponding to correction joint angles,angular impulse,and joint torques with the level of significance set under 5%.Koshiwari was found to involve markedly greater excursions of abduction(maximum and minimum angle,correction angle to 20%-60%)and external rotation(maximum and minimum angle)at the hip compared with the WSQ,as well as markedly less hip flexion(maximum angle,correction angle 10%-90%)and torso forward tilt(maximum angle,correction angle 30%-100%).Koshiwari also involved greater extension-flexion axis,abduction-adduction axis,external rotation-internal rotation axis angular impulse and flexion(10%-100%),adduction(40%-60%),and external rotation(20%)torques at the hip than WSQ exercises.Results suggest that hip external rotation torque is attributable to hip external rotator muscle activity.The activity can apparently reduce the risk of ACL(Anterior cruciate ligament)injuries and patellofemoral pain syndrome and improve athletic performance.

Development of a Training Textbook for Countermeasures to “Verbal Abuse, Physical Assault, and Harassment in Pediatric Medical Settings”

Background: Recently, abuse, assault, and harassment in pediatric medical settings have become more serious. We extracted typical problems from a nationwide simultaneous survey on abuse in the pediatric medical field and developed a training textbook to simulate or discuss these issues with colleagues. This study aimed to confirm the validity and usability of the contents of this training textbook. Methods: The textbook was mailed to the heads of 51 medical institutions affiliated with the Society of Ambulatory and General Pediatrics of Japan (SAGPJ) and the participants of the SAGPJ online workshop, who were asked to evaluate the textbook using a three-point scale to answer the following questions and provide opinions and impressions about the textbook. Q1. Do you think the whole content and structure of this textbook are useful? Q2. Would you use this textbook as a training textbook for all staff at your facility? A simple tabulation was performed on the evaluation using a three-point scale, while content analysis was performed on the opinions and impressions of the participants. Results: In response to Q1 and Q2, all 63 staff members from 55 facilities answered “3: Yes.” Opinions and impressions on the training textbook included “I think it can be used for workplace training” and “it is useful for exchanging various opinions among staff members and gaining a common opinion.” Conclusion: We developed a training textbook on abuse, assault, and harassment in pediatric medical settings based on a nationwide survey and confirmed the validity and usability of its contents.

Experiences and Countermeasures of a Perinatal Ward Nursing Manager Dealing with Family Members’ Problematic Behaviors

Background: When family members and/or patients behave in a problematic way, this hinders the provision of safe and secure medical care. During the perinatal period, a family’s relationships and functions change significantly, and each family member is prone to experiencing stress. As such, conflict arises easily between family members and medical staff. Aims: Therefore, we conducted this study to shed light on the following phenomena: 1) family members’ problematic behaviors;2) the concerns of a perinatal ward nurse manager (hereafter referred to as the manager) and ward nurses;and 3) countermeasures carried out by the manager, together with the ward nurses, based on the manager’s experiences. Methods: We conducted an 80-minute, semi-structured interview with the manager, following which we analyzed the content of her narrated accounts. Results: According to the findings, 1) family members’ problematic actions include verbal abuse;arrogance, unreasonableness, and selfish behaviors;and violent conduct;2) the manager’s and ward nurses’ fears and worries about family members’ problematic behaviors;responses to gradually becoming involved with family members;and resistance to staying involved with family members following patient discharge. In addition, we examined 3) countermeasures carried out by the manager together with the ward nurses: resolute and consistent responses to family members’ problematic behaviors;attempted enforcement measures taken to deal with family members who exhibit problematic behaviors;engagement while trying to avoid conflict with family members;preparation that anticipates the occurrence of problematic conduct;cooperation with the medical team;cooperation with the hospital organization;cooperation with social resources outside the hospital;and patient protection. Conclusions: With awareness of cooperation with the medical team toward family members who engage in problematic actions, the medical staff members try to unify their response and share their feelings of hardship with each other.