著者

松田 保 児玉 直子 秀野 啓子 小河原 緑 松崎 俊久 村上 元孝 山之内 博

出版者

一般社団法人 日本血栓止血学会

雑誌

血液と脈管 (ISSN:03869717)

巻号頁・発行日

vol.7, no.2, pp.146-150, 1976

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Apparent blood viscosity was measured on freshly shed blood from 127 healthy subjects, ages 21 to 88, and patients hospitalized in Tokyo Metropolitan Yoikuin Geriatrics Hospital, over age 60. Determination of blood viscosity was performed at 37&deg;C using rotational viscometer at shear rates between 0.07 and 4.6sec^-1.<br>Mean blood viscosity in 43 healthy older subjects over age 60 (mean age: 74&plusmn;6) was 45&plusmn;25cp at 0.07sec^-1 and 8&plusmn;2cp at 4.6sec^-1, respectively. Yield stress was calculated from Casson plot at very low shear rates (between 0.44 and 0.07sec^-1) by the method of least squares. Mean value of yield stress in the healthy older subjects was 0.011 dynes/cm². Blood viscosity in the healthy subjects was significantly correlated with hematocrit values. Yield stress in these subjects was also correlated with hematocrit values and blood viscosity at very low shear rates. In these healthy subjects, blood viscosity, yield stress and hematocrit values were highest in the group at age 30-39. Blood viscosity and yield stress showed a slight decline with age in the healthy older subjects.<br>In the hospitalized patients, blood viscosity was higher than 70cp at 0.07sec^-1, and/or higher than 11cp at 4.6sec^-1 in 107 measurements (86 cases) out of 1443 determinations from December 1973 to October 1974. These patients with blood high viscosity included 12 cases of cancer (one of them was accompanied with disseminated intravascular coagulation (DIC); three of them developed DIC thereafter), 5 cases of acute myocardial infarction, 4 cases of acute cerebral infarction, 5 cases of angina pectoris, 6 cases of old myocardial infarction, 18 cases of old cerebrovascular diseases, 11 cases of diabetes mellitus, and 5 cases of stress polycythemia or polycythemia vera. In these cases, viscosity at 4.6sec^-1 was significantly correlated with hematocrit values, whereas viscosity at 0.07sec^-1 was not. All patients with blood high viscosity and relatively low hematocrit values suffered from cancer. In 6 cases of acute myocardial, cerebral of renal infarction, in whom changes in blood viscosity, yield stress and hematocrits were investigated before and after the development of infarction, changes in blood viscosity and yield stress were parallel with hematocrits.<br>From these results, it was concluded that high hematocrits caused blood high viscosity and were regarded as one of the risk factors in the pathogenesis of thrombosis, although the other factors than hematocrits might also influence blood viscosity at very low shear rates.

著者

帆苅 真由美 倉井 佳子 五十嵐 恵 児玉 直子 金子 史代 Hokari Mayumi Kurai Yoshiko Ikarashi Megumi Kodama Naoko Kaneko Fumiyo

出版者

新潟青陵学会誌

雑誌

新潟青陵学会誌 (ISSN:1883759X)

巻号頁・発行日

vol.8, no.3, pp.39-47, 2016-03

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In this study we looked at the team approach taken to provide rehabilitation care, whereby nurses, physical therapists, and occupational therapists work together to support acute phase stroke patients to regain their independence and improve their performance of activities of daily living (ADL). The aim ofthe research was to clarify the factors affecting the team approach from nurses’ perspective. Ten nurses who are engaged in acute phase stroke rehabilitation took part in semi-structured interviews regardingcollaboration between nurses, physical therapists, and occupational therapists. The results were analyzed using a qualitative synthesis method (KJ method). It was found that collaboration was promoted by “ensuring achievement of the team objective by fulfilling professional duties and reaching a cooperative relationship,” based on “ providing support to stabilize the medical condition,” “ demonstrating empathetic understanding and providing support to patients with paralysis, aphasia, or other disabilities” and “providing support in prioritizing patient’s physical and mental security,” and that nurses’ recognition of the factors that affect the team approach included “ selecting appropriate methods to ensure smoothinformation-sharing,” “ reaching consensus in decision making based on proactive suggestions” and “coordinating work and providing support of ADL.” The findings suggested that information-sharing and consensus in decision making between the different professions are important factors to fulfill professional duties of each profession and to promote the cooperative relationship. 急性期脳卒中患者の日常生活動作の自立と向上を支援する看護師、理学療法士、作業療法士によるチームアプローチの要因を看護師の視点から見出すことを目的に、急性期脳卒中患者のリハビリテーションに関わる看護師10名に看護師、理学療法士、作業療法士の連携について半構成的面接を行い、質的統合法(KJ法)を用いて分析した。看護師が認識するチームアプローチに影響する要因には、【病状の安定に向けた支援】【麻痺や失語等の障害に対する共感的理解と支援】【心身の安全を最優先にした支援】を基盤にして、【目標を達成するための各職種の業務の遂行と補完の関係】により連携を図っており、【円滑な情報共有のための手段の選択】【主体的な意見提案による判断の一致】【看護業務の調整とADLの支援】が影響要因となっていた。職種間の情報共有と判断の一致が各職種の業務の遂行と補完の関係を推進する重要な要因となることが示唆された。