著者

玉森 祐矢 藤生 慎 高山 純一 西野 辰哉 寒河江 雅彦 柳原 清子 平子 紘平

出版者

公益社団法人 土木学会

雑誌

AI・データサイエンス論文集 (ISSN:24359262)

巻号頁・発行日

vol.2, no.J2, pp.841-847, 2021 (Released:2021-11-17)

参考文献数

18

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日本の少子高齢化は世界に類を見ない速度で進展しており,我が国の医療費は増加の一途をたどっている.このような状況が続けば,日本の医療保険制度の維持ができなくなる.また,日本では生活習慣病の急増を受け,「第4次国民健康づくり対策」が策定されている.現在,高血圧症や糖尿病といった生活習慣病が増加しており,そのような生活習慣病を早期発見する機会である特定健康診査受診率が伸び悩んでいることが課題となっている.そこで,本研究では,国保データベース(KDB)を用いて,まず,生活習慣病と健診回数の関係を示し,健診の効果を示唆する.また,生活環境との関連を調べるため,地域の現況や特性を考慮した分析を行い,健康課題・健診率の地域差を明らかにし,地域別の健康課題や健康な地域の特性について把握する.

著者

柳原 清子 Yanagihara Kiyoko

出版者

Wellness and Health Care Society

雑誌

Journal of wellness and health care = Journal of wellness and health care (ISSN:24341509)

巻号頁・発行日

vol.44, no.1, pp.1-7, 2020-08-03

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"House/home" and "family" have become keywords once again during the current outbreak of COVID-19. Expectations are placed on "relationships" and "bonds" as well as "family nursing," which supports the resilience of the family to emerge from the crisis. This article describes what family nursing is, what kind of support it provides, and the latest family nursing practices. At the core of family nursing lies "family systems theory," according to which the family is a system, and patients, family members and health care providers are mutually influential members of an environmental system. Family nursing practice consists of taking an overview of individuals (patients), families, and society (the setting for healthcare) through systems thinking, and making adjustments to the system using circular communication. Recently, in medical fields including home care, conflict has frequently arisen between medical staff and the family; often, there is also intra-family conflict due to the reduced ability of the family to cope. A solution-oriented approach is effective in coordinating between health care providers and family members, and between family members themselves, including support in decision-making. The "Watanabe-style" family assessment/support model is based on this solution-oriented approach. The Watanabe-style assessment/support process involves: (1) narrowing down the goals to be solved "here and now" and the target people to approach, (2) grasping the context of each person, (3) distinguishing vicious circles from interactions, and (4) coordinating relationships through circular communication aimed at breaking the vicious circles. In family nursing in the age of COVID-19, it is important to provide support with a systematic and solution-oriented approach that enables the family to respond to environmental threats.

著者

平子 紘平 森崎 裕磨 藤生 慎 高山 純一 柳原 清子 西野 辰哉 寒河江 雅彦

出版者

公益社団法人 土木学会

雑誌

土木学会論文集F6(安全問題) (ISSN:21856621)

巻号頁・発行日

vol.74, no.2, pp.I_41-I_51, 2018 (Released:2019-02-19)

参考文献数

18

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東北地方太平洋沖地震において,高齢者や障がい者の被害も甚大であったことから,避難行動要支援者の名簿作成が各自治体に義務付けられた.一方,熊本地震において,庁舎の被災等により,名簿が活用できない事例が発生し,平時より避難行動要支援者の精緻な支援計画策定が重要視されている.本研究ではArc GISのNetwork Analystツールの到達圏解析を用い,道路ネットワークを考慮し,避難行動要支援者の避難施設へ到達可能性の検証を行った.本研究では,我が国における超高齢化に伴い,人数が莫大に増加している後期高齢者に着目し,中でも特に避難にケアを必要とする自宅に居住する要介護認定者を分析対象者とした.到達圏解析の結果,要介護認定者の避難時の実態と何人の要支援者が避難所まで到達できない可能性を持つのか,詳細な把握を行うことが可能となった.

著者

松井 希代子 柳原 清子 佐藤 正美 能登原 寛子 下 綾華 塚本 愛実 中村 優希 西野 ひかり 東 郁江 兵田 亜未 村田 奈穂 元橋 茉佑 森田 恵里 米澤 智亜紀

出版者

ウェルネス・ヘルスケア学会

雑誌

Journal of wellness and health care (ISSN:24333190)

巻号頁・発行日

vol.41, no.1, pp.125-135, 2017

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Cancer medicine is becoming more sophisticated and complex, and therefore it is becoming more difficult to care for people at the end of life. This study was performed to identify the nature of positive attitudes to nursing practice of nurses in general hospitals, and to examine their associations with various different factors. The participants were 683 nurses working in 41 wards in eight regional general hospitals. The survey was carried out as an anonymous self-administered questionnaire. Four factors were identified as constituents of nurses' positive attitudes to nursing practice. These consisted of three factors concerning attitudes and knowledge, comprising [The practice of specialist end-of-life specific care], [Making the best arrangements until the end], and [Spiritual care], and one affirmative sentiment, that of [The confidence to nurse someone at the end of life]. The mean score for factors related to knowledge of nursing practice was > 4 points on a 6-point scale, corresponding to "Somewhat applicable," whereas the mean score for the sentiment [The confidence to nurse someone at the end of life] was > 3 points, corresponding to "Not really applicable." In terms of related factors, for all factors other than spiritual care, positive attitudes to nursing practice increased significantly with increasing experience. There was no association with having cared for a dying family member. Although having experienced an educational opportunity was not associated with the practice of case conferences for deceased patients, it was significantly associated with the experience of having been able to talk at length about the care they had provided and their own thoughts in venues such as case conferences, receiving recognition by colleagues at their own level of seniority or above, and reflection. Improving nurses' positive attitudes to nursing practice in end-of-life care in general hospitals, therefore, depended not on personal characteristics, such as having taken care of a dying family member, but rather on having repeatedly overcome difficulties in the course of nursing experience. Talking at length about care and expressing one's own thoughts, receiving recognition from colleagues at one's own level of seniority or above, and reflection on nursing practice were all important in this process.がん医療が高度・複雑化し、結果、人々が「死」を看取っていくことが難しくなっている。本研究の目的は、総合病院における看護師のがん終末期の実践への肯定感はどのようなものかを明らかにし、要因との関連を見ることとである。対象は地方の 8 つの総合病院 41 病棟683 名の看護師である。自記式質問紙調査を行い、看護師の実践への肯定感は 4 因子の構造として見いだされた。それは【終末期固有の専門的ケア実践】、【最期までの最善の調整】、【スピリティアルなケア】という実践への態度や認識と、【最期を看取っていく自信】という肯定的心情であった。実践への認識の平均値は 6 段階中 4 点台で、「どちらかといえばできる」レベルであり、【最期を看取っていく自信】の心情は 3 点台で「どちらかといえば自信がない」であった。関連要因では、スピリティアルケアを除く全ての因子で、経験年数が増すと実践への肯定感が有意に高まっていた。また、身内の死の看取り経験は関連がなかった。一方、教育的働きかけを受けた経験との関連は、デスカンファレンス実施の有無とは関係がなかったが、自分の行ったケアや思いを十分に語った経験、先輩や同僚に認められた経験、そしてリフレクションが有意に関係していた。つまり、総合病院の終末期ケアにおいて、看護師の実践への肯定感の高まりは、身内の死の看取りなどの個人的特性ではなく、看護経験の中で、困難感からの転換の形で積み重ねられていた。その過程では、ケアや思いを十分に語り、先輩や同僚に認められ、そして実践をリフレクションすることが重要となる。