著者

滝川 栄二 江戸 晶子 山本 千穂 難波 和広 松浦 育代 鴨居 弘斉 大森 美季 片岡 睦子 三船 和史 大坂 京子 安原 由子 谷岡 哲也

出版者

徳島医学会

雑誌

四国医学雑誌 = Shikoku acta medica (ISSN:00373699)

巻号頁・発行日

vol.76, no.1, pp.99-106, 2020-04-25

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Patients with mental health problems in long-term hospitalization have severe impairments and disabilities in their daily social life, thereby needing constant assistance. The purpose of this study was to clarify the relationships between the status of the improved duration of participation in occupational therapy activities through active motivation and interdisciplinary collaboration in enhancing mental health and severe physical functional level as evaluated by the Global Assessment of Function(GAF)score. Subjects were175hospitalized patients in psychiatric units at a Psychiatric hospital in Kagawa Prefecture. The duration of participation in the occupational therapy group activities was divided into Groups A-0‐5, B-6‐10, C-11‐15, and D-16‐20times per month. The number of the occupational therapy group activities per month was 20 times in August 2017 and 21 times in March2018, respectively. The number of classified four group participants before and after were calculated by the chi-square test with adjusted residuals. Comparing the number of participants in the four groups before and after 7 months by the active motivation, the number of participants was significantly decreased in group C but was increased in group D(χ2 = 6.82, p <.05). Findings show the number of participants was increased because of the active motivation by interdisciplinary collaboration and enhanced relations. However, the degree of GAF was not related to the duration of participation times. Moreover, it was clearly found that respect for individuality and patient's will were critical motivational factors in effective patient participation.

著者

杉本 博子 安原 由子 谷岡 哲也 郷木 義子 森 健治 冨士 翔子 斎藤 憲

出版者

徳島医学会

雑誌

四国医学雑誌 = Shikoku acta medica (ISSN:00373699)

巻号頁・発行日

vol.72, no.1, pp.43-52, 2016-04-25

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The purpose of this study was to clarify the relationship between sleep-wake rhythms and autonomic nerve activities using actigraphy and heart rate variability(HRV)analysis. Subjects were comprised of six children who were in the fourth to sixth grade levels of elementary school(four boys and two girls). The study was conducted between January and December 2015. The data collection procedure was performed following the Private Information Protection Law, with approval from Tokushima University Hospital Ethics Board(approval number 2021). These subjects were evaluated in an Attentive-Care-Needed stress state based on the PSI(Public Health Research Foundation Type Stress Inventory)and PSQI-J(Pittsburgh Sleep Quality Index, Japanese Version). In analyzing their sleep-wake rhythms, autonomic nervous activities were determined using an actigraph and HRV through RR interval sequence electrocardiography. The results of actigraph data of sleep efficiency in Subject Number 6 was low(76.47%). Regardless, the subject experienced subjective sleep satisfaction. However, Subject Number 2, insisted that she could not easily wake up in the morning because of being sleepy. Low Frequency(LF)/High Frequency(HF)data indicated sympathetic nervous activity showing that all subjects had significantlyhigher LF/HF value during wakefulness than when asleep. HF data indicated parasympatheticactivity of five out of the six children showing significantly higher value during sleep than when awake. Subject number 3 expressed that he was sleepy and could not get up in the morning,and also had trouble going to and maintaining sleep. However, this subject's results of the PSQI-Jindicated that he had no problem expressing subjective sleep satisfaction. Furthermore, in the actigraph and HRV analysis, findings showed that subjects had good sleeping patterns. These findings strongly signify the importance of determining the sleep-wake rhythms of school children based on data from subjective and physiological evaluation methods.

著者

八木 恵子 廣瀬 久美子 曽我 哲朗 手束 典子 手束 昭胤 湯浅 哲也 佐藤 浩充 遠藤 雅充 株式会社トーカイ

出版者

徳島医学会

雑誌

四国医学雑誌 = Shikoku acta medica (ISSN:00373699)

巻号頁・発行日

vol.69, no.3, pp.145-150, 2013-08-25

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We report on a new mat experimentally developed by us for changing the position of the body (named i-mat), based on an idea of a floating body. [Method] At first,4, approximately 70cm long, belts were attached to both the right and left side of the pad for tying to the beds. For a lateral position with a 30-degree tilt to the right side, the belt attached on the left side is fixed to the right bed fence and the length of the belt is adjusted so that the patient's position becomes lateral with a 30-degree tilt. The body pressure levels (mmHg) at sites of bone were measured after position changes by using a simple body pressure-measuring device (PREDIA®) in 10 patients with an independence degree of daily living rating of C2 (group i) in whom the i-mat was used, and compared with the levels measured after position changes in patients where a mat made of urethane (Nasentpat®) was used (group N). [Results] The pressure levels in the sacral region and occipital region could be significantly lowered in group i as compared with that in group N. We also measured and compared the pressures at the major trochanter, acrominon, and iliac regions, because the high-pressure loaded region shifted to these regions on the side facing the bed in the lateral position. No significant differences in the pressure levels at the major trochanter and acrominon were found between the i and N groups. The pressure level in the iliac region in the i group was significantly higher than that that in the N group. [Conclusion] Use of this experimentally produced i-mat can significantly lower the pressure load at the sacral and occipital regions when the patient is placed in the lateral position of either side with a 30-degree tilt, as compared to that of Nasentpat®. But it appears that caution should be exercised to prevent the occurrence of bedsores in the iliac region.