学会誌

異なる入浴法が下肢のむくみ改善に及ぼす影響－リンパ浮腫患者のセルフケアのための検討－

著者

下村義弘¹ 夏　亜麗¹ 津田文香¹ 大賀久美¹ 横井麻里¹ 藤村寛子²

所属

1. 千葉大学大学院工学研究院人間生活工学研究室
2. 東京ガス株式会社都市生活研究所

要旨

浮腫は疾患本来の内的要因に加え，同じ姿勢を維持するといった日常生活の外的要因によって，より一層，進行する．外的要因のなかでも日常生活で起こる可能性の高い下肢のむくみと入浴行為に注目した．ミストサウナ，全身浴，シャワーの3種の異なる入浴法を比較した．直立位タスクで下肢にむくみを誘発し，その後に入浴を行い，回復期を設けてむくみの改善効果を調べた．測定項目は主観評価とふくらはぎ周囲長であった．その結果，すべての入浴方法は回復期終了時点で，タスクによって誘発されたふくらはぎ周囲長はもとに戻らなかった．しかし，主観的不快感は緩和された．また，ミストサウナでは，出浴後の最大周囲長の有意な減少がみられた．入浴方法によってはおもに血液性のむくみに対して異なる影響を与えることが分かった．つまり回復期を長くすると，入浴法によっては客観的な改善効果が認められる可能性がある．

キーワード

入浴，下肢のむくみ，リンパ浮腫患者，セルフケア，生活の質

The effects of three different bathing methods on improving swelling of the lower limbs： self-care in patients with lymphedema

Author(s)

Yoshihiro Shimomura¹ Yali Xia¹ Fumika Tsuda¹ Kumi Oga¹ Mari Yokoi¹ Hiroko Fujimura²

Affiliation

1. Humanomics Unit, Division of Design Science, Graduate School of Engineering, Chiba University
2. Urban Life Research Institute, Tokyo Gas Co., Ltd

Abstract

Progression of edema in patients with lymphedema is caused by internal factors and external factors, e.g., maintaining the same posture. We aimed to determine the bathing method for self-care that would best improve lower-limb swelling caused by standing in a constrained position in the same posture. Three different bathing methods, mist sauna, whole-body bath, and shower were tested. After a task was performed in the upright position, changes in lower-limb swelling were examined during and after bathing. Subjective evaluation and calf circumference measured improvement in swelling. We found that after bathing, the increase in calf circumference was not restored to the value observed at the end of the task in the upright position. However, bathing helped to eliminate subjective discomfort. Further, it was found that significant reduction in the maximum calf circumference was seen following mist sauna, which significantly affected the swelling by accumulation of venous blood owing to vasodilation and contraction in response to thermal stimulation. The bathing method has different effects, mainly on swelling by accumulation of venous blood. Therefore, the effects of bathing method on objective improvement in swelling over longer recovery periods may be recognized.

Keyword

bathing, lower-limb swelling, lymphedema, self-care, quality of life

情報通信機器を用いた重症患者を有する産科混合病棟の夜勤帯看護師の滞在場所と滞在時間の分析

著者

大滝千文¹ 齋藤いずみ¹ 和泉慎太郎² 大澤佳代^3,4

所属

1. 神戸大学大学院保健学研究科看護学領域
2. 神戸大学大学院システム情報学研究科
3. 神戸大学大学院保健学研究科病態解析学領域
4. 神戸常磐大学医療検査学科

要旨

日本の病院における分娩は，産科とほかの科が混合する産科混合病棟で約80％実施される．産科混合病棟では複数の科の患者の看護を行っているが，産科混合病棟の看護師全員を対象とした看護および，看護人員配置が少ない夜勤帯の看護は明らかになっていない．そのため，重症患者を有する産科混合病棟の夜勤帯看護の実態を明らかにする．本研究は，情報通信機器を用いて，産科混合病棟に勤務する夜勤帯看護師の勤務中の滞在場所と滞在時間を測定した．結果，夜勤帯の看護師の，一般病室患者1人あたりのベッドサイド平均滞在時間は，重症患者室に重症患者が入院している日は31.9分，入院していない日は33.6分であった．また，夜勤帯13時間勤務の各場所平均滞在時間割合は，一般病室担当看護師はナースステーション39.2％，一般病室34.4％，重症患者室1.7％であった．本研究結果は，安全な混合病棟の運営に寄与する看護人員配置の資料として活用できると考える．

キーワード

産科混合病棟，タイムスタディ，夜勤帯看護，看護師滞在場所，重症患者

Analysis of night-shift nurses’ locations and durations using information communication equipment： A prospective observational study of a mixed obstetric ward with severe patients in Japan

Author(s)

Chifumi Otaki¹ Izumi Saito¹ Shintaro Izumi² Kayo Osawa^3,4

Affiliation

1. Department of Nursing, Kobe University Graduate School of Health Science
2. Graduate School of System Informatics, Kobe University
3. Department of Biophysics, Kobe University Graduate School of Health Sciences
4. Department of Health Science, Kobe Tokiwa University

Abstract

Approximately 80% of hospital-based childbirth in Japan takes place in mixed obstetric wards, which comprise a mix of the obstetrics department and other departments. Although mixed obstetric wards treat patients from multiple departments, previous studies have not clarified the procedures used by nursing staff in the ward, or nursing by night-time nurses. The purpose of this study was to reveal the actual status of night-shift nurses in a mixed obstetrics ward that treats severe patients. This time motion study used smartphones and beacons to measure the place and duration of stay for night-shift nurses working in a mixed obstetric ward. We found that nurses’ mean bedside stay time per patient in a general patient room was 31.9 minutes on days when there were severe patients hospitalized in the severe patient room, and 33.6 minutes on days when there were no severe patients. Furthermore, the mean stay time in each place during a nurse’s 13-hour shift was 39.2% in the nurse station, 34.4% in the general patient room, and 1.7% in the severe patient room. We believe that these results can be used as data for the placement of nursing staff involved in operating a safe mixed ward.

Keyword

mixed obstetric ward, Time Motion Studies (TMS), night shift nursing, nursing task locations, severe patients

分娩第1期の産痛緩和効果に対する腰部温罨法と腰部マッサージの比較

著者

森川真衣¹ 鏡（関塚）真美² 田淵紀子²

所属

1. 富山県立中央病院
2. 金沢大学医薬保健研究域保健学系

要旨

本研究の目的は分娩第1期における腰部温罨法（以下温罨法）と腰部マッサージの産痛緩和効果を比較することである．妊娠37週以降の初経産婦15人を分娩開始順に2群に分け，第1群は温罨法を受ける群，第2群はマッサージを受ける群として割り付けた．分娩第1期で産婦が腰部痛を訴えたときを介入時期とし，温罨法またはマッサージを繰り返し行った．初回介入前後にVisual Analogue Scale（VAS）を使用し，産痛の測定を行った．第1群に7人，第2群に8人が割り付けられた．時期（介入前・後）と介入方法（温罨法・マッサージ）を2要因とし，VAS得点を従属変数とした混合モデルで比較したところ，時期において主効果（p＜0.001）を認め，介入前のVAS得点に対し，介入後の得点は低下していた．しかし，介入方法の主効果は認めなかった（p＝0.982）．温罨法はマッサージに匹敵する効果があることが示唆された．

キーワード

産痛緩和，陣痛，女性，マッサージ，温罨法

Comparison of lumbar hot compresses and lumbar massage on labor pain-alleviating effects during the first stage of labor

Author(s)

Mai Morikawa¹ Naomi Sekizuka-Kagami² Noriko Tabuchi²

Affiliation

1. Toyama Prefectural Central Hospital
2. Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University

Abstract

The aim of this study was to compare labor pain-alleviating effects of lumbar hot compresses (hot compress) and lumbar massage during the first stage of labor. This quasi-experimental study that included 15 primiparous and multiparous women at 〓37 weeks of gestation. Parturient women were divided into 2 groups and treated with hot compress or lumbar massage continuously, in the order in which they began the first stage of labor. The first group received hot compresses, whereas the second received massages. Group 1 comprised 7 subjects and group 2 comprised 8. A visual analog scale (VAS) was used before and after the first intervention to measure pain. The groups were compared in a mixed model with the period (before and after intervention) and intervention (hot compress/massage) as the 2 factors; VAS scores were the independent variables. Comparison of the group VAS scores revealed a primary effect in this period (p <0.001). Post-intervention VAS scores decreased compared to pre-intervention VAS scores. A primary intervention effect was not observed (p=0.982). Both interventions reduced pain with no significant difference. Our findings suggest that hot compress is equivalent to massage for alleviating labor pain.

Keyword

pain-alleviating, labor pain, women, massage, hot compress

バランスとキネマティクスに着目した左膝関節固定時の歩行分析

著者

山添大丈¹ 満上育久² 小川拓也³ 八木康史³

所属

1. 立命館大学情報理工学部
2. 広島市立大学大学院情報科学研究科
3. 大阪大学産業科学研究所

要旨

本論文では，左膝関節障害を模擬した場合の歩行変化を分析する．健常被験者が膝関節を固定する装具を装着することで障害歩行を模擬し，通常歩行と障害歩行を比較することで関節障害に伴う歩行変化を分析する．本研究では，2つの要因，バランスとキネマティクスに着目する．バランス分析では，margin of stability（MoS）を用いる．キネマティクス分析では，各部位の姿勢を計算し，通常歩行と障害歩行の違いを比較する．分析結果より，（1）装具装着（模擬関節障害）による影響は胴・腰に多くみられること，（2）腕振りへの影響は突発的なバランス変化の際に限られること，（3）頭部の変化は小さいことが分かった．

キーワード

バランス，キネマティクス，歩行変化，モーションキャプチャ，Margin of Stability （MoS）

Analysis of gait changes caused by fixing left knee joint focusing on balance and kinematics

Author(s)

Hirotake Yamazoe¹ Ikuhisa Mitsugami² Takuya Ogawa³ Yasushi Yagi³

Affiliation

1. College of Information Science and Engineering, Ritsumeikan University
2. Graduate School of Information Sciences, Hiroshima City University
3. The Institute of Scientific and Industrial Research, Osaka University

Abstract

In this paper, we analyze gait changes by simulating left knee disorders in participants. Healthy participants wear knee brace. We compared the normal and simulated disordered walking (while wearing the knee brace) to analyze what changes occur in their gait due to physical disorders. For analysis, we focus on two factors: balance and kinematics. In the balance analysis, we use margin of stability (MoS) for evaluating balance during walking. In the kinematics analysis, we calculate poses of the body parts and compare the poses between normal and disordered walking. Analysis results show that 1) the effects caused by wearing brace can be observed in the torso and waist, 2) the effects to the arms can be observed only when sudden changes in balance occur, and 3) the effects to the head are small.

Keyword

balance, kinematics, change of walking, motion capture, Margin of Stability (MoS)

分娩第1期の産痛緩和効果に対する腰部温罨法と腰部マッサージの比較

著者

安宅和佳奈¹ 岡山久代² 内藤紀代子³

所属

1. 筑波大学附属病院看護部
2. 筑波大学医学医療系
3. びわこ学院大学教育福祉学部

要旨

産後1ヵ月の女性の骨盤底筋力の実態と分娩に関する要因との関連性を明らかにするため，産後1ヵ月の女性92名の骨盤底筋力測定と分娩に関する要因の調査を行った．その結果，骨盤底筋の最大収縮力は0.74kgf，最大収縮時間は3.29秒で，骨盤底筋の随意収縮が困難な女性は9.7％，随意収縮は可能であるが持続収縮が困難な女性は17.4％存在した．産後1ヵ月の骨盤底筋力と有意な関連を示したのは妊娠前の尿失禁であり，その他の分娩に関する要因との関連は示されなかった．以上より，産後1ヵ月の骨盤底筋力を予測するためには，分娩時の要因よりも，妊娠前からの尿失禁の有無についての情報収集が必要であるといえる．また，産後には関連要因からのハイリスク群の予測に加えて，個々の骨盤底筋力の評価を行い，筋力に合ったケアを実施する必要があると考える．

キーワード

分娩，産後１ヵ月，骨盤底筋収縮，骨盤底筋力，尿失禁

Pelvic floor muscle strength of women at postpartum month 1 and the relationship between pelvic floor muscle strength and delivery-related factors

Author(s)

Wakana Atagi¹ Hisayo Okayama² Kiyoko Naito³

Affiliation

1. Department of Nursing, University of Tsukuba Hospital
2. Faculty of Medicine, University of Tsukuba
3. Faculty of Education Welfare, Biwako Gakuin University

Abstract

This study aimed to elucidate the pelvic floor muscle strength of women at postpartum month 1 and the relationship between pelvic floor muscle strength and delivery-related factors. We measured the pelvic floor muscle strength of 92 women at postpartum month 1 and investigated factors related to delivery. The study found that the maximum contraction force and duration were 0.74 kgf and 3.29 seconds, respectively. Of 92 women, 9.7% found it difficult to voluntarily contract the pelvic floor muscle and 17.4% could voluntarily contract the muscle but had difficulty with prolonged contraction. Moreover, a significant relationship was observed between pelvic floor muscle strength at postpartum month 1 and pre-pregnancy urinary incontinence. The above-mentioned findings suggest that collecting information about pre-pregnancy urinary incontinence rather than delivery-related factors is necessary to predict pelvic floor muscle strength at postpartum month 1. In addition, it is also suggested that in order to provide appropriate care for the pelvic floor of postpartum women, their pelvic floor muscle strength must be evaluated, as well as estimation of high-risk from delivery-related factors.

Keyword

delivery, one month postpartum, pelvic floor muscle contraction, pelvic floor muscle strength, urinary incontinence

妊娠中期の糖代謝と活動量計による生活活動量の関連

著者

藤浪優花¹ 川野亜津子²

所属

1. 筑波大学大学院人間総合科学研究科看護科学専攻博士前期課程
2. 筑波大学医学医療系

要旨

妊娠糖尿病予防のケアを検討していくための基礎資料を得て，臨床現場で生活に即した具体的な指導へ繋げるために，本研究では3軸加速度センサーを搭載した活動量計を用いて妊娠中期の生活活動量を実測し，4週間後の糖代謝との関連を明らかにした．対象者となった妊娠中期女性の1日あたりの歩数は平均3407.4歩であり，一般成人女性と比較して少なかった．これは，交通手段によるものや天候に左右されることも考えられ，今後も検討する必要があると考えられた．歩数と関連があったものは，妊娠前BMI，50gGCT時BMI，就業状況であったが，妊婦の生活活動の多くを占めている就労については，今後どのような動作でより生活活動量が増えるのか検討する必要がある．生活活動量と糖代謝の指標である血糖値との関連について，総消費エネルギー量r＝－.15，生活活動エネルギー量r＝－.09といずれも相関が認められなかったが，歩数はr＝－.22であり，弱い負の相関傾向がみられた．

キーワード

妊娠中期，糖代謝，活動量計，生活活動量，妊娠糖尿病

Relationship between carbohydrate metabolism in the middle pregnancy and daily activity measured by accelerometer

Author(s)

Yuika Fujinami¹ Atsuko Kawano²

Affiliation

1. University of Tsukuba, Graduate School Comprehensive Human Sciences Master’s Program in Nursing Science
2. Faculty of Medicine, University of Tsukuba

Abstract

This study aims to obtain basic data to study care for prevention of gestational diabetes and to connect to specific guidance at the clinical site. Activity levels were objectively measured using an activity meter equipped with a tri-axis accelerometer, and dietary intake details were examined concurrently, followed by an investigation into the relationship with glucose levels four weeks thereafter. The participants’ average daily step count was 3407.4, which was lower than that of general adult women. The difference in step counts may be because of in the means of transport as well as weather; therefore, further investigation is required. Pre-pregnancy BMI, BMI at the time of conducting the 50g glucose challenge test (GCT), and employment were factors associated with step counts. In future research, it is necessary to investigate what type of movement increases activity levels in pregnant women in employment, which accounts for a large part of their physical activity. No correlation was observed between activity levels and blood glucose levels, which are an index of glucometabolic, for total energy consumption (r=-.15) or energy amounts for everyday activities (r=-.09); however, a slightly negative correlation was found with step counts (r=-.22).

Keyword

middle pregnancy, carbohydrate metabolism, accelerometer, daily activity, gestational diabetes mellitus

高齢者に発生するスキンテアの起因外力を推定する形態的特徴

著者

小谷野結衣子¹ 仲上豪二朗^2,3 玉井奈緒^3,4 須釜淳子⁵ 真田弘美^2,3

所属

1. 東京大学医学部附属病院看護部
2. 東京大学大学院医学系研究科健康科学・看護学専攻老年看護学/創傷看護学分野
3. 東京大学大学院医学系研究科附属グローバルナーシングリサーチセンター
4. 東京大学大学院医学系研究科社会連携講座イメージング看護学
5. 金沢大学新学術創成研究機構

要旨

本研究の目的は高齢者のスキンテア再発を予防するために起因外力に関連するスキンテアの形態的特徴を抽出することである．研究デザインは質的記述的研究で，腕に発生したテア23例の写真と起因外力に関する情報を発見者から半構造化面接で得た．最初にテアの形態的特徴を抽出するために，写真をスケッチして形態的特徴を分類するドラフトを作成した．つぎに，テアの起因外力に関するインタビューから外力サブカテゴリーを抽出した．形態分類ドラフトのカテゴリーとして部位・形・スキンフラップ・紫斑・サイズが含まれた．起因外力に関する情報から起因者（患者・介助者・装着物）と外力のタイプを示すサブカテゴリー（ぶつける・拭く・引っ張る・爪が食い込む・引っ掻く・擦れる）が抽出された．起因外力サブカテゴリーに対応する形態分類ドラフトを分析すると，テアの起因外力を推定する要素として4つの形態的特徴（紫斑・形・円弧の深さ・サイズ）が特定された．

キーワード

形態分析，質的記述的研究，スキンテア再発，形

Morphological characteristics of skin tears to estimate the etiology-related external forces that cause skin tears in an elderly population

Author(s)

Yuiko Koyano¹ Gojiro Nakagami^2,3 Nao Tamai^3,4 Junko Sugama⁵ Hiromi Sanada^2,3

Affiliation

1. Department of Nursing, The University of Tokyo Hospital
2. Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo
3. Division of Care Innovation, Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo
4. Department of Imaging Nursing Science, Graduate School of Medicine, The University of Tokyo
5. Institute for Frontier Science Initiative, Kanazawa University

Abstract

The aim of this study was to identify the morphological characteristics of skin tears（STs）associated with specific external forces for preventing skin tear recurrence. This was a qualitative descriptive study. To investigate the relationship between ST morphology and causative external forces, we conducted semi-structured interviews concerning of development for 23 STs on their arms. First, we described data related to morphological characteristics of STs by sketching from photographs for developing a draft morphological classification. Next, we compared the codes for similarities and differences and extracted subcategories representing the external force factor. Categories of the morphological characteristics were follows: anatomical location, shape, skin flap, purpura, and size. Interviews identified two categories of external forces that cause STs:“origin”had three subcategories (caregiver, patient, and skin-contacting medical implements), and“type of external forces”with six subcategories (bumping, wiping, pulling, fingernail lacerations, scratching, and friction). We identified morphological characteristics of STs according to nine external force subcategories by comparing within and across each category and subcategory of external forces. Four characteristics (purpura, shape, depth of arc, and size) were identified as factors that could estimate the cause of STs.

Keyword

morphological analysis, qualitative descriptive research, recurrent skin tears, shape

ロボットスーツHAL による起立が血圧と脳血流におよぼす影響

著者

浅野美礼¹

所属

1. 筑波大学医学医療系

要旨

　高さ40cmの椅子に腰かけた姿勢から起立する動作について，①通常どおり能動的に行った場合，②他者による全介助で行った場合，③パワーアシストロボット（HAL）装着で行った場合に平均血圧および酸素化ヘモグロビンの濃度変化でみた脳血流量がどのように変化するかを，若年者（22.3±2.1歳）と高齢者（69.6±3.5歳）各12人で比較した．平均血圧の低下は若年者のほうが高齢者より有意に大きかった．起立方法の違いによる差異はなかった．脳血流量の低下については，起立方法の違いによる有意差がみられたが，効果量は小さかった．一方で若年者と高齢者に有意差はなかったが効果量は中程度あった．高齢者であっても，若年者と比較のうえでは，起立の方法にかかわらず起立時の血圧および脳血流量の低下は大きくなく，有利とも言える結果であった．HALは高齢者に対して循環血流の面では不自然さの少ないデバイスと考えられた．

キーワード

介助ロボット，起立性低血圧，健康な高齢者，理学療法

Effect on blood pressure and cerebral blood flow of using a hybrid assistive limb (HAL) for standing

Author(s)

Yoshihiro Asano¹

Affiliation

1. Faculty of Medicine, University of Tsukuba

Abstract

　Aim: This study compared how blood pressure and cerebral blood flow changed in young and elderly individuals when actively standing up (standing up from a sitting position on a 40 cm-high chair), when passively standing up with assistance from others, and when standing up with the aid of a lower-limb power-assisted robot or Hybrid Assistive Limb (HAL). Methods: Twelve young (22.3±2.1) and elderly (69.6±3.5) healthy individuals participated in this experiment. Participants were asked to stand up under 3 different conditions and blood pressure and cerebral blood flow were measured by monitoring changes in the concentration of oxygenated hemoglobin. Results and Conclusion: As decrease in mean blood pressure, the main effect of age was noted. The standing method did not have any main effect. As decreased cerebral blood flow, the standing method was noted although the effect size was small. No main effect of age was noted, but its effect size was medium. These findings indicate that the decrease in blood flow was greater in younger individuals than in elderly individuals. Regardless of age, the decrease in cerebral blood flow was relatively small for assisted standing and relatively large for assisted standing with HAL.

Keyword

power assist device, orthostatic hypotension, healthy elderly, physical therapy

抗がん剤の血管外漏出早期発見のための新しい液晶感温フィルムの使用感，実現可能性，安全性における臨床評価：パイロットスタディ

著者

阿部麻里¹ 村山陵子^1,2 田邊秀憲³ 上山恵三子⁴ 小見山智恵子⁴ 松井優子⁵ 真田弘美^2,6

所属

1. 東京大学大学院医学系研究科社会連携講座アドバンストナーシングテクノロジー
2. 東京大学医学部附属グローバルナーシングリサーチセンター
3. テルモ株式会社研究開発部門
4. 東京大学医学部附属病院看護部
5. 公立小松大学保健医療学部看護学科
6. 東京大学大学院医学系研究科健康科学・看護学専攻老年看護学／創傷看護学分野

要旨

抗がん剤の血管外漏出の早期発見は重要であるが，そのアセスメントはむずかしく，客観的手法が求められている．そこで液体貯留が皮膚表面温度の低下をもたらすことから，非侵襲的かつ持続使用可能で安全な血管外漏出アセスメントツールとして，液晶感温フィルムを開発した．研究目的は，開発したフィルムの使用感，安全性，皮膚表面温度の可視化における実現可能性を確認することである．患者40名と看護師8名を対象とした．明らかな血管外漏出はなかった．使用後の調査において，患者は全員がフィルムを使用してもよいと答え，かゆみなどの不快感があったものはいなかった．看護師は，感温フィルムをカテーテル固定用フィルムの上に貼付し，通常通り薬剤投与を行い，使用感を感温フィルム1枚ごとに評価した．看護師の回答の80％において観察の頻度は変わらなかったことから，業務負担への影響は少ないと考えられた．カメラで記録された温度分布は6つのパターンに分類された．以上より，血管外漏出アセスメントツールとしての実現可能性が示唆された．

キーワード

化学療法，血管外漏出，末梢静脈カテーテル，皮膚表面温度

Usability, feasibility, and safety test of a new thermosensitive liquid crystal film for the early detection of extravasation in clinical practice: A pilot study

Author(s)

Mari Abe-Doi¹ Ryoko Murayama^1,2 Hidenori Tanabe³ Emiko Kamiyama⁴ Chieko Komiyama⁴ Yuko Matsui⁵ Hiromi Sanada^2,6

Affiliation

1. Department of Advanced Nursing Technology, Graduate School of Medicine, the University of Tokyo
2. Global Nursing Research Center, Graduate School of Medicine, the University of Tokyo
3. Research and Development Center, Terumo Corporation
4. Department of Nursing, The University of Tokyo Hospital
5. Department of Nursing, Faculty of Health Sciences, Komatsu University
6. Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, the University of Tokyo

Abstract

Early detection of extravasation is important due to possible drug leakage, which can cause severe tissue damage. However, its signs and symptoms are difficult to be assessed, and objective assessment is necessary. Given that fluid accumulation provides a low skin-surface temperature, a thermosensitive liquid crystal film was developed to be used as a noninvasive, continuous, and safe extravasation assessment tool. This study aimed to confirm its usability, safety, and feasibility for visualizing skin temperature in the clinical setting. This study included clinical nurses and outpatients who received chemotherapy. No extravasation occurred. Forty patients and 8 nurses were included. All patients responded that they did not mind using the film, and they did not experience any side effects due to using the film, such as itching, tightened feeling, or other discomfort. Nurses placed the film on a catheter securement film and routinely administered drugs. Nurses evaluated the usability of the film after every use. The frequency of observation remained unchanged, according to 80% of the nurses’ answers. It suggested that additional treatment time due to film use was acceptable. During treatment, the skin-surface temperature distribution pattern was recorded using a camera. The temperature distribution patterns were classified into six. The thermosensitive liquid crystal film can be a potential assessment tool to early detect extravasation.

Keyword

chemotherapy, extravasation, peripheral intravenous catheter, skin temperature

ハーネスを用いて腰部に接続する杖歩行訓練器の歩行者の運動に対する追従性の検討

著者

井上淳¹ 飯岡俊光¹ 川村和也² 花崎　泉¹

所属

1. 東京電機大学
2. 千葉大学

要旨

本研究では筆者らが開発している，従来の歩行器の形状とは異なる新しい形状の杖歩行訓練器が歩行に与える影響について検討した．本杖歩行訓練器は杖歩行の量的訓練を，患者1人でも安全に行わせることを目的としている．現在まで，使用時の歩幅・歩隔・骨盤動揺量の変化等を計測し，安全性を確認してきた．しかし，杖歩行訓練器が人間の歩行に与える影響や操作性を検討するため，歩行時の遅れ時間を評価する必要性がある．本論文では，人間と杖歩行訓練器の進行方向加速度の相互相関を取ることで，2物体間の遅れ時間を導出して杖歩行訓練器の影響を評価した．その結果，杖歩行訓練器の周波数の高い振動がハーネスで吸収されていることと，人体を引っ張るような危険な動きにはなっていないことが分かった．また，サイズが大きくなると遅れ時間が増大することが分かった．

キーワード

歩行解析，福祉機器，片麻痺，杖歩行，加速度計

Examination of the followability of the Crutch-Walk Assisting Walker connected to the waist using the harness to the movement of the user

Author(s)

Jun Inoue¹ Toshimitu Iioka¹ Kazuya Kawamura² Izumi Hanazaki¹

Affiliation

1. Tokyo Denki University
2. Chiba University

Abstract

The authors are developing a new shape walker. The purpose of this walker is to allow quantitative training of walking with a crutch safely. For this reason, it is highly necessary to examine the influence of a walker on human walking. We measured the changes in stride length, stride, and pelvic sway during use to confirm safety. However, it is necessary to evaluate the delay time during walking to examine the influence and operability of the walking walker on human walking. In this paper, we calculated the delay time between human and walker by cross correlating the acceleration in the direction of travel between human and walker and evaluated the influence of walker. As a result, it was found that neither of the two walkers with different frame sizes had a dangerous movement that pulled the human body. It was also found that the delay time increases as the size increases. Besides, it was found that the lag time was significantly longer and the variance tended to be larger in walking with a cane than with normal walking.

Keyword

gait analysis, assistive technology, hemiplegia, crutch walking, acceleration sensor

介護保険病床を有する病院スタッフから見た認知症症状を有する 患者へのコミュニケーションロボットの導入・継続に成功した要因

著者

中山絵美子¹ 高橋聡明² 北村　言¹ 野口博史³ 仲上豪二朗^1,4 桑田美代子⁵ 四垂美保⁵ 真田弘美^1,4

所属

1. 東京大学大学院医学系研究科老年看護学/創傷看護学分野
2. 東京大学大学院医学系研究科ライフサポート技術開発学（モルテン）寄付講座
3. 大阪市立大学大学院工学研究科電子情報系専攻
4. 東京大学大学院医学系研究科グローバルナーシングリサーチセンター
5. 医療法人社団慶成会青梅慶友病院

要旨

本研究は，介護保険病床を有する病院に入院している認知症高齢者を対象に，1．患者とコミュニケーションロボット（以下ロボット）との関係構築にかかわる要因，2．ロボットの継続的な使用にかかわる要因，3．ロボットへの期待を明らかにすることを目的とし，ロボット事業が継続している介護保険病床を有する病院において，6名の病棟スタッフへの半構造化面接の記録を質的に分析した．その結果，関係構築にかかわる要因として｛患者のもつさまざまな特性や変化する患者・療養環境とロボットのマッチング｝が，継続使用にかかわる要因として｛スタッフがやりがいを感じながら，新しい試みであるロボットの導入・活用と向き合うこと｝が，ロボットへの期待として｛ロボットが患者・スタッフとともに過ごすことができる存在となる｝ことがテーマとして抽出された．これらから，ロボット導入時には患者-ロボット間，継続使用の際にはスタッフ-ロボット間の関係構築が重要であると示唆された．

キーワード

コミュニケーションロボット，認知症，継続使用

Factors related to introduction and continuous use of communication robots for patients with symptoms of dementia from view of staff in a long-term care hospital

Author(s)

Emiko Nakayama¹ Toshiaki Takahashi² Aya Kitamura¹ Hiroshi Noguchi³ Gojiro Nakagami^1,4 Miyoko Kuwata⁵ Miho Shidare⁵ Hiromi Sanada^1,4

Affiliation

1. Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo
2. Department of Life Support Technology (Molten), Graduate School of Medicine, The University of Tokyo
3. Department of Electric Information, School of Engineering, Osaka City University
4. Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo
5. Oumekeiyu Hospital

Abstract

This study was conducted in a long-term care hospital where communication robots have been continuously used for elderly with dementia. The aim of the present study was to explore the following: 1. factors related to the establishment of patients-communication robot relationship, 2. factors related to the continuous use of robots, and 3. nursing staff expect regarding robots. We conducted semi-structured interview with six hospital staff and analyzed the records qualitatively. The factor related to the establishment of the relationship between patients and robots was {robot characteristics match patient characteristics and patient conditions and care environment that change}. The factor related to the continuous use of robots was {staff face to introduce and use robots, finding their activity rewarding}. The staff expectation regarding robots was {robots become beings that live together with patients and staff}. These results indicated that establishing the patients-robots relationship was as important as introducing robots, and that establishing staff-robots relationship was as important as using robots continuously.

Keyword

robot, dementia, continued use

情報通信機器を用いた重症患者を有する産科混合病棟に勤務する看護師と助産師の日勤帯の滞在場所と滞在時間の分析

著者

大滝千文¹ 齋藤いずみ² 和泉慎太郎³ 大澤佳代⁴

所属

1. 神戸大学大学院保健学研究科
2. 神戸大学大学院保健学研究科看護学領域
3. 神戸大学大学院システム情報学研究科
4. 神戸常盤大学保健科学部医療検査学科

要旨

【背景】日本では，産科と産科以外の患者が入院する産科混合病棟が増加し，産科混合病棟で働く看護師と助産師は，働き方と役割分担に困っている．【目的】重症患者がいる産科混合病棟の看護師と助産師の勤務中の滞在場所と時間を測定し，看護師と助産師の働き方と役割の共有を明らかにする．【方法】産科混合病棟に勤務する看護師と助産師を対象に，スマートフォンとビーコンを使用し，前向き観察研究で滞在場所と時間計測を行った．【結果】一般病室患者1人あたりの看護師と助産師の平均ベッドサイド滞在時間は，病棟に重症患者がいる日といない日で有意差はなかった（p＝0.092）．重症患者が入院していると，看護師と助産師のナースステーション滞在時間は短くなった．【結論】産科混合病棟の助産師が産科看護に専念できる人員配置であっても，重症患者室および一般病室の看護師滞在時間は確保され，産科患者への看護も看護師と助産師の協働が認められた．

キーワード

産科混合病棟，タイムスタディ，日勤帯看護，看護師滞在場所，看護人員配置

Analysis of day shift nurses’ and midwives’ locations and durations using information communication equipment: A prospective observational study of a mixed obstetric ward with critical patients in Japan

Author(s)

Chifumi Otaki¹ Izumi Saito² Shintaro Izumi³ Kayo Osawa⁴

Affiliation

1. Kobe University Graduate School of Health Science
2. Department of Nursing, Kobe University Graduate School of Health Science
3. Graduate School of System Informatics, Kobe University
4. Department of Health Science, Kobe Tokiwa University

Abstract

[Introduction] The number of mixed obstetric wards, which combine obstetric and non-obstetric patients, is increasing in Japan. The nurses and midwives working in these wards are concerned with their work process and sharing of roles. [Purpose] This study aimed to clarify how nurses and midwives work and share roles by measuring the location and duration of their work-related movements in mixed obstetric wards with critical patients. [Methods] We conducted a prospective observational study of nurses and midwives working in a mixed obstetric ward and measured times in various tasks according to a time-motion design using a smartphone and a beacon. [Results] The mean bedside time for nurses and midwives per patient in a general patient room did not differ significantly between days with and without critical patients in the ward (p=0.092). When critical patients were hospitalized, the nurses and midwives spent less time at the nurses’ station. [Conclusion] Nurses’ stay time per patient in general rooms was stable regardless of admission of critical patients. This staffing, which defined the role of nurses and midwives working in a mixed obstetric ward, secured nursing time for critical, general, and obstetric patients despite the mixed ward.

Keyword

mixed obstetric ward, time motion studies (TMS), day shift nursing, nurse task locations, nurse staffing

ハーネスを用いて腰部に接続する杖歩行訓練器の歩行者の運動に対する追従性の検討

著者

大江真琴¹ 小池紀子² 戸部浩美¹ 大橋優美子² 倉持江美子² 池田真理³ 鈴木　亮⁴ 山内敏正⁵ 村山陵子^1,6 真田弘美^1,7

所属

1. 東京大学大学院医学系研究科附属グローバルナーシングリサーチセンター
2. 東京大学医学部附属病院看護部
3. 東京女子医科大学看護学部
4. 東京医科大学糖尿病・代謝・内分泌内科
5. 東京大学大学院医学系研究科糖尿病・代謝内科
6. 東京大学大学院医学系研究科社会連携講座アドバンストナーシングテクノロジー
7. 東京大学大学院医学系研究科健康科学・看護学専攻老年看護学/創傷看護学分野

要旨

超高齢社会のなかで，血糖自己測定（SMBG）を実施する高齢者のためのデバイスや教育方法の開発に対するニーズは高い．本研究の目的はSMBG手技の観察により高齢糖尿病患者のSMBG実施の困難を明らかにすることである．SMBGの手技を録画し，手技を言語化して，生じている困難を帰納的に抽出する質的研究を行った．参加者は65歳以上の高齢糖尿病者29名であった．高齢者には「準備」「電極の挿入」「針の取りはずし」「穿刺」に関連した困難があり，「採血量が不足している」や「針が出てこない」などの失敗を経験していた．SMBG手技を習得したあとでも，高齢者はSMBGの実施に困難を抱えていた．ボタンやレバーを間違ったり，技術が不十分であっても彼らはさまざまな工夫をしながらSMBGを継続していた．定期的な手技の確認とフィードバックが高齢者には必要かもしれない．これらの知見は高齢者に使用しやすいSMBGデバイスを開発する必要性を示している．

キーワード

血糖測定，失敗，穿刺

Difficulties of self-monitoring blood glucose in the aged with diabetes: An analysis based on observations of self-monitoring blood glucose procedures

Author(s)

Makoto Oe¹ Noriko Koike² Hiromi Tobe¹ Yumiko Ohashi² Emiko Kuramochi² Mari Ikeda³ Ryo Suzuki⁴ Toshimasa Yamauchi⁵ Ryoko Murayama^1,6 Hiromi Sanada^1,7

Affiliation

1. Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo
2. Department of Nursing, The University of Tokyo Hospital
3. Nursing Administration, School of Nursing, Tokyo Women’s Medical University
4. Department of Diabetes, Endocrinology, and Metabolism, Tokyo Medical University
5. Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo
6. Department of Advanced Nursing Technology, Graduate School of Medicine, The University of Tokyo
7. Department of Gerontological Nursing and Wound Care Management, Graduate School of Medicine, The University of Tokyo

Abstract

There is a great need for the development of self-monitoring blood glucose (SMBG) devices adapted for the aged and educational methods to support the aged to conduct SMBG in super aging societies. The purpose of this study was to clarify the difficulties associated with conducting SMBG among the aged with diabetes based on observations of SMBG procedures. A qualitative study was carried out involving observations of video-recorded SMBG procedures. The participants were 29 patients with diabetes aged 65 years and older. The video data were transcribed verbatim, and then difficulties were extracted. The aged were found to have difficulties regarding“Preparation”,“Insertion of the electrode”,“Attaching and removing the needle”, and“Puncturing”, and experienced failures such as“The amount of blood sampling is inadequate”and“The needle does not come out”. After learning the SMBG procedures, the aged still had difficulties conducting SMBG properly. Although they used the wrong buttons and levers and did not have sufficient skillfulness, they continued conducting SMBG using a variety of approaches. Regular checking and feedback may help the aged conduct SMBG properly. These findings suggest that the development of new and more user-friendly SMBG devices for the aged is needed.

Keyword

gait analysis, assistive technology, hemiplegia, crutch walking, acceleration sensor

オプティカルフローに基づく新たな活動量測定方法の妥当性の検証−アクションカメラの動画を利用した装着者の活動量測定の試み−

著者

土屋守克^1,2 伊藤幸太³ 髙橋誠一⁴ 坂上貴之⁵ 眞邉一近^1,6

所属

1. 日本大学大学院総合社会情報研究科
2. 日本医療科学大学保健医療学部看護学科
3. 慶應義塾大学理工学部機械工学科
4. 埼玉医科大学総合医療センター看護部
5. 慶應義塾大学
6. 日本大学生物資源科学部

要旨

本研究においては，新たに開発したオプティカルフローに基づく活動量測定方法の妥当性の検証を目的とした．対象者1名に，動画を撮影するためのアクションカメラと，加速度を測定するためのスマートフォンを胸部に装着した．歩行や静止などいくつかの条件を設定し，その条件下で動画撮影，加速度測定を行った．撮影した動画からオプティカルフローを使用して活動量を算出し，加速度との相関関係を検討した．対象者のオプティカルフローに基づく活動量の変化は，いくつかの条件において加速度と有意な相関関係が認められた．オプティカルフローに基づく活動量が，測定対象者の加速度と相関関係が認められた本研究の結果は，今回新たに開発した方法が，対象者の活動量を反映する可能性を示唆している．今後は，加速度との特性の相違の検証，活動量にかかわる外的基準とのさらなる比較に加え，より複雑な条件において検証を進める必要がある．

キーワード

オプティカルフロー，アクションカメラ，ウェアラブルカメラ，活動量，加速度

Verification of the validity of the new method of measuring activity level based on optical flow action cameras －Testing of the measurement of activity level of the wearer using videos from the action camera－

Author(s)

Morikatsu Tsuchiya^1,2 Kohta Ito³ Seiichi Takahashi⁴ Takayuki Sakagami⁵ Kazuchika Manabe^1,6

Affiliation

1. Graduate School of Social and Cultural Studies, Nihon University
2. Department of Nursing, Faculty of Health Sciences, Nihon Institute of Medical Science
3. Department of Mechanical Engineering, Keio University
4. Nursing Office, Saitama Medical Center, Saitama Medical School
5. Keio University
6. College of Bioresource Sciences, Nihon University

Abstract

The present study aims to verify the validity of the newly developed method of measuring activity level based on optical flow. 1 subject wore on his chest an action camera for capturing video images and a smartphone for measuring acceleration. Video shooting and acceleration measurement were performed under several preset conditions such as walking, while stationary, etc. The activity level was calculated from the video images using optical flow and its correlation with acceleration was examined. The change in activity level based on the subject’s optical flow was found to have significant correlation with acceleration under several of the preset conditions. The correlation with acceleration obtained from the results of this study suggests that the newly developed method is capable of reflecting the activity level of the subject. Future studies must include verification under more complex conditions such as verification of differences in terms of characteristics from acceleration in addition to further comparison with external standards related to activity levels.

Keyword

optical flow, action camera, wearable camera, activity, acceleration

力覚センサを用いた口腔ケアシミュレータのための計測アルゴリズムの構築

著者

松野孝博¹ 三谷篤史² 平井慎一¹

所属

1. 立命館大学理工学部ロボティクス学科
2. 札幌市立大学デザイン学部人間情報デザインコース

要旨

本研究では力覚センサを用いた口腔ケアシミュレータを提案し，接触点およびブラッシング力の導出に関する基礎理論を構築する．提案するシミュレータでは，口腔モデルの底部に力覚センサを1つだけ設置する．そのため，従来のシミュレータと比較し，配線やセンサ数の大幅な削減が可能である．また，口腔モデルの歯やブラシ側にセンサを必要としないため，使用可能な口腔モデルやブラシの制約が少ない．口腔モデルの接触点を導出するために，まず，歯茎形状と力の作用線に着目し，接触点の候補を計算する．つぎに，各接触点候補における力の方向および移動速度を吟味し，理論上存在しうる接触点を絞りこむ．最後に，接触点におけるブラッシング力を導出し，使用者へフィードバックする．試作機による検証実験を行った結果，接触点および法線・接線力の導出が適切に行えることを確認した．今後は，介護士育成現場への導入を目指し，シミュレータを改善する．

キーワード

口腔ケアシミュレータ，看護教育，力覚センサ

Measurement algorithm for oral care simulator using force sensor

Author(s)

Takahiro Matsuno¹ Atsushi Mitani² Shinichi Hirai¹

Affiliation

1. Department of Robotics, College of Science and Engineering, Ritsumeikan University
2. Course of Communication Design for Human Life, School of Design, Sapporo City University

Abstract

In this research, we propose the oral care simulator using a force sensor. The basic algorithm of measuring contact point and brushing force were constructed. In the proposed simulator, only one force sensor is installed at the bottom of the oral model. Therefore, it is possible to reduce the number of signal wiring and sensors compared with a previous oral care simulator. Firstly, focusing on a line of action of force and shape of oral model, the locations that can be the contact point are calculated. Next, the direction of the force and the velocity at each candidate of contact point are compared, and these points are narrowed down to the theoretically possible contact points. Finally, the brushing force at the contact point is derived and feed back to the user. The prototype of oral care simulator was produced, the proposed algorism was experimentally verified. The results show that the contact point of brush can estimated, normal and tangential force could be measured. In the next step of research, we will improve the measurement accuracy of simulator, and then the full system of oral care simulator will be developed.

Keyword

oral care simulator, nursing education, force sensor

高齢者を想定した水平方向累進レンズを用いた焦点調節意思対応遠近両用眼鏡の開発

著者

梶原志保子¹ 中出麻紀子² 服部知彦³

所属

梶原志保子1
中出麻紀子2
服部知彦3

要旨

眼の調節意思に従い輻輳と調節を一致させることが可能な遠近両用眼鏡の開発を目的とした．想定は70歳とし，累進レンズを輻輳に従って水平方向に累進させることで，本開発眼鏡を設計した．本設計に従い光学部材を配置しステレオ画像を撮影し定性評価した．結果，本開発眼鏡は，従来の遠近両用眼鏡にくらべ，より自然な観察が可能であり，画像歪みが軽減された．定量評価としてレンズ累進率対両眼瞳孔間距離表を作成した．両眼瞳孔間距離55×10－3，58×10－3，61×10－3，64×10－3，67×10－3，70×10－3（m）の場合のレンズ累進性換算表が作成でき，定量的に本開発眼鏡の実現可能性が示唆された．さらに，眼鏡の装着再現性を評価した．結果，眼鏡装着位置の変位は0.113×10－3（m）であり，眼鏡の装着再現性の本開発眼鏡への影響は，想定年齢70歳との誤差が約3.4歳であった．

キーワード

遠近両用眼鏡，累進レンズ，輻輳，調節

Development of perspective glasses in conjunction with focusing intention using horizontal progressive lenses for elderly people

Author(s)

Shihoko Kajiwara¹ Makiko Nakade² Tomohiko Hattori³

Affiliation

1. Heisei College of Health Sciences
2. University of Hyogo
3. Nagoya Isen College of Medical Care & Welfare Dep. of CE.

Abstract

A newly developed perspective glasses that could match convergence and accommodation according to the focal intent of the eye was described in this paper. The target age was 70 years old, and the developed glasses were designed by gradually changing the diopter of a progressive lens horizontally in accordance with convergence. In accordance with this design, the optical components were placed, stereo images were taken and qualitatively evaluated. As a result, the developed perspective glasses enabled more natural observation and reduced image distortion compared to conventional perspective glasses. The progressive value of lens versus the distance between pupils table for the lens was created as a quantitative evaluation. Tables with the distances of 55×10－3, 58×10－3, 61×10－3, 64×10－3, 67×10－3, 70×10－3 (m) were got. The feasibility of perspective glasses was quantitatively suggested. In addition, the reproducibility of wearing glasses was evaluated. As a result, the displacement of the glasses wearing position was 0.113×10－3 (m), and the effect of the reproducibility of glasses wearing on the newly developed perspective glasses was about 3.4 years younger than the target age of 70 years old.

Keyword

perspective glasses, progressive lenses, convergence, accommodation

高齢者を想定した水平方向累進レンズを用いた焦点調節意思対応遠近両用眼鏡の開発

著者

野口博史¹ 大江真琴² 竹原君江³ 森　武俊⁴ 真田弘美^5,6

所属

1. 大阪市立大学大学院工学研究科電子情報系専攻
2. 金沢大学医薬保健研究域保健学系
3. 名古屋大学医学部・医学系研究科看護学専攻基礎・臨床看護学講座
4. 東京大学次世代知能科学研究センター
5. 東京大学大学院医学系研究科附属グローバルナーシングリサーチセンター
6. 東京大学大学院医学系研究科健康科学・看護学専攻老年看護学/創傷看護学分野

要旨

　糖尿病足潰瘍を防ぐために，看護師は適切なサイズと形状の靴の選択について患者を指導している．しかし，神経障害をもつ方は靴の着用感を得ることができず功を奏さない場合がある．その解決策として靴と足を3Dスキャナで計測しその不適合を3DCGで可視化する方法を提案する．パイロットスタディとして健常者3人の素足をハンディタイプの3Dスキャナで計測後，本人の靴も計測した．不適切な靴として1サイズ小さな靴を用意し同様に計測した．開発した可視化ソフトにより足と靴の3Dモデルの重なる領域は赤色で表示される．本人の靴では赤い領域は存在しなかったが，小さな靴では指の先端や靴側部が赤く表示された．その領域は小さな靴を着用した際の接触の感覚とも一致した．このことからハンディスキャナは足や靴の3Dデータを取得することができる可能性があることが分かり，また，可視化ソフトは適切な靴サイズや形状の教育に利用可能性があることが分かった．

キーワード

３次元計測，3DCG，糖尿病足潰瘍予防

Onsite visualization of shoe fitting for education of the people with diabetes using 3D scanner: A pilot study

Author(s)

Hiroshi Noguchi¹ Makoto Oe² Kimie Takehara³ Taketoshi Mori⁴ Hiromi Sanada^5,6

Affiliation

1. Department of Electric Information, School of Engineering, Osaka City University
2. Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University
3. Department of Nursing, Graduate School of Medicine, Nagoya University
4. Next Generation Artificial Intelligence Research Center, The University of Tokyo
5. Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo
6. Department of Gerontological Nursing/Wound Care Management, Division of Health Science and Nursing, Graduate School of Medicine, The University of Tokyo

Abstract

To prevent diabetic foot ulcers, the nurses teach the patient to select correct shoe size and shape. However, this education is less effective for the people with diabetic neuropathy, because the patient cannot feel contact between shoe and foot. To resolve this problem, we propose the 3D computer graphic visualization of contact between shoe and foot using 3D scanner. Bare feet of three participants were scanned by a portable 3D scanner. Their own shoes were also scanned. The small shoes were prepared as typical ill-fitting shoes, and they were scanned. Contact area between bare foot and shoe 3D models were visualized by our developed 3D visualization software as red color. In their own shoes, red areas were not observed. On the contrary, in the small shoes, the tip of thumb or side of foot were visualized at the toe of shoe or side of shoe. This visualized areas were matched with the feelings of the participants. The result indicated that 3D portable scanner has capability of measurement of 3D foot and shoe contour. This pilot study results also demonstrated that our visualization concept has potential to contribute the education of correct shoe size and shape.

Keyword

3D measurement, 3DCG, prevention of diabetic foot ulcer

ヒト型コミュニケーションロボットはリハビリテーションのモチベーションをあげることができるか？

著者

小谷野結衣子¹ 野口博史² 真田弘美^3,4

所属

1. 東京大学医学部附属病院看護部
2. 大阪市立大学大学院工学研究科電子情報系専攻
3. 東京大学大学院医学系研究科健康科学・看護学専攻老年看護学/創傷看護学分野
4. 東京大学大学院医学系研究科附属グローバルナーシングリサーチセンター

要旨

高齢者が急性期リハビリテーション（以下リハビリと略す）を導入しても意欲が低下するとプログラムの進捗が滞る．励ましや言語的なフィードバックはリハビリ意欲を維持するうえで有効である．本研究では人型コミュニケーションロボット（Pepper）による励ましが，高齢者のリハビリに対する取り組みを支援できるか評価した．症例患者（67歳男性）はリハビリ意欲が低下し，経験が浅い看護師にくらべて経験豊かなベテラン看護師のケアを好んだ．初めに，看護師とともに日常生活動作に基づいた励ます会話を作成し，ロボットに会話を取り込んだ．会話はリハビリの進捗とともに更新され，患者はロボットに励まされることで経験が浅い看護師を拒否することもなくなり，毎日リハビリに通い続けた．ロボットは一方的に話しかけるだけで，人とは異なり患者の会話を評価しない．ロボットによる励ましは，患者のリハビリ意欲を向上させただけでなく，看護師との関係構築もサポートした．

キーワード

看護ケア，承認欲求，言語的フィードバック，励まし

Can the use of a human-shaped communication robot enhance motivation for inpatient rehabilitation?

Author(s)

Yuiko Koyano¹ Hiroshi Noguchi² Hiromi Sanada^3,4

Affiliation

1. Department of Nursing, The University of Tokyo Hospital
2. Department of Electric Information, School of Engineering, Osaka City University
3. Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo
4. Division of Care Innovation, Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo

Abstract

The decline in motivation for inpatient rehabilitation among older adults after the acute stage of an illness has become an urgent issue. Repeated encouragement and structured verbal feedback during inpatient rehabilitation has been shown to result in sufficient motivation. This study aims to verify whether a human-shaped customizable communication robot (Pepper) can encourage elderly individuals to seek inpatient rehabilitation after the acute phase of an illness. The patient in this study was a 67-year-old man who lacked motivation for rehabilitation and often preferred experienced nurses to inexperienced ones. First, we created a key construct of encouraging phrases used by experienced nurses on a daily basis, which were subsequently integrated into Pepper. Phrases were updated daily for a more targeted behavior. The patient communicated with Pepper and was satisfied with Pepper’s comments. He underwent rehabilitation daily and stopped refusing routine communication with inexperienced nurses. Pepper did not jeopardize his self-respect, because it did not evaluate the patient’s basic conversations. Furthermore, Pepper not only enhanced motivation, but also helped establish a good relationship with inexperienced nurses. The encouragement and structured verbal feedback during inpatient rehabilitation provided by Pepper contributed to the patient’s recovery by enhancing his motivation for rehabilitation.

Keyword

nursing care, self-respect, structured verbal feedback, encouragement