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Objective: This study aimed to clarify outpatient nurses' awareness of their support for the decision-making of newly diagnosed cancer patients undergoing surgical therapy.Methods: Semi-structured interviews were conducted with eight outpatient nurses from two hospitals, and transcribed data were analyzed qualitatively.Results: The following four categories of outpatient nurses' awareness were extracted: "Difficult environment for supporting decision-making", "Identifying a patient in need of support", "Collaborating at the organizational level", and "Supporting the patient until a satisfying decision is made". Although the nurses recognized the need to support cancer patients' decision-making when undergoing surgical therapy, they were obliged to prioritize other duties and found it difficult to adequately provide the support needed. Although it was difficult, nurses tried to identify patients requiring support during their routine work, and to assist them until a satisfying decision was made by collaborating with colleagues at the organizational level.Conclusion: In order for outpatient nurses to more effectively support cancer patients' decision-making, it is necessary to allocate an adequate number of personnel, secure interview spaces, and provide training for nurses to improve their skills in decision-making support, in addition to implementing the necessary organizational changes.
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Objective@#This study sought to estimate the prevalence of erectile dysfunction (ED) and to ascertain risk factors among Vietnamese men with diabetes. @*Methodology@#One hundred and fifty one diabetic patients were recruited from the People’s Hospital 115 between August 2011 and March 2012. They were asked to complete a self-administered questionnaire that included the International Index for Erectile Function Questionnaire (IIEF-5) and the World Health Organization (WHO) - Five Well-being Index. Medical history, anthropometric measures, and laboratory test results were recorded. ED was classified based on the IIEF-5 total score. @*Results@#Of the 151 diabetic men, 135 (89%) completed the IIEF-5. The overall prevalence of ED was 84%; majority (65%) were classified as mild to moderate, while 10% were considered severe. The prevalence of ED was higher among those with peripheral neuropathy [adjusted odds ratio (OR) 5.22, 95% confidence interval (CI) 1.14-21.89] and longer duration of diabetes (OR 1.11, 95% CI 1.00-1.24). @*Conclusion@#ED represents a prevalent major complication among men with type 2 diabetes. The presence of peripheral neuropathy and long duration of diabetes may be useful indicators of ED.
Subject(s)
Diabetes Mellitus , Erectile Dysfunction , Vietnam , Peripheral Nervous System Diseases , Surveys and QuestionnairesABSTRACT
Public health education in the United States has historically been separate from medical education and has emphasized practical training. Public health education is standardized under an accreditation system and is offered by interdisciplinary faculties. Schools have made efforts to provide a variety of programs responding to the vast needs of students with different professional backgrounds. Despite a constant increase in the number of students, the public health workforce remains too small, and schools are reforming their educational systems.
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Introduction: Epidemiologic evidence on childhood vaccination is scarce in Japan. Our aim was to investigate the vaccination completion rate and risk factors of incomplete vaccination. <br>Methods:This study was a secondary analysis of the database developed for a childhood infection study of 2368 attendants of 18-month health checkups in one city in Japan. The data of vaccination history included bacillus Calmette-Guérin, diphtheria-pertussis-tetanus, measles-rubella, and polio. A total of 1622 children were included in analyses after 746 were excluded because a large portion of their data was missing, and because their birthweight was <2500 g or their gestational age, <37 weeks. <br>Results:The overall vaccine completion rate was 79.3%. The factors significantly associated with incomplete vaccination by multivariate logistic analysis were two or more children living together, child care attendance, parents’ smoking habits and absence of exclusive breastfeeding at 4-month health checkups. As the number of risk factors for hospital admission due to infections increased, the vaccine completion rate tended to decrease. <br>Conclusion:Families with children who attend child care facilities and with two or more other children should be provided with more information regarding vaccination and positive health behaviors in general.
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This cross-sectional study examined cigarette smoking knowledge, attitudes, and practices among medical students in a southwestern region of China. The subjects included 557 and 223 first and fourth year Chinese medical students, respectively. Comparison data were collected from 74 Japanese and 90 Vietnamese fourth year medical students. The smoking rate among the fourth year medical students in China (7.0%) was significantly higher than among the first year medical students (2.8%), and higher than among the medical students from Vietnam, but lower than the medical students from Japan. The fourth year Chinese students had a more permissive attitude toward cigarette smoking by physicians compared with the first year students, and the lowest knowledge base on cigarette smoking-related diseases among the students from all three countries. Based on a multivariate analysis, the factors associated with cigarette smoking were male gender, having friends who smoked, and exhibiting a permissive attitude toward smoking. Implementations aimed at improving tobacco education and addressing the gender differences and peer influences related to cigarette smoking are needed to improve Chinese medical students’ knowledge and attitudes about cigarette smoking, and to prevent students from starting to smoke cigarettes.
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1) Obstetrics medical education in Japan, Vietnam, Thailand was compared.The education differed according to the levels of knowledge and the techniques required for first-year doctors.In Japan and Vietnam, the importance of selfdirected learning was stressed in doctors' interviews.<BR>2) The number of deliveries students attended was much higher among Vietnamese students than among Japanese students. Accordingly, Vietnamese students rated their obstetric knowledge and clinical skills more highly than did Japanese students.<BR>3) The major challenges in Japanese medical education are to provide medical students with opportunities to participate in medical care as a member of a treatment team by introducing clinical clerkship training and to enable students to learn in a more self-directed manner.
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To identify methods for improving reproductive health in developing countries, we reviewed recent family planning issues in Japan. Findings showed that the process of approval for oral contraceptives in Japan has been influenced by sociopolitical discussions without much focus on women's needs for effective contraceptives. We next analyzed recent abortion trends and conducted surveys on unintended pregnancy. Results showed unintended pregnancy to be highly prevalent, which suggested an association with child rearing outcomes when carried out to term. Additional epidemiologic data is needed to document women's health status and to promote evidence-based health services.<br>Given that Japan and Vietnam share several common characteristics related to reproductive health, we are currently conducting a prospective study of pregnant women in both countries to determine the impact of pregnancy intention on child rearing. Prior to the survey, we started a training program to improve capacity of local health professionals to carry out epidemiologic studies. When assisting developing countries in reaching their health goals, it is important to increase local capacity in collecting scientific evidence and to promote its application in health practice.