Examination of the lifestyle of head injury patients using the Frenchay Activities Index.

Objectives: The purpose of this study was to capture the lifestyle characteristics of traumatic brain injury (TBI) patients by administering the Frenchay Activities Index (FAI), a self-assessment questionnaire used for assessing life-related activities, among TBI patients. Methods: This study was conducted using the revised FAI Self-Assessment Form, administering an interview-based questionnaire survey to TBI patients and healthy participants. The target group comprised 60 traumatic brain injury patients who had progressed from at least 1 year since the injury, with a comparison group of 788 healthy participants. Results: A comparison of FAI scores between TBI patients and healthy participants by questionnaire revealed that TBI patients exhibited significantly higher FAI scores than healthy participants for outdoor walking and transportation use (Mann-Whitney U test, P<0.01). A comparison by occupation revealed that TBI patients were significantly less among the unemployed and other categories (Mann-Whitney U test, P<0.01). For office workers, government employees, high school students, and college students, scores were higher among TBI patients compared with healthy participants, although the differences were not significant. Conclusions: Although TBI patients were less active than healthy participants in life-related activities, their scores for cleaning up after meals and cleaning and putting things in order were close to those of healthy participants, indicating that TBI patients cannot be considered to be inactive. The findings also revealed differences in TBI patients' engagement in life-related activities and frequency of activities depending on their social position.

Do therapists with fewer years of clinical experience encounter more accidents? The relationship between number of years of clinical experience and number of accidents in a year.

OBJECTIVES: This study sought to determine whether therapists experience more accidents annually with increased clinical experience, and whether experiencing an accident in the first year of practice is associated with accidents in the second year of practice. METHODS: We categorized 642 therapists into five groups based on years of clinical experience (first, second, third, fourth, and 5-20 years; n=138, 112, 117, 58, and 217, respectively) and tallied the accidents they reported over an 8-year period. The difference between the five groups in the number of accidents per person per year was subjected to multiple comparisons testing using Kruskal-Wallis tests. RESULTS: Significant differences were revealed between the first year group and the 5-20 years group (p<0.01), between the second year group and the 5-20 years group (p<0.05), and between the third year group and the 5-20 years group (p<0.05). Specifically, participants in the 5-20 years group encountered fewer accidents than those in the other groups. Therapists who encountered an accident in their first year, compared with those who had not, had significantly more accidents in their second year. CONCLUSIONS: Therapists with 1-3 years of clinical experience are more likely to encounter an accident than therapists with >5 years of clinical experience. We conclude that young therapists who have experienced accidents are prone to future accidents. These findings inform the optimal allocation of educational resources to reduce the number of accidents encountered by therapists.

Moving beyond superficial communication to collaborative communication: learning processes and outcomes of interprofessional education in actual medical settings.

OBJECTIVES: The current study sought to understand the learning outcomes experienced by students and to explain their learning process in detail using interpretive data analysis. METHODS: A qualitative study examined students who participated in a multidisciplinary course in a ward. This study investigated latent meanings rather than factual information, using an interpretive paradigm. Data were collected via focus groups and analyzed using Steps for Coding and Theorization (SCAT). RESULTS: Students in the Assembly IV trial (interprofessional education in actual medical settings) experienced a process of transition from a competing (exclusive) mode to a mutual-understanding mode when communicating with people in other professions, and they acquired the perspective of an interactive (dialectic) link between involved communication (communication that attempts to connect directly with patients) and uninvolved communication (communication with patients indirectly through data and other methods) for patient communication. This enabled students to move beyond superficial communication while deepening their connections with people in other professions, complementing each other's strengths, and learning about the possibilities inherent in the provision of collaborative medical practice. CONCLUSIONS: Students participating in interprofessional education within medical settings learned about the potential to achieve a circular realization of collaborative medical practice. A circular realization of collaborative medical practice involves incorporating diverse approaches into one's own professional work via exposure to the viewpoints of other occupations and avoiding decision-making based on assumptions that are only valid within one's own profession. This process enables the discovery of better methods and perspectives and the achievement of effective medical practice by moving beyond superficial communication.

[Regional Differences in Selecting a Place for Recuperation].

I studied a case that let me to consider the regional medical differences in Akita Prefecture. The patient was 85-year-old and female. After she was rushed to an acute care hospital in Yuri-Honjo Nikaho district, she was diagnosed with right leg acute artery obstruction and treated with thrombectomy. Unfortunately, it had no effect. Hence, it was necessary to amputate the right leg. However, her son who lived in Akita city refused the operation and requested that she be transferred. She received treatment at this hospital until she transferred to Akita city. When leg necrosis progresses in Yuri-Honjo Nikaho district, it is common to stay in the hospital for treatment. However, in Akita city, some medical treatments are given not only in hospitals but also at patients' homes. We can receive the same medical treatments not only in the hospital but also at home. Comparing the 2 districts, hospital dependence in Yuri-Honjo Nikaho district is higher than that in Akita city. Many patients are rushed to hospitals in Yuri-Honjo Nikaho district due to slight changes in their condition. Even if patients' conditions change in Akita city, many are treated at home and facilities until the end of life. Currently, the population is aging and there is a need to improve the care environment. Additionally, there is a need to further improve and strengthen the integrated community care system to effectively utilize valuable society resources. Therefore, it is more important to conduct educational campaigns for the integrated community care system.