Outcomes of Physiotherapy on Activities of Daily Living and Discharge to the Community in Psychiatric Long-term Care Ward Patients.

OBJECTIVE: The purpose of this study was to investigate the outcomes of physiotherapy on patients in psychiatric long-term care wards in Japan and to identify the characteristics of patients who have been discharged to the community. METHODS: The subjects comprised 50 patients who were admitted to the psychiatric long-term care wards at four different hospitals in Japan and prescribed physiotherapy. General physiotherapy for the patients' diseases was provided. The main outcome was whether a patient was discharged to the community (discharged group) or remained hospitalized (hospitalized group) at the end of physiotherapy. Basic subject characteristics, including age, sex, F-code, classification of the diagnosis that led to physiotherapy, length of hospital stay, and length of physiotherapy, were collected from medical records. The Functional Independence Measure (FIM) tool was administered at the initial and final evaluations. RESULTS: At the end of physiotherapy, there were 14 subjects in the discharged group and 36 subjects in the hospitalized group. There were significant differences in the classification of diagnosis, length of stay (LOS), and classification of LOS between the two groups. Two-way analysis of variance showed interactions between the FIM subitems of self-care, transfer, and locomotion. CONCLUSION: The discharged group had higher FIM scores at the start of physiotherapy and a greater FIM gain.

Needs of Children with Neurodevelopmental Disorders and Geographic Location of Emergency Shelters Suitable for Vulnerable People during a Tsunami.

In the current study, we sought to identify special needs and safe evacuation conditions for children with neurodevelopmental disorders (CNDs) along Japan's tsunami-prone Pacific coast. A survey and spatial analysis were used to collect data of CNDs (n = 47) and their caregivers. Areas predicted to be flooded in a tsunami, as well as evacuation routes to emergency shelters for vulnerable people (ESVPs), were mapped using geographic information systems (GIS). Our results showed that five professional staff were needed to support 33 CNDs requiring 135.9 m2 of ESVP space. Critical safety factors were altitude, vertical evacuation, accessibility to ESVPs, and nonexistence of estuaries in the direction of evacuation. GIS-based spatial analysis and evacuation modeling for disaster preparedness and training plans that involve nurses are essential.

Gait Reacquisition Rate, Home Outcome Rate, and Gait Prognosis in Patients with Femoral Neck Fractures and Mental Illness - A Multicenter Study.

OBJECTIVE: A total of 183 patients admitted to five hospitals for proximal femoral fractures and psychiatric disorders were examined to determine whether their physical function could be improved by rehabilitation and to identify factors that affected home discharge. METHODS: We conducted surveys to collect data regarding patients' age, sex, type of mental illness, location at time of injury, complications, Charlson Comorbidity Index, Global Assessment of Functioning scale scores, surgical technique, time from surgery to the start of rehabilitation at the target hospital, rehabilitation duration, results of cognitive function tests (e.g., the Mini Mental Status Examination), walking ability before the injury, final walking ability, functional independence measure (FIM) of the patient's activities of daily living at the start and end of treatments, and discharge destinations. RESULTS: The motor function index showed a significant improvement from an average of 36.0 points at admission to an average of 53.0 points at discharge. Overall, 47.9% of patients who were able to walk before injury could regain gait ability. The discharge rate to the patient's home was 15.8%. CONCLUSIONS: The gait reacquisition rate for patients with femoral neck fractures and mental illness admitted to a psychiatric ward was 47.9%, which was lower than that reported in previous studies, but higher than that for dementia patients. Binomial logistic regression analysis identified the following predictive items for home discharge: whether the fracture occurred at home, FIM cognition item scores at admission, and total and motor item scores at discharge. The derived equation had a high hit rate of 80.9%.

Development of Embodied Sense of Self Scale (ESSS): Exploring Everyday Experiences Induced by Anomalous Self-Representation.

The scientific exploration of the self has progressed, with much attention focused on the Embodied Sense of Self (ESS). Empirical studies have suggested the mechanisms for self-representation. On the other hand, less attention has been paid to the subjectivity itself of the self. With reference to previous studies, the current study collected items that reflect the ESS and statistically extracted three factors for it: Ownership, Agency, and Narrative. The developed questionnaire [Embodied Sense of Self Scale (ESSS)] showed good enough validity and reliability for practical use. Furthermore, ESSS discriminated schizophrenia, a disorder of the ESS, from controls. We discuss the factorial structure of ESS and the relationship among factors on the basis of the current results.