Engaging in Action Research with Nurses: Overcoming Challenges and Gaining Positive Insights into End-of-Life Care.

The aim of this study was to qualitatively describe, from a practitioner's perspective, the process by which nurses struggle to support a patient with end-of-life cancer with frequent nurse calls and gain positive insights through two methodologies: AR and the case study method. The participants were four ward nurses who supported a patient receiving end-of-life cancer in his 80s. The participants engaged in monthly group work and practical training sessions, which included facilitators, to reflect on and develop care plans. Based on these activities, care was provided to the patient. After the intervention period, the patient's course and practice was documented and analysed qualitatively. The intervention significantly improved the nurses' ability to support inpatients with many needs through careful observation, enhancement, and practical skill improvement. This process resulted in a better understanding of patient needs, proactive skill development, enhanced team performance, and an innovative care-delivery system that resonated throughout the ward. This study demonstrated a successful strategy for nurses to improve support for high-need inpatients, emphasising the importance of attentive care, proactive skill improvement, and a team-based approach to healthcare innovation.

Amitriptyline intoxication in bullfrogs causes widening of QRS complexes in electrocardiogram.

Amitriptyline intoxication is caused by its suicidal or accidental overdose. In the present study, by intravenously injecting 1.5 or 3.0 mg/kg amitriptyline into bullfrogs, we actually revealed that amitriptyline causes the widening of QRS complexes in electrocardiogram (ECG). In simultaneous recordings of the cardiac action potential, amitriptyline decreased the slope of phase 0 in the action potential, indicating the inhibition of the inward sodium currents during this phase. The following treatment with sodium bicarbonate quickly restored the widened QRS complexes in the ECG, demonstrating the counteraction with the sodium channel blockade caused by amitriptyline. The dual recordings of ECG waveforms and the action potential in cardiomyocytes enabled us to demonstrate the mechanisms of characteristic ECG abnormalities caused by amitriptyline intoxication.

Nursing Students' Experiences in Consecutive Clinical Interprofessional Education in Japan: Application of the IPE in Nursing Colleges.

AIM: To document nursing students' experiences of continuous participation in a clinical interprofessional education (IPE) program with the Faculty of Pharmacy of other universities in Japan, which had been incorporated into the existing practicum program, and consider how to develop a one-shot clinical IPE program. METHODS: The study participants were two nursing students from a single-department college; they were participating in a clinical IPE program-the first IPE program they had ever participated in-during an area-based practicum in Year 3. Subsequently, in Year 4, a semi-structured interview was conducted, and these interview data were qualitatively and inductively analyzed. RESULTS: Seven categories were identified, and it was found that through continuous participation in the IPE program, there was a change from "clinical IPE is stuck at the back of their mind as a bitter experience" to "the process of clinical IPE stimulates their maturity as a nursing student" and "cultivates attitudes necessary for cooperation". CONCLUSION: Consecutive years of continuous clinical IPE helps students deepen their understanding of learning content by reducing the physical and mental burden of multidisciplinary cooperation and collaboration. For difficulties with regard to step-by-step IPE, it is suggested that one-shot clinical IPE can be conducted for the upper grades along with continuous reflection activities for teams and individuals.

Behavioral intention to prevent cervical cancer and related factors among female high school students in Japan.

AIM: This study aimed to examine female high school students' behavioral intention to prevent cervical cancer and related factors. METHODS: The participants were 2158 female high school students at 16 high schools in A prefecture in the Tohoku region in Japan. A self-administered questionnaire was carried out that was developed based on a conceptual framework comprising the Health Belief Model and Theory of Reasoned Action. RESULTS: The responses were obtained from 2072 students (96.0%). Of these, the answers of 2028 respondents were analyzed after excluding those participants who did not complete the behavioral intention item (effective response rate: 97.0%). A factor analysis and covariance structure analysis yielded a model with strong goodness-of-fit that explained the behavioral intentions based on an "Awareness of the importance and effectiveness of cervical cancer screening," "Obstacles to cervical cancer prevention behavior," "Subjective norms for adopting cervical cancer prevention behavior," and "The behavior of someone close that encourages cervical cancer prevention behavior." CONCLUSION: The statistical analysis yielded a model with strong goodness-of-fit that explained female high school students' behavioral intentions, which were related to four factors, including "the awareness of the importance and effectiveness of cervical cancer screening."

Relationship between self-esteem and living conditions among stroke survivors at home.

AIM: To clarify the relationship between self-esteem of stroke survivors at home and their living conditions. METHODS: Study participants were stroke survivors who lived at home and commuted to one of two medical facilities in the Tohoku region of Japan. Stroke survivors were recruited for the present study when they came to the hospital for a routine visit. The researcher or research assistant explained the study objective and methods to the stroke survivor, and the questionnaire survey was conducted. Survey contents included the Japanese version of the Rosenberg Self-Esteem Scale (RSE) and questions designed to assess living conditions. A total of 65 participants with complete RSE data were included in the analysis. RESULTS: The mean (standard deviation) age of participants was 70.9 years (± 11.1), with a mean RSE score of 32.12 (± 8.32). Only a minor decrease in participant self-esteem was observed, even after having experienced a stroke. Factors associated with self-esteem, including "independent bathing" (standardized partial regression coefficient, ß = 0.405, P < 0.001), "being needed by family members" (ß = 0.389, P < 0.001), "independent grooming" (ß = 0.292, P = 0.009), and "sleep satisfaction" (ß = 0.237, P = 0.017), were analyzed by stepwise multiple regression analysis. The multiple correlation coefficient adjusted for the degrees of freedom was 0.738 (P < 0.001). CONCLUSION: Our analysis revealed that the maintenance of activities of daily living, and the presence of a suitable environment that enhances physical function recovery and promotes activity and participation, are necessary to improve self-esteem in stroke survivors living at home.