Mentoring of nursing students-A comparative study of Japan and five European countries.

AIMS: This study aimed to explore mentoring competence in nursing student mentors during clinical practice by identifying different mentor profiles and connections between different competence areas among five European countries and Japan. METHODS: The study implemented a cross-sectional design in Finland, Italy, Lithuania, Slovenia, Spain, and Japan during 2016 and 2019. In total, 6208 mentors were invited, and 1862 participated from 58 healthcare organizations. The data were collected with a survey questionnaire by including background question items with the Mentor Competence Instrument. K-clustering and structural equation modeling were used for data analysis. RESULTS: Four mentor profiles, A (43%), B (30%), C (18%), and D (9%), were identified according to the seven mentoring competence areas with high statistical significance (p < 0.001). Higher mentoring competence (mean >3.50) was observed among Finnish, Lithuanian, and Slovenian mentors with university education in nursing, older ages, more work experience, and previous education in mentoring. Lower competence (mean <2.49) was observed among Japanese and Italian mentors with diplomas in nursing, younger ages, less work experience, and no previous education in mentoring. CONCLUSION: Mentoring requires motivated, highly competent mentors since mentoring is a critical aspect of nursing education. Mentoring roles should be given to nurses with higher education and mentoring training. Younger, less experienced nurses without formal mentoring training may need support from senior nurses when performing mentoring roles and could also facilitate a more balanced workload between patient care and mentoring for senior nurses.

Differences in the risk of severe falls between patients aged <65 years and patients aged ≥65 years at a psychiatric hospital based on 12-year incident reports.

PURPOSE: This study compared age differences in risk factors for falls requiring treatment in psychiatric patients. DESIGN AND METHODS: An incident database was used to compare fall incidents in patients aged less than 65 years and those aged greater than or equal to 65 years. FINDINGS: Approximately 30% of fallers were less than 65 years. Mental status and medication were the main risk factors. Decreased activities of daily living were associated with the most falls in patients greater than or equal to 65 years. PRACTICE IMPLICATIONS: Fall risk differed between the two age groups. Medication may play a major role in falls among patients less than 65 years.

Analysis of inedible substance ingestion at a Japanese psychiatric hospital.

BACKGROUND: Inedible substance ingestion increases the risk of ileus, poisoning, and suffocation. Prevention is especially important in a psychiatric setting. This study aimed to analyze the incidence of inedible substance ingestion in a Japanese psychiatric hospital. METHODS: Inedible substance ingestion incidents were extracted from an incident report database spanning 2000-2012 at a 400-bed psychiatric hospital in Japan. We tabulated the frequencies of incidents in accordance with major diagnosis, ingested materials, incident levels, and time of occurrence. RESULTS: The incidence rate was 0.09/1000 patient days, and 149 cases in 105 patients were classified as having experienced inedible substance ingestion. The most common diagnosis was dementia (n = 58), followed by schizophrenia (n = 22). Materials ingested by dementia patients were nappies or gauze attached to the patient's body after medical procedures. Materials ingested by schizophrenic patients were liquid soap, detergent or shampoo, and cigarettes. Inedible substance ingestion among dementia patients occurred mostly before or during meals. Among schizophrenic patients, the peak period of incidents was in the evening. CONCLUSIONS: Dementia patients were overrepresented in the inedible substance ingestion incidents. Items they wore or applied to their bodies were often subject to ingestion, and such behaviours mostly occurred around meal time. Therefore, the nursing staff were able to discover them quickly and treat most of the cases free of serious consequences. In contrast, schizophrenic patients were underrepresented in the incidents, and most cases involved ingestion of detergent powder or cigarettes, resulting in more serious consequences and requiring treatment.

Assessment and care of visuospatial disorientation in a mixed dementia patient: a case study using objective measurements.

We present a case of a mixed dementia patient with visuospatial disorientation and a developmental disability. The patient was a 69-year-old man who was hospitalized for resistance to care, wandering, and a sleep disorder. He was in the advanced stages of dementia and had severe visual impairment due to cataracts. We used an integrated circuit monitoring system and Actiwatch to measure the distance moved per day and sleep-rest cycle, respectively. We administered a coloured paper test to assess the colour most easily recognized by the patient, which was red. We found that displaying his name in large red letters by his door enabled the patient to read his name. We also moved him to a private room next to the day room. The distance moved per day decreased significantly after the implementation of the care plan. However, after the room change, large urine spills were often observed in the bathroom, indicating visuospatial problems. We placed red adhesive tape onto the toilet bowl to make it more visible, which solved the urine spill problem. This case study demonstrates the efficacy of using simple assessment techniques to identify the remaining abilities of a dementia patient and taking simple steps to address the behavioural and psychological symptoms of dementia.

Discrepancy between subjective and objective assessments of wandering behaviours in dementia as measured by the Algase Wandering Scale and the Integrated Circuit tag monitoring system.

AIM: Although wandering is one of the major research focuses of the behavioural psychological symptoms of dementia, assessment of wandering has mostly relied on caregiver-administered questionnaires. The purpose of this study was to compare staff-administered Algase Wandering Scale outcomes with objective temporal and spatial movement indicators obtained from the Integrated Circuit (IC) tag monitoring system. METHODS: Patients with dementia were recruited from a dementia care unit in Osaka, Japan in 2007. Primary nurses administered the Algase Wandering Scale, and the temporal and spatial movements of the subjects were monitored by the IC tag. Written informed consent was obtained from each subject's proxies. RESULTS: Nurses' assessments of wandering were in agreement with the IC tag outcomes only during the day shift. Spatial movements assessed by the staff did not reflect those measured by the IC tag. CONCLUSION: This objective measurement of wandering showed the limitations in the assessment of spatial and temporal movement by the staff.

[The status of smoking cessation support by nurses in general hospitals, and related factors].

OBJECTIVE: To examine the status of smoking cessation support by nurses in general hospitals, as well as related factors METHODS: We conducted a questionnaire survey of 1,206 nurses working in three hospitals (inpatient and outpatient departments), and received 830 valid responses. We collected information in the following areas: sociodemographics, smoking status, work-related stress, experience of learning how to support smoking cessation, knowledge about smoking hazards and methods of assistance with quitting smoking, attitudes towards supporting smoking cessation, subjective norms to support smoking cessation, self-efficacy in smoking cessation support, intention to smoking cessation support, and status of smoking cessation support(Five "A's"). Multiple regression analysis was performed in order to identify factors related to status of smoking cessation support. We explained to subjects, both in verbal and written form, the purpose of the study, maintenance of anonymity, and the data handling and protection of confidentiality. RESULTS: Nurses who asked patients about their smoking status (Ask) accounted for 87.8% of the total, and 88.4% advised them to quit smoking (Advice). A total of 67.5% assessed the intentions of patients to quit (Assess), 66.6% assisted their attempts to quit (Assist), and 53.3% arranged programs to prevent patients from slipping back into the habit (Arrange). The positive influential factors on "Assess" were work-related stress, attitudes, self-efficacy and intention. The positive influential factors for "Assist" were age, experience of learning, self-efficacy, intension. For "Arrange" they were attitudes, self-efficacy and intention. The results suggested that hospital nurses showed positive attitudes towards supporting smoking cessation and were highly motivated. On the other hand, 37.1% had not yet learned methods to support smoking cessation, particularly nicotine replacement therapy, the stages of cessation, and counseling methods and self-efficacy of the support related to them was low. CONCLUSIONS: In order to encourage nurses to "Assess", "Assist", and "Arrange", it is necessary to spread training programs which raise self-efficacy.