The Development of the Arm Fixation Method to Prevent Ipsilateral Shoulder Pain in Patients Undergoing Lung Resection.

PURPOSE: The aim of the present study was to investigate the efficacy of a new upper limb fixation method-body pillow position for preventing postoperative ipsilateral shoulder pain (ISP) in patients undergoing lung resection. DESIGN: An experimental study design was used. METHODS: We conducted two comparisons (group A: the previous position using the arm fixation device; group B: the body pillow position) at random and examined an arm fixation method that is effective for ISP prophylaxis in patients undergoing surgery in the lateral decubitus position. FINDINGS: We approached 87 patients, two were excluded, and, thus, 85 were randomly assigned to group A (n = 43) or group B (n = 42). No significant differences were observed in the frequency of ISP between groups A and B (25.6% vs 26.2%). The intensity of ISP between both groups was analyzed by a repeated-measures analysis of variance and was shown to decrease over time in 22 patients (P = .010). The intensity of ISP on postoperative days 0 to 3 was slightly lower in group B than in group A (P = .158). Risk factors for ISP were the duration of surgery (odds ratio, 1.01; 95% confidence interval, 1.00 to 1.01) and pre-existing shoulder stiffness (odds ratio, 5.15; 95% confidence interval, 1.07 to 24.83). CONCLUSIONS: There was no significance in the frequency of ISP between group A and group B. The intensity of ISP on postoperative days 0 to 3 was lower in group B than in group A, although there was no significant difference. It is important perspective for perioperative care providers to prevent ISP for early postoperative recovery and improvement of postoperative quality of life. These results suggested that we must consider a better position for preventing postoperative ISP in patients undergoing lung resection.

Ipsilateral shoulder pain in patients following lung resection in the decubitus position.

AIMS AND OBJECTIVES: To examine the frequency, influencing factors and clinical course of shoulder pain in patients following lung resection. BACKGROUND: Thoracoscopes have been introduced in the surgical treatment of lung cancer and allow for less invasive surgery with a minimal incision. However, decubitus position-related shoulder pain on the operated side has not yet been investigated. DESIGN: A longitudinal descriptive study. METHODS: Patients who underwent lung resection in the decubitus position. Patients were interviewed 2 days before surgery and once daily for 5 days after surgery. Interview items included background data, the concomitant use of epidural anaesthesia, operative duration, the presence of preoperative shoulder stiffness (excluding shoulder pain), type of surgery and site of operation. The intensity of pain was approximately 5 on an 11-point numerical rating scale. Descriptive statistics on patient backgrounds were obtained using SPSS Statistics 22 for Windows. RESULTS: Of the 74 patients who underwent lung resection in a decubitus position, 30 (40.5%) developed shoulder pain on the operated side. The highest rating occurred 1 day after surgery and decreased over time. The following two factors were found to influence shoulder pain on the operated side: operative duration (Z = -2.63; p = .01) and the presence of preoperative shoulder stiffness (excluding shoulder pain) (χ2  = 4.16; p = .04). CONCLUSIONS: This study demonstrated that approximately 40% of patients who underwent lung resection in the decubitus position developed shoulder pain. RELEVANCE TO CLINICAL PRACTICE: The presence of postoperative shoulder pain was related to both the duration of the operation and to the presence of preoperative shoulder stiffness. Although the shoulder pain resolves within 4 days, it causes the patient additional discomfort and distress. Therefore, further research is needed on positioning for thoracotomy in order to investigate ways to reduce or eliminate this complication of lung surgery.

Motivation for physical activity before and after allogeneic hematopoietic stem cell transplantation.

Background and Purpose: This study aimed to identify patient motivation for physical activity before and after allogeneic hematopoietic stem cell transplantation (HSCT). Methods: We conducted 14 semi-structured interviews of seven patients (two of each patient): one before starting a conditioning regimen and one after leaving the protected environment. All interviews were recorded and analyzed using the inductive content analysis method. The data collection period was May to December 2018. Results: The participants comprised three men and four women aged 40-70 years. The patients underwent bone marrow, umbilical cord blood, or peripheral HSCT. The patients' motivation for physical activity before and after HSCT was classified into six categories and categorized into five themes including "to overcome HSCT," "to look after myself," "to respond to the donor," "the existence of supporters," and "encouragement from supporters." Conclusions and implications for practice: The categories and themes developed here based on patient responses provide an important perspective that should be promoted among healthcare providers who care for patients undergoing HSCT.

Relationship between Older persons with cancer' Coping Attitudes and Mental Adjustment.

Objective Purpose is to examine the relationship between older persons with cancer coping attitudes and patterns of mental adjustment during treatment. Methods : Coping attitudes and patterns of mental adjustment were measured using an original questionnaire and the Mental Adjustment Cancer Scale (MAC) in 193 patients with cancer aged 65 or over under treatment with surgical therapy, chemotherapy, or radiotherapy. Results : The mean scores for "Do my best to cope with cancer" ,"Make my own decisions on treatment" in coping attitudes showed a significant positive correlation with [fighting spirit] scores in MAC, and "Cancer is just a part of my life", "At my age, no complaint about cancer development", "Face cancer in an easy-going manner", "Do my best to cope with cancer" "Be anxious about my future" were significantly correlated with [fatalism] scores. Conclusions : In conclusion, [fighting spirit] [fatalism] were shown to form the basis for elderly's mental adjustment. [Fatalism] was shown to be a main component of mental adjustment for elderly to develop affirmative coping skills based on their life experiences. In addition, [fighting spirit] was also essential to fulfill their lives, and it may be necessary to support them to keep [fighting spirit] to the end of their lives. J. Med. Invest. 67 : 44-50, February, 2020.

Effects of lifestyle habits and eating meals together with the family on the prevalence of obesity among school children in Tokushima, Japan: a cross-sectional questionnaire-based survey.

Obesity in children has become a major global public health concern. The prevention of obesity must start from early childhood in order to establish sound lifestyle habits and promote healthy adulthood. In this study, we evaluated factors associated with the prevention of obesity and the development of healthy lifestyle habits in children. A cross-sectional, questionnaire-based survey was performed in elementary and junior high school students in Tokushima Prefecture, Japan, during the summer of 2004. The questionnaire consisted of 30 items such as physique, sleep, eating habits, diet, exercise, free time, and attending after-school lessons. Our study revealed that eating meals as a family every day is associated with a lower rate of obesity as well as getting good lifestyle habits such as eating balanced meals and getting enough sleep. Of the 3,291 students who responded to the questionnaire, 2,688 (81.7%) reported that they eat meals with their family every day. The percentage of students who eat meals with their family every day decreased with increasing school grade, with the lowest percent in the junior high school students. However, the results regarding female junior high school students revealed a marked association between eating meals with the family every day and good lifestyle habits. We recommend that parents and school teaching staff encourage the establishment of sound, healthy lifestyle habits in children from early childhood as an effective measure for the prevention of obesity.

Treatment-associated symptoms and coping of postoperative patients with lung cancer in Japan: Development of a model of factors influencing hope.

AIM: Postoperative patients with lung cancer have a high recurrence rate and poor prognosis; hence, it was aimed to identify the factors affecting hope to develop a care-oriented perspective that focuses on the levels of hope of postoperative patients with lung cancer. METHODS: In the study, postoperative patients with lung cancer were included and data were collected for treatment-related symptoms, coping, and support-related factors as the primary variables. The Herth Hope Index, Quality of Life Questionnaire Lung Cancer Module of the European Organization for Research and Treatment of Cancer, Japanese version of the Coping Inventory for Stressful Situations, and Social Support Scale for Cancer Patients were used. RESULTS: For the 82 patients that were included in this study, 55% of the variance in the level of hope was explained by using a model that included the following: (i) symptoms of dyspnea, sore mouth, and chest pain; (ii) support, including satisfaction with postoperative symptom control by healthcare providers, satisfaction with the amount of information provided by healthcare providers, and the level of trust in the nurses during treatment and recovery; and (iii) task-oriented and social diversion coping behaviors. CONCLUSION: As a result of this study, the support-related factors had no direct influence on hope, but they did have a significantly negative influence on the treatment-related symptoms, with improved symptoms also influencing hope.

Relationship between Uncertainty and Emotions in Advanced Lung Cancer Patients after Initial Therapy.

PURPOSE: We investigated the relationship between uncertainty and emotions in advanced lung cancer patients after initial therapy. METHODS: Fourteen advanced lung cancer patients participated in this study. A survey was conducted using the Universal Uncertainty in Illness Scale (UUIS) and the Profile of Mood States-Brief Form (POMS-Brief Form), Japanese Version. RESULTS: The total UUIS score of each participant ranged from 42 to 109, with a mean±SD of 70.7±20.9. The T-scores for the 6 factors of the POMS-Brief Form were 50.2±11.9 (mean±SD) for tension-anxiety (T-A); 49.6±12.2 for depression-dejection (D); 40.4±4.9 for anger-hostility (A-H); 41.8±9.3 for vigor (V); 44.2±5.8 for fatigue (F); and 52.7±15.2 for confusion (C). In terms of the correlation between the total UUIS score and the respective T-scores of the six POMS-Brief Form factors, a strong correlation was seen between total UUIS score and D (r=0.735, p=0.003). A substantial correlation was also seen between total UUIS score and T-A (r=0.694, p=0.006). CONCLUSIONS: In advanced lung cancer patients after initial therapy, uncertainty had an effect on emotions. J. Med. Invest. 64: 96-100, February, 2017.

Truth disclosure of cancer diagnoses and its influence on bereaved Japanese families.

The purpose of this study was to investigate how patients with cancer and their families are informed of the results of the patients' diagnoses. The bereaved families' assessments and satisfaction with the consequences of their decisions were examined after the patients' deaths. Data were collected from the bereaved families of 53 patients who had died of lung cancer at a Japanese university hospital between January 1994 and December 1997. Data were analyzed by employing descriptive statistics for each factor. Fifty-three bereaved families responded to the questionnaire. The true diagnosis-lung cancer-was disclosed to 15.1% of the patients, whereas 26.4% were told that they were suffering from lung tumors. Other less ominous clinical descriptions were given to 58.5% of the participants. Concerning the bereaved families' responses to the manner in which the decisions had been made on truth disclosure, the average degree of satisfaction was expressed as 3.7 cm on a 5.0-cm scale. An ambiguous expression such as "lung tumor" has been arbitrarily interpreted. However, simple truth disclosure to the patient does not necessarily satisfy a bereaved family. If family members can allay a patient's doubt about the diagnosis, the family's satisfaction may improve.

Determinants of life satisfaction among Japanese elderly women attending health care and welfare service facilities.

Prolonged life expectancy must be recognized as an excellent achievement of modern medicine, but not all the elderly people are satisfied with their lives. Life satisfaction is a multi-dimensional issue that depends on many objective and subjective characteristics. In this study, we aimed at investigating the factors affecting life satisfaction of 314 elderly Japanese women attending in 28 elderly-care and welfare facilities at Tokushima Prefecture, Japan. Our results indicated that elderly subjects with depression tendencies always show significantly lower degrees of life satisfaction than others who are not depressed (p<0.001) regardless of their cognitive status. Furthermore, elderly women who shared decision for their living place and whose opinions were considered for daily life decisions reported significantly more life satisfaction levels than others. We conclude that elderly life satisfaction is affected by various determinants however, with different influencing weight. Life satisfaction of elderly people, with or without dementia, is greatly affected by their mood status and share in decision making. Avoiding elderly people depressive mood, sharing them in various daily decisions, considering their opinions, and allowing them to decide their elderly-care facility placement are crucial determinants for their life satisfaction and essential for their coping, adaptation, well-being and successful aging.

Weight and height growth velocities of Japanese boys and girls between age 7 and 14 years: a critical window for early adolescent overweight risk.

Childhood overweight is an important worldwide problem of public health concern, with metabolic, physical and psychosocial complications. More and more evidence is accumulating that children who gain weight rapidly earlier in life are at higher risk of becoming overweight later in adulthood life. Therefore, in a seven-year longitudinal study, we studied mid-childhood and early adolescence weight and height growth velocities among 5,024 Japanese 2(nd) grade primary school boys and girls along with its effect on the likelihood of being overweight adolescents by the age of 14 y. Our findings showed that weight growth velocity of both sexes was associated with being overweight at the end of longitudinal study. Boys' risk of accelerated weight growth velocity and becoming overweight adolescents was almost doubled during ages 7 approximately 11 y and become reduced afterward. Otherwise, odds ratios of girls' weight growth velocity peaks were found only at ages from 9 approximately 10 and 10 approximately 11 y. Thus, we suggest a critical window of mid-childhood period associated with adolescence risk of overweight, and we recommend that studying weight growth determinants during 7 approximately 11 y of boys and 9 approximately 11 y of girls may help in developing and applying proper programs for prevention and intervention of overweight problem.

Tracking overweight and obesity in Japanese children; a six years longitudinal study.

Childhood overweight/obesity is growing steeply, globally. It is usually regarded as a risk factor for severe obesity over life-time course. Here, we investigated temporal course of overweight/obesity development in Japanese school children. A six-year longitudinal study was performed on 16,245 Japanese primary school children (8,427 boys and 7,818 girls) comprising three cohorts of 1(st) approximately 3(rd) grade. A baseline survey was conducted at 2001, followed by annual baseline studies from 2002 approximately 2007 to determine the prevalence and track overweight/obesity. Our results showed that the prevalence of overweight was 15 approximately 23% in boys and 15 approximately 18% in girls, however, for obesity it ranged between 4 approximately 7% in boys; and 2 approximately 4% in girls. As regards for tracking status, 60 approximately 80% of overweight and 35 approximately 70% of obese Japanese primary school boys track into overweight or obese junior high school adolescents. However, these percentages are lower among primary school girls, where only 50 approximately 70% overweight and 30 approximately 60% obese primary school girls track into overweight and obese adolescents, respectively. We conclude that Japanese boys are fatter than girls; and approximately 80% of overweight/obese Japanese primary school children track into junior high school overweight/obese adolescents.

Prediction of Japanese children at risk for complications of childhood obesity: gender differences for intervention approaches.

Childhood obesity is one of the most serious public health problems in Japan, especially in Tokushima compared with other prefectures. This study was designed to clarify the life habits which predispose to development of obesity and can be modified through an appropriate intervention program to combat childhood obesity and its lifestyle-related diseases. A total of 216 school children from Itano Town, a municipality of Tokushima Prefecture, Japan, who are attending the fourth grade (9-10 years) of elementary schools, participated in the study from 2004 to 2007. The study included child's life habits questionnaire, investigating physical activity by recording the daily steps using a pedometer, anthropometric measurements, hematological examination and hemodynamometry in a cross-sectional survey during a two-month period from June to July every year. We conclude that there are considerable gender-related differences for developing obesity and other lifestyle-related diseases; and all intervention strategies against obesity must consider such gender differences. For example, restriction of television watching hours must be intervened for controlling obesity in boys, however for girls, promotion of exercise practice or making more steps per day with adequate sleeping periods should be intervened as the proper approaches for preventing and controlling obesity and other lifestyle-related diseases.