動作を伴う視線計測に関する文献的考察

目　的：本研究の目的は，動作を伴う視線計測に関する先行研究から，視線の測定方法，分析方法，対象者数の妥当性を明らかにすることである。方　法：文献の選定には，CiNii Articles，医学中央雑誌Web 版（Ver.5），Medical Online を用い，キーワードは「視線計測」「アイマークレコーダ」「注視」とした。得られた文献のうち，選定基準に合致した文献23 件を分析対象とした。帰納的に内容を分析し，機器の条件設定，対象者数，分析指標等をマトリックスシートに整理し，視線の測定方法や分析方法の妥当性を検討した。結　果：視線計測機器の条件設定において，眼球運動の測定には瞳孔角膜反射法が多く用いられており，視野カメラレンズには水平角92°のレンズが最も多く用いられていた。対象者と分析処理方法について，対象者5 名以下では視線パターンを把握することを目的としており，統計的検定は行われていなかった。一方で，11 名以上を対象とした文献では，若齢者と比較した高齢者の視線，非熟練者と比較した熟練者の視線の特徴を統計学的検定から明らかにしていた。分析指標としては「注視時間」「注視回数」「注視項目変化表」「視線軌跡」が多く用いられていた。考　察：動作を伴う視線計測から熟練者の技の可視化，新人看護師や看護学生の技術習得，患者教育に繋げるためには，モバイル型視線計測機器を用い，動作環境に合わせた視野カメラレンズ，キャリブレーション方法を選択する必要がある。また，10 名以上を対象とした注視時間や注視回数の比較，注視項目変化表の分析より，動作中の思考や認知のプロセスを推定することが可能になると示された。資

手術を受ける胄がん患者の入院前から退院後における手術に関する心配事およぴ健康関連QOLの推移

Purpose：To elucidate the changes in worry related to surgery and health-related quality of life (QOL) from before admission to the initial outpatient visit after discharge with the objective of identifying suggestions for effective perioperative nursing support in gastric cancer patients undergoing surgery.Methods：A self-administered questionnaire that included the Elective Surgery Worry Assessment Tool (ESWAT) and Short Form-8 (SF-8) was conducted on gastric cancer patients undergoing surgery. Data were collected before admission (T1), on the day of admission (T2), and at the initial outpatient visit (T3). Data were analyzed using the paired t-test and one-way ANOVA with repeated measures.Results：Fifteen men and ten women (mean age, 67.9 years) were analyzed. The mean ESWAT scores were 44.5 at T1 and 50.3 at T2, a difference that was not statistically significantly (t=1.509, p=0.144). On the SF-8, Physical functioning scores were 48.9 at T1, 48.9 at T2, and 45.0 at T3 (F=3.902, p=0.040), Role physical scores were 48.9 at T1, 48.0 at T2, and 41.5 at T3 (F=6.138, p=0.004), Vitality scores were 50.5 at T1, 50.6 at T2, 47.6 at T3 (F=3.289, p=0.046), Social functioning scores were 49.6 at T1, 48.2 at T2, and 41.7 at T3 (F=8.845, p=0.001), and Role emotional scores were 48.4 at T1, 48.1 at T2, and 44.3 at T3 (F=4.747, p=0.029), confirming a main effect of time. Bodily pain scores were 52.9 at T1, 51.2 at T2, and 48.0 at T3 (F=2.764, p=0.103), General health scores were 48.1 at T1, 48.5 at T2, and 47.3 at T3 (F=0.228, p=0.740), and Mental health scores were 47.8 at T1, 47.3 at T2, and 48.1 at T3 (F=0.211, p=0.811), indicating the absence of a main effect of time.Discussion：In order to reduce the worry of gastric cancer patients undergoing surgery and to increase their health-related QOL, the perioperative management team should refer to the concepts of enhanced recovery after surgery and provide mental support as well as intervention in anticipation for postoperative reduction in physical activity and presentation of digestive and absorption disorders starting before hospitalization.目的：胃がん手術患者の効果的な周手術期看護援助の示唆を得るために，入院前から退院後初回外来受診時までの手術に関する心配事および健康関連QOLの推移を明らかにする。方法：胃がん手術患者を対象に，ESWATとSF-8を用いた自記式質問紙調査を実施した。データ収集は，入院前（T1），入院日（T2），初回外来受診時（T3）に実施した。分析は，対応のあるt検定と繰り返しのある一要因の分散分析を行った。結果：分析対象者は，男性15名，女性10名で，平均年齢67.9歳であった。ESWAT得点は，T1：44.5点，T2：50.1点であり，有意な差は認められなかった（t＝1.509，p＝0.144）。SF-8では，PFはT1：48.9点，T2：48.9点，T3：45.0点（F＝3.902，p＝0.040），RPはT1：48.9点，T2：48.0点，T3：41.5点（F＝6.138，p＝0.004），VTはT1：50.5点，T2：50.6点，T3：47.6点（F＝3.289，p＝0.046），SFはT1：49.6点，T2：48.2点，T3：41.7点（F＝8.845，p＝0.001），REはT1：48.4点，T2：48.1点，T3：44.3点（F＝4.747，p＝0.029）であり，時間の主効果が認められた。BPはT1：52.9点，T2：51.2点，T3：48.0点（F＝2.764，p＝0.103），GHはT1：48.1点，T2：48.5点，T3：47.3点（F＝0.228，p＝0.740），MHはT1：47.8点，T2：47.3点，T3：48.1点（F＝0.211，p＝0.811）であり，時間の主効果は認められなかった。考察：胃がん手術患者の手術に関する心配事を低減し，健康関連QOLを高めるためには，周手術期管理チームがERASに基づき，入院前から患者に対して，精神的支援と術後の身体活動量の低下や消化・吸収障害を見据えた介入を行っていくことが必要である。原

Factors Influencing Scores on a Lymphedema Self-management Skill（LESMS）Scale

application/pdfdepartmental bulletin pape

Clarification of the experiences of patients who underwent hysterectomy for uterine fibroids, from the time of decision to operate until discharge

departmental bulletin pape

Nursing the body and mind throughout the progression of Amyotrophic Lateral Sclerosis

departmental bulletin pape

脊椎手術後固定装具装着をした患者の入院中の日常生活動作における体験の明確化

　Purpose：Experience in activities of daily living during hospitalization of patients wearing spine immobilization braces were examined to obtain suggestions for daily living assistance for spine surgery patients.　Methods：An interview survey of 18 hospital in-patients，aged ≥ 50 years，who had undergone cervical spine or lumbar surgery and were wearing a spine immobilization brace，was conducted using a semi-structured interview method．The interviews were conducted 2–3 days before the patients were scheduled to be discharged from the hospital，and the data were analyzed with reference to the summarizing content analysis of Mayring．　Results：The experiences in activities of daily living during hospitalization of patients wearingcervical spine immobilization braces were divided into 8 categories：adherence to contraindicated positions accompanying cervical rest，visual field restriction when wearing a collar，movement restrictions accompanying cervical rest，difficulty with eating movements when wearing a collar，burden and feeling of security in wearing a collar，caution when using a walking aid，postoperative effects on the body ，and support in activities of daily living ．In patients wearinglumbar spine immobilization braces，the 8 categories were：adherence to contraindicated positions accompanying lumbar rest，difficulty with eating movements accompanying lumbar rest，burden and feeling of security in wearing a corset，measures to prevent falls when walking，caution when using a walking aid，effects on the body from surgery，modifications in activities of daily living because of contraindicated positions ，and support in activities of daily living ．　Discussion：Patients wearing spine immobilization braces experience many kinds of difficulties in activities of daily living，due to the need for avoidance of contraindicated positions．Patients wearing cervical spine immobilization braces not only had a restricted range of motion in the neck，but also had to contend with restrictions in their visual field and mouth opening，which hindered expansion of their range of activities of daily living．Patients wearing lumbar spine immobilization braces used aids to deal with the difficulties in activities of daily living resulting from the restricted range of motion，and acquired new movements to expand their range of activities of daily living． The challenges faced by patients wearing spine immobilization braces include the need to avoid contraindicated positions and acquiring new daily living activities．For patients to safely expand their activities of daily living，training to predict and avoid danger at an early stage needs to be incorporated into daily living guidance from preadmission.　目　的：脊椎手術患者に対する日常生活支援の示唆を得るために，脊椎固定装具装着患者の入院中の日常生活動作における体験を明らかにすることである。　方　法：頸椎手術・腰椎手術を受け，脊椎固定装具を装着している50 歳以上の成人・老年期にある入院患者18 名を対象に，半構造化面接法による面接調査を実施した。面接時期は退院予定日の2 ～ 3日前とし，データはMayring の要約的内容分析の手法を参考に分析した。　結　果：頸椎固定装具装着患者の入院中の日常生活動作における体験は，【頸部安静に伴う禁忌肢位の遵守】【カラー装着に伴う視野制限】【頸部安静に伴う体動制限】【カラー装着に伴う食事動作の困難感】【カラー装着の負担と安心感】【歩行器を使用するときの注意】【手術後の身体への影響】【日常生活動作のサポート】の8 カテゴリーで構成された。また，腰椎固定装具装着患者では，【腰部安静に伴う禁忌肢位の遵守】【腰部安静に伴う食事動作の困難感】【コルセット装着の負担と安心感】【歩行時に転倒しない対策】【歩行器を使用するときの注意】【手術による身体への影響】【禁忌肢位のための日常生活動作の工夫】【日常生活動作のサポート】の8 カテゴリーで構成された。　考　察：脊椎固定装具装着患者は，禁忌肢位をとらないことを遵守することで，日常生活動作におけるあらゆる困難を体験していた。頸椎固定装具装着患者は頚部の可動域制限に加え，視野制限や開口制限も強いられており，日常生活動作の拡大が阻害されていた。腰椎固定装具装着患者は可動域制限による困難な日常生活動作に対し，補助具を使用したり，新たな動作を獲得することで日常生活動作を拡大していた。脊椎固定装具装着患者の課題は，禁忌肢位をとらないことの遵守と新たな日常生活動作の獲得である。患者が安全に日常生活動作を拡大していくためには，危険を早期に予測し回避するトレーニングを，入院前からの日常生活指導に取り入れていくことが必要である。報

腰部脊柱管狭窄症患者の周手術期における健康関連QOL および不安・抑うつの推移

Objective：The objective of this study was to elucidate the changes in quality of life （QOL），anxiety，and depression from before admission to 1 month post-discharge in order to gain insight into the types of perioperative nursing support needed for patients undergoing surgery for lumbar spinal stenosis（ LSS）．　Methods：A self-administered questionnaire survey of 31 LSS patients was conducted using the 36-Item Short-Form Health Survey （SF-36） and Hospital Anxiety and Depression Scale． Data were collected between 1 and 2 weeks before admission（ T1），1 to 3 days after admission（ T2），1 to 3 days before discharge（ T3），and at 1 month after discharge（ T4）． The data were analyzed byrepeated one-way analysis of variance．　Results：The subjects were 17 men（ 54.8%） and 14 women（ 45.2%） with a mean age of 70.9 ± 9.7years. The anxiety score was 6.1 points at T1，6.2 points at T2，4.8 points at T3，and 5.0 points at T4，with a main effect for time （F= 3.29，p = 0.024）． The depression score was 6.7 points at T1，6.8 points at T2，6.0 points at T3，and 7.0 points at T4，with no main effect for time. The SF-36 scores were 13.6 points at T1，14.2 points at T2，and 15.9 points at T4 for physical functioning; 22.7 points at T1，23.5 points at T2，and 20.4 points at T4 for role-physical; 43.7 points at T1，44.6 points at T2，and 45.3 points at T4 for general health; 42.4 points at T1，42.7 points at T2，and 46.1 points at T4 for vitality; 34.3 points at T1，31.6 points at T2，and 34.8 points at T4 for social functioning; and 31.4 points at T1，34.3 points at T2，and 29.4 points at T4 for role-emotion. There was no main effect for time for any of these subscales. The scores for bodily pain were 32.1 points at T1，33.7 points at T2，and 44.1 points at T4，with a main effect for time（ F= 19.93，p ＜ 0.001）．The scores for mental health were 43.6 points at T1，40.9 points at T2，and 46.0 points at T4，with a main effect for time（ F= 4.24，p = 0.019）．　Discussion：The present results suggest that in order to reduce anxiety and depression and increase health-related QOLperioperatively in LSS patients，preparatory education beginning before admission and discharge support for a smooth transition from the hospital to home are needed．目　的 ： 腰部脊柱管狭窄症で手術を受ける患者（LSS 患者）の周手術期看護援助の示唆を得るために，入院前から退院後1 ヶ月のQOL および不安・抑うつ状態の推移を明らかにすることである。　方　法 ： LSS患者31 名を対象に，SF-36，HADSを用いた自記式質問紙調査を実施した。データ収集は，入院前1 ～ 2 週間：T1，入院後1 ～ 3 日以内：T2，退院前1 ～ 3 日以内：T3，退院後1 ヶ月：T4 に実施した。分析は，繰り返しのある一要因の分散分析を行った。　結　果：対象者は，男性17 名（54.8％），女性14 名（45.2％），平均年齢70.9 ± 9.7 歳であった。不安得点はT1：6.1 点，T2：6.2 点，T3：4.8 点，T4：5.0 点であり，時間の主効果があった（F=3.29，p =0.024）。抑うつ得点はT1：6.7 点，T2：6.8 点，T3：6.0 点，T4：7.0 点であり，時間の主効果はなかった。SF-36 では，PF はT1：13.6 点，T2：14.2 点，T4：15.9 点，RP はT1：22.7 点，T2：23.5 点，T4：20.4 点，GHはT1：43.7 点，T2：44.6 点，T4：45.3 点，VT はT1：42.4 点，T2：42.7 点，T4：46.1 点，SF は，T1：34.3 点，T2：31.6 点，T4：34.8 点，RE はT1：31.4 点，T2：34.3 点，T4：29.4 点であり，いずれも時間の主効果はなかった。また，BP はT1：32.1 点，T2：33.7 点，T4：44.1 点で，時間の主効果があり（F=19.93，p ＜ 0.001），MHはT1：43.6 点，T2：40.9 点，T4：46.0 点で，時間の主効果があった（F=4.24，p =0.019）。　考　察：LSS 患者の周手術期の不安・抑うつを低減し，健康関連QOL を高めるには，入院前からの準備教育，病院から在宅への円滑な移行のための退院支援の必要性が示唆された。原

看護学生が臨床場面を観察する時のアセスメント力を視覚情報から可視化する試み

Objective：To investigate whether the assessment capabilities of nursing students can be clarified from the observation contents of a questionnaire-based survey and the descriptive contents of thought processes using visual information to visualize the trajectories of their cognitive processes for patient observation.　Methods：Still images of model dummies receiving oxygen therapy and fluid therapy were shown to five third-year nursing college students who had taken all courses prior to practical training in different areas of nursing，and gaze measurements and a questionnaire-based survey were conducted.　Results：The students fixed their gazes the longest and the most frequently on intravenous（ IV）infusions，followed by oxygen inhalation and aspiration. Gaze trajectories followed a pattern of first looking at the face，perfunctorily checking all areas，and then carefully looking at each area considered necessary for observation，such as IV infusions，oxygen inhalation and aspiration. Four of the five students began by looking at the face and all of the students stopped to observe IVinfusions，oxygen inhalation，and aspiration for 2 seconds or longer.　In the studentsʼ descriptions of IV infusions，on which students fixated the longest and the most frequently，four students described noticing that “an IV infusion was attached” and thought that “drugs and other fluids were being fed into the body,” “a risk of IV infusion-related complications existed,” and “they would check for loosening of the needle or any bleeding.” Furthermore，“infusion management” and “ensuring reliable IV infusion management and an IV route” were described by the students as necessary support.　Discussion：The students surveyed in this study appeared to recognize that oxygen inhalation and IV infusions are areas that must be observed. Current practical training in nursing is aprocess of acquiring knowledge and experience; however，the findings of this study suggest that “the ability to anticipate,” “the ability to estimate safety and pain,” and “the ability to predict risks” are also being nurtured in students. These abilities allow students to use observations to recognize problems，such as the possibility that an IV needle may have come loose or that a patient may be receiving insufficient oxygen.The assessment capabilities of nursing students could conceivably be understood by visualizing the gazes fixed on focused images　and analyzing in conjunction with the observation contents of a questionnaire-based survey and the descriptive contents of thought processes. 　Increasing opportunities for students to observe nursing care through clinical images and increasing experiences that confirm knowledge，skills，and coping strategies that are necessary together with teachers could enhance studentsʼ assessment capabilities.目　的：本研究の目的は，動作を伴う視線計測に関する先行研究から，視線の測定方法，分析方法，対象者数の妥当性を明らかにすることである。方　法：文献の選定には，CiNii Articles，医学中央雑誌Web 版（Ver.5），Medical Online を用い，キーワードは「視線計測」「アイマークレコーダ」「注視」とした。得られた文献のうち，選定基準に合致した文献23 件を分析対象とした。帰納的に内容を分析し，機器の条件設定，対象者数，分析指標等をマトリックスシートに整理し，視線の測定方法や分析方法の妥当性を検討した。結　果：視線計測機器の条件設定において，眼球運動の測定には瞳孔角膜反射法が多く用いられており，視野カメラレンズには水平角92°のレンズが最も多く用いられていた。対象者と分析処理方法について，対象者5 名以下では視線パターンを把握することを目的としており，統計的検定は行われていなかった。一方で，11 名以上を対象とした文献では，若齢者と比較した高齢者の視線，非熟練者と比較した熟練者の視線の特徴を統計学的検定から明らかにしていた。分析指標としては「注視時間」「注視回数」「注視項目変化表」「視線軌跡」が多く用いられていた。考　察：動作を伴う視線計測から熟練者の技の可視化，新人看護師や看護学生の技術習得，患者教育に繋げるためには，モバイル型視線計測機器を用い，動作環境に合わせた視野カメラレンズ，キャリブレーション方法を選択する必要がある。また，10 名以上を対象とした注視時間や注視回数の比較，注視項目変化表の分析より，動作中の思考や認知のプロセスを推定することが可能になると示された原

手術を受ける肺がん患者の入院前から退院後における健康関連QOL

Purpose：To elucidate the trends in anxiety, depression, and health-related quality of life （QOL） from the time pre-admission to one week post-discharge in order to formulate suggestions for effective perioperative nursing support for lung cancer patients undergoing surgery （lung resection）.Methods：A self-administered questionnaire using the Japanese version of the Hospital Anxiety and Depression Scale and the 8-item Short Form Health Survey（ SF-8） was distributed to 32 lung resection patients. Data were collected at the preoperative examination visit before admission（ T1）, on the day of admission（ T2）, at the time of deciding discharge（ T3）, and at the first outpatient visit one week post-discharge（ T4）. Analysis was done using a one-way repeated measures analysis of variance.Results：The participants were 20 men（ 62.5%） and 12 women（ 37.5%） with a mean age of 66.8 ± 11.9 years. Anxiety scores were 5.4 at T1, 5.8 at T2, 5.1 at T3, and 4.9 at T4, with no main effect for time（ F = 0.779, p = 0.470）. Depression scores were 5.7 at T1, 7.0 at T2, 7.0 at T3, and 7.2 at T4, also with no main effect for time （F = 2.123, p = 0.119）. In the SF-8, physical functioning scores were 49.3 at T1, 49.8 at T2, and 43.9 at T4（ F = 10.954, p < 0.001）, role physical scores were 49.7 at T1, 49.9 at T2, and 41.9 at T4（ F = 15.534, p < 0.001）, bodily pain scores were 58.0 at T1, 56.9 at T2, and 44.1 at T4（ F= 47.216, p < 0.001）, social functioning scores were 50.3 at T1, 50.7 at T2, and 45.1 at T4（ F = 10.416, p < 0.001）, and role emotional scores were 50.3 at T1, 50.3 at T2, and 46.6 at T4 （F = 6.150, p = 0.008）, revealing main effects for time in these domains. General health scores were 49.9 at T1, 49.0 at T2, and 47.7 at T4, vitality scores were 50.7 at T1, 50.4 at T2, and 47.6 at T4, and mental health scores were 48.5 at T1, 47.5 at T2, and 49.9 at T4, indicating no main effects for time in any of these domains.　Discussion：To reduce anxiety and depression and improve health-related QOL among lung resection patients in the perioperative period, perioperative management teams must intervene with patients prior to hospital admission with a view to supporting patientsʼ mental state and addressing post-discharge pain and declining physical functioning.原

Anti-Trypanosoma cruzi activity of Coptis rhizome extract and its constituents

Background:Current therapeutic agents, including nifurtimox and benznidazole, are not sufficiently effective in the chronic phase of Trypanosoma cruzi infection and are accompanied by various side effects. In this study, 120 kinds of extracts from medicinal herbs used for Kampo formulations and 94 kinds of compounds isolated from medicinal herbs for Kampo formulations were screened for anti-T. cruzi activity in vitro and in vivo.Methods:As an experimental method, a recombinant protozoan cloned strain expressing luciferase, namely Luc2-Tulahuen, was used in the experiments. The in vitro anti-T. cruzi activity on epimastigote, trypomastigote, and amastigote forms was assessed by measuring luminescence intensity after treatment with the Kampo extracts or compounds. In addition, the cytotoxicity of compounds was tested using mouse and human feeder cell lines. The in vivo anti-T. cruzi activity was measured by a murine acute infection model using intraperitoneal injection of trypomastigotes followed by live bioluminescence imaging.Results:As a result, three protoberberine-type alkaloids, namely coptisine chloride, dehydrocorydaline nitrate, and palmatine chloride, showed strong anti-T. cruzi activities with low cytotoxicity. The IC50 values of these compounds differed depending on the side chain, and the most effective compound, coptisine chloride, showed a significant effect in the acute infection model.Conclusions:For these reasons, coptisine chloride is a hit compound that can be a potential candidate for anti-Chagas disease drugs. In addition, it was expected that there would be room for further improvement by modifying the side chains of the basic skeleton