Aims: To evaluate the reliability and validity of the Mongolian Version of the Spinal Cord Independence Measure (mSCIM).

Methods: Spinal cord independence measure III (SCIM III) was translated into Mongolian and data collected from 40 patients with spinal cord injury (SCI) were analysed. Reliability and validity were analysed in 30 patients, and the responsiveness was tested in 10 patients at admission to rehabilitation and discharge.

Results: Percent agreement and Kappa values between two raters were 83-100% and 0.70-1.00, respectively, in all mSCIM items. Intraclass correlations were shown to be above 0.99 within subscales and total score, and Cronbach’s alpha was above 0.75 aside from the respiration and sphincter subscale. The correlation between mSCIM and motor parts of the Functional Independence Measure (mFIM) was above 0.86 in each rater. The mSCIM showed more responsiveness to functional changes for patients at discharge than mFIM.

Conclusions: The SCIM III scale was translated into Mongolian, high inter-rater reliability and validity was shown. In addition, more sensitive to changes in function compared with mFIM. Furthermore, we justified the use of mSCIM in the field of rehabilitation, which might be easier for rehabilitation staff to use, because it is in their mother language.

Aim: This study aims to clarify the process leading mothers of one- to two-month-old infants to seek help from nursing professional and to contribute to the discussion of how best to support mothers in seeking help. Method: Semi-structured interviews were conducted with 10 primipara mothers of one- to two-month-old infants, and the data were analyzed qualitatively and inductively using the Modified Grounded Theory Approach. Results: The process by which these mothers seek help from nursing professional began with feeling “trivial concerns about their own child that arise regularly” during parenting. Parents fall into a “cycle amplifying parenting anxiety” and this process was impacted by “disappointment in the response of nursing professional”, “satisfaction with the response of nursing professional”, and an “affirmative attitude toward help-seeking and reassurance from hearing typical experiences of other mothers”. The process ultimately impacted the mothers’ “idea and decision to seek help from nursing professional” while their feelings about help-seeking spiraled back and forth. Conclusion: These results suggested that reducing barriers to help-seeking and establishing an environment where support is readily available even if barriers arise are important ways to assist mothers in seeking help from nursing professional.

Background & Aims: The purpose of this study was to gain insights into how patients experience involuntary admission under Japan’s system of psychiatric care. To this end, patients who had been involuntarily admitted and were scheduled for discharge were interviewed about their experiences at hospital admission to clarify the feelings of such patients’ experience on the day of admission.

Method: Semi-structured interviews were conducted among 12 inpatients who had been involuntary admitted to the hospital and consented to participate. The interview data was analysed qualitatively and descriptively.

Results: Feeling of involuntary admitted patients were summarised into five thematic categories: [Life/work commitments are bigger priorities than admission], [Surprise and anger at being deceived by family], [Recognising one’s emotionally driven behaviour], [Resigning to and accepting intangible exogenous forces], and [Unconvinced of explanation by health care professionals on admission].

Conclusion: Even after visiting to the hospital, patients remained clearly committed to their life/work, which were their bigger priorities than admission. The patients also felt that they had been deceived by their family. Issues regarding decision-making regarding hospitalization emerged. As they were aware of their own situation, they resigned to and accepted the inpatient treatment. As an initiative for outpatients at the time of non-voluntary hospitalisation, our results suggest that support is required for deciding treatment plans while sharing the opinions of both patients/family members and health care professionals while respecting what is important for the patients.

Aim: First-year medical students’ attitudes toward health care teams were compared between Sapporo Medical University and Gunma University, to evaluate the effect of the student placements in community health on the attitudinal change toward collaborative practice (CP).

Methods: The modified Attitudes Toward Health Care Teams Scale was used to measure the attitudes of medical students from Sapporo Medical University and Gunma University. The scale was subjected to exploratory factor analysis to examine the underlying constructs of the survey.

Results: The questionnaire was categorized into three subscales. The regression factor scores of “Quality of care delivery” were significantly reduced at both universities, while those for “Patient-centered care” trend toward an increase at both universities after subjects. Interestingly, there was no significant difference, with almost the same levels in all subscales, after the subjects between the two universities.

Conclusions: Medical students may rather expect high values of CP from the viewpoints of care providers at the entry level. The interprofessional education (IPE) program can contribute to their awareness of the values. Finally, the additive effects of community placement in the IPE program could not be revealed for only one year.

Purpose: To identify preceptor role performance and related factors among university hospital nurses. Methods: We conducted an anonymous self-administered questionnaire survey with 89 nursing preceptors at university hospital A. The questionnaire included the “self-evaluation scale of preceptor role performance for new graduate nurses”; and items on relationships with newly graduated and more experienced nurses, degree of cooperation from the head nurse, the vice-head nurse, and more experienced nurses for newly graduated nurse training, and experience of external leader training. Data were analyzed using the Mann-Whitney U test and Kruskal-Wallis test. Result: Eighty nursing preceptors answered the questionnaire. The preceptors who had a high degree of cooperation from the head nurse and vice-head nurse scored higher on the “teaching and evaluation according to the teaching plan” subscale. The preceptors who had good relationships with more experienced nurses and high degree of cooperation from head nurse and vice-head nurse and more experienced nurses scored higher on the “conducting systematically normal tasks” subscale. Conclusion: Good relationship with more experienced nurses, and cooperation from all members in the departments for newly graduated nurse training are important factors for nursing preceptors to perform well.

Aims: The purpose of this study was to assess the reliability and validity of “a scale of hospital nurses’ nursing activities towards providing home care,” and to elucidate factors related to the implementation of nursing activities towards providing home care. Methods: Data from two surveys of nurses in 11 hospitals in Gunma Prefecture were reanalyzed to assess the reliability and validity of the scale and to investigate the relationship between their attributes and the factor scores. Results: Data from 1568 nurses in the 2014 survey and 1693 nurses in the 2018 survey were analyzed. The scale consisted of the following 4 factors, [understanding of information on life at home], [discharge coordination and guidance], [utilization of social resources] and [multi-professional collaboration]. The reliability coefficient （Cronbach’s α） of the whole scale was found to be as high as 0.96. Visiting nursing/home care training was related to the scores for all 4 factors. In addition, age and years of experience were related to the scores for [utilization of social resources] and [multi-professional collaboration]. Conclusion: Our results suggested that the scale can be used to comprehensively assess hospital nurses’ nursing activities towards providing home care.

Many surgeons separate pulmonary arteries and veins using vascular stapling devices. However, unexpected catastrophic incidents can occur using this method. We experienced a case of critical bleeding from a tear located near the distal site of the stump of the first branch (common branch to the anterior and apical segment) of the left main pulmonary artery, while the patient was waking from general anesthesia after surgical manipulation. Surgeons should leave a stump length equal to half the diameter of the pulmonary artery and closely observe the chest drainage during changes in blood pressure when waking patients from general anesthesia.

An 83-year-old man was admitted to our hospital with the complaint of epigastric pain. He was diagnosed with gallstone pancreatitis, and a temporary bile duct placement was performed. Subsequently, laparoscopic cholecystectomy was performed for the removal of residual gallbladder stones. Intraoperatively, because of tissue sclerosis （mainly in the Calot’s triangle and the neck of the gallbladder）, we removed the gallbladder after dissecting the hepatic bed from the fundus of the gallbladder, and dissecting the cholecystic artery and cholecystic duct. Gross examination of the excised specimen showed a 13-mm papillary protuberance in the body of the gallbladder. Histopathological examination showed that it was a low-grade, atypical, papillary proliferation of the gallbladder epithelium. The lesion was diagnosed as an intracystic papillary neoplasm （ICPN）. ICPN is considered to be an intraductal papillary neoplasm of the bile duct growing within the gallbladder. This disease is poorly recognized, and only a limited number of cases have been reported. They are often diagnosed together with cancer because they are precancerous lesions. Because it is very rare to have an incidental diagnosis of ICPN without a concurrent cancer, we report this case along with a review of literature with this condition.