Updated on 2022/04/07

写真a

 
TAKEHARA Kimie
 
Organization
Graduate School of Medicine Associate professor
Graduate School
Graduate School of Medicine
Undergraduate School
School of Health Sciences
Title
Associate professor

Degree 3

  1. 博士(保健学) ( 2013.3   東京大学 ) 

  2. 修士(保健学) ( 2010.3   東京大学 ) 

  3. 学士(保健学) ( 2006.3   東京大学 ) 

Research Areas 1

  1. Life Science / Fundamental of nursing  / foot care, diabetic foot

Current Research Project and SDGs 1

  1. Development of tinea pedis care for prevention of diabetic foot

Research History 4

  1. 名古屋大学大学院医学系研究科看護学専攻   准教授

    2018.4

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    Country:Japan

  2. 東京大学大学院医学系研究科健康科学・看護学専攻   講師

    2016.8 - 2018.3

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    Country:Japan

  3. 東京大学大学院医学系研究科健康科学・看護学専攻   助教

    2013.4 - 2016.8

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    Country:Japan

  4. 東京大学医学部附属病院   看護部   看護師

    2006.4 - 2008.3

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    Country:Japan

Education 3

  1. The University of Tokyo   Graduate School, Division of Medical Sciences

    - 2013.3

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    Country: Japan

  2. The University of Tokyo   Graduate School, Division of Medical Sciences

    - 2010.3

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    Country: Japan

  3. The University of Tokyo   Faculty of Medicine

    - 2006.3

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    Country: Japan

 

Papers 61

  1. DEVELOPMENT OF THE DMIST SCALE FOR MONITORING THE HEALING PROCESS OF DIABETIC FOOT ULCERS

    Oe M., Yotsu R., Sakai Y., Takehara K., Nakagami G., Tamaki T., Sugama J., Sanada H.

    WOUND REPAIR AND REGENERATION   Vol. 29 ( 5 ) page: A5 - A5   2021.9

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    Language:Japanese  

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  2. KERATINASE VISUALIZATION FOR THE DEVELOPMENT OF A TINEA PEDIS SCREENING TOOL FOR THE PREVENTION OF DIABETIC FOOT ULCER

    Takehara K., Narita T., Honda I.

    WOUND REPAIR AND REGENERATION   Vol. 29 ( 5 ) page: A17 - A18   2021.9

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    Language:Japanese  

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  3. Relationship Between Teams’ Leader–Member Exchange Characteristics and Psychological Outcomes for Nurses and Nurse Managers: A Cross-Sectional Study in Japan

    Saeka Kawaguchi, Yukie Takemura, Kimie Takehara, Keiko Kunie, Naoko Ichikawa, Kazunori Komagata, Koji Kobayashi, Mitsuyo Soma, Chieko Komiyama

    SAGE Open Nursing   Vol. 7   page: 23779608211025981 - 237796082110259   2021.6

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    Language:Japanese   Publishing type:Research paper (scientific journal)   Publisher:SAGE Publications  

    <sec><title>Introduction</title> The Leader–Member Exchange (LMX) theory, based on the social exchange theory, relates to positive psychological states among nurses. However, the influence of various LMX qualities coexisting within a team on nurses or nurse managers is still uncleared.

    </sec><sec><title>Objective</title> This study examines the relationship of nurses and nurse managers’ psychological states with the average LMX and LMX dispersion among nurses in their units.

    </sec><sec><title>Methods</title> The study was conducted at two university hospitals in March 2017 using anonymous questionnaires. Nurses completed the LMX-7 scale and the subscales of job satisfaction, achievement, and growth from the Checklist on Commitments Related to Work. Nurse managers completed the subscales of management satisfaction, effectiveness, and extracting extra effort from the Multifactor Leadership Questionnaire. Both nurses and managers completed the Intention to Continue Working scale. The nurses’ data were analyzed using a multilevel analysis to clarify associations between nurses’ psychological states and LMX, average LMX, and LMX dispersion. Hierarchical multiple regression analysis tested to test the correlations of the psychological states of nurse managers with average LMX and LMX dispersion.

    </sec><sec><title>Results</title> Data from 586 nurses and 28 managers were analyzed. The LMX and average LMX of nurses were positively related to positive psychological states. Nurse managers displayed significant associations between high LMX dispersion and good psychological states. When average LMX was low, management effectiveness increased as LMX dispersion increased; when average LMX was high, management effectiveness was almost constant.

    </sec><sec><title>Conclusion</title> The unit’s LMX characteristics appear to be related to the psychological states of both nurses and nurse managers. Increasing the LMX of each nurse may lead to positive psychological states for not only that nurse but all nurses in the unit. When LMX with subordinates is low, increasing LMX with a portion of nurse managers should be a priority to improve their psychological states.

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    DOI: 10.1177/23779608211025981

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    Other Link: http://journals.sagepub.com/doi/full-xml/10.1177/23779608211025981

  4. Prevention of diabetic foot ulcers using a smartphone and mobile thermography: a case study. International journal

    Makoto Oe, Kahori Tsuruoka, Yumiko Ohashi, Kimie Takehara, Hiroshi Noguchi, Taketoshi Mori, Toshimasa Yamauchi, Hiromi Sanada

    Journal of wound care   Vol. 30 ( 2 ) page: 116 - 119   2021.2

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    Language:Japanese   Publishing type:Research paper (scientific journal)  

    OBJECTIVE: Early identification of pre-ulcerative pathology is important to preventing diabetic foot ulcers (DFU), but signs of inflammation are difficult to detect on the feet of patients with diabetic neuropathy due to decreased sensation. However, infrared thermography can objectively identify inflammation. Therefore, a device that allows patients to visualise thermograms of their feet might be an effective way to prevent DFU. We aimed to determine the effects of a novel self-monitoring device to prevent DFU using a thermograph attached to a smartphone. METHOD: A self-monitoring device comprising a mobile thermograph attached to a smartphone on a selfie stick was created, and its effects in two patients with diabetic neuropathy and foot calluses assessed. RESULTS: For one patient, he understood that walking too much increased the temperature in the skin of his feet (a sign of inflammation). The other patient could not detect high-risk findings, because the temperature of his skin did not increase during the study period. CONCLUSION: This device might provide self-care incentives to prevent DFU, although some issues, such as the automatic detection of high-risk thermographic changes, need to be improved.

    DOI: 10.12968/jowc.2021.30.2.116

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  5. Reliability and Validity of the Japanese version of the Job Characteristics Scale among nurses

    Komagata Marie, Takemura Yukie, Ichikawa Naoko, Takehara Kimie, Kunie Keiko

    The Journal of the Japan Academy of Nursing Administration and Policies   Vol. 25 ( 1 ) page: 12 - 19   2021

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    Language:Japanese   Publisher:The Japan Academy of Nursing Administration and Policies  

    <p>Job characteristics theory proposes that five job characteristics of skill variety, task significance, task identity, autonomy, and feedback are associated with internal motivation and these affect work-related outcomes. This study developed a Japanese version of the Job Characteristics Scale based on the modified scale (Idaszak & Drasgow, 1987) of the Job Diagnostic Survey (Hackman & Oldham, 1975), which includes a scale for measuring the five job characteristics, and verified its reliability and validity in nurses. Permission from the original author was obtained beforehand. In June 2017, anonymous self-administered questionnaires were distributed to 308 nurses working in an acute care hospital, and 297 responses were collected. The responses of 240 with no missing values in the developed scale were analyzed. All Cronbach's alphas for the subscales were over 0.7, the item-total correlation coefficients were 0.46–0.67, and the intraclass correlation coefficients by a retest method were 0.62–0.71. Four factors were extracted by exploratory factor analysis. However, the results of the confirmatory factor analysis showed higher goodness of fit for the five-factor model based on the theory than the four-factor model identified by exploratory factor analysis. To confirm criterion validity, correlation coefficients of each subscale of the developed scale with job satisfaction and psychological empowerment were calculated. Significant correlations were found as assumed (coefficients were 0.23–0.53 for job satisfaction and 0.16–0.73 for psychological empowerment). Internal consistency, reproducibility, factorial validity, and criterion validity were confirmed, demonstrating acceptable reliability and validity of the developed scales for use by nurses.</p>

    DOI: 10.19012/janap.25.1_12

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  6. Quality of work among part-time nurses and its relationship to job satisfaction and work values: A cross-sectional study. International journal

    Marie Komagata, Yukie Takemura, Naoko Ichikawa, Kimie Takehara, Keiko Kunie

    Nursing & health sciences   Vol. 22 ( 4 ) page: 1010 - 1021   2020.12

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    Language:Japanese   Publishing type:Research paper (scientific journal)  

    This study compared the quality of work between part-time and full-time nurses and investigated the relationship between quality of work and satisfaction with the work itself among part-time nurses. Quality of work was measured by specific work content and job characteristics. It was hypothesized that work content would affect satisfaction mediated by job characteristics. Furthermore, the moderating effects of intrinsic work values on the relationship between job characteristics and satisfaction were examined. A cross-sectional survey was conducted with 444 part-time and 795 full-time nurses working in Japanese hospital wards in 2017. The Mann-Whitney U test, χ2 test, and hierarchical multiple regressions were used. Work content differed between part-time and full-time nurses; however, job characteristics and satisfaction showed little difference. Work content was not associated with satisfaction mediated by job characteristics. Within the job characteristics, autonomy and feedback had positive effects on the satisfaction of part-time nurses, whereas interaction with work values was insignificant. When assigning work, it is important to allow part-time nurses to experience higher levels of autonomy and feedback regardless of their intrinsic work values.

    DOI: 10.1111/nhs.12760

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  7. Factors Associated with Callus Formation in the Plantar Region through Gait Measurement in Patients with Diabetic Neuropathy: An Observational Case-Control Study. International journal

    Ayumi Amemiya, Hiroshi Noguchi, Makoto Oe, Kimie Takehara, Yumiko Ohashi, Ryo Suzuki, Toshimasa Yamauchi, Takashi Kadowaki, Hiromi Sanada, Taketoshi Mori

    Sensors (Basel, Switzerland)   Vol. 20 ( 17 ) page: 1 - 12   2020.9

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    Language:Japanese   Publishing type:Research paper (scientific journal)  

    Callus has been identified as a risk factor leading to severe diabetic foot ulcer; thus, it is necessary to prevent its formation. Callus formation under the first, second, and fifth metatarsal heads (MTHs) is associated with external forces (pressure and shear stress) during walking. However, the gait factors increasing the external forces remain undetermined. Thus, this study aims to identify the factors increasing the external forces to prevent callus formation. In 59 patients with diabetic neuropathy wearing their usual shoes, the external forces, and the lower extremity joint angles were measured using MEMS force sensors and motion sensors. The external forces and their relationship with the lower extremity joint angles and footwear size were determined. Risk factors causing high external forces on the first MTH included small flexion of the knee joint (p = 0.015) and large ankle pronation motion (p = 0.034) to obtain propulsion. For the second MTH, wearing excessively long footwear was identified (p = 0.026). For the fifth MTH, high external force was related to tight width footwear (p = 0.005). An effective intervention for preventing callus formation for the first MTH would involve assisting the push-off foot motion using rocker-sole footwear or gait training. For the second and fifth MTHs, wearing appropriate size footwear would be effective.

    DOI: 10.3390/s20174863

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  8. Relationship between nurses' perceptions of nursing assistant roles and information-sharing behaviors: A cross-sectional study. International journal

    Masatoshi Saiki, Keiko Kunie, Yukie Takemura, Kimie Takehara, Naoko Ichikawa

    Nursing & health sciences   Vol. 22 ( 3 ) page: 706 - 713   2020.9

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    Language:Japanese   Publishing type:Research paper (scientific journal)  

    Information-sharing between nurses and nursing assistants is necessary for appropriate inpatient care. Nurses who perceive nursing assistant roles highly may display positive behaviors related to information-sharing with nursing assistants. This study aims to examine the relationship between nurses' perceptions of nursing assistant roles and the frequency of their sharing information with nursing assistants. Using a self-administered, cross-sectional survey questionnaire, data from 2,642 nurses in 182 hospitals were collected. Nurses' perceptions of nursing assistant roles were measured with a scale containing four factors: (i) improving patients' abilities through daily care; (ii) caring for various patients using broad perspectives; (iii) facilitating co-ordination and co-operation among team members; and (iv) increasing the amount of information on patients among team members. Information-sharing behaviors included "expressing," "asking," "linguistic response," and "feedback." Multiple regression analyses for each nurse's information-sharing behaviors were conducted. Nurses' perceptions of nursing assistant roles were positively correlated with the frequency of sharing information with nursing assistants. The degree of the correlations differed, depending on the type of information-sharing behavior. Therefore, improving nurses' understanding of nursing assistant roles might increase their information-sharing behaviors.

    DOI: 10.1111/nhs.12717

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  9. Frontline nurse managers' visions for their units: A qualitative study. International journal

    Tamaki Isobe, Keiko Kunie, Yukie Takemura, Kimie Takehara, Naoko Ichikawa, Mari Ikeda

    Journal of nursing management   Vol. 28 ( 5 ) page: 1053 - 1061   2020.7

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    Language:Japanese   Publishing type:Research paper (scientific journal)  

    AIMS: To elucidate frontline nurse managers' visions of their units. BACKGROUND: Managers have the opportunity to imagine and share their visions for effective unit management. METHODS: Semi-structured interviews were conducted with 12 frontline nurse managers working at inpatient units in two hospitals between 2016 and 2017. Data were qualitatively analysed using an inductive approach, focusing on participants' intents. RESULTS: Although participants showed four types of difficulties in verbalizing visions, five categories and 18 subcategories were extracted through analysis of their descriptions about actual cases reflecting their visions. The categories were (a) provide excellent care to ensure patient recovery based on reliable knowledge and skills, (b) make efforts to broaden patients' futures, (c) create a climate for pursuing better practice, (d) all staff continuously pursue professional development and (e) provide nursing care that responds to external changes. All categories were common to all participants' images of the future and linked together to form each manager's vision. CONCLUSION: Frontline managers experienced difficulty in articulating their visions. However, through episodes, they represented images of visions. The managers' visions comprised five categories reflecting various perspectives. IMPLICATIONS FOR NURSING MANAGEMENT: Using a conceptualized vision framework, and identifying difficulties in verbalizing their images, can help managers articulate their visions.

    DOI: 10.1111/jonm.13050

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  10. Validity of DMIST for monitoring healing of diabetic foot ulcers. International journal

    Makoto Oe, Rie Roselyne Yotsu, Defa Arisandi, Suriadi, Yukie Sakai, Imran, Kimie Takehara, Gojiro Nakagami, Takeshi Tamaki, Junko Sugama, Hiromi Sanada

    Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society   Vol. 28 ( 4 ) page: 539 - 546   2020.7

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    Language:Japanese   Publishing type:Research paper (scientific journal)  

    A new diabetic foot evaluation scale was proposed, using the seven domains of depth, maceration, inflammation/infection, size, tissue type of the wound bed, type of wound edge, and tunneling/undermining. This scale was named "DMIST" as an acronym from the initials of the domains. The purpose of this study was to evaluate the validity of DMIST. Secondary analysis was conducted in three investigations performed using the diabetic foot ulcer assessment scale (DFUAS) in Japan and Indonesia. Secondary analysis was assessed using DMIST, PUSH, and DESIGN for 4 weeks based on DFUAS score and photographs of diabetic foot ulcers by researchers. Concurrent validity was determined from the correlation of total DMIST scores with PUSH and DESIGN scores. Construct validity was determined by comparisons between total DMIST score and grade of the Wagner classification. Predictive validity was determined by receiver operating characteristic curve analysis for wound non-healing 4 weeks later. Subjects comprised 35 Japanese patients and 118 Indonesian patients. Correlations of total DMIST score with PUSH and DESIGN scores were 0.831 and 0.822, respectively. Comparison of total DMIST scores with grade of the Wagner classification (Grade I vs. Grade II/III vs. Grade IV/V) was p < 0.001. Based on an area under the curve of 0.872, a DMIST score of 9 was selected as a cut-off, offering sensitivity of 0.855 and specificity of 0.786 for wound non-healing 4 weeks later. Our findings suggest that DMIST offers high validity.

    DOI: 10.1111/wrr.12816

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  11. Nursing activities at clinics in rural areas in Japan: gaps between recognition of importance and implementation.

    Manami Tateishi, Keisuke Nakanishi, Kimie Takehara, Ikumi Honda, Toyoaki Yamauchi

    Nagoya journal of medical science   Vol. 82 ( 2 ) page: 251 - 260   2020.5

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    Language:Japanese   Publishing type:Research paper (scientific journal)  

    This study determined the level of implementation and the importance placed on various nursing activities at clinics in rural areas of Japan in order to explore the achievement and perceived importance of implementing certain nursing roles and activities at such clinics. To identify these items, a questionnaire was administered to 40 nurses working in rural clinics. The results showed that activities related to "Basic Nursing Practice" and "Community Understanding" were recognized as important and were performed by almost all nurses. Some activities related to "Administration and Operation" and "Cooperation with Local Government" were recognized as important, but were not implemented, thereby hampering the continuum of care across the health system. These activities, which are related to collaboration with hospitals and local governments that support the clinics, included adjustment of staff inside and outside the facilities to guarantee the use of paid holidays, as well as collaboration with acute care, remote medical systems, and local governments during emergencies and for disaster preparation. Additional support for nurses in collaboration between clinics in rural areas, hospitals, and regional administrations that support the clinics remains a challenge to be addressed.

    DOI: 10.18999/nagjms.82.2.251

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  12. Effects of skin care education for care staff at elderly care facilities on skin conditions of the residents. International journal

    Yuichiro Tsunemi, Gojiro Nakagami, Kimie Takehara, Nao Tamai, Aya Kitamura, Yuko Mugita, Makoto Oe, Momoyo Kishida, Hiromi Sanada

    The Journal of dermatology   Vol. 47 ( 4 ) page: 327 - 333   2020.4

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    Asteatosis is common in elderly people due to a decrease in the moisture content of the epidermal stratum corneum through a loss of skin barrier function caused by aging. Because itching often accompanies asteatosis, this condition may cause a decrease in quality of life. Care staff in elderly care facilities have many opportunities to provide care for residents. In this study, we examined how educational training on skin care changed the thoughts and actions of care staff in these facilities and how these changes impacted the skin conditions of residents. The subjects for the training were all care staff in facilities because these staff work most closely with facility residents. We performed skin care training for the subjects and investigated changes in the skin conditions of the residents before and after the training. The training promoted the understanding of skin care among the care staff and improved the skin symptoms of residents with asteatosis. However, there were no changes in the severity of itchiness based on a verbal rating scale and in interviews of residents. This study showed that skin care training for the care staff in facilities is effective to improve skin conditions of residents. In addition, it was suggested that a full grasp of the residents' skin symptoms based upon an interview on itching alone was difficult, and thus there is a need to observe skin conditions directly.

    DOI: 10.1111/1346-8138.15213

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  13. Onsite visualization of shoe fitting for education of the people with diabetes using 3D scanner: A pilot study

    Noguchi Hiroshi, Oe Makoto, Takehara Kimie, Mori Taketoshi, Sanada Hiromi

    Journal of Nursing Science and Engineering   Vol. 7 ( 0 ) page: 162 - 169   2020

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    Language:English   Publishing type:Research paper (scientific journal)   Publisher:The Society for Nursing Science and Engineering  

    To prevent diabetic foot ulcers, the nurses teach the patient to select correct shoe size and shape. However, this education is less effective for the people with diabetic neuropathy, because the patient cannot feel contact between shoe and foot. To resolve this problem, we propose the 3D computer graphic visualization of contact between shoe and foot using 3D scanner. Bare feet of three participants were scanned by a portable 3D scanner. Their own shoes were also scanned. The small shoes were prepared as typical ill-fitting shoes, and they were scanned. Contact area between bare foot and shoe 3D models were visualized by our developed 3D visualization software as red color. In their own shoes, red areas were not observed. On the contrary, in the small shoes, the tip of thumb or side of foot were visualized at the toe of shoe or side of shoe. This visualized areas were matched with the feelings of the participants. The result indicated that 3D portable scanner has capability of measurement of 3D foot and shoe contour. This pilot study results also demonstrated that our visualization concept has potential to contribute the education of correct shoe size and shape.

    DOI: 10.24462/jnse.7.0_162

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  14. Workplace Environmental Factors Related to the Nursing Assessment Implementation for Cancer Patients before Beginning Outpatient Chemotherapy for the First Time: Focusing on Psychological and Social Aspects

    Ozawa Mayu, Takehara Kimie, Takemura Yukie, Kunie Keiko, Ichikawa Naoko

    The Journal of the Japan Academy of Nursing Administration and Policies   Vol. 24 ( 1 ) page: 199 - 211   2020

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    Language:Japanese   Publishing type:Research paper (scientific journal)   Publisher:The Japan Academy of Nursing Administration and Policies  

    <p><b>Aim: </b>This study aimed to clarify the implementation of a nursing assessment and the degree to which nurses recognize its importance for cancer patients before their first outpatient chemotherapy, and to verify factors, including workplace environment, related to psychological and social nursing assessment implementation.</p><p><b>Method: </b>A questionnaire was administered to nurses in departments conducting outpatient chemotherapy in 500 randomized metropolitan hospitals. The physical, psychological, and social conditions of patients were compared for implementation of assessment and recognition of importance. Next, a hierarchical multiple regression analysis with psychological and social assessment as dependent variables was conducted.</p><p><b>Result: </b>Of 2500 questionnaires mailed, 317 valid responses from 120 hospitals were returned. The implementation of assessment for psychological and social aspects was significantly lower than for physical aspects. The recognition of its importance for all three aspects was high. The result of the hierarchical multiple regression analysis, found that "Having independent chemotherapy room" and "many years of experience of outpatient chemotherapy" were significantly correlated after controlling for the independent variables of nurse-related and hospital-related factors. When all factors were added to the model, "the high degree of recognition of assessment importance" and "setting time to talk with patients" were significantly correlated. "prepared manual," "having study meeting," "dedicated chemotherapy," were significantly correlated limited to implementation of assessment for social aspects.</p><p><b>Conclusion: </b>Nurse's implemented psychological and social assessments for outpatient chemotherapy significantly less than physical assessments. The implementation rate of nursing assessment can possibly be facilitated by improving the workplace environment.</p>

    DOI: 10.19012/janap.24.1_199

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  15. 研究 看護職および看護補助者による看護補助者役割の認識-測定尺度の開発

    佐伯 昌俊, 國江 慶子, 武村 雪絵, 竹原 君江, 市川 奈央子

    病院   Vol. 78 ( 5 ) page: 358 - 363   2019.5

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    Publisher:株式会社医学書院  

    DOI: 10.11477/mf.1541210959

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  16. 看護職および看護補助者による看護補助者役割の認識 測定尺度の開発

    佐伯 昌俊, 國江 慶子, 武村 雪絵, 竹原 君江, 市川 奈央子

    病院   Vol. 78 ( 5 ) page: 358 - 363   2019.5

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    Language:Japanese   Publisher:(株)医学書院  

    <文献概要>[目的]看護職と看護補助者(以下,補助者)の補助者役割認識を測定する尺度を作成し,信頼性と妥当性を検討する.[方法]2017年6〜9月に地域包括ケア病棟の看護職3,781名と補助者1,316名を対象に調査を行った.補助者役割を示す19項目について,看護職には「補助者に求めているか」,補助者には「看護職から求められていると思うか」,および「補助者として担いたいか」を尋ねた.項目を患者にとっての機能とチームにおける役割に分けて探索的因子分析を行い,看護職と補助者共通の因子構造を採用した後,尺度の信頼性と妥当性を検証した.[結果]<広い視野をもち多様な段階に対応する><ケアを通じて患者の力を引き出す><一員としてネットワークを築く><チームの患者情報を豊かにする>の4因子計16項目を抽出した.各因子のα係数は0.76〜0.85であった.基準関連妥当性なども確認された.[結論]補助者役割認識を測定する尺度を作成し,一定の信頼性と妥当性を確認した.

    Other Link: https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J01282&link_issn=&doc_id=20190521160013&doc_link_id=1903687&url=https%3A%2F%2Fkango-sakuin.nurse.or.jp%2Fnid%2F1903687&type=%8D%C5%90V%8A%C5%8C%EC%8D%F5%88%F8Web&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00014_1.gif

  17. Nurses’ knowledge, perceptions and attitudes towards stuttering and the work environment of nurses who stutter: A cross-sectional study<b> </b> Reviewed

    Endo Yu, Komagata Kazunori, Takemura Yukie, Ikeda Mari, Takehara Kimie, Iimura Daichi

    The Journal of the Japan Academy of Nursing Administration and Policies   Vol. 23 ( 1 ) page: 28 - 39   2019

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    Language:Japanese   Publishing type:Research paper (scientific journal)   Publisher:The Japan Academy of Nursing Administration and Policies  

    <p>This study aimed to clarify 1) the proportion of nurses who stutter (NWS); 2) knowledge regarding stuttering on the part of nurses who do not stutter (NWNS), and their perceptions and attitudes regarding people who stutter (PWS); and 3) what NWS think about their difficulties on the job and the work environment, and to identify ways of improving their work environment. This study targeted nurses from 10 hospitals, each with fewer than 200 beds, in Tokyo's 23 wards. Of the 575 nurses surveyed, 290 completed anonymous questionnaires covering characteristics, stuttering status, knowledge of stuttering, and perceptions and attitudes regarding PWS. Thirteen of 290 participants (4.5%) were NWS, and reported difficulties in their work and work environment. Moreover, although 70% of NWNS knew the term "stuttering," they had insufficient knowledge of its symptoms and epidemiology. There were no associations between knowledge, perceptions, and attitudes regarding PWS; however, exposure to PWS was associated with some perceptions and attitudes regarding PWS. Eight of 13 NWS answered the question about perceived difficulties at work. Four NWS experienced severe difficulties, whereas the other four did not. The former tended to confide in their co-workers about their stuttering and the need to be understood and considered by them; therefore, they were more satisfied with their workplaces compared to the latter. This suggests that the proportion of NWS is larger than that of PWS in the general population (1%), and some NWS are not understood or considered by co-workers and are not satisfied with their workplaces.</p>

    DOI: 10.19012/janap.23.1_28

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  18. Differences Between Patient-Reported Versus Clinician-Observed Nonulcerative Signs and Symptoms of the Foot in Patients With Diabetes Mellitus

    Takehara Kimie, Oe Makoto, Ohashi Yumiko, Tsunemi Yuichiro, Kadowaki Takashi, Sanada Hiromi

    JOURNAL OF WOUND OSTOMY AND CONTINENCE NURSING   Vol. 46 ( 2 ) page: 113 - 116   2019

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    Language:Japanese   Publishing type:Research paper (scientific journal)  

    DOI: 10.1097/WON.0000000000000504

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  19. 糖尿病患者を対象としたサーモグラフィによる靴の適合性の検討 Reviewed

    川村 留美, 大江 真琴, 竹原 君江, 雨宮 歩, 大橋 優美子, 野口 博史, 村山 陵子, 森 武俊, 植木 浩二郎, 門脇 孝, 小見山 智恵子, 真田 弘美

    日本フットケア学会雑誌   Vol. 16 ( 2 ) page: 75-79   2018

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  20. 特集 ビジュアル化への挑戦―糖尿病足潰瘍教育への応用を目指して:足白癬予防のための足部の洗い残し・拭き残しの可視化 Invited

    竹原君江,真田弘美

    日本フットケア学会雑誌   Vol. 16 ( 1 ) page: 18-22   2018

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    Authorship:Lead author   Language:Japanese  

  21. Introduction of care to prevent diabetic foot ulcer in Indonesia Reviewed

    Oe M, Takehara K, Suriadi, Sanada H

    Japanese Journal of Foot Care   Vol. 16 ( 2 ) page: 80-84   2018

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  22. Confirming the placement of nasogastric tubes by hand-carried ultrasonography device. Reviewed

    Komagata K, Yabunaka K, Nakagami G, Ikeda M, Takehara K, Takemura Y, Sanada H

    Journal of Nursing Science and Engineering   Vol. 5 ( 1 ) page: 52-57   2018

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    Language:English   Publishing type:Research paper (scientific journal)  

  23. Skin hydration of the heel with fissure in patients with diabetes: a cross-sectional observational study. Reviewed

    Oe M, Takehara K, Noguchi H, Ohashi Y, Fukuda M, Kadowaki T, Sanada H

    Chronic Wound Care Management and Research   Vol. 5   page: 11-16   2018

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  24. The Association between Tinea Pedis and Feet-Washing Behavior in Patients with Diabetes: A Cross-sectional Study. International journal

    Kimie Takehara, Ayumi Amemiya, Yuko Mugita, Yuichiro Tsunemi, Yoko Seko, Yumiko Ohashi, Kohjiro Ueki, Takashi Kadowaki, Makoto Oe, Takashi Nagase, Mari Ikeda, Hiromi Sanada

    Advances in skin & wound care   Vol. 30 ( 11 ) page: 510 - 516   2017.11

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    OBJECTIVES: To examine the correlations between elements of feet-washing behavior, presence of tinea pedis (TP), and patients' background characteristics in order to identify a concrete intervention method to prevent TP. DESIGN AND PARTICIPANTS: A cross-sectional study of 30 patients with diabetes (16 with TP) who were admitted to or visited the university hospital. MAIN OUTCOME MEASURES: The presence of TP was confirmed by the detection of dermatophytes by direct microscopy. Data on elements of feet-washing behavior, such as scrubbing between the toes, were collected by observing recorded videos of participants normally washing their feet as they do at home. The patients' background characteristics included demographic data; diabetes-related factors; patient knowledge regarding diabetes, foot problems, and TP prevention; purpose for feet washing; and any difficulties in feet washing. MAIN RESULTS: The number of times patients scrubbed between their toes while washing with soap was significantly lower in patients with TP (odds ratio, 0.95; P = .036; with a cutoff value of 35 times) and those who had difficulty in reaching their feet with their hands (B = -14.42, P = .041). CONCLUSIONS: An effective foot-washing protocol should include specific instructions for patients to scrub between their toes at least 35 times in all 8 spaces while washing with soap. Appropriate advice is also needed for individuals who have difficulty reaching their feet with their hands. Education about appropriate foot-washing behavior may potentially prevent TP.

    DOI: 10.1097/01.ASW.0000525903.07883.8f

    PubMed

  25. Thermographic findings in a case of type 2 diabetes with foot ulcer due to callus deterioration.

    Makoto Oe, Kimie Takehara, Hiroshi Noguchi, Yumiko Ohashi, Ayumi Amemiya, Hideyuki Sakoda, Ryo Suzuki, Toshimasa Yamauchi, Kohjiro Ueki, Takashi Kadowaki, Hiromi Sanada

    Diabetology international   Vol. 8 ( 3 ) page: 328 - 333   2017.8

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    Abstract: A number of studies have reported the usefulness of monitoring skin temperature at local points in reducing the risk of ulceration. Thermography has the advantage of being able to visualize morphological temperature distribution. We reported that inflammation was detected by thermography in 10% of diabetes mellitus (DM) patients with foot calluses, and the area in which increased skin temperature was observed was limited to the callus. However, no reports have described thermographic findings of calluses deteriorating into foot ulcers. We report a case monitoring the skin temperature distribution using thermography, which might be useful for predicting ulceration. Case: A 53-year-old male patient, diagnosed with type 2 DM, was treated with insulin therapy. The duration of DM was 4 years. He was also diagnosed with dyslipidemia and hypertension. Using thermography, the skin temperature was evaluated in the patient with calluses on the 5th metatarsal heads. Areas of increased skin temperature were observed, involving not only the callused part, but also the plantar arch. We shaved his calluses once a month and explained the importance of his therapeutic shoes to prevent the ulcers. After 43 months, an ulcer developed. Discussions: Thermographic findings of an extended area of increased skin temperature not limited to the callus may suggest the progression of a callus to ulcer. Expansion of the area of increased skin temperature might show the inflammation or infection extending along the fascia. Based on these findings, thermography could provide a useful assessment of callus in DM patients with a high risk of progression.

    DOI: 10.1007/s13340-017-0315-1

    PubMed

  26. 特集 下肢潰瘍予防・治療に役立つアセスメント: 工学技術に基づく足のアセスメント―歩き方, 足底の圧とずれの客観計測― Invited

    野口博史, 雨宮歩, 大江真琴, 竹原君江, 真田弘美, 森武俊

    日本下肢救済足病学会誌   Vol. 9 ( 1 ) page: 42-49   2017

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  27. Reliability and validity of a portable device for measuring stratum corneum hydration Reviewed

    Takehara K, Iizaka S, Oe M, Sanada H

    Journal of Japanese Society Wound, Ostomy, and Continence Management   Vol. 21 ( 4 ) page: 296-303   2017

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  28. 特集 下肢潰瘍予防・治療に役立つアセスメント: 糖尿病足潰瘍予防を目的とした足白癬・爪白癬のアセスメントとケア Invited

    竹原君江, 大江真琴, 野口博史, 大橋優美子, 常深祐一郎, 真田弘美

    日本下肢救済足病学会誌   Vol. 9 ( 1 ) page: 25-32   2017

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  29. Association between tinea pedis and feet washing behavior in diabetic patients: A cross-sectional study. Reviewed

    Takehara K, Amemiya A, Mugita Y, Tsunemi Y, Seko Y, Ohashi Y, Ueki K, Kadowaki T, Oe M, Nagase T, Ikeda M, Sanada H.

    Adv Skin Wound Care   Vol. 30 ( 11 ) page: 510-516   2017

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  30. Examining the accuracy of visual diagnosis of tinea pedis and tinea unguium in aged care facilities Reviewed

    Goto T, Nakagami G, Takehara K, Nakamura T, Kawashima M, Tsunemi Y, Sanada H

    J Wound Care.   Vol. 26 ( 4 ) page: 179-183   2017

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  31. Thermographic findings in a case of type 2 diabetes with foot ulcer due to callus deterioration.

    Oe M, Takehara K, Noguchi H, Ohashi Y, Amemiya A, Sakoda H, Suzuki R, Yamauchi T, Ueki K, Kadowaki T, Sanada H

    Diabetology International   Vol. 8 ( 3 ) page: 328-333   2017

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  32. Specimens processed with extraction solution of Dermatophyte Test Strip can be used for direct microscopy. Reviewed

    Tsunemi Y, Takehara K, Miura Y, Nakagami G, Sanada H, Kawashima M

    Br J Dermatol.   Vol. 177 ( 3 ) page: e50-e51   2017

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  33. 糖尿病患者における足部胼胝の要因:カルテ調査による検討 Reviewed

    大江 真琴, 大場 美穂, 竹原 君江

    日本創傷・オストミー・失禁管理学会誌   Vol. 20(4)   page: 426 - 33   2017

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  34. 足潰瘍予防のための靴の選択方法に関する研究―足潰瘍のない糖尿病患者自身における靴の選択基準 Reviewed

    2. 古川 久美子, 大江 真琴, 保坂 嘉成, 大橋 優美子, 竹原 君江, 村山 陵子, 大友 英子, 小見山 智恵子, 加藤 聡, 真田 弘美

    日本フットケア学会雑誌   Vol. 14 ( 1 ) page: 11-15   2016

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  35. Comparison of Gait Features Between Feet With Callus or Corns and Normal Feet Using Motion Sensors in People With Diabetes and People Without Diabetes. Reviewed

    Amemiya A, Noguchi H, Oe M, Ohashi Y, Takehara K, Ueki K, Kadowaki T, Sanada H, Mori T

    J Diabetes Sci Technol.   Vol. 10 ( 2 ) page: 614-615   2016

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  36. Factors Associated With Callus in Diabetic Patients, Focused on Plantar Shear Stress During Gait. Reviewed

    Hamatani M, Mori T, Oe M, Noguchi H, Takehara K, Amemiya A, Ohashi Y, Ueki K, Kadowaki T, Sanada H

    J Diabetes Sci Technol.   Vol. 10 ( 6 ) page: 1353-1359   2016

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  37. Foot complications in patients with diabetes mellitus: practical report of diabetic foot clinic in Beijing. Reviewed

    Oe M, Ohashi Y, Takehara K, Oba M, Doi M, Iizuka Y, Murayama R, Kadowaki T, Sanada H

    Japanese Journal of Foot Care   Vol. 14 ( 2 ) page: 57-61   2016

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  38. Shear stress-normal stress (Pressure) Ratio (SPR) decides forming callus in patients with diabetic neuropathy. Reviewed

    Amemiya A, Noguchi H, Oe M, Takehara K, Ohashi Y, Suzuki R, Yamauchi T, Kadowaki T, Sanada H, Mori T

    J Diabetes Res.   Vol. 2016   page: 1-10   2016

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    DOI: 10.1155/2016/3157123

  39. Validation of a skin hardness meter for foot callus in patients with diabetes: pilot study. Reviewed

    Oe M, Takehara K, Noguchi H, Ohashi Y, Watanabe A, Murayama R, Kadowaki T, Sanada H

    Japanese Journal of Foot Care   Vol. 14 ( 4 ) page: 141-143   2016

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  40. 糖尿病患者における足部胼胝の要因:カルテ調査による検討. Reviewed

    大江真琴, 濱谷雅子, 野口博史, 大場美穂, 竹原君江, 大橋優美子, 植木浩二郎, 門脇孝, 森武俊, 真田弘美

    日本創傷オストミー失禁管理学会誌   Vol. 20 ( 4 ) page: 426-433   2016

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  41. Association between Washing Residue on the Feet and Tinea Pedis in Diabetic Patients. Reviewed

    Takehara K, Amemiya A, Mugita Y, Tsunemi Y, Seko Y, Ohashi Y, Ueki K, Kadowaki T, Oe M, Nagase T, Ikeda M, Sanada H.

    Nursing Research and Practice     page: 1-7   2015

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  42. 携帯型皮膚水分計の妥当性評価 Reviewed

    飯坂 真司, 竹原 君江, 真田 弘美

    日本創傷・オストミー・失禁管理学会誌   Vol. 19 ( 1 ) page: 33-39   2015

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  43. Reliability and validity of an on-site measurement and visualization system to measure plantar pressure and shear force in footwear for the education of diabetic patients. Reviewed

    Noguchi H, Oe M, Takehara K, Mori T, Sanada H

    Journal of Japanese Society of Wound, Ostomy, and Continence   Vol. 19 ( 3 ) page: 327-335   2015

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  44. Incidence of foot ulcers in patients with diabetes at a university hospital in Tokyo over a 5-year period. Reviewed

    Oe M, Takehara K, Ohashi Y, Mugita Y, Murayama R, Komiyama C, Ueki K, Kadowaki T, Sanada H

    Diabetol Int.   Vol. 6 ( 1 ) page: 55-59   2015

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  45. Diagnosis of tinea pedis by dermatophyte test strip. Reviewed

    Tsunemi Y, Takehara K, Miura Y, Nakagami G, Sanada H, Kawashima M

    Br J Dermatol.   Vol. 173 ( 5 ) page: 1323-1324   2015

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  46. Diagnostic accuracy of tinea unguium based on clinical observation. Reviewed

    Tsunemi Y, Takehara K, Oe M, Sanada H, Kawashima M

    J Dermatol.   Vol. 42 ( 2 ) page: 221-222   2015

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  47. Screening for tinea unguium by thermography in older adults with subungual hyperkeratosis. Reviewed

    Miura Y, Takehara K, Nakagami G, Amemiya A, Kanazawa T, Kimura N, Kishi C, Koyano Y, Tamai N, Nakamura T, Kawashima M, Tsunemi Y, Sanada H

    Geriatr Gerontol Int.   Vol. 15 ( 8 ) page: 991-996   2015

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  48. Relationship between activity of daily living and asteatosis in the lower legs among elderly residents in long-term care institutions: a cross-sectional study. Reviewed

    Nakagami G, Kimura N, Takehara K, Nakamura T, Kawashima M, Tsunemi Y, Sanada H

    Int Wound J.   Vol. 12 ( 5 ) page: 586-589   2015

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  49. Antifungal Effect of Non-Woven Textiles Containing Polyhexamethylene Biguanide with Sophorolipid: A Potential Method for Tinea Pedis Prevention. Reviewed

    Sanada H, Nakagami G, Takehara K, Goto T, Ishii N, Yoshida S, Ryu M, Tsunemi Y.

    Healthcare   Vol. 2   page: 183-191   2014

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  50. Screening for tinea unguium by dermatophyte test strip. Reviewed

    Tsunemi Y, Takehara K, Miura Y, Nakagami G, Sanada H, Kawashima M

    Br J Dermatol.   Vol. 170 ( 2 ) page: 328-331   2014

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  51. Morphological pattern classification system for plantar thermography of patients with diabetes. Reviewed

    Mori T, Nagase T, Takehara K, Oe M, Ohashi Y, Amemiya A, Sanada H

    J Diabetes Sci Technol.   Vol. 7 ( 5 ) page: 1102-1112   2013

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  52. 靴の種類による足部皮膚温パターンの比較-非糖尿病者における検討- Reviewed

    大江真琴, 貝谷敏子, 玉井奈緒, 竹原君江, 真田弘美

    日本創傷・オストミー・失禁管理学会誌   Vol. 16 ( 1 ) page: 9-14   2012

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  53. Evaluation of skin temperature, humidity, and comfort of two types of absorbent products for urinary incontinence. Reviewed

    Tamai N, Kaitani T, Takehara K, Oe M, Nagase T, Murayama R

    J Jpn WOCM.   Vol. 16 ( 4 ) page: 345-352   2012

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  54. 静脈性下腿潰瘍における形態的特徴と創傷治癒のプロセスに関する質的研究 Reviewed

    内藤 亜由美, 大江 真琴, 岡島 静子, 山本 裕子, 長瀬 敬, 貝谷 敏子, 竹原 君江, 飯坂 真司, 玉井 奈緒, 峰松 健夫, 孟 真, 真田 弘美

    日本創傷・オストミー・失禁管理学会誌   Vol. 16 ( 3 ) page: 257-267   2012

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  55. Factors associated with presence and severity of toenail onychomycosis in patients with diabetes: A cross-sectional study. Reviewed

    Takehara K, Oe M, Tsunemi Y, Nagase T, Ohashi Y, Iizaka S, Ueki K, Tsukamoto K, Kadowaki T, Sanada H.

    Int J Nurs Stud.   Vol. 48 ( 9 ) page: 1101-1108   2011

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  56. 一般病棟看護師による糖尿病患者へのフットケアに対するフローチャート式足チェックシートが及ぼす影響 Reviewed

    田口和貴子, 雨宮歩, 田中郁弥, 伊藤玲子, 竹原君江, 大江真琴, 真田弘美

    日本創傷・オストミー・失禁管理学会雑誌   Vol. 15 ( 3 ) page: 250-254   2011

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  57. Variations of plantar thermographic patterns in normal controls and non-ulcer diabetic patients: Novel classification using angiosome concept. Reviewed

    Nagase T, Sanada H, Takehara K, Oe M, Iizaka S, Ohashi Y, Oba M, Kadowaki T, Nakagami G

    J Plast Reconstr Aesthet Surg.   Vol. 64 ( 7 ) page: 860-866   2011

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  58. Relationship between morphological characteristics and etiology of pressure ulcers in intensive care unit patients. Reviewed

    Nanjo Y, Nakagami G, Kaitani T, Naito A, Takehara K, Lijuan J, Yahagi N, Sanada H

    J Wound Ostomy Continence Nurs.   Vol. 38 ( 4 ) page: 404-412   2011

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  59. Aging enhances maceration-induced ultrastructural alteration of the epidermis and impairment of skin barrier function. Reviewed

    Minematsu T, Yamamoto Y, Nagase T, Naito A, Takehara K, Iizaka S, Komagata K, Huang L, Nakagami G, Akase T, Oe M, Yoshimura K, Ishizuka T, Sugama J, Sanada H

    J Dermatol Sci.   Vol. 62 ( 3 ) page: 160-168   2011

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  60. 大都市部独居高齢者の抑うつとその関連要因 Reviewed

    和久井(竹原)君江, 田高悦子, 真田弘美, 金川克子

    日本地域看護学会誌   Vol. 9 ( 2 ) page: 32-36   2007

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  61. 介護予防事業への男性参加に関連する事業要因の予備的検討―介護予防事業事例の検討から- Reviewed

    大久保豪, 斎藤民, 李賢情, 吉江悟, 和久井君江, 甲斐一郎

    日本公衆衛生雑誌   Vol. 52 ( 12 ) page: 1050-1058   2005

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Books 6

  1. スキンケアガイドブック Part2. 実践編 第2部 皮膚障害別スキンケア 足病の予防・ケア

    竹原君江, 大江真琴 (一般社団法人日本創傷・オストミー・失禁管理学会編)( Role: Contributor)

    照林社  2017.5 

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    Total pages:311   Language:Japanese Book type:Textbook, survey, introduction

  2. 最新版ナースのための糖尿病フットケア技術 Ⅲ-1 リスクを見極める

    竹原君江(宮地良樹, 真田弘美, 大江真琴 編集)( Role: Contributor)

    メディカルレビュー社  2014.3 

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    Language:Japanese Book type:General book, introductory book for general audience

  3. エビデンスに基づく疾患別看護ケア関連図 改訂版 17章 関節リウマチ

    竹原君江(阿部俊子 監修, 山本則子 編集) ( Role: Contributor)

    中央法規出版  2014.2 

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    Total pages:306   Language:Japanese Book type:General book, introductory book for general audience

  4. Global Perspective on Diabetic Foot Ulcerations. Screening of foot inflammation in diabetic patients by non-invasive imaging modalities.

    Nagase T, Sanada H, Oe M, Takehara K, Nishide K, Kadowaki T.

    2011.12 

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    Language:English Book type:Scholarly book

  5. すべてがわかる 最新 糖尿病 IV糖尿病足病変とフットケア 4爪・胼胝・鶏眼の処置と足白癬のケア

    竹原君江( 門脇孝, 真田弘美 編集)( Role: Contributor)

    照林社  2011.6 

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    Total pages:450   Language:Japanese Book type:General book, introductory book for general audience

  6. インフォームドコンセントのための図説シリーズ 糖尿病のフットケア 付録3) フットケアに使用する機材, 4) フットケアに関する医療費

    竹原君江(門脇孝, 真田弘美, 植木浩二郎, 大橋優美子 編集)( Role: Contributor)

    医薬ジャーナル社  2010.9 

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    Total pages:172   Language:Japanese Book type:General book, introductory book for general audience

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MISC 36

  1. パーキンソン病患者における便秘の重症度とQuality of Lifeとの関連

    土井 智子, 竹原 君江, 中西 啓介, 平山 正昭, 本田 育美

    日本難病医療ネットワーク学会機関誌   Vol. 8 ( 1 ) page: 88 - 88   2020.11

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    Language:Japanese   Publisher:日本難病医療ネットワーク学会  

  2. パーキンソン病患者における便秘の重症度とQuality of Lifeとの関連

    土井 智子, 竹原 君江, 中西 啓介, 平山 正昭, 本田 育美

    日本難病看護学会誌   Vol. 25 ( 1 ) page: 68 - 68   2020.10

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    Language:Japanese   Publisher:(一社)日本難病看護学会  

  3. 心不全患者の退院時疾病管理自己効力感と退院後疾病管理行動との関連について

    東田 雪絵, 渡邊 桃子, 柴田 賢一, 亀島 匡高, 藤山 裕晃, 島田 晶子, 江原 真理子, 前田 靖子, 本田 育美, 竹原 君江, 中西 啓介, 足立 拓史, 山田 純生

    日本循環器学会学術集会抄録集   Vol. 84回   page: CP23 - 4   2020.7

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    Language:Japanese   Publisher:(一社)日本循環器学会  

  4. 【表在性皮膚真菌症 治療薬を活用するための基礎と実践総まとめ】患者背景を考慮した表在性皮膚真菌症治療・予防Q&A 糖尿病患者の足白癬に対してケアと患者教育はどう行えばよい?

    竹原 君江

    薬局   Vol. 71 ( 6 ) page: 2525 - 2530   2020.5

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    Language:Japanese   Publisher:(株)南山堂  

    <Key Points>◎糖尿病患者にとって足白癬は潰瘍や蜂窩織炎などにつながるリスクがあるため、早期発見、治療、予防が重要である。◎糖尿病合併症による視力や知覚の低下があっても、患者自身あるいは身近な者が適切なフットケアができるよう工夫する。◎足白癬の早期発見については、重症度の低い足白癬の画像などを用いて、皮膚科受診が必要な所見についての知識を提供する。◎足白癬の治療については、足部全体に抗真菌薬を塗布すること、症状消失後も1〜2ヵ月は塗布を継続することの必要性を説明する。◎足白癬の予防(再発予防)については、毎日の足洗浄、環境中の白癬菌の除去が効果的である。(著者抄録)

  5. 3Dスキャナを利用した糖尿病患者の教育のための靴のフィッティングの可視化 パイロットスタディ(Onsite visualization of shoe fitting for education of the people with diabetes using 3D scanner: A pilot study)

    野口 博史, 大江 真琴, 竹原 君江, 森 武俊, 真田 弘美

    看護理工学会誌   Vol. 7   page: 162 - 169   2020

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    糖尿病足潰瘍を防ぐために,看護師は適切なサイズと形状の靴の選択について患者を指導している.しかし,神経障害をもつ方は靴の着用感を得ることができず功を奏さない場合がある.その解決策として靴と足を3Dスキャナで計測しその不適合を3DCGで可視化する方法を提案する.パイロットスタディとして健常者3人の素足をハンディタイプの3Dスキャナで計測後,本人の靴も計測した.不適切な靴として1サイズ小さな靴を用意し同様に計測した.開発した可視化ソフトにより足と靴の3Dモデルの重なる領域は赤色で表示される.本人の靴では赤い領域は存在しなかったが,小さな靴では指の先端や靴側部が赤く表示された.その領域は小さな靴を着用した際の接触の感覚とも一致した.このことからハンディスキャナは足や靴の3Dデータを取得することができる可能性があることが分かり,また,可視化ソフトは適切な靴サイズや形状の教育に利用可能性があることが分かった.(著者抄録)

  6. 【白癬の今】(Part4)現場から診た白癬とその類縁疾患(case10) 糖尿病フットケアナースのみる足白癬

    竹原 君江

    Visual Dermatology   Vol. 19 ( 1 ) page: 85 - 87   2019.12

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  7. 看護師の吃音に対する知識・認識・態度及び吃音を持つ看護師の職場環境 横断研究

    遠藤 優, 駒形 和典, 武村 雪絵, 池田 真理, 竹原 君江, 飯村 大智

    日本看護管理学会誌   Vol. 23 ( 1 ) page: 28 - 39   2019.12

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    本研究の目的は、1)吃音を持つ看護師(吃音看護師)の就業割合、2)吃音がない看護師(非吃音看護師)の吃音に関する知識や吃音者への認識及び態度、3)吃音看護師が感じている困難さや職場環境を明らかにして、吃音看護師の職場環境を改善する資料を得ることである。東京都23区内の200床以下の病院100施設を無作為抽出し、研究協力に同意した10施設に勤務する看護師575名に無記名自記式質問紙調査を実施した。全員に基本属性、吃音の有無、吃音に関する知識、吃音者への認識及び態度を尋ね、吃音看護師には困難の程度や職場環境を尋ねた。290名中13名(4.5%)が吃音看護師であった。非吃音看護師の7割が吃音あるいはどもりという言葉を知っていたが、症状や病態の知識は十分とはいえなかった。これらの知識量は吃音者への認識及び態度とは関連がなく、吃音者との接点の有無が吃音者への認識及び態度の一部と関連していた。吃音看護師13名中8名が吃音当事者への質問に回答した。内4名は職場や生活で深刻な困難を感じていた(深刻群)が、残り4名は困難の程度は軽かった(非深刻群)。非深刻群の4名は吃音であることを周囲に伝えておらず、深刻群の4名の方が周囲の理解や配慮を得て、職場に満足している傾向があった。本研究により看護師には一般保有率1%を上回る吃音者がおり、周囲から理解や配慮を十分得られていない者もいる可能性が示唆された。(著者抄録)

    Other Link: https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J03391&link_issn=&doc_id=20200114530004&doc_link_id=10.19012%2Fjanap.23.1_28&url=https%3A%2F%2Fdoi.org%2F10.19012%2Fjanap.23.1_28&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_2.gif

  8. へき地診療所における看護師の活動内容の実態と重要性の認識

    立石 愛美, 中西 啓介, 竹原 君江, 本田 育美, 山内 豊明

    日本看護科学学会学術集会講演集   Vol. 39回   page: [PA - 04]   2019.11

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  9. 見える化」して身体を看る-新たな気づきからケアへの発展- 炎症の見える化を教育活用している足外来の紹介

    大橋 優美子, 大江 真琴, 下嶋 祐子, 鶴岡 かほり, 竹原 君江, 野口 博史, 真田 弘美

    日本糖尿病教育・看護学会誌   Vol. 23 ( 特別号 ) page: 60 - 60   2019.8

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  10. 新規血液透析導入患者の足の特徴について

    大場 美穂, 清水 真紀, 大江 真琴, 竹原 君江, 真田 弘美, 土井 英子, 小林 珠実, 田代 理沙, 野村 美香

    日本フットケア学会年次学術集会プログラム・抄録集   Vol. 17回   page: 200 - 200   2019.2

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  11. 糖尿病患者におけるブラックライトを用いた視覚的デバイスによる足部清拭の教育効果

    竹原 君江, 大江 真琴, 野口 博史, 駒形 和典, 大橋 優美子, 鈴木 亮, 山内 敏正, 真田 弘美

    糖尿病   Vol. 62 ( 1 ) page: 63 - 63   2019.1

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  12. 地域在住後期高齢者における足部形状からみた転倒予防機能との関連

    本田 育美, 宮崎 つた子, 竹原 君江

    日本看護科学学会学術集会講演集   Vol. 38回   page: [P1 - 15]   2018.12

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  13. 短時間勤務看護師の労働アウトカムと関連する業務配分についての研究 職務特性と労働価値に着目して

    栫井 万里絵, 武村 雪絵, 市川 奈央子, 國江 慶子, 竹原 君江

    医療の広場   Vol. 58 ( 11 ) page: 13 - 16   2018.11

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    全国の100床以上の病院から無作為抽出した1000病院のうち、看護部門責任者から研究協力に同意が得られた病院の短時間勤務の看護師、フルタイム勤務看護師の職務特性の違い、短時間勤務看護師の職務満足度に対する職務特性の主効果および労働価値観との相互作用を調査した。65病院1867名の看護師に質問紙を送付し、1239名(短時間444名、フルタイム795名)から有効回答が得られた。分析の結果、短時間勤務看護師とフルタイム勤務看護師のスキル多様性、タスク一貫性、タスク位完成、自律性、フィードバックといった職務特性の得点に有意差はみられなかった。短時間勤務看護師において、労働価値観の強さに関わらず自律性とフィードバックが職務満足と有意に相関していた。短時間勤務看護師に対して、自律性やフィードバックの高い業務を配分することで、短時間勤務看護師の職務満足向上につなげられる可能性があることが示唆された。

  14. 病棟勤務する短時間看護師の業務内容と職務特性との関連

    駒形 万里絵, 武村 雪絵, 市川 奈央子, 竹原 君江, 國江 慶子

    日本医療・病院管理学会誌   Vol. 55 ( Suppl. ) page: 71 - 71   2018.10

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  15. 患者教育・チーム医療 中国各地における糖尿病現状の調査および医療の国際化に向けた試み

    飯塚 陽子, Li Shuyan, Sun Haiqin, Thor Hongwooi, 大橋 優美子, 大江 真琴, 竹原 君江, 土井 麻里, 井上 享子, 久井 良之, 菅原 正純, 北野 選也, 國井 大輔, 真田 弘美, Wang Guanbao, Huang Dongsheng, Jia Weiping, 山内 敏正, 門脇 孝

    糖尿病合併症   Vol. 32 ( Suppl.1 ) page: 259 - 259   2018.10

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  16. 糖尿病患者を対象としたサーモグラフィによる靴の適合性の検討

    川村 留美, 大江 真琴, 竹原 君江, 雨宮 歩, 大橋 優美子, 野口 博史, 村山 陵子, 森 武俊, 植木 浩二郎, 門脇 孝, 小見山 智恵子, 真田 弘美

    日本フットケア学会雑誌   Vol. 16 ( 2 ) page: 75 - 79   2018.6

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    靴ずれは糖尿病性足潰瘍の発症因子の一つであることが指摘されている。そこで、糖尿病患者が着用している靴の適合性につき、サーモグラフィを用いて検討したので報告する。糖尿病患者30名を対象に、靴を脱いだ後20分間、足部のサーモグラフィを撮影し、同時に着用していた靴のサイズと幅を測定した。足のサイズと幅は過去に外来受診した際に測定した値を診療記録より収集した。データがそろった上で、靴を脱いだ後の足の温度変化と足と靴のサイズの差および足と靴の幅の差を比較検討した。対象55肢のうち、靴を脱いだ20分後の足部の皮膚温が「一部の趾のみ上昇」していたものが17肢あった。この群における靴のサイズと足のサイズの差は0.59±0.97cmであり、靴を脱いだ20分後の足部の皮膚温が「変化なし」または「足先から低下」していたものの0.87±0.84cmに比べ、有意に小さかった(p=0.029)。なお、靴と足の幅の差については、有意差はなかった。したがって、靴を脱いだ後にみられる「一部の趾のみ上昇」は、履いている靴のサイズが短いことを反映していると考えた。以上のことから、サーモグラフィによる足部の皮膚温測定は足潰瘍の予防に有用である可能性が示唆された。(著者抄録)

    Other Link: https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2018&ichushi_jid=J05437&link_issn=&doc_id=20180709480005&doc_link_id=10.18970%2Ffootcare.47&url=https%3A%2F%2Fdoi.org%2F10.18970%2Ffootcare.47&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

  17. グローバル・スタンダード化を目指した糖尿病足潰瘍評価スケール「DMIST」の開発 信頼性と妥当性の検証

    大江 真琴, 四津 里英, Arisandi Defa, 酒井 透江, Imran, 仲上 豪二朗, 竹原 君江, 須釜 淳子, 玉木 毅, 真田 弘美

    日本創傷・オストミー・失禁管理学会誌   Vol. 22 ( 2 ) page: 182 - 182   2018.5

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  18. 糖尿病患者における足白癬とフットケア因子との関連

    竹原 君江, 大江 真琴, 大橋 優美子, 門脇 孝, 真田 弘美

    日本創傷・オストミー・失禁管理学会誌   Vol. 22 ( 2 ) page: 174 - 174   2018.5

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  19. グローバル・スタンダード化を目指した糖尿病足潰瘍評価スケール「DMIST」の開発 項目の精選

    大江 真琴, 四津 里英, Arisandi Defa, Suriadi, 仲上 豪二朗, 竹原 君江, 須釜 淳子, 玉木 毅, 真田 弘美

    糖尿病   Vol. 61 ( Suppl.1 ) page: S - 390   2018.4

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  20. 中国各地における糖尿病現状の調査および医療の国際化に向けた試み

    飯塚 陽子, Li Shuyan, Sun Haiqin, Thor Hongwooi, 大橋 優美子, 大江 真琴, 竹原 君江, 雨宮 歩, 山田 案美加, 土井 麻里, 井上 享子, 久井 良之, 菅原 正純, 國井 大輔, Bao Yuqian, Fu Jian, 真田 弘美, Wang Guanbao, Huang Dongsheng, Jia Weiping, 山内 敏正, 門脇 孝

    糖尿病   Vol. 61 ( Suppl.1 ) page: S - 411   2018.4

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  21. 【ビジュアル化への挑戦-糖尿病足潰瘍教育への応用を目指して】足白癬予防のための足部の洗い残し・拭き残しの可視化

    竹原 君江, 真田 弘美

    日本フットケア学会雑誌   Vol. 16 ( 1 ) page: 18 - 22   2018.3

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    足白癬は、糖尿病足潰瘍の予防のため治療することが推奨されており、その予防(再発予防)・早期発見・治療が重要であるといえる。予防には足の清潔ケア、つまり洗浄や清拭が必要である。足白癬は環境中の白癬菌が足部に付着し皮膚角層に侵入して感染するため、洗い残しや拭き残しが少ない方が効果的な予防ケアとなる。これらを可視化し患者自身が確認できれば、セルフケアの実態を認識し行動変容につながる可能性がある。そこで、医療従事者の手指衛生の教育に一般的に使用されている蛍光ローションと紫外線ライトを用い、足部を簡便に観察できるようなデバイス(ブラックライトツール)を開発した。このデバイスを用い、糖尿病患者を対象に足部の清拭について視覚に訴える教育を行い、教育前後で効果を比較検証した。その結果、教育前より教育後の方で足の拭き残しが有意に減少した。このことから、足の清潔ケアの可視化が患者の行動変容に効果的であった可能性が示唆された。現在、足白癬のアセスメント方法の可視化にも取り組んでおり、これらを効果的に活用し糖尿病足潰瘍予防教育を進めていきたいと考えている。(著者抄録)

    Other Link: https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2018&ichushi_jid=J05437&link_issn=&doc_id=20180411390004&doc_link_id=10.18970%2Ffootcare.39&url=https%3A%2F%2Fdoi.org%2F10.18970%2Ffootcare.39&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

  22. 初めて外来で化学療法を受けるがん患者への看護師によるアセスメントの実施に関連する職場環境要因 心理面・社会面に着目して

    小澤 茉祐, 武村 雪絵, 竹原 君江, 市川 奈央子

    日本看護評価学会学術集会講演抄録集   Vol. 8回   page: 47 - 47   2018.2

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  23. 看護師長の心理状態と部下看護師が認識するLeader-Member Exchange(LMX)との関連

    川口 倖左, 竹原 君江, 武村 雪絵, 市川 奈央子, 駒形 和典, 小見山 智恵子, 小林 康司

    日本看護評価学会学術集会講演抄録集   Vol. 8回   page: 46 - 46   2018.2

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  24. 携帯型超音波装置を用いた経鼻胃管の位置確認の検討(Confirming the placement of nasogastric tubes by hand-carried ultrasonography device)

    駒形 和典, 藪中 幸一, 仲上 豪二朗, 池田 真理, 竹原 君江, 武村 雪絵, 真田 弘美

    看護理工学会誌   Vol. 5 ( 1 ) page: 52 - 57   2018.1

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    背景:経鼻胃管を使用する際の問題の一つに気道への誤挿入があげられる。経鼻胃管の位置の確認方法として、聴診法などの簡便な方法が用いられているが、それらの方法は正確性に欠ける。また胸部レントゲンは最も正確な方法であるが、簡便性に欠ける。そこで本研究では、簡便かつ正確に経鼻胃管の位置を確認する方法として携帯型超音波装置を用いて経鼻胃管の描出が可能か検討を行った。方法:携帯型超音波装置を用いて、10名の患者の経鼻胃管の位置の確認を頸部および上腹部で行った。超音波画像の視認性を向上させる目的で、必要に応じて胃内容物の吸引および左側臥位への体位変換を実施した。結果:10名すべてで頸部もしくは上腹部で経鼻胃管が確認された。頸部および上腹部のそれぞれの描出率はともに80%であった。また8Frから12Frの小径な経鼻胃管も確認することができた。結論:携帯型超音波装置が経鼻胃管の位置の確認方法として有用であることが示された。(著者抄録)

    Other Link: https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2018&ichushi_jid=J06462&link_issn=&doc_id=20180206470006&doc_link_id=10.24462%2Fjnse.5.1_52&url=https%3A%2F%2Fdoi.org%2F10.24462%2Fjnse.5.1_52&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

  25. ビジョンについての病棟看護師長の語りの比較:ビジョン言語化の困難さ

    磯部環, 武村雪絵, 國江慶子, 竹原君江, 市川奈央子, 池田真理, 駒形和典, 小見山智恵子, 川崎つま子, 相馬光代

    日本看護管理学会学術集会抄録集   Vol. 22nd   2018

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  26. 携帯型皮膚水分計の信頼性と妥当性の検討(Reliability and validity of a portable device for measuring stratum corneum hydration)

    竹原 君江, 飯坂 真司, 大江 真琴, 真田 弘美

    日本創傷・オストミー・失禁管理学会誌   Vol. 21 ( 4 ) page: 296 - 303   2017.12

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    Language:English   Publisher:(一社)日本創傷・オストミー・失禁管理学会  

    【目的】皮膚バリア機能の低下により皮膚障害のリスクが増加する。臨床および研究において適切に皮膚アセスメントを行うため、客観的に皮膚の角質水分量を測定する必要がある。本研究では携帯型皮膚水分計の信頼性と妥当性を検証した。【方法】研究デザインは準実験研究であり、ボランティア37名と測定者3名を対象とした。測定者内信頼性、測定者間信頼性、機器間信頼性の評価のため、対象者の片方の前腕部を各測定者が携帯型皮膚水分計2台を用い、各機器3回ずつ測定した。併存妥当性および既知集団妥当性のため、測定者1名が携帯型皮膚水分計1台と標準機器1台を使用し、片方の前腕部、前頭部および踵部を各機器で3回ずつ測定した。本研究は当該施設の倫理審査委員会の承認を得たうえで実施した。【結果】測定者内信頼性は級内相関係数(ICC)0.97-0.99、測定者間信頼性はICC 0.88-0.96、機器間信頼性はICC 0.89-0.94であった。併存妥当性として携帯型皮膚水分計と標準機器との相関係数は前腕部で0.92、前頭部で0.82、踵部で0.80であった(いずれもp<0.01)。既知集団妥当性として携帯型皮膚水分計、標準機器はともに前腕部より踵部で有意に低い角質水分量を示した(p<0.01)。【結論】携帯型皮膚水分計は十分な信頼性、併存妥当性、既知集団妥当性を有することが確認できた。(著者抄録)

    Other Link: https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2017&ichushi_jid=J05543&link_issn=&doc_id=20180122470001&doc_link_id=1703388&url=https%3A%2F%2Fkango-sakuin.nurse.or.jp%2Fnid%2F1703388&type=%8D%C5%90V%8A%C5%8C%EC%8D%F5%88%F8Web&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00014_1.gif

  27. 組織を分析単位とする看護管理事例研究に特有の倫理的課題とその対処方法の検討

    武村 雪絵, 國江 慶子, 竹原 君江, 佐藤 博子, 駒形 和典, 佐々木 美奈子, 池田 真理, 市川 奈央子

    日本看護科学学会学術集会講演集   Vol. 37回   page: [PF - 2]   2017.12

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    Language:Japanese   Publisher:(公社)日本看護科学学会  

  28. 看護師長のコンピテンシー自己評価と上司評価の比較

    小林 康司, 武村 雪絵, 國江 慶子, 竹原 君江, 市川 奈央子, 小見山 智恵子, 相馬 光代, 駒形 和典, 佐藤 博子

    日本看護科学学会学術集会講演集   Vol. 37回   page: [PF - 4]   2017.12

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  29. 患者教育・チーム医療 糖尿病における医療の国際化に向けた取り組み

    飯塚 陽子, Li Shuyan, Sun Haiqin, Thor Hongwooi, 大橋 優美子, 大江 真琴, 竹原 君江, 土井 麻里, 井上 享子, 久井 良之, 菅原 正純, 國井 大輔, 真田 弘美, Wang Guanbao, Huang Dongsheng, Jia Weiping, 山内 敏正, 植木 浩二郎, 門脇 孝

    糖尿病合併症   Vol. 31 ( Suppl.1 ) page: 310 - 310   2017.10

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  30. 糖尿病における医療の国際化に向けた取り組み

    飯塚 陽子, Li Shuyan, Sun Haiqin, Thor Hongwooi, 大橋 優美子, 大江 真琴, 竹原 君江, 土井 麻里, 井上 享子, 久井 良之, 菅原 正純, 國井 大輔, 真田 弘美, Wang Guanbao, Huang Dongsheng, Jia Weiping, 山内 敏正, 門脇 孝

    肥満研究   Vol. 23 ( Suppl. ) page: 170 - 170   2017.9

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  31. 亀裂を有する糖尿病患者における踵部角質水分量

    大江 真琴, 竹原 君江, 野口 博史, 大橋 優美子, 門脇 孝, 真田 弘美

    日本創傷・オストミー・失禁管理学会誌   Vol. 21 ( 2 ) page: 202 - 202   2017.5

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  32. 糖尿病患者の足白癬予防のための教育システムの開発 自動拭き取り領域検出の試み

    野口 博史, 竹原 君江, 大江 真琴, 大橋 優美子, 鈴木 亮, 山内 敏正, 森 武俊, 真田 弘美

    日本創傷・オストミー・失禁管理学会誌   Vol. 21 ( 2 ) page: 203 - 203   2017.5

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  33. 糖尿病における医療の国際化に向けた取り組み

    飯塚 陽子, Li Shuyan, Sun Haiqin, Thor Hongwooi, 大橋 優美子, 大江 真琴, 竹原 君江, 雨宮 歩, 山田 案美加, 土井 麻里, 井上 享子, 久井 良之, 菅原 正純, 北野 選也, 國井 大輔, Bao Yuqian, Fu Jian, 真田 弘美, Wang Guanbao, Huang Dongsheng, Jia Weiping, 山内 敏正, 植木 浩二郎, 門脇 孝

    糖尿病   Vol. 60 ( Suppl.1 ) page: S - 144   2017.4

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    Language:Japanese   Publisher:(一社)日本糖尿病学会  

  34. 【下肢潰瘍予防・治療に役立つアセスメント】工学技術に基づく足のアセスメント 歩き方、足底の圧とずれの客観計測

    野口 博史, 雨宮 歩, 大江 真琴, 竹原 君江, 真田 弘美, 森 武俊

    日本下肢救済・足病学会誌   Vol. 9 ( 1 ) page: 42 - 49   2017.3

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    糖尿病足潰瘍予防を目的に、われわれは足底にかかる力に着目し客観的なアセスメントのための計測装置を開発してきた。具体的には、1)足底圧分布センサと小型の脚運動の計測可能なモーションセンサとの組み合わせによる歩行計測システム、2)薄型のシートタイプのずれ力計測のセンサによる歩行時のずれ力計測システム、3)小型の3軸力覚センサを用いた局所の圧力とずれ力の計測システムである。これらのシステムによりこれまで困難であった歩行時の胼胝部位におけるずれ力の計測などが実現できるようになってきた。また、システムを用いた臨床調査により胼胝発症に関係するエビデンスも出てきており、それらを患者へフィードバックするシステムの改良も行っている。本稿では、それらのシステムの紹介ならびに利用することで判明したエビデンスについて紹介する。(著者抄録)

    Other Link: https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2017&ichushi_jid=J05747&link_issn=&doc_id=20170414460006&doc_link_id=10.7792%2Fjlspm.9.42&url=https%3A%2F%2Fdoi.org%2F10.7792%2Fjlspm.9.42&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_2.gif

  35. 【下肢潰瘍予防・治療に役立つアセスメント】糖尿病足潰瘍予防を目的とした足白癬・爪白癬のアセスメントとケア

    竹原 君江, 大江 真琴, 野口 博史, 大橋 優美子, 常深 祐一郎, 真田 弘美

    日本下肢救済・足病学会誌   Vol. 9 ( 1 ) page: 25 - 32   2017.3

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    糖尿病足潰瘍の予防には非潰瘍性病変を早期にアセスメントし、適切なケアを行うことが重要である。本稿では非潰瘍性病変である白癬に焦点を絞って紹介する。白癬は、感染予防と、早期発見による悪化予防が重要である。われわれはこれらについて研究を進めてきた。感染予防については、足部に付着した白癬菌を感染前に除去するための適切な足洗浄方法を検討した。その結果、(1)毎日の足洗浄、(2)各趾間の4-5回、石鹸洗浄、(3)足に手が届きにくい認識がある場合は適切な体勢を検討、(4)身体的に足洗浄がむずかしい場合はフットケアシートを活用、という4点が効果的である可能性が示された。早期発見については、足底に鱗屑がある場合は足白癬、爪に混濁がある場将は爪白癬の可能性があり、爪下角質増殖があり足趾の表面温度が33.0℃以下のときには爪白癬の可能性があることが示唆された。これらの視点から患者のセルフケア能力や白癬をアセスメントし適切なケアを行うことが重要である。(著者抄録)

    Other Link: https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2017&ichushi_jid=J05747&link_issn=&doc_id=20170414460004&doc_link_id=10.7792%2Fjlspm.9.25&url=https%3A%2F%2Fdoi.org%2F10.7792%2Fjlspm.9.25&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_2.gif

  36. 糖尿病患者における足部胼胝の要因 カルテ調査による検討

    大江 真琴, 濱谷 雅子, 野口 博史, 大場 美穂, 竹原 君江, 大橋 優美子, 植木 浩二郎, 門脇 孝, 森 武俊, 真田 弘美

    日本創傷・オストミー・失禁管理学会誌   Vol. 20 ( 4 ) page: 426 - 433   2017.1

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    【目的】糖尿病患者は、足部に胼胝が発生し、炎症を伴って潰瘍化することが知られている。胼胝の要因は足底圧との関係が考えられるが、炎症を伴う胼胝と足底圧の関係をみた報告はない。本研究の目的は、糖尿病患者における足部胼胝保有の要因および炎症の要因を足底圧に関する因子を中心に明らかにすることである。【方法】2009年12月から2010年11月の大学病院糖尿病足外来受診者のうち足部胼胝保有者を対象に、胼胝部の炎症(サーモグラフィ上、周囲皮膚にくらべて胼胝部の皮膚温が相対的に上昇)、知覚神経障害、静止時足底圧のデータを診療記録から得た。【結果】胼胝保有者は52名(38.8%)であり、平均年齢68.4±9.3歳、罹病期間16.9±10.6年であった。胼胝の部位は計149個中、第1趾が最も多く30個、ついで第1中足骨25個であった。前足部静止足底最大圧に関しては、前足部胼胝保有者(2.59±1.25kg/cm2)が非保有者(1.57±0.90kg/cm2)と比較して有意に大きかった(p<0.001)。胼胝部に炎症を伴っていた者は5名(3.7%)であり、全員知覚神経障害を合併していた。そのうち前足部静止足底最大圧を測定していた者は3名であり、それぞれ2.12、2.85、4.52kg/cm2であった。前足部炎症無の胼胝保有者の前足部静止足底最大圧の平均は2.57±1.18kg/cm2であった。【考察・結論】糖尿病患者における胼胝保有の要因として前足部静止足底最大圧が関連していること、炎症を伴う胼胝を有する者は全員知覚神経障害を合併していることが明らかとなった。炎症を伴う胼胝を有する糖尿病患者の静止足底最大圧は、炎症を伴わない胼胝を有する糖尿病患者にくらべて大きい傾向にはなかった。この結果は、胼胝が炎症を伴い潰瘍化する過程には、足底圧以外の要因が影響している可能性を示している。(著者抄録)

    Other Link: https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2017&ichushi_jid=J05543&link_issn=&doc_id=20170908340014&doc_link_id=1701479&url=https%3A%2F%2Fkango-sakuin.nurse.or.jp%2Fnid%2F1701479&type=%8D%C5%90V%8A%C5%8C%EC%8D%F5%88%F8Web&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00014_1.gif

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KAKENHI (Grants-in-Aid for Scientific Research) 16

  1. 看護理工学的手法を用いた足白癬トータルケアシステムの確立

    Grant number:21H03231  2021.4 - 2025.3

    科学研究費助成事業  基盤研究(B)

    竹原 君江, 常深 祐一郎, 峰松 健夫, 野口 博史

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    Authorship:Principal investigator 

    Grant amount:\17290000 ( Direct Cost: \13300000 、 Indirect Cost:\3990000 )

    足白癬は、糖尿病足潰瘍、高齢者の転倒のリスク要因である。これらは足切断や寝たきりにつながるため、足白癬の予防、スクリーニング、適切な治療の援助を含めたトータルケアが必要である。それには患者のセルフケア支援システムが不可欠である。そこで、本研究の目的を1)deep learningを活用した足の拭き残しの自動可視化技術の開発、2)deep learning による自動視診技術と生物学的手法による白癬菌検出シートによる白癬菌検出法の開発、3)deep learning を活用した治療サポート技術の開発の3点とした。これらの成果により患者のセルフケア能力が向上することを目指す。

  2. Development of non-invasive skin physiology evaluation technique aiming at tailor-made care for patients on dialysis

    Grant number:21K10747  2021.4 - 2025.3

    Grants-in-Aid for Scientific Research  Grant-in-Aid for Scientific Research (C)

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    Authorship:Coinvestigator(s) 

  3. 足部白癬スクリーニングシステムの構築

    2018.4

    科学研究費補助金  基盤研究(C)

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    Authorship:Principal investigator 

  4. Construction of tinea pedis screening system

    Grant number:18K10268  2018.4 - 2021.3

    Grants-in-Aid for Scientific Research  Grant-in-Aid for Scientific Research (C)

    Takehara Kimie

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    Authorship:Principal investigator 

    Grant amount:\4550000 ( Direct Cost: \3500000 、 Indirect Cost:\1050000 )

    It is important to early detection of tinea pedis, because tinea pedis is a risk factor for diabetic foot ulcer. The purpose of this study is to develop a tinea pedis visualization technology by a science and engineering approach for constructing a tinea pedis screening system.
    In the engineering approach, we developed an image processing method to detect the tinea pedis findings by deep learning, and at least one area could be reliably estimated as a tinea pedis finding on each sole image with tinea pedis.
    In the science approach, we focused on the keratinase secreted when Trichophyton invades the stratum corneum, and developed a visualization system for human-derived Trichophyton keratinase using fluorescently labeled keratin.

  5. 足ケアが高齢者の歩行・姿勢制御機能にもたらす効果の構造化

    2017.4

    科学研究費補助金  基盤研究(B)

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    Authorship:Coinvestigator(s) 

  6. サーモグラフィを用いた糖尿病足潰瘍予防支援システムの開発

    2017.4

    科学研究費補助金  基盤研究(C)

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    Authorship:Coinvestigator(s) 

  7. 透析患者における足スクリーニングシステムの構築

    2017.4

    科学研究費補助金  基盤研究(C)

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    Authorship:Coinvestigator(s) 

  8. 足ケアが高齢者の歩行・姿勢制御機能にもたらす効果の構造化

    Grant number:17H04429  2017.4 - 2021.3

    日本学術振興会  科学研究費助成事業  基盤研究(B)

    本田 育美, 竹原 君江

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    Authorship:Coinvestigator(s) 

    本研究の目的は、高齢者に提供される‘足ケア’の効果を、足部の状態のほか、身体面での機能性の向上といった運動力学の評価とともに、転倒予防という視点から、日常での生活活動の量および質に関する側面を加え解き明かし、構造化を目指すことである。そこで令和元年度では、①高齢者における測定項目の検討と、②在宅高齢者を対象とした身体機能・足部状態と活動効力感・転倒不安との関連についての縦断的検討(ベースラインおよび1か月後評価)を計画として挙げた。
    《測定項目の検討》 前年度収集データをもとに、身体平衡の保持機能とくに静的姿勢ならびに立ち上がり時の重心動揺の安定性・回復性を解析した。足趾の可動性が向上した15名に対し平衡機能に関する評価を行ったところ、一定の傾向性を導きだすことはできなかった。そのため平衡機能を指標する項目単独では、足部の微細な機能変化をとらえるのは難しいと判断した。そのため、介入に伴う変化の評価指標を検討し、足部の皮膚表面温度と可動域の計測を行った。その結果、循環機能に関する足部評価を追加して評価していくこととなった。
    《身体機能・足部状態と転倒不安のベースライン+1か月後評価》 令和元年度終了までに、在宅後期高齢者 77名〔男性9名(11.7%),年齢81.9±3.6歳,BMI 23.0±3.61,MMSE 28.2±2.33点,転倒歴あり22名(28.6%),独居44名(57.1%)〕の測定を行った。身体機能として、FRT 32.4±5.60cm,10m歩行時間 8.2±1.94秒,握力(良) 21.7±6.89Kg,足趾筋力(良) 7.8±3.98Kg,1日活動量4,885±2,471歩であった。また、転倒不安では、FES-I 24.2±8.51点,身体活動SE 26.9±9.83点であった。
    令和元年度の計画では、①高齢者における測定項目の検討と、②在宅高齢者を対象とした身体機能・足部状態と活動効力感・転倒不安との関連についての縦断的検討(ベースラインおよび1か月後評価)を計画として挙げた。
    評価指標としての足部評価法の見直しにより、再検討を要したため、追加のデータ収集に着手する時期に遅れが生じた。前年度に加え循環機能に関する計測法で試みることとし、その他の指標となる足趾機能ならびに転倒不安の側面も含めた測定項目でのデータ収集を行い、計70名余りの対象のベースライン評価および1か月後の状態計測を実施することができた。そのような点から、当初に掲げた年度内の計画よりやや時間的な遅れは生じたが、内容的にはおおむね順調に遂行できていると判断している。
    令和元度までに収集できたデータの分析として、ベースラインおよび1か月後評価としての一般状態・身体機能および、足の状態と日常生活活動状況についての評価を行っていく。また、足部の状態別にみた身体活動機能や日常生活活動状態との関連について検討を行う。これらの成果については、学会発表等を行っていく。
    また、引き続き前年度プログラム参加者の追跡データの収集に取り組むともに、足ケア介入における、歩行・起立動作と姿勢制御能の変化の検討も予定している。在宅高齢者の足状態と身体機能ならびに生活機能評価(身体活動量,転倒不安)との関連について、得られた結果を取りまとめ、成果の発表を行っていく予定である。

  9. Development of diabetic foot ulcer prevention system using thermography

    Grant number:17K12209  2017.4 - 2020.3

    Japan Society for the Promotion of Science  Grants-in-Aid for Scientific Research Grant-in-Aid for Scientific Research (C)  Grant-in-Aid for Scientific Research (C)

    OE Makoto

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    Authorship:Coinvestigator(s) 

    The purpose of this study is to develop the diabetic foot ulcer prevention system using thermography.
    Thermographic images of the plantar calluses and ulcer regions of 449 patients with diabetes were analyzed. It might be suggested that elevated skin temperature in the range from the callus region to the arch, the sections with the highest skin temperature coincided with the callus region, and the highest value of [the average of the metatarsal skin temperature minus the average of the sole skin temperature] could be an index of ulceration.We developed a device with a thermography camera attached to a smartphone to observe the sole skin temperature using a selfie stick and lent it to two patients with diabetes. The method of connection and fixation of the camera has been changed to allow the smartphone operation at hand. An automatic detection function for the risk status of ulceration should be developed in the future.

  10. Development of the foot screening system in the dialysis patients

    Grant number:17K12218  2017.4 - 2020.3

    Japan Society for the Promotion of Science  Grants-in-Aid for Scientific Research Grant-in-Aid for Scientific Research (C)  Grant-in-Aid for Scientific Research (C)

    OBA Miho

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    Authorship:Coinvestigator(s) 

    Participants of this study were adult patients who had newly introduced hemodialysis in a hemodialysis center. Compared with the cutoff point of skin hydration in the patients with diabetes at risk of heel fissure, more than 90% of them were below the criteria. However, no one used moisturizer daily. Patients who had higher skin moisture tend to bathe frequently.
    About 60% of the patients had thickened toenails. They cut their toenails with nail-clippers or nippers but had difficulty cutting not only due to thickness of their toe nails but also because of their poor eye sight, a reduced rate of range of motion, or lack of coordinated movement.
    All the patients who had sensation of cold feet had low toe temperature. However, some patients without sensation of cold feet had low toe temperature and positive signs of Peripheral Arterial Disease (PAD). Thermography will be a handy tool to look for PAD at the bedside.

  11. 糖尿病患者を対象とした足白癬アセスメントツールの開発

    2015.4 - 2018.3

    科学研究費補助金  基盤研究(C)

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    Authorship:Principal investigator 

  12. The development of tinea pedis assessment tool for diaabetic patients

    Grant number:15K11578  2015.4 - 2018.3

    Japan Society for the Promotion of Science  Grants-in-Aid for Scientific Research Grant-in-Aid for Scientific Research (C)  Grant-in-Aid for Scientific Research (C)

    TAKEHARA KIMIE

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    Authorship:Principal investigator 

    Grant amount:\4810000 ( Direct Cost: \3700000 、 Indirect Cost:\1110000 )

    It is because tinea pedis can be a risk to diabetic foot for diabetic patients that it is important to detect it early and lead to treatment and care. Therefore, in this research, we focused on blotting technology and tried to develop a tool that could assess tinea pedis by visualizing the enzyme secreted by Trichophyton. As a result, it was confirmed that it was possible to detect the enzyme secreted by Trichophyton and evaluate the enzyme activity experimentally. Additionally, it was suggested that the enzyme could be detected in the patient who had tinea pedis. However, since special light was necessary for detection, above method was not convenient. Next, a method which does not require a special light source was examined. As a result, it was suggested that tinea pedis could be detected by a staining method using colloidal gold.

  13. Development of evaluation methods for nursing skills using ultrasonography: confirmation methods of nasogastric tube placement.

    Grant number:15K20661  2015.4 - 2017.3

    Japan Society for the Promotion of Science  Grants-in-Aid for Scientific Research Grant-in-Aid for Young Scientists (B)  Grant-in-Aid for Young Scientists (B)

    Komagata Kazunori, YABUNAKA Koichi, NAKAGAMI Gojiro, IKEDA Mari, TAKEHARA Kimie, NAKATOMI Hirofumi, SHIMIZU Yoshiko, TAKEMURA Yukie, SANADA Hiromi

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    Misplacement of the nasogastric tube in the respiratory tract can cause complications, including pneumonia and death. Therefore, it is essential to confirm that a nasogastric tube is correctly positioned. The purpose of this study was to evaluate the effectiveness of portable ultrasound machine for confirming nasogastric tube placement. A trained registered nurse used portable ultrasound machine to confirm the nasogastric tube placement. Consequently, using portable ultrasound machine, nasogastric tube positions in neck and epigastric regions were accurately visualized. In conclusion, portable ultrasound machine appears to have potential as a new method to confirm accurate nasogastric tube position in diverse clinical settings.

  14. フットケアシートを使用した糖尿病患者に対する視覚的足白癬予防ケア教育の効果の検証

    2013.8 - 2015.3

    科学研究費補助金  研究活動スタート支援

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    Authorship:Principal investigator 

  15. 長期療養施設における慢性痛ケアの質向上のための教育プログラム開発

    2013.4 - 2017.3

    科学研究費補助金  基盤研究(B)

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    Authorship:Coinvestigator(s) 

  16. Development of Quality Improvement Strategies for Care of Chronic Pain in Long-term Care Facilities

    Grant number:25293462  2013.4 - 2017.3

    Japan Society for the Promotion of Science  Grants-in-Aid for Scientific Research Grant-in-Aid for Scientific Research (B)  Grant-in-Aid for Scientific Research (B)

    Yamamoto-Mitani Noriko, SAITO Yumiko

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    This study aimed at developing an educational program to improve the care of chronic pain in long-term care hospitals. In the interviews to the staff and the nationwide questionnaire survey, it was found that the care staff were very busy with high stress, and any educational program was not considered acceptable. Therefore instead we attempted the following activities: 1) case conferences in which the staff members examine successful cases so that they can appreciate the value of care they provide and have elevated work engagement; 2) we established the long-term care research society in which the staff members can communicate beyond facility boundaries; 3) we attempted letting the staff members learn person centered care; and 4) we developed process- and outcome-oriented quality indicators for elderly care. We are to open a website and share our findings.

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