看護理工学会

The Society for Nursing Science and Engineering

看護理工学会誌 7巻

原 著

  • (英文論文)The effects of three different bathing methods on improving swelling of the lower limbs: self-care in patients with lymphedema(異なる入浴法が下肢のむくみ改善に及ぼす影響-リンパ浮腫患者のセルフケアのための検討-)
    日本語抄録 Engish Abstract
    異なる入浴法が下肢のむくみ改善に及ぼす影響-リンパ浮腫患者のセルフケアのための検討-
    下村義弘 1 夏 亜麗 1 津田文香 1 大賀久美 1 横井麻里 1 藤村寛子 2
    1. 千葉大学大学院工学研究院人間生活工学研究室
    2. 東京ガス株式会社都市生活研究所

    浮腫は疾患本来の内的要因に加え,同じ姿勢を維持するといった日常生活の外的要因によって,より一層,進行する.外的要因のなかでも日常生活で起こる可能性の高い下肢のむくみと入浴行為に注目した.ミストサウナ,全身浴,シャワーの3種の異なる入浴法を比較した.直立位タスクで下肢にむくみを誘発し,その後に入浴を行い,回復期を設けてむくみの改善効果を調べた.測定項目は主観評価とふくらはぎ周囲長であった.その結果,すべての入浴方法は回復期終了時点で,タスクによって誘発されたふくらはぎ周囲長はもとに戻らなかった.しかし,主観的不快感は緩和された.また,ミストサウナでは,出浴後の最大周囲長の有意な減少がみられた.入浴方法によってはおもに血液性のむくみに対して異なる影響を与えることが分かった.つまり回復期を長くすると,入浴法によっては客観的な改善効果が認められる可能性がある.

    入浴,下肢のむくみ,リンパ浮腫患者,セルフケア,生活の質
    The effects of three different bathing methods on improving swelling of the lower limbs: self-care in patients with lymphedema
    Yoshihiro Shimomura 1 Yali Xia 1 Fumika Tsuda 1 Kumi Oga 1 Mari Yokoi 1 Hiroko Fujimura 2
    1. Humanomics Unit, Division of Design Science, Graduate School of Engineering, Chiba University
    2. Urban Life Research Institute, Tokyo Gas Co., Ltd

    Progression of edema in patients with lymphedema is caused by internal factors and external factors, e.g., maintaining the same posture. We aimed to determine the bathing method for self-care that would best improve lower-limb swelling caused by standing in a constrained position in the same posture. Three different bathing methods, mist sauna, whole-body bath, and shower were tested. After a task was performed in the upright position, changes in lower-limb swelling were examined during and after bathing. Subjective evaluation and calf circumference measured improvement in swelling. We found that after bathing, the increase in calf circumference was not restored to the value observed at the end of the task in the upright position. However, bathing helped to eliminate subjective discomfort. Further, it was found that significant reduction in the maximum calf circumference was seen following mist sauna, which significantly affected the swelling by accumulation of venous blood owing to vasodilation and contraction in response to thermal stimulation. The bathing method has different effects, mainly on swelling by accumulation of venous blood. Therefore, the effects of bathing method on objective improvement in swelling over longer recovery periods may be recognized.

    bathing, lower-limb swelling, lymphedema, self-care, quality of life
  • (英文論文)Analysis of night-shift nurses’ locations and durations using information communication equipment: A prospective observational study of a mixed obstetric ward with severe patients in Japan(情報通信機器を用いた重症患者を有する産科混合病棟の夜勤帯看護師の滞在場所と滞在時間の分析)
    日本語抄録 Engish Abstract
    情報通信機器を用いた重症患者を有する産科混合病棟の夜勤帯看護師の滞在場所と滞在時間の分析
    大滝千文 1 齋藤いずみ 1 和泉慎太郎 2 大澤佳代 3,4
    1. 神戸大学大学院保健学研究科看護学領域
    2. 神戸大学大学院システム情報学研究科
    3. 神戸大学大学院保健学研究科病態解析学領域
    4. 神戸常磐大学医療検査学科

    日本の病院における分娩は,産科とほかの科が混合する産科混合病棟で約80%実施される.産科混合病棟では複数の科の患者の看護を行っているが,産科混合病棟の看護師全員を対象とした看護および,看護人員配置が少ない夜勤帯の看護は明らかになっていない.そのため,重症患者を有する産科混合病棟の夜勤帯看護の実態を明らかにする.本研究は,情報通信機器を用いて,産科混合病棟に勤務する夜勤帯看護師の勤務中の滞在場所と滞在時間を測定した.結果,夜勤帯の看護師の,一般病室患者1人あたりのベッドサイド平均滞在時間は,重症患者室に重症患者が入院している日は31.9分,入院していない日は33.6分であった.また,夜勤帯13時間勤務の各場所平均滞在時間割合は,一般病室担当看護師はナースステーション39.2%,一般病室34.4%,重症患者室1.7%であった.本研究結果は,安全な混合病棟の運営に寄与する看護人員配置の資料として活用できると考える.

    産科混合病棟,タイムスタディ,夜勤帯看護,看護師滞在場所,重症患者
    Analysis of night-shift nurses’ locations and durations using information communication equipment: A prospective observational study of a mixed obstetric ward with severe patients in Japan
    Chifumi Otaki 1 Izumi Saito 1 Shintaro Izumi 2 Kayo Osawa 3,4
    1. Department of Nursing, Kobe University Graduate School of Health Science
    2. Graduate School of System Informatics, Kobe University
    3. Department of Biophysics, Kobe University Graduate School of Health Sciences
    4. Department of Health Science, Kobe Tokiwa University

    Approximately 80% of hospital-based childbirth in Japan takes place in mixed obstetric wards, which comprise a mix of the obstetrics department and other departments. Although mixed obstetric wards treat patients from multiple departments, previous studies have not clarified the procedures used by nursing staff in the ward, or nursing by night-time nurses. The purpose of this study was to reveal the actual status of night-shift nurses in a mixed obstetrics ward that treats severe patients. This time motion study used smartphones and beacons to measure the place and duration of stay for night-shift nurses working in a mixed obstetric ward. We found that nurses’ mean bedside stay time per patient in a general patient room was 31.9 minutes on days when there were severe patients hospitalized in the severe patient room, and 33.6 minutes on days when there were no severe patients. Furthermore, the mean stay time in each place during a nurse’s 13-hour shift was 39.2% in the nurse station, 34.4% in the general patient room, and 1.7% in the severe patient room. We believe that these results can be used as data for the placement of nursing staff involved in operating a safe mixed ward.

    mixed obstetric ward, Time Motion Studies (TMS), night shift nursing, nursing task locations, severe patients
  • (英文論文)Comparison of lumbar hot compresses and lumbar massage on labor pain-alleviating effects during the first stage of labor (分娩第1期の産痛緩和効果に対する腰部温罨法と腰部マッサージの比較)
    日本語抄録 Engish Abstract
    分娩第1期の産痛緩和効果に対する腰部温罨法と腰部マッサージの比較
    森川真衣 1) 鏡(関塚)真美 2) 田淵紀子 2)
    1. 富山県立中央病院
    2. 金沢大学医薬保健研究域保健学系

    本研究の目的は分娩第1期における腰部温罨法(以下温罨法)と腰部マッサージの産痛緩和効果を比較することである.妊娠37週以降の初経産婦15人を分娩開始順に2群に分け,第1群は温罨法を受ける群,第2群はマッサージを受ける群として割り付けた.分娩第1期で産婦が腰部痛を訴えたときを介入時期とし,温罨法またはマッサージを繰り返し行った.初回介入前後にVisual Analogue Scale(VAS)を使用し,産痛の測定を行った.第1群に7人,第2群に8人が割り付けられた.時期(介入前・後)と介入方法(温罨法・マッサージ)を2要因とし,VAS得点を従属変数とした混合モデルで比較したところ,時期において主効果(p<0.001)を認め,介入前のVAS得点に対し,介入後の得点は低下していた.しかし,介入方法の主効果は認めなかった(p=0.982).温罨法はマッサージに匹敵する効果があることが示唆された.

    産痛緩和,陣痛,女性,マッサージ,温罨法
    Comparison of lumbar hot compresses and lumbar massage on labor pain-alleviating effects during the first stage of labor
    Mai Morikawa 1) Naomi Sekizuka-Kagami 2) Noriko Tabuchi 2)
    1. Toyama Prefectural Central Hospital
    2. Faculty of Health Sciences, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University

    The aim of this study was to compare labor pain-alleviating effects of lumbar hot compresses (hot compress) and lumbar massage during the first stage of labor. This quasi-experimental study that included 15 primiparous and multiparous women at 〓37 weeks of gestation. Parturient women were divided into 2 groups and treated with hot compress or lumbar massage continuously, in the order in which they began the first stage of labor. The first group received hot compresses, whereas the second received massages. Group 1 comprised 7 subjects and group 2 comprised 8. A visual analog scale (VAS) was used before and after the first intervention to measure pain. The groups were compared in a mixed model with the period (before and after intervention) and intervention (hot compress/massage) as the 2 factors; VAS scores were the independent variables. Comparison of the group VAS scores revealed a primary effect in this period (p <0.001). Post-intervention VAS scores decreased compared to pre-intervention VAS scores. A primary intervention effect was not observed (p=0.982). Both interventions reduced pain with no significant difference. Our findings suggest that hot compress is equivalent to massage for alleviating labor pain.

    pain-alleviating, labor pain, women, massage, hot compress
  • バランスとキネマティクスに着目した左膝関節固定時の歩行分析
    日本語抄録 Engish Abstract
    バランスとキネマティクスに着目した左膝関節固定時の歩行分析
    山添大丈 1) 満上育久 2) 小川拓也 3) 八木康史 3)
    1. 立命館大学情報理工学部
    2. 広島市立大学大学院情報科学研究科
    3. 大阪大学産業科学研究所

    本論文では,左膝関節障害を模擬した場合の歩行変化を分析する.健常被験者が膝関節を固定する装具を装着することで障害歩行を模擬し,通常歩行と障害歩行を比較することで関節障害に伴う歩行変化を分析する.本研究では,2つの要因,バランスとキネマティクスに着目する.バランス分析では,margin of stability(MoS)を用いる.キネマティクス分析では,各部位の姿勢を計算し,通常歩行と障害歩行の違いを比較する.分析結果より,(1)装具装着(模擬関節障害)による影響は胴・腰に多くみられること,(2)腕振りへの影響は突発的なバランス変化の際に限られること,(3)頭部の変化は小さいことが分かった.

    バランス,キネマティクス,歩行変化,モーションキャプチャ,Margin of Stability (MoS)
    Analysis of gait changes caused by fixing left knee joint focusing on balance and kinematics
    Hirotake Yamazoe 1) Ikuhisa Mitsugami 2) Takuya Ogawa 3) Yasushi Yagi 3)
    1. College of Information Science and Engineering, Ritsumeikan University
    2. Graduate School of Information Sciences, Hiroshima City University
    3. The Institute of Scientific and Industrial Research, Osaka University

    In this paper, we analyze gait changes by simulating left knee disorders in participants. Healthy participants wear knee brace. We compared the normal and simulated disordered walking (while wearing the knee brace) to analyze what changes occur in their gait due to physical disorders. For analysis, we focus on two factors: balance and kinematics. In the balance analysis, we use margin of stability (MoS) for evaluating balance during walking. In the kinematics analysis, we calculate poses of the body parts and compare the poses between normal and disordered walking. Analysis results show that 1) the effects caused by wearing brace can be observed in the torso and waist, 2) the effects to the arms can be observed only when sudden changes in balance occur, and 3) the effects to the head are small.

    balance, kinematics, change of walking, motion capture, Margin of Stability (MoS)
  • 産後1ヵ月の女性の骨盤底筋力の実態および分娩に関する要因との関連性の検討
    日本語抄録 Engish Abstract
    分娩第1期の産痛緩和効果に対する腰部温罨法と腰部マッサージの比較
    安宅和佳奈 1) 岡山久代 2) 内藤紀代子 3)
    1. 筑波大学附属病院看護部
    2. 筑波大学医学医療系
    3. びわこ学院大学教育福祉学部

    産後1ヵ月の女性の骨盤底筋力の実態と分娩に関する要因との関連性を明らかにするため,産後1ヵ月の女性92名の骨盤底筋力測定と分娩に関する要因の調査を行った.その結果,骨盤底筋の最大収縮力は0.74kgf,最大収縮時間は3.29秒で,骨盤底筋の随意収縮が困難な女性は9.7%,随意収縮は可能であるが持続収縮が困難な女性は17.4%存在した.産後1ヵ月の骨盤底筋力と有意な関連を示したのは妊娠前の尿失禁であり,その他の分娩に関する要因との関連は示されなかった.以上より,産後1ヵ月の骨盤底筋力を予測するためには,分娩時の要因よりも,妊娠前からの尿失禁の有無についての情報収集が必要であるといえる.また,産後には関連要因からのハイリスク群の予測に加えて,個々の骨盤底筋力の評価を行い,筋力に合ったケアを実施する必要があると考える.

    分娩,産後1ヵ月,骨盤底筋収縮,骨盤底筋力,尿失禁
    Pelvic floor muscle strength of women at postpartum month 1 and the relationship between pelvic floor muscle strength and delivery-related factors
    Wakana Atagi 1) Hisayo Okayama 2) Kiyoko Naito 3)
    1. Department of Nursing, University of Tsukuba Hospital
    2. Faculty of Medicine, University of Tsukuba
    3. Faculty of Education Welfare, Biwako Gakuin University

    This study aimed to elucidate the pelvic floor muscle strength of women at postpartum month 1 and the relationship between pelvic floor muscle strength and delivery-related factors. We measured the pelvic floor muscle strength of 92 women at postpartum month 1 and investigated factors related to delivery. The study found that the maximum contraction force and duration were 0.74 kgf and 3.29 seconds, respectively. Of 92 women, 9.7% found it difficult to voluntarily contract the pelvic floor muscle and 17.4% could voluntarily contract the muscle but had difficulty with prolonged contraction. Moreover, a significant relationship was observed between pelvic floor muscle strength at postpartum month 1 and pre-pregnancy urinary incontinence. The above-mentioned findings suggest that collecting information about pre-pregnancy urinary incontinence rather than delivery-related factors is necessary to predict pelvic floor muscle strength at postpartum month 1. In addition, it is also suggested that in order to provide appropriate care for the pelvic floor of postpartum women, their pelvic floor muscle strength must be evaluated, as well as estimation of high-risk from delivery-related factors.

    delivery, one month postpartum, pelvic floor muscle contraction, pelvic floor muscle strength, urinary incontinence
  • 妊娠中期の糖代謝と活動量計による生活活動量の関連
    日本語抄録 Engish Abstract
    妊娠中期の糖代謝と活動量計による生活活動量の関連
    藤浪優花 1) 川野亜津子 2)
    1. 筑波大学大学院人間総合科学研究科看護科学専攻博士前期課程
    2. 筑波大学医学医療系

    妊娠糖尿病予防のケアを検討していくための基礎資料を得て,臨床現場で生活に即した具体的な指導へ繋げるために,本研究では3軸加速度センサーを搭載した活動量計を用いて妊娠中期の生活活動量を実測し,4週間後の糖代謝との関連を明らかにした.対象者となった妊娠中期女性の1日あたりの歩数は平均3407.4歩であり,一般成人女性と比較して少なかった.これは,交通手段によるものや天候に左右されることも考えられ,今後も検討する必要があると考えられた.歩数と関連があったものは,妊娠前BMI,50gGCT時BMI,就業状況であったが,妊婦の生活活動の多くを占めている就労については,今後どのような動作でより生活活動量が増えるのか検討する必要がある.生活活動量と糖代謝の指標である血糖値との関連について,総消費エネルギー量r=-.15,生活活動エネルギー量r=-.09といずれも相関が認められなかったが,歩数はr=-.22であり,弱い負の相関傾向がみられた.

    妊娠中期,糖代謝,活動量計,生活活動量,妊娠糖尿病
    Relationship between carbohydrate metabolism in the middle pregnancy and daily activity measured by accelerometer
    Yuika Fujinami 1) Atsuko Kawano 2)
    1. University of Tsukuba, Graduate School Comprehensive Human Sciences Master’s Program in Nursing Science
    2. Faculty of Medicine, University of Tsukuba

    This study aims to obtain basic data to study care for prevention of gestational diabetes and to connect to specific guidance at the clinical site. Activity levels were objectively measured using an activity meter equipped with a tri-axis accelerometer, and dietary intake details were examined concurrently, followed by an investigation into the relationship with glucose levels four weeks thereafter. The participants’ average daily step count was 3407.4, which was lower than that of general adult women. The difference in step counts may be because of in the means of transport as well as weather; therefore, further investigation is required. Pre-pregnancy BMI, BMI at the time of conducting the 50g glucose challenge test (GCT), and employment were factors associated with step counts. In future research, it is necessary to investigate what type of movement increases activity levels in pregnant women in employment, which accounts for a large part of their physical activity. No correlation was observed between activity levels and blood glucose levels, which are an index of glucometabolic, for total energy consumption (r=-.15) or energy amounts for everyday activities (r=-.09); however, a slightly negative correlation was found with step counts (r=-.22).

    middle pregnancy, carbohydrate metabolism, accelerometer, daily activity, gestational diabetes mellitus
  • (英文論文)Morphological characteristics of skin tears to estimate the etiology-related external forces that cause skin tears in an elderly population (高齢者に発生するスキンテアの起因外力を推定する形態的特徴)
    日本語抄録 Engish Abstract
    高齢者に発生するスキンテアの起因外力を推定する形態的特徴
    小谷野結衣子 1) 仲上豪二朗 2), 3) 玉井奈緒 3), 4) 須釜淳子 5) 真田弘美 2), 3)
    1. 東京大学医学部附属病院看護部
    2. 東京大学大学院医学系研究科健康科学・看護学専攻老年看護学/創傷看護学分野
    3. 東京大学大学院医学系研究科附属グローバルナーシングリサーチセンター
    4. 東京大学大学院医学系研究科社会連携講座イメージング看護学
    5. 金沢大学新学術創成研究機構

    本研究の目的は高齢者のスキンテア再発を予防するために起因外力に関連するスキンテアの形態的特徴を抽出することである.研究デザインは質的記述的研究で,腕に発生したテア23例の写真と起因外力に関する情報を発見者から半構造化面接で得た.最初にテアの形態的特徴を抽出するために,写真をスケッチして形態的特徴を分類するドラフトを作成した.つぎに,テアの起因外力に関するインタビューから外力サブカテゴリーを抽出した.形態分類ドラフトのカテゴリーとして部位・形・スキンフラップ・紫斑・サイズが含まれた.起因外力に関する情報から起因者(患者・介助者・装着物)と外力のタイプを示すサブカテゴリー(ぶつける・拭く・引っ張る・爪が食い込む・引っ掻く・擦れる)が抽出された.起因外力サブカテゴリーに対応する形態分類ドラフトを分析すると,テアの起因外力を推定する要素として4つの形態的特徴(紫斑・形・円弧の深さ・サイズ)が特定された.

    形態分析,質的記述的研究,スキンテア再発,形
    Morphological characteristics of skin tears to estimate the etiology-related external forces that cause skin tears in an elderly population
    Yuiko Koyano 1) Gojiro Nakagami 2), 3) Nao Tamai 3), 4) Junko Sugama 5) Hiromi Sanada 2), 3)
    1. Department of Nursing, The University of Tokyo Hospital
    2. Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo
    3. Division of Care Innovation, Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo
    4. Department of Imaging Nursing Science, Graduate School of Medicine, The University of Tokyo
    5. Institute for Frontier Science Initiative, Kanazawa University

    The aim of this study was to identify the morphological characteristics of skin tears(STs)associated with specific external forces for preventing skin tear recurrence. This was a qualitative descriptive study. To investigate the relationship between ST morphology and causative external forces, we conducted semi-structured interviews concerning of development for 23 STs on their arms. First, we described data related to morphological characteristics of STs by sketching from photographs for developing a draft morphological classification. Next, we compared the codes for similarities and differences and extracted subcategories representing the external force factor. Categories of the morphological characteristics were follows: anatomical location, shape, skin flap, purpura, and size. Interviews identified two categories of external forces that cause STs:“origin”had three subcategories (caregiver, patient, and skin-contacting medical implements), and“type of external forces”with six subcategories (bumping, wiping, pulling, fingernail lacerations, scratching, and friction). We identified morphological characteristics of STs according to nine external force subcategories by comparing within and across each category and subcategory of external forces. Four characteristics (purpura, shape, depth of arc, and size) were identified as factors that could estimate the cause of STs.

    morphological analysis, qualitative descriptive research, recurrent skin tears, shape
  • (英文論文)Effect on blood pressure and cerebral blood flow of using a hybrid assistive limb (HAL) for standing(ロボットスーツHAL による起立が血圧と脳血流におよぼす影響)
    日本語抄録 Engish Abstract
    ロボットスーツHAL による起立が血圧と脳血流におよぼす影響
    浅野美礼 1)
    1. 筑波大学医学医療系

     高さ40cmの椅子に腰かけた姿勢から起立する動作について,①通常どおり能動的に行った場合,②他者による全介助で行った場合,③パワーアシストロボット(HAL)装着で行った場合に平均血圧および酸素化ヘモグロビンの濃度変化でみた脳血流量がどのように変化するかを,若年者(22.3±2.1歳)と高齢者(69.6±3.5歳)各12人で比較した.平均血圧の低下は若年者のほうが高齢者より有意に大きかった.起立方法の違いによる差異はなかった.脳血流量の低下については,起立方法の違いによる有意差がみられたが,効果量は小さかった.一方で若年者と高齢者に有意差はなかったが効果量は中程度あった.高齢者であっても,若年者と比較のうえでは,起立の方法にかかわらず起立時の血圧および脳血流量の低下は大きくなく,有利とも言える結果であった.HALは高齢者に対して循環血流の面では不自然さの少ないデバイスと考えられた.

    介助ロボット,起立性低血圧,健康な高齢者,理学療法
    Effect on blood pressure and cerebral blood flow of using a hybrid assistive limb (HAL) for standing
    Yoshihiro Asano 1)
    1. Faculty of Medicine, University of Tsukuba

     Aim: This study compared how blood pressure and cerebral blood flow changed in young and elderly individuals when actively standing up (standing up from a sitting position on a 40 cm-high chair), when passively standing up with assistance from others, and when standing up with the aid of a lower-limb power-assisted robot or Hybrid Assistive Limb (HAL). Methods: Twelve young (22.3±2.1) and elderly (69.6±3.5) healthy individuals participated in this experiment. Participants were asked to stand up under 3 different conditions and blood pressure and cerebral blood flow were measured by monitoring changes in the concentration of oxygenated hemoglobin. Results and Conclusion: As decrease in mean blood pressure, the main effect of age was noted. The standing method did not have any main effect. As decreased cerebral blood flow, the standing method was noted although the effect size was small. No main effect of age was noted, but its effect size was medium. These findings indicate that the decrease in blood flow was greater in younger individuals than in elderly individuals. Regardless of age, the decrease in cerebral blood flow was relatively small for assisted standing and relatively large for assisted standing with HAL.

    power assist device, orthostatic hypotension, healthy elderly, physical therapy
  • (英文論文)Usability, feasibility, and safety test of a new thermosensitive liquid crystal film for the early detection of extravasation in clinical practice: A pilot study(抗がん剤の血管外漏出早期発見のための新しい液晶感温フィルムの使用感,実現可能性,安全性における臨床評価:パイロットスタディ)
    日本語抄録 Engish Abstract
    抗がん剤の血管外漏出早期発見のための新しい液晶感温フィルムの使用感,実現可能性,安全性における臨床評価:パイロットスタディ
    阿部麻里 1) 村山陵子 1), 2) 田邊秀憲 3) 上山恵三子 4) 小見山智恵子 4) 松井優子 5) 真田弘美 2), 6)
    1. 東京大学大学院医学系研究科社会連携講座アドバンストナーシングテクノロジー
    2. 東京大学医学部附属グローバルナーシングリサーチセンター
    3. テルモ株式会社研究開発部門
    4. 東京大学医学部附属病院看護部
    5. 公立小松大学保健医療学部看護学科
    6. 東京大学大学院医学系研究科健康科学・看護学専攻老年看護学/創傷看護学分野

    抗がん剤の血管外漏出の早期発見は重要であるが,そのアセスメントはむずかしく,客観的手法が求められている.そこで液体貯留が皮膚表面温度の低下をもたらすことから,非侵襲的かつ持続使用可能で安全な血管外漏出アセスメントツールとして,液晶感温フィルムを開発した.研究目的は,開発したフィルムの使用感,安全性,皮膚表面温度の可視化における実現可能性を確認することである.患者40名と看護師8名を対象とした.明らかな血管外漏出はなかった.使用後の調査において,患者は全員がフィルムを使用してもよいと答え,かゆみなどの不快感があったものはいなかった.看護師は,感温フィルムをカテーテル固定用フィルムの上に貼付し,通常通り薬剤投与を行い,使用感を感温フィルム1枚ごとに評価した.看護師の回答の80%において観察の頻度は変わらなかったことから,業務負担への影響は少ないと考えられた.カメラで記録された温度分布は6つのパターンに分類された.以上より,血管外漏出アセスメントツールとしての実現可能性が示唆された.

    化学療法,血管外漏出,末梢静脈カテーテル,皮膚表面温度
    Usability, feasibility, and safety test of a new thermosensitive liquid crystal film for the early detection of extravasation in clinical practice: A pilot study
    Mari Abe-Doi 1) Ryoko Murayama 1), 2) Hidenori Tanabe 3) Emiko Kamiyama 4) Chieko Komiyama 4) Yuko Matsui 5) Hiromi Sanada 2), 6)
    1. Department of Advanced Nursing Technology, Graduate School of Medicine, the University of Tokyo
    2. Global Nursing Research Center, Graduate School of Medicine, the University of Tokyo
    3. Research and Development Center, Terumo Corporation
    4. Department of Nursing, The University of Tokyo Hospital
    5. Department of Nursing, Faculty of Health Sciences, Komatsu University
    6. Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, the University of Tokyo

    Early detection of extravasation is important due to possible drug leakage, which can cause severe tissue damage. However, its signs and symptoms are difficult to be assessed, and objective assessment is necessary. Given that fluid accumulation provides a low skin-surface temperature, a thermosensitive liquid crystal film was developed to be used as a noninvasive, continuous, and safe extravasation assessment tool. This study aimed to confirm its usability, safety, and feasibility for visualizing skin temperature in the clinical setting. This study included clinical nurses and outpatients who received chemotherapy. No extravasation occurred. Forty patients and 8 nurses were included. All patients responded that they did not mind using the film, and they did not experience any side effects due to using the film, such as itching, tightened feeling, or other discomfort. Nurses placed the film on a catheter securement film and routinely administered drugs. Nurses evaluated the usability of the film after every use. The frequency of observation remained unchanged, according to 80% of the nurses’ answers. It suggested that additional treatment time due to film use was acceptable. During treatment, the skin-surface temperature distribution pattern was recorded using a camera. The temperature distribution patterns were classified into six. The thermosensitive liquid crystal film can be a potential assessment tool to early detect extravasation.

    chemotherapy, extravasation, peripheral intravenous catheter, skin temperature
  • ハーネスを用いて腰部に接続する杖歩行訓練器の歩行者の運動に対する追従性の検討
    日本語抄録 Engish Abstract
    ハーネスを用いて腰部に接続する杖歩行訓練器の歩行者の運動に対する追従性の検討
    井上淳 1) 飯岡俊光 1) 川村和也 2) 花崎 泉 1)
    1. 東京電機大学
    2. 千葉大学

    本研究では筆者らが開発している,従来の歩行器の形状とは異なる新しい形状の杖歩行訓練器が歩行に与える影響について検討した.本杖歩行訓練器は杖歩行の量的訓練を,患者1人でも安全に行わせることを目的としている.現在まで,使用時の歩幅・歩隔・骨盤動揺量の変化等を計測し,安全性を確認してきた.しかし,杖歩行訓練器が人間の歩行に与える影響や操作性を検討するため,歩行時の遅れ時間を評価する必要性がある.本論文では,人間と杖歩行訓練器の進行方向加速度の相互相関を取ることで,2物体間の遅れ時間を導出して杖歩行訓練器の影響を評価した.その結果,杖歩行訓練器の周波数の高い振動がハーネスで吸収されていることと,人体を引っ張るような危険な動きにはなっていないことが分かった.また,サイズが大きくなると遅れ時間が増大することが分かった.

    歩行解析,福祉機器,片麻痺,杖歩行,加速度計
    Examination of the followability of the Crutch-Walk Assisting Walker connected to the waist using the harness to the movement of the user
    Jun Inoue 1) Toshimitu Iioka 1) Kazuya Kawamura 2) Izumi Hanazaki 1)
    1. Tokyo Denki University
    2. Chiba University

    The authors are developing a new shape walker. The purpose of this walker is to allow quantitative training of walking with a crutch safely. For this reason, it is highly necessary to examine the influence of a walker on human walking. We measured the changes in stride length, stride, and pelvic sway during use to confirm safety. However, it is necessary to evaluate the delay time during walking to examine the influence and operability of the walking walker on human walking. In this paper, we calculated the delay time between human and walker by cross correlating the acceleration in the direction of travel between human and walker and evaluated the influence of walker. As a result, it was found that neither of the two walkers with different frame sizes had a dangerous movement that pulled the human body. It was also found that the delay time increases as the size increases. Besides, it was found that the lag time was significantly longer and the variance tended to be larger in walking with a cane than with normal walking.

    gait analysis, assistive technology, hemiplegia, crutch walking, acceleration sensor

速 報

  • 力覚センサを用いた口腔ケアシミュレータのための計測アルゴリズムの構築
    日本語抄録 Engish Abstract
    力覚センサを用いた口腔ケアシミュレータのための計測アルゴリズムの構築
    松野孝博 1 三谷篤史 2 平井慎一 1
    1. 立命館大学理工学部ロボティクス学科
    2. 札幌市立大学デザイン学部人間情報デザインコース

    本研究では力覚センサを用いた口腔ケアシミュレータを提案し,接触点およびブラッシング力の導出に関する基礎理論を構築する.提案するシミュレータでは,口腔モデルの底部に力覚センサを1つだけ設置する.そのため,従来のシミュレータと比較し,配線やセンサ数の大幅な削減が可能である.また,口腔モデルの歯やブラシ側にセンサを必要としないため,使用可能な口腔モデルやブラシの制約が少ない.口腔モデルの接触点を導出するために,まず,歯茎形状と力の作用線に着目し,接触点の候補を計算する.つぎに,各接触点候補における力の方向および移動速度を吟味し,理論上存在しうる接触点を絞りこむ.最後に,接触点におけるブラッシング力を導出し,使用者へフィードバックする.試作機による検証実験を行った結果,接触点および法線・接線力の導出が適切に行えることを確認した.今後は,介護士育成現場への導入を目指し,シミュレータを改善する.

    口腔ケアシミュレータ,看護教育,力覚センサ
    Measurement algorithm for oral care simulator using force sensor
    Takahiro Matsuno 1 Atsushi Mitani 2 Shinichi Hirai 1
    1. Department of Robotics, College of Science and Engineering, Ritsumeikan University
    2. Course of Communication Design for Human Life, School of Design, Sapporo City University

    In this research, we propose the oral care simulator using a force sensor. The basic algorithm of measuring contact point and brushing force were constructed. In the proposed simulator, only one force sensor is installed at the bottom of the oral model. Therefore, it is possible to reduce the number of signal wiring and sensors compared with a previous oral care simulator. Firstly, focusing on a line of action of force and shape of oral model, the locations that can be the contact point are calculated. Next, the direction of the force and the velocity at each candidate of contact point are compared, and these points are narrowed down to the theoretically possible contact points. Finally, the brushing force at the contact point is derived and feed back to the user. The prototype of oral care simulator was produced, the proposed algorism was experimentally verified. The results show that the contact point of brush can estimated, normal and tangential force could be measured. In the next step of research, we will improve the measurement accuracy of simulator, and then the full system of oral care simulator will be developed.

    oral care simulator, nursing education, force sensor
  • 高齢者を想定した水平方向累進レンズを用いた焦点調節意思対応遠近両用眼鏡の開発
    日本語抄録 Engish Abstract
    高齢者を想定した水平方向累進レンズを用いた焦点調節意思対応遠近両用眼鏡の開発
    梶原志保子 1) 中出麻紀子 2) 服部知彦 3)
    1. 平成医療短期大学
    2. 兵庫県立大学
    3. 名古屋医専

    眼の調節意思に従い輻輳と調節を一致させることが可能な遠近両用眼鏡の開発を目的とした.想定は70歳とし,累進レンズを輻輳に従って水平方向に累進させることで,本開発眼鏡を設計した.本設計に従い光学部材を配置しステレオ画像を撮影し定性評価した.結果,本開発眼鏡は,従来の遠近両用眼鏡にくらべ,より自然な観察が可能であり,画像歪みが軽減された.定量評価としてレンズ累進率対両眼瞳孔間距離表を作成した.両眼瞳孔間距離55×10-3,58×10-3,61×10-3,64×10-3,67×10-3,70×10-3(m)の場合のレンズ累進性換算表が作成でき,定量的に本開発眼鏡の実現可能性が示唆された.さらに,眼鏡の装着再現性を評価した.結果,眼鏡装着位置の変位は0.113×10-3(m)であり,眼鏡の装着再現性の本開発眼鏡への影響は,想定年齢70歳との誤差が約3.4歳であった.

    遠近両用眼鏡,累進レンズ,輻輳,調節
    Development of perspective glasses in conjunction with focusing intention using horizontal progressive lenses for elderly people
    Shihoko Kajiwara 1) Makiko Nakade 2) Tomohiko Hattori 3)
    1. Heisei College of Health Sciences
    2. University of Hyogo
    3. Nagoya Isen College of Medical Care & Welfare Dep. of CE.

    A newly developed perspective glasses that could match convergence and accommodation according to the focal intent of the eye was described in this paper. The target age was 70 years old, and the developed glasses were designed by gradually changing the diopter of a progressive lens horizontally in accordance with convergence. In accordance with this design, the optical components were placed, stereo images were taken and qualitatively evaluated. As a result, the developed perspective glasses enabled more natural observation and reduced image distortion compared to conventional perspective glasses. The progressive value of lens versus the distance between pupils table for the lens was created as a quantitative evaluation. Tables with the distances of 55×10-3, 58×10-3, 61×10-3, 64×10-3, 67×10-3, 70×10-3 (m) were got. The feasibility of perspective glasses was quantitatively suggested. In addition, the reproducibility of wearing glasses was evaluated. As a result, the displacement of the glasses wearing position was 0.113×10-3 (m), and the effect of the reproducibility of glasses wearing on the newly developed perspective glasses was about 3.4 years younger than the target age of 70 years old.

    perspective glasses, progressive lenses, convergence, accommodation