This case report presents one important aspect of promoting ACP in Japanese culture, which is different from Western cultures. The report suggests the possibility that legal support contributes to the promotion of ACP, while considering differences in cultural contexts.
Journal Article Corrected proof 2024 Noto Peninsula Earthquake—elderly evacuees and mental health challenges Get access Y Kaneda, Y Kaneda Conceptualization, Writing - original draft School of Medicine, Hokkaido University, Hokkaido, Japan Address correspondence to Y. Kaneda, School of Medicine, Hokkaido University, Kita15, Nishi7, Kita-ku, Sapporo, Hokkaido 0608638, Japan. email: nature271828@gmail.com https://orcid.org/0000-0001-8302-9439 Search for other works by this author on: Oxford Academic PubMed Google Scholar A Ozaki, A Ozaki Writing - review & editing Department of Breast and Thyroid Surgery, Jyoban Hospital of Tokiwa Foundation, Fukushima, Japan https://orcid.org/0000-0003-4415-9657 Search for other works by this author on: Oxford Academic PubMed Google Scholar M Endo, M Endo Writing - review & editing Department of public health, Medical Governance Research Institute, Tokyo, Japan Search for other works by this author on: Oxford Academic PubMed Google Scholar E Nakamura, E Nakamura Writing - review & editing Home-Visit Nursing Station Minagi, Kowakai, Japan Search for other works by this author on: Oxford Academic PubMed Google Scholar H Beniya H Beniya Writing - review & editing Orange Home-Care Clinic, Fukui City, Japan Search for other works by this author on: Oxford Academic PubMed Google Scholar QJM: An International Journal of Medicine, hcae062, https://doi.org/10.1093/qjmed/hcae062 Published: 03 April 2024 Article history Published: 03 April 2024 Corrected and typeset: 12 April 2024
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With advances in medical technology, the number of children with medical complexity (CMC) has increased. Excursions with such children encourage their social participation and have been shown to have a positive impact on their caregivers. However, the first-hand experience of the excursions has not yet been evaluated regarding the difficulties faced by CMC and their caregivers during preparation, transportation, and in the local area.Semi-structured interviews were conducted with eight informal and eight formal caregivers of CMC who attended an excursion to Tokyo Disney Land (TDL) via video conference. We investigated challenges that they had experienced through the excursion, performing inductive thematic analysis.Three themes were identified: the preparation stage (Theme 1), problems encountered while traveling to the theme park (Theme 2), and problems at the theme park (Theme 3). In the preparation stage, three subthemes, i.e. preparation for the trip, cooperation with related parties, and researching about the theme park and asking for help, are reported. Theme 2 includes four subthemes: activities of daily living, respiratory care, luggage, and weather changes. Theme 3 has three subthemes: activities of daily living, physical condition management, and issues for the theme parks.We found that securing the power supply, location, and time for daily procedures are challenges in realizing excursions for CMC, but with sufficient preparation, it is possible in Japan without major difficulty.
BACKGROUND Telemedicine has been increasingly used in many health care fields, including home care, where patients receive medical care at home. Owing to the current COVID-19 crisis, the value of telemedicine via videoconferencing is more recognized, particularly in allowing immobile patients to continue receiving care. However, the efficacy of telemedicine in home care settings in Japan remains to be fully appraised. OBJECTIVE This study aims to identify the use and impact of telemedicine in a singular home care delivery setting in Japan. METHODS A retrospective observational study was conducted using patient and other administrative records from a home care clinic. We considered patients who were involved in videoconferencing with home care physicians and telepresenters serving patients during 2018 and 2019. We extracted sociodemographic data of the patients and details of the videoconferencing and descriptively illustrated some specific cases. RESULTS In a home care clinic in Japan, videoconferencing was conducted in 17 cases (involving 14 patients) over a 2-year period. Of all the cases, 12% (2/17) required emergency transfers and were hospitalized. A total of 88% (15/17) of cases remained; 71% (12/17) of cases were found to need extra medication or to go to a medical facility for consultation, whereas 18% (3/17) of cases were found not to be in need of urgent attention and were asked to rest. Problematic symptoms subsequently improved in 82% (14/17) of cases, and only 6% (1/17) of cases were later hospitalized. CONCLUSIONS Telemedicine was deemed effective for assessing patients’ conditions in the home care setting in situations where home visits by a physician cannot be carried out. Our findings indicate that consultations via videoconferencing are safe and effective, suggesting more active use of videoconferencing in other clinical contexts. CLINICALTRIAL
This study aimed to evaluate a risk of flooding and landslides among home-care patients, to reveal an extent to which patients require support for evacuation, and to determine whether risk was accurately perceived among the patients.This is a cross-sectional study targeting the patients who were actively treated at the home-care clinic in Fukui Prefecture, Japan. We collected data on the patients' sociodemographic and clinical characteristics. Additionally, we collected data on their risk of flooding and landslides through hazard maps and distributed a questionnaire to these patients regarding their risk awareness of flooding and landslides.Of the 199 eligible home-care patients, 84.9% (169 of 199) were at risk of flooding and/or landslides, and 58.6% (99 of 169) of them needs support during evacuation. Furthermore, of those who were at risk of flooding and/or landslides, 46.0% (45 of 99) had accurate risk assessments. Factors that resulted in inadequate risk awareness of flooding and landslides included: not placing importance on evacuation, not using medical equipment, and living on the first floor.There was limited risk awareness of flooding and/or landslides among the home-care patients. The information of the risk factors regarding inadequate risk awareness of flooding and landslides should be used to sophisticate flooding and landslides evacuation strategy.
Abstract On January 1, 2024, an earthquake with a maximum seismic intensity of 7 struck the Noto Peninsula in Ishikawa Prefecture, Japan, causing significant casualties and displacement. The Noto Peninsula has a high aging rate, with 49.5% of its population aged 65 or older. This case study focuses on a 68-year-old woman who developed aspiration pneumonia after being admitted to a welfare shelter. The case highlights the challenges of managing chronic medical care during disasters, particularly for the elderly.
Natural disasters pose significant challenges to affected communities, particularly vulnerable populations such as older adults. The aftermath of the Great East Japan Earthquake highlighted the necessity of welfare shelters to provide essential care. However, little is known about the specific role of physical therapists in these shelters. The aim of this article is to share the experiences and contributions of physical therapists in a welfare shelter in Wajima, Ishikawa Prefecture, immediately after the 2024 Noto Peninsula earthquake. The earthquake, with a magnitude of 7.6, damaged 76,589 houses, injured over 1,100 people, resulting in 245 deaths. The authors comprised a multidisciplinary team, including physical therapists, that provided short-term medical support at a welfare shelter in Wajima. Through several examples, we describe the contribution of physical therapists to evacuees' health outcomes. Physical therapists played multifaceted roles in the welfare shelter, optimizing living environments, conducting physical screenings, and delivering continuous medical care, including respiratory care and exercise programs. The involvement of physical therapists in post-disaster evacuation shelters is crucial for enhancing emergency health care delivery and promoting community resilience.
Abstract Background Parents of children with medical complexity (CMC) have extra child‐raising responsibilities because of the time commitments necessary for care, and their social participation is often compromised. Experiencing leisure excursions with such children may be a solution to some of these problems but the first‐hand experience of excursions in regard to their psychological impact on the caregivers of CMC remains to be appraised. Methods Semi‐structured interviews were conducted, via video conference, with eight informal and eight formal caregivers of CMC who attended an excursion to Tokyo Disney Land (TDL). We investigated the psychological changes that they had experienced through the excursion, performing inductive thematic analysis. Results Three themes were identified among parents and five were identified among medical professionals. Themes reported by the parents were: Increased trust in the public and society (Theme 1); confidence for other challenges (Theme 2), and connection with other parents in the non‐medical settings (Theme 3). Themes reported by medical professionals were: Expanding the initiative to other CMC (Theme 1); feeling bonded with other caregivers within the working group (Theme 2); information exchange across different working groups (Theme 3), positive responses from CMC (Theme 4); families' confidence to go out (Theme 5). Conclusions This study showed that the excursion to TDL led to positive psychological changes in both medical professionals and parents of CMC, enhancing trust, connection, and confidence. The promising results of this study suggest a need for further research about the impact of an excursion on caregivers of CMC.
