Journal of rural medicine : JRM最新文献

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Ability of older male caregivers to seek help when caring for a wife or mother with dementia living at home. 老年男性照顾者在照顾家中患有痴呆症的妻子或母亲时寻求帮助的能力。
Journal of rural medicine : JRM Pub Date : 2023-07-01 DOI: 10.2185/jrm.2022-039
Midori Nishio, Sayori Sakanashi, Naoki Uchida, Shinji Oma, Hiromi Kimura, Hiroko Kukihara, Kayoko Koga
{"title":"Ability of older male caregivers to seek help when caring for a wife or mother with dementia living at home.","authors":"Midori Nishio, Sayori Sakanashi, Naoki Uchida, Shinji Oma, Hiromi Kimura, Hiroko Kukihara, Kayoko Koga","doi":"10.2185/jrm.2022-039","DOIUrl":"https://doi.org/10.2185/jrm.2022-039","url":null,"abstract":"Objective: We aimed to clarify factors associated with the ability to seek help among older male caregivers who care for women with dementia in their families. Patients and Methods: This information will inform strategies to support their continued provision of long-term care. Participants were 364 male caregivers recruited from three places: The study period was 2017–2018. We obtained ethical approval for this study from the relevant ethics committee. Results: The ability to seek help for care problems among male caregivers was normally distributed. We found that more than 90% of older male caregivers did not actively seek help to resolve care problems, suggesting that older male caregivers had problems with long-term care. In the high score group, health status and the number of emotional support persons in the household were significantly and somewhat strongly positively correlated. The low score group showed a significant and rather weak positive correlation between economic status and health status, and the number of emotional supporters inside and outside the household. Positive correlations for the high score group were self-esteem and depressive symptoms, and self-esteem and resources. Positive correlations for the low score group were self-esteem and depressive symptoms, self-esteem and resources, and resources and depressive symptoms. Conclusion: Male caregivers are more likely to seek help if they are employed or play a role in their community. Nurses also need to support male caregivers with positive words and praise to help them use available support and resources and continue to provide long-term care. It is important for healthcare professionals to observe whether a caregiver presents with depressive symptoms or has long-term care problems because older male caregivers do not seek help. Collaboration between caregivers and medical, long-term care, and welfare professionals is necessary. Direct and timely intervention is needed.","PeriodicalId":73939,"journal":{"name":"Journal of rural medicine : JRM","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bf/fb/jrm-18-182.PMC10336345.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9822957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Step-by-step instructions for detecting whirlpool sign in adnexal torsion. 一步一步的说明检测附件扭转漩涡的迹象。
Journal of rural medicine : JRM Pub Date : 2023-07-01 DOI: 10.2185/jrm.2023-002
Ryo Higashide, Kazuki Saito, Nanako Hashido, Tomonori Ishikawa, Naoyuki Miyasaka
{"title":"Step-by-step instructions for detecting whirlpool sign in adnexal torsion.","authors":"Ryo Higashide,&nbsp;Kazuki Saito,&nbsp;Nanako Hashido,&nbsp;Tomonori Ishikawa,&nbsp;Naoyuki Miyasaka","doi":"10.2185/jrm.2023-002","DOIUrl":"https://doi.org/10.2185/jrm.2023-002","url":null,"abstract":"<p><p><b>Objective:</b> Adnexal torsion is a common gynecological emergency whose prompt diagnosis is essential because a delay may lead to ovarian dysfunction. Although the whirlpool sign is reliable for diagnosing ovarian cyst torsion, technical difficulties hinder its use by sonographers. Here we developed a systematic approach to visualizing this sign by focusing on the fact that torsion arises from the space between the uterus and the pelvic wall. One must determine the origin of the torsion via transverse imaging of the uterus and follow the twisted ligaments to the ovarian cyst. <b>Patients and Methods:</b> Two women aged 56 (Case 1) and 28 years (Case 2) visited our hospital with lower abdominal pain. Transvaginal ultrasonography showed a 7-cm right ovarian cyst in Case 1 and a 5-cm cyst in the Douglas pouch in Case 2; normal bilateral ovaries and the whirlpool sign were detected in both cases. Under laparoscopic guidance in Cases 1 and 2, an ovarian cyst and a paraovarian cyst were confirmed and removed. <b>Results:</b> Our step-by-step method allowed us to identify the whirlpool sign and confirm adnexal torsion, leading to prompt surgery in both cases. <b>Conclusion:</b> Using a systematic procedure helps less experienced practitioners detect the whirlpool sign.</p>","PeriodicalId":73939,"journal":{"name":"Journal of rural medicine : JRM","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5d/b3/jrm-18-189.PMC10336344.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10199028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Prevalence of systemic and local risk factors for pulmonary non-tuberculous mycobacterial disease in Japan: a single-institution study. 日本肺部非结核分枝杆菌病的系统性和局部危险因素的患病率:一项单机构研究
Journal of rural medicine : JRM Pub Date : 2023-07-01 DOI: 10.2185/jrm.2023-001
Ryohei Kamei, Michiru Sawahata, Masayuki Nakayama, Toshiyuki Yamada, Nobuyuki Taniguchi, Masashi Bando, Koichi Hagiwara
{"title":"Prevalence of systemic and local risk factors for pulmonary non-tuberculous mycobacterial disease in Japan: a single-institution study.","authors":"Ryohei Kamei,&nbsp;Michiru Sawahata,&nbsp;Masayuki Nakayama,&nbsp;Toshiyuki Yamada,&nbsp;Nobuyuki Taniguchi,&nbsp;Masashi Bando,&nbsp;Koichi Hagiwara","doi":"10.2185/jrm.2023-001","DOIUrl":"https://doi.org/10.2185/jrm.2023-001","url":null,"abstract":"<p><p><b>Objective:</b> To identify the prevalence of risk factors for pulmonary non-tuberculous mycobacterial (NTM) disease in a Japanese population. <b>Patients and Methods:</b> We reviewed 337 consecutive Japanese patients (210 women) with pulmonary NTM disease, including 225 patients with Mycobacterium avium complex (MAC) disease (95.8%) at our hospital during 2006-2017. We calculated the prevalence of risk factors reported in Western countries among mycobacterial species. <b>Results:</b> Pulmonary MAC disease cases comprised 78.2% of pulmonary NTM patients in their 40s, increasing to 100% at age ≥80 years. Body mass index (BMI) was <18.5 in approximately 40% of patients, which was significantly higher than the prevalence of underweight in the Japanese population. The percentage of male heavy smokers (Brinkman index ≥600) was 58.2% of pulmonary NTM disease and was high for all mycobacterial species. In pulmonary MAC disease, systemic factors were observed in the order of malignant tumors (other than lung cancer), diabetes, rheumatoid arthritis, and tuberculosis. Local factors were observed in the order of bronchiectasis, chronic obstructive pulmonary disease, lung cancer, and bronchial asthma. <b>Conclusion:</b> The risk factors reported in Western countries were relatively highly prevalent among Japanese pulmonary NTM disease patients. This observation may help elucidate disease onset mechanisms.</p>","PeriodicalId":73939,"journal":{"name":"Journal of rural medicine : JRM","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ca/f3/jrm-18-168.PMC10336341.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10199026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Food and nutrition security in the Philippines during the COVID-19 pandemic. 2019冠状病毒病疫情期间菲律宾的粮食和营养安全。
Journal of rural medicine : JRM Pub Date : 2023-07-01 DOI: 10.2185/jrm.2022-049
Ana Kriselda B Rivera, Ernani R Bullecer, Raycha Lei Concess M Rama, Rowel C Malimban
{"title":"Food and nutrition security in the Philippines during the COVID-19 pandemic.","authors":"Ana Kriselda B Rivera,&nbsp;Ernani R Bullecer,&nbsp;Raycha Lei Concess M Rama,&nbsp;Rowel C Malimban","doi":"10.2185/jrm.2022-049","DOIUrl":"https://doi.org/10.2185/jrm.2022-049","url":null,"abstract":"<p><p><b>Objective:</b> The COVID-19 pandemic placed the Philippines' food and nutrition issues front and center. In this paper, we discuss the response of its government in addressing food and nutrition security at the beginning of the COVID-19 pandemic and describe its implications on nutritional status. We also cite initiatives that address food accessibility and availability in the communities. Lastly, we explore the importance of nutrition security dimension in food security. <b>Methods:</b> We analyze food and nutrition security issues in the Philippines during the COVID-19 pandemic through online reports and news articles. <b>Results:</b> The distribution of food and financial assistance in the country was extensive, albeit insufficient, considering the prolonged lockdown restrictions. Constantly changing community quarantine guidelines have affected the movement of food supply, delivery of health services, and household economic security. Nutrition programs, such as vitamin A supplementation, feeding for children, and micronutrient supplementation for pregnant women, had lower coverage rates, and by the latter half of 2020, the country had reached its highest recorded hunger rate. Cases of both undernutrition and overnutrition are predicted to rise because of dietary imbalances and a variety of factors. Conversely, community members and some local government units took it upon themselves to improve the food situation in their areas. The provision of food packs containing fresh fruits and vegetables was lauded, as it exemplified a conscious effort to deal with nutrition security. <b>Conclusion:</b> Efforts to address food security have always focused on increasing accessibility, availability, and affordability, often neglecting the nutritional components of foods. Strategies that incorporate nutrition security into food security are much needed in the country, especially during emergencies like the COVID-19 pandemic.</p>","PeriodicalId":73939,"journal":{"name":"Journal of rural medicine : JRM","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7d/7e/jrm-18-162.PMC10336346.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10180920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Total pain in advanced dementia: a quick literature review. 晚期痴呆的总疼痛:一个快速的文献综述。
Journal of rural medicine : JRM Pub Date : 2023-04-01 DOI: 10.2185/jrm.2022-007
Yoshihisa Hirakawa, Tsukasa Muraya, Takashi Yamanaka, Satoshi Hirahara, Jiro Okochi, Masafumi Kuzuya, Hisayuki Miura
{"title":"Total pain in advanced dementia: a quick literature review.","authors":"Yoshihisa Hirakawa,&nbsp;Tsukasa Muraya,&nbsp;Takashi Yamanaka,&nbsp;Satoshi Hirahara,&nbsp;Jiro Okochi,&nbsp;Masafumi Kuzuya,&nbsp;Hisayuki Miura","doi":"10.2185/jrm.2022-007","DOIUrl":"https://doi.org/10.2185/jrm.2022-007","url":null,"abstract":"<p><p><b>Objective:</b> This quick literature review aimed to organize information on the detailed components of total pain in older people with advanced dementia in a holistic manner. <b>Materials and Methods:</b> The authors analyzed qualitative data from relevant clinical guidelines or textbooks, focusing on certain types of pain and distress in older people with advanced dementia, followed by an expert panel review by research team members. In the search, the authors defined a person with advanced dementia as having a functional assessment staging tool scale score greater than or equal to six. <b>Results:</b> The model covered a wide variety of pain, from physical pain to dementia-related psychological and spiritual aspects of total pain, including living environment change, stigma, discrimination, lack of communication and understanding, loss of sense of control and dignity, and cultural distress. It also identified physical appearance as an important factor in dying with dignity, as established by existing research on individuals with incurable cancers. <b>Conclusion:</b> The conceptual model of total pain in people with advanced dementia is expected to help turn healthcare professionals' attention to physical, psychological, social, and spiritual contributors to total pain in advanced dementia.</p>","PeriodicalId":73939,"journal":{"name":"Journal of rural medicine : JRM","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/14/5b/jrm-18-154.PMC10079462.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9626428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
What's in your water? A well-known risk for arsenic toxicity. 你的水里有什么?这是众所周知的砷中毒风险。
Journal of rural medicine : JRM Pub Date : 2023-04-01 DOI: 10.2185/jrm.2022-034
Dominika A Jegen, Paul J Jannetto
{"title":"What's in your water? A well-known risk for arsenic toxicity.","authors":"Dominika A Jegen,&nbsp;Paul J Jannetto","doi":"10.2185/jrm.2022-034","DOIUrl":"https://doi.org/10.2185/jrm.2022-034","url":null,"abstract":"<p><p>Arsenic cannot be tasted, seen or smelled and can vary in concentration between water wells even in condensed areas. American domestic well water is not regulated to meet the same drinking water standards as other types of water supplies and often contains arsenic. If arsenic is not detected in a well water sample, it is unlikely to be found later. Conversely, if it is detected in a new well, it is recommended to retest six months later as levels may fluctuate in the first months following well construction. It is up to the well owner to test their water and remove arsenic through commercially available water filters. If it is not detected and removed via filtration, a variety of serious, yet common, medical conditions may arise from chronic arsenic exposure, some of which are life-threatening. These include diabetes mellitus, hypertension, skin cancer, renal, bladder and lung cancers, polyneuropathy and cardiac QTc prolongation. Testing is best done through urine speciation if an initial total urine arsenic concentration is elevated. Consider a complete blood count, renal and liver function tests, an electrocardiogram as well as a urinalysis assessing for evidence of hematuria when examining patients with histories concerning for chronic arsenic exposure.</p>","PeriodicalId":73939,"journal":{"name":"Journal of rural medicine : JRM","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1d/e9/jrm-18-149.PMC10079467.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9626431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Does greater distance from the hospital exacerbate socioeconomic barriers to neonatal intensive care unit clinic attendance? 离医院越远是否加剧了新生儿重症监护室门诊就诊的社会经济障碍?
Journal of rural medicine : JRM Pub Date : 2023-04-01 DOI: 10.2185/jrm.2022-035
Emily Cox, Mofoluwake Awe, Stephiya Sabu, Dmitry Tumin, Uduak S Akpan
{"title":"Does greater distance from the hospital exacerbate socioeconomic barriers to neonatal intensive care unit clinic attendance?","authors":"Emily Cox,&nbsp;Mofoluwake Awe,&nbsp;Stephiya Sabu,&nbsp;Dmitry Tumin,&nbsp;Uduak S Akpan","doi":"10.2185/jrm.2022-035","DOIUrl":"https://doi.org/10.2185/jrm.2022-035","url":null,"abstract":"<p><p><b>Objective:</b> To determine if distance from our Neonatal Intensive Care Unit (NICU) follow-up clinic exacerbated risk of clinic non-attendance in high-risk groups defined by socioeconomic status or medical complexity, as geographical distance from the hospital can affect attendance rates at NICU follow-up clinics. <b>Patients and Methods:</b> We retrospectively identified infants born between January 2014 and June 2018, and subsequently discharged from our 50-bed level IV NICU, which serves a predominantly rural population. Patients were included in our study if they had at least one NICU clinic follow-up visit scheduled at discharge. Distance to the clinic was calculated based on family ZIP code. Mixed-effects logistic regression analysis of attendance at each scheduled visit was used to identify independent associations and interactions with distance among study covariates. <b>Results:</b> We included 576 patients in our study, with 74% missing at least one clinic appointment, and 30% not attending any of the three appointments. Median distance between our hospital and families was 53 km. On multivariable analysis, neither distance nor other infant or family characteristics were associated with clinic non-attendance. Only interfacility transfer had a statistically significant interaction with distance and this association only reached statistical significance for patients living furthest from our center. <b>Conclusions:</b> NICU follow-up is important, but clinic attendance is poor. For families living furthest away, transfers of care during the infant's hospitalization may be associated with lower completion of recommended post-discharge follow-up. Further research is needed to understand how clinics can mitigate barriers to attendance.</p>","PeriodicalId":73939,"journal":{"name":"Journal of rural medicine : JRM","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e4/32/jrm-18-055.PMC10079457.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9325586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Factors associated with the acceptance of employing nursing assistants aged 65 and older among those younger than 65 years old. 65岁以下人群接受65岁及以上护理员的相关因素。
Journal of rural medicine : JRM Pub Date : 2023-04-01 DOI: 10.2185/jrm.2022-045
Yasushi Kudo, Taeko Toyoda
{"title":"Factors associated with the acceptance of employing nursing assistants aged 65 and older among those younger than 65 years old.","authors":"Yasushi Kudo,&nbsp;Taeko Toyoda","doi":"10.2185/jrm.2022-045","DOIUrl":"https://doi.org/10.2185/jrm.2022-045","url":null,"abstract":"<p><p><b>Objectives:</b> Japan has implemented a policy to facilitate the employment of people aged 65 and older. It should be common practice for hospitals to employ older nursing assistants. We investigated factors associated with the acceptance of employing older nursing assistants among those younger than 65. <b>Materials and Methods:</b> The subjects were female nursing assistants younger than 65 working in 30 hospitals. A questionnaire-based survey was conducted. We performed factor analyses of both respondents' opinions on the employment of \"Nursing assistants aged 65-69\" and \"Nursing assistants aged 70-74\". To examine the associations between the \"Acceptance of employing nursing assistants aged 65-69\" and the \"Opinions on the employment of nursing assistants aged 65-69\", we conducted multiple regression analysis (Statistical Model 1). To examine the associations between the \"Acceptance of employing nursing assistants aged 70-74\" and the \"Opinions on the employment of nursing assistants aged 70-74\", we also conducted multiple regression analysis (Statistical Model 2). <b>Results:</b> By factor analyses of the opinions on the employment of both \"Nursing assistants aged 65-69\" and \"Nursing assistants aged 70-74\", the same factors were extracted. These factors were: \"Health and job performance\", \"Utilization of the knowledge and experience of older nursing assistants\", \"Reducing the workload of nursing assistants\", and \"Manners of older nursing assistants\". By multiple regression analyses in both \"Statistical Models 1 and 2\", \"Health and job performance\", \"Utilization of the knowledge and experience of older nursing assistants\", and \"Reducing the workload of nursing assistants\" were significant variables. Moreover, only in \"Statistical Model 1\", full-time nursing assistants were more accepting of employing nursing assistants aged 65-69 compared to part-time nursing assistants. <b>Conclusion:</b> To facilitate the acceptance of employing older nursing assistants, hospital managers should pay careful attention to these findings.</p>","PeriodicalId":73939,"journal":{"name":"Journal of rural medicine : JRM","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/59/0e/jrm-18-108.PMC10079460.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9325585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Grasping the structure of the care management process evaluation items that are related to care management skills with regard to individual users: conducting verification through self-assessment by care managers. 掌握个体用户与护理管理技能相关的护理管理流程评价项目的结构:通过护理管理者的自评进行验证。
Journal of rural medicine : JRM Pub Date : 2023-04-01 DOI: 10.2185/jrm.2022-028
Yoshio Suzuki, Reiko Ishiyama
{"title":"Grasping the structure of the care management process evaluation items that are related to care management skills with regard to individual users: conducting verification through self-assessment by care managers.","authors":"Yoshio Suzuki,&nbsp;Reiko Ishiyama","doi":"10.2185/jrm.2022-028","DOIUrl":"https://doi.org/10.2185/jrm.2022-028","url":null,"abstract":"<p><p><b>Objective:</b> This study aimed to understand the structure of a self-assessment for evaluating the care management skills of individuals in the care management process. <b>Materials and Methods:</b> A survey was distributed to 964 care managers in home care management hailing from each committee in Japanese municipalities in Ibaraki, Chiba, Saitama, Kanagawa, and Tokyo. The process implementation degree of care management in 46 care management process evaluation items was assessed using a five-point method. Cronbach's alpha coefficients were derived for the items, and an exploratory factor analysis was conducted to ascertain the factor structure. We also verified the relationship between the factor scores, presence or absence of a chief care manager, and years of experience. <b>Results:</b> We received 385 responses (response rate: 39.9%), of which 372 were included in the analysis (valid response rate: 96.6%). Six factors were extracted, and 29 items were retained because of the exploratory factor analysis. Three of the six factors did not exist in the existing scales and had a unique structure. The cumulative contribution rate of the six factors was 64.9%, and Cronbach's alpha coefficient for all items was α=0.95, with Factor 1 being 0.88; Factor 2 being 0.83; Factor 3 being 0.86; Factor 4 being 0.85; Factor 5 being 0.80; and Factor 6 being 0.87. The total score for Factors 1, 2, 4, and 5 was significantly higher among chief care managers. Pearson's correlation coefficients were calculated to determine the correlation between scale scores and years of experience. Factor 1 (r=0.22) and Factor 2 (r=0.21) showed a modest positive correlation between the scale scores and years of experience. <b>Conclusion:</b> We retained 29 items and extracted six factors for the care manager self-assessment items that had a unique factor structure while following existing scales' factor structure.</p>","PeriodicalId":73939,"journal":{"name":"Journal of rural medicine : JRM","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8f/b0/jrm-18-096.PMC10079459.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9641103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Using complete blood count parameters in the diagnosis of iron deficiency and iron deficiency anemia in Filipino women. 用全血细胞计数参数诊断菲律宾妇女缺铁和缺铁性贫血。
Journal of rural medicine : JRM Pub Date : 2023-04-01 DOI: 10.2185/jrm.2022-047
Ana Kriselda B Rivera, Angelica Anne E Latorre, Keiko Nakamura, Kaoruko Seino
{"title":"Using complete blood count parameters in the diagnosis of iron deficiency and iron deficiency anemia in Filipino women.","authors":"Ana Kriselda B Rivera,&nbsp;Angelica Anne E Latorre,&nbsp;Keiko Nakamura,&nbsp;Kaoruko Seino","doi":"10.2185/jrm.2022-047","DOIUrl":"https://doi.org/10.2185/jrm.2022-047","url":null,"abstract":"<p><p><b>Objectives:</b> Correct diagnosis of iron deficiency remains challenging due to the cost of ferritin tests. Physicians, especially those in resource-limited settings, may resort to a complete blood count (CBC) when considering iron deficiency and anemia due to its accessibility. Although this has been practiced, it is still beneficial to assess whether CBC parameters exhibit the diagnostic capability of discriminating such medical conditions. <b>Materials and Methods:</b> Serum ferritin and CBC were performed on venous blood samples of 170 Filipino women aged 18-44 years. The diagnostic ability of the CBC parameters to detect iron deficiency and iron deficiency anemia was analyzed using receiver operating characteristic (ROC) curves. Iron deficiency was defined as a ferritin level <30 µg/L, while iron deficiency anemia was defined as a ferritin level <30 µg/L with hemoglobin level <120 g/L. <b>Results:</b> Ferritin levels correlated with red blood cell (RBC) count and hematocrit levels. With an area under the ROC curve (AUC) of 0.60, a hematocrit cutoff value of 38.5% was found to have low discriminating power in diagnosing iron deficiency only. Five parameters were observed to have higher discriminating powers for iron deficiency anemia: RBC count cutoff at 4.04 × 10<sup>12</sup>/L with AUC of 0.73, mean corpuscular volume (MCV) at 84.10 fL with AUC of 0.77, mean corpuscular hemoglobin concentration (MCHC) at 337.5 g/L with AUC of 0.80, mean corpuscular hemoglobin (MCH) at 29.15 pg with AUC of 0.81, and hematocrit at 35.5% with AUC of 0.96. <b>Conclusion:</b> CBC parameters can be a satisfactory discriminator for iron deficiency anemia among the women studied. However, further studies are needed to elucidate its utility in discriminating iron deficiency. With further investigations in this field, the potential use of CBC as a diagnostic tool for iron deficiency and iron deficiency anemia is promising, particularly in rural areas.</p>","PeriodicalId":73939,"journal":{"name":"Journal of rural medicine : JRM","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/67/99/jrm-18-079.PMC10079471.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9325583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
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