Journal of rural medicine : JRM最新文献

{"title":"Tele-education by an orthopedic specialist increased the confidence in orthopedics of a general practitioner at a rural solo-practice clinic.","authors":"Takashi Akimoto, Tadashi Kobayashi, Hiroki Maita, Takahiro Hirano","doi":"10.2185/jrm.2023-025","DOIUrl":"10.2185/jrm.2023-025","url":null,"abstract":"<p><p><b>Objective:</b> General practitioners in rural clinics are required to deal with musculoskeletal problems, but they often lack the confidence. We aim to confirm changes in their confidence in orthopedic practices after using tele-education. <b>Materials and Methods:</b> We conducted tele-education in orthopedic practices from June 1, 2022, to November 30, 2022. Using a teleconference system, the first author, an orthopedic specialist, provided tele-education training to an independent general practitioner in a rural clinic. We adopted a 7-point Likert scale to assess the general practitioner's confidence levels. In pre- and post-research, the counts and confidence levels in the scale were assessed for 18 types of orthopedic practices each month. Furthermore, we interviewed the general practitioner to examine the factors influencing their confidence. <b>Results:</b> The confidence levels increased for all measurement items. The most experienced orthopedic practice was \"Advising on daily care for musculoskeletal problems\", with confidence levels increasing from 3 to 6. The least experienced orthopedic practice was \"Manipulative reduction of radial head subluxation\", with confidence levels increasing from 4 to 5. The factors that influenced the change in confidence levels were regular feedback and unrestricted availability of consultations. <b>Conclusion:</b> Tele-education in orthopedics may enhance general practitioners' confidence in orthopedic practices.</p>","PeriodicalId":73939,"journal":{"name":"Journal of rural medicine : JRM","volume":"19 1","pages":"40-43"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10773997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139405525","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}

{"title":"Experience of students who participated in psychiatric nursing educational program aiming at competency development.","authors":"Miwa Sasaki, Mie Kumachi","doi":"10.2185/jrm.2023-034","DOIUrl":"10.2185/jrm.2023-034","url":null,"abstract":"<p><p><b>Purpose:</b> To clarify experience of students who participated in psychiatric nursing educational program aiming at competency development. <b>Methods:</b> We conducted a semi-structured interview with five students who participated in a psychiatric nursing educational program and analyzed the results qualitatively and descriptively. <b>Results:</b> We generated 19 categories and 39 subcategories. The students reached [acquisition of diversity and multi-phase viewpoint] through team discussion and attempted to understand patients holistically, including [acquisition of patient's viewpoints]. Moreover, they formed supportive relationships while [repeating trial and error] and gained self-understanding based on [egocentrism awareness]. <b>Conclusion:</b> Participation in this program increased students' preparedness for psychiatric nursing practical training, believed to contribute to competency development. Some students had difficulty relating to patients and hesitated to express negative emotions while establishing supportive relationships. This indicates the need for an educational approach that encourages students to express negative emotions easily.</p>","PeriodicalId":73939,"journal":{"name":"Journal of rural medicine : JRM","volume":"19 1","pages":"24-32"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10774002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139405470","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}

{"title":"Barriers to lifestyle modification in patients with non-alcoholic fatty liver disease: a scoping review.","authors":"Kaoru Shibayama, Chie Furushima, Minako Saka, Takako Sakamoto, Hirokazu Takahashi","doi":"10.2185/jrm.2023-026","DOIUrl":"10.2185/jrm.2023-026","url":null,"abstract":"<p><p><b>Objective:</b> Non-alcoholic fatty liver disease is common worldwide, and lifestyle modifications are key to its treatment. This study aimed to identify the barriers to lifestyle modifications in patients with non-alcoholic fatty liver disease and to organize the results using the Capability Opportunity Motivation-Behavior (COM-B) model. <b>Materials and Methods:</b> The framework of Arksey and O' Malley was used in this scoping review. We searched PubMed, Scopus, and the Cochrane Library without language restrictions for reports published up to September 11, 2022, including peer-reviewed literature reporting barriers to lifestyle modifications in patients with non-alcoholic fatty liver disease. Patient-reported barriers were analyzed inductively and organized into the components (capability, opportunity, and motivation) of the COM-B model. <b>Results:</b> The literature search yielded 583 articles, of which seven qualitative studies, four quantitative studies, and one mixed-methods study met the inclusion criteria. Lack of time, lack of information on the diagnosis and management of non-alcoholic fatty liver disease, negative perceptions of the prescribed exercise and diet, physical symptoms interfering with the behavior, presence of comorbidities, and lack of family cooperation were frequently reported as barriers. <b>Conclusion:</b> The results of this study may contribute to the development of appropriate care and education strategies to promote behavioral changes in patients with non-alcoholic fatty liver disease.</p>","PeriodicalId":73939,"journal":{"name":"Journal of rural medicine : JRM","volume":"19 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10774003/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139405932","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}

{"title":"Comparison of attitudes toward community-based medicine between regional-quota and general-selected medical student in Japan.","authors":"Nobuyasu Komasawa, Masanao Yokohira","doi":"10.2185/jrm.2023-020","DOIUrl":"10.2185/jrm.2023-020","url":null,"abstract":"<p><p><b>Objective:</b> This study compared the regional-quota and general-selected medical students' understanding, interest, and confidence in the community medicine practice and their attitudes toward the concept guidelines. <b>Methods:</b> We conducted a Web-based questionnaire survey regarding the understanding, interest, and confidence in future community medicine practice and attitudes toward concept guidelines among medical students of all grades (regional-quota and general-selected: n=82 and n=617, respectively). <b>Results:</b> The overall response rates were 68.5% (56/82) and 66.0% (409/617) in the regional-quota and general-selected groups, respectively. Although there was no significant difference between the groups in terms of understanding (<i>P</i>=0.998), interest and confidence in future practice were significantly higher in the regional-quota group (both <i>P</i><0.001). There was no significant difference between the two groups for any of the six questions regarding community medicine guidelines. <b>Conclusion:</b> The understanding of community medicine or its conceptual guidelines did not significantly differ between the two groups; however, interest and confidence in future practice were significantly higher in the regional-quota group. These results suggest that the regional-quota system positively upregulates the interest in community medicine, which could be associated with confidence in future practice. Comprehensive and longitudinal improvements in the regional-quota system may be effective in cultivating community medicine.</p>","PeriodicalId":73939,"journal":{"name":"Journal of rural medicine : JRM","volume":"19 1","pages":"10-16"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10773998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139405469","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}

{"title":"Corrigendum: Rural-urban disparities in knowledge, attitude, and practice toward child oral health among mothers of 9-36-month-old children.","authors":"","doi":"10.2185/jrm.2022-043c","DOIUrl":"https://doi.org/10.2185/jrm.2022-043c","url":null,"abstract":"<p><p>[This corrects the article on p. 175 in vol. 18 PMC10336342.].</p>","PeriodicalId":73939,"journal":{"name":"Journal of rural medicine : JRM","volume":"18 4","pages":"241"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/dc/9a/jrm-18-241.PMC10579926.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49685836","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}

{"title":"The disparity of utilization rate among specific groups for a rapid spreading telehealth application called LEBER during the COVID-19 state of emergency in Japan.","authors":"Yurie Kobashi,&nbsp;Masaki Oguni,&nbsp;Masaharu Tsubokura,&nbsp;Naoki Kanda,&nbsp;Naomi Ito,&nbsp;Shunichiro Ito","doi":"10.2185/jrm.2022-052","DOIUrl":"https://doi.org/10.2185/jrm.2022-052","url":null,"abstract":"<p><strong>Objectives: </strong>The purpose of this research is to describe the social demographics and chief complaints of users of a free medical consultation application in Ibaraki Prefecture, where a free medical consultation application was released.</p><p><strong>Methods: </strong>The present study included users of a telehealth application in Ibaraki Prefecture between April 9 and May 17, 2020, during the state of emergency. User background characteristics were descriptively analyzed to clarify individual factors with the potential to act as barriers to equally using innovative solutions. Additionally, the age and consultation time distribution by sex were examined for those who used the application for COVID-19 and non-COVID-19 issues.</p><p><strong>Results: </strong>Most of the participants were in their thirties. Moreover, 72% were female, with most being in their thirties (86%) and the least being in their sixties (45%). The number of consultations was concentrated between 6 p.m. and 10 p.m., with the least between 1 a.m. and 5 a.m. The telehealth application users were mainly females in their thirties and forties.</p><p><strong>Conclusions: </strong>To prevent the widening of health disparities due to the rapid introduction of telehealth, further research is required to identify why the use of the application did not spread beyond the aforementioned user groups.</p>","PeriodicalId":73939,"journal":{"name":"Journal of rural medicine : JRM","volume":"18 4","pages":"233-240"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/67/1e/jrm-18-233.PMC10579928.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49685839","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}

{"title":"Utilization of and barriers to a telemedicine system at a rural general hospital in Japan: a mixed methods study.","authors":"Takahiro Hirano,&nbsp;Tadashi Kobayashi,&nbsp;Hiroki Maita,&nbsp;Takashi Akimoto,&nbsp;Hiroyuki Kato","doi":"10.2185/jrm.2023-015","DOIUrl":"https://doi.org/10.2185/jrm.2023-015","url":null,"abstract":"<p><strong>Objective: </strong>The initial and operational costs of telemedicine are major barriers to its adoption. We aimed to investigate and identify the barriers to adopting a telemedicine system in a Japanese rural general hospital without incurring setup and operational costs.</p><p><strong>Materials and methods: </strong>Our study was conducted between May and August 2018, and included six general practitioners working at a rural general hospital. We extracted data collected from messages (date and time, sender and recipient, and counts and contents of messages) and conducted semi-structured interviews, which were then analyzed using quantitative and qualitative methods.</p><p><strong>Results: </strong>We quantitatively analyzed the total counted of the 179 messages. The total counts recorded for each physician were 56 (A), 20 (B), 3 (C), 74 (D), 5 (E), and 21 (F). The mean monthly counts were 2.17 (May), 8.50 (June), 11.50 (July), and 7.67 (August). Interview data from the six physicians yielded 13 codes that included various points of dissatisfaction acting as barriers to using our system, which we grouped into mental and physical barriers. Mental barriers included suspicion of carrying, feelings of isolation, and loss, whereas physical barriers included portability, user authentication, internet speed, group chat system, notice, search image, typing, chat system, print facility, and limited function.</p><p><strong>Conclusion: </strong>The representative barriers to introducing a telemedicine system at a rural general hospital in Japan without initial and running costs could be classified as feelings of isolation and suspicion of carrying (mental barriers); and notice, portability, and user authentication (physical barriers). Continued investigation in this area is warranted, and solutions to these barriers could improve the shortage of medical staff in the context of declining birth rates and aging populations in Japan.</p>","PeriodicalId":73939,"journal":{"name":"Journal of rural medicine : JRM","volume":"18 4","pages":"226-232"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/95/6d/jrm-18-226.PMC10579925.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49685841","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}

{"title":"Outcomes of patients with decompression illness transported by physician-staffed helicopter according to Japanese Registry data (2015-2020).","authors":"Youichi Yanagawa, Marika Nunotani, Keiki Abe, Hiroki Nagasawa, Ikuto Takeuchi","doi":"10.2185/jrm.2023-012","DOIUrl":"10.2185/jrm.2023-012","url":null,"abstract":"<p><strong>Objective: </strong>No nationwide reports have focused on patients with decompression illness (DCI) transported by doctor helicopter (DH) in Japan. We performed this retrospective study to examine this population using data from the Japan DH registry system (JDRS).</p><p><strong>Patients and methods: </strong>Patients were initially selected from the JDRS database. They were divided into two groups: those transported by the Eastern Shizuoka DH (ES-DH) and those transported by other DHs. Variables were compared between the two groups.</p><p><strong>Results: </strong>There were 44 patients who had DCI out of 41,592 patients in the JDRS. The majority of cases (70%) were transported by the ES-DH. In the ES-DH group, age, rate of request type using key words, and rate of instrumental intervention to secure an airway were significantly greater, and the median Glasgow Coma Scale score was significantly lower than that of the other DH group. However, there was no statistically significant difference in the rate of cases with fatal outcomes between the two groups.</p><p><strong>Conclusions: </strong>This is the first report regarding the current status of patients with DCI transported by DH in Japan. Most patients were transported by ES-DH to the Izu Peninsula. In addition, the patients transported by ES-DH due to decompression illness tended to be severely ill; however, the outcomes of the ES-DH and other DH groups did not differ to a statistically significant extent and therefore effective recompression therapy could be successfully performed at suitable hospitals owing to timely transportation.</p>","PeriodicalId":73939,"journal":{"name":"Journal of rural medicine : JRM","volume":"18 4","pages":"222-225"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/17/99/jrm-18-222.PMC10579929.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49685837","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}

{"title":"Uptake and impact of COVID-19 vaccination among HIV key populations: a cohort study from Tamil Nadu, India.","authors":"M Saleem,&nbsp;Janakiram Marimuthu,&nbsp;Aravind P Gandhi","doi":"10.2185/jrm.2023-008","DOIUrl":"https://doi.org/10.2185/jrm.2023-008","url":null,"abstract":"<p><strong>Objective: </strong>Human Immunodeficiency Virus (HIV) Key Populations (KPs) include Female Sex Workers (FSWs), men who have sex with men (MSM), transgender (TG), and transsexual (TS) persons. This study assessed coronavirus disease 2019 (COVID-19) vaccine uptake among KPs for HIV in India, adverse events following immunization (AEFI), and breakthrough infections among the vaccinated.</p><p><strong>Materials and methods: </strong>This retrospective cohort study was conducted among 421 KPs enrolled in 41 Targeted Intervention (TI) clusters in 31 districts of the Tamil Nadu State Acquired Immunodeficiency Syndrome (AIDS) Control Society (TANSACS), India, from June to September 2022. A semi-structured, bilingual (English and Tamil), interviewer-administered questionnaire was used to collect data on socio-demographic characteristics, vaccination status, AEFIs, and breakthrough infections among the KPs under the TIs.</p><p><strong>Results: </strong>Among the KPs, 45.4% were FSWs, 37.1% were MSM, 16.2% were TG, and 1.4% were TS persons. Among them, 4.3% had HIV, and 2.9% had syphilis or other sexually transmitted infections (STIs). The COVID-19 vaccine uptake rate was 96%. Among the KPs, TG/TS persons had the highest vaccine uptake (98.6%), followed by FSWs (96.3%) and MSM (94.2%). AEFIs were reported by 85.4% of the participants. HIV positive status was significantly associated with the incidence of AEFI. The breakthrough infection rate was 5.4% among the vaccinated participants.</p><p><strong>Conclusion: </strong>The COVID-19 vaccine uptake among HIV KPs was high in Tamil Nadu. AEFIs and breakthrough infections among COVID-19 vaccinated HIV KPs may be low, with mild AEFIs.</p>","PeriodicalId":73939,"journal":{"name":"Journal of rural medicine : JRM","volume":"18 4","pages":"215-221"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b9/9d/jrm-18-215.PMC10579930.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49685840","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}

{"title":"Suffering of patients developing lymphedema following gynecological cancer surgery.","authors":"Keiko Seki,&nbsp;Ayako Okutsu","doi":"10.2185/jrm.2023-003","DOIUrl":"https://doi.org/10.2185/jrm.2023-003","url":null,"abstract":"<p><strong>Objective: </strong>Lymphedema developing in the lower extremities following gynecological cancer surgery (LE-GCS) produces various kinds of sufferings, including impacts on quality of life (QOL) and body image. This research will serve as a basic resource for the care of patients with this type of lymphedema (LE).</p><p><strong>Patients and methods: </strong>A qualitative discursive research method: Thirteen patients suffering from LE-GCS were interviewed in a semi-organized manner. Analysis involved extracting and codifying from transcripts and expressions related to the suffering of LE. Next, these codes were arranged into categories and subcategories under the supervision of qualitative researchers. Furthermore, this study was conducted with the approval of the Research Ethics Review Specialist Committee, which targets individuals affiliated with the public university corporation of Shiga Prefectural University.</p><p><strong>Results: </strong>Based on the interviews with 13 patients aged 47-79 (median age 62), two core categories were created: 1). Suffering of LE Developing in Lower Extremities (570 codes, seven categories, 23 subcategories); and 2). Supports that Allow Patients to Face Suffering of LE (254 codes, four categories, 14 subcategories).</p><p><strong>Conclusion: </strong>Patients with LE-GCS live with the fear that LE exacerbation will produce adverse life changes, and this may exceed the fear of cancer itself. The aggravation of their condition results in immense pain as well as reduced mobility, change in appearance, and loss of self-worth. The symptoms fluctuate, and may lead to chronic misery, which does not manifest, but occasionally flares-up because of both, worsening physical disability as well as ordinary events. Additionally, every patient subjectively described the strength they found within themselves to face the suffering. They cited the support of family and friends, existence of compassionate therapists and doctors, acquisition of knowledge, and self-care.</p>","PeriodicalId":73939,"journal":{"name":"Journal of rural medicine : JRM","volume":"18 4","pages":"205-214"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/35/ee/jrm-18-205.PMC10579927.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49685838","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}