Nami Imai, Ph.D, RN Mie University, JAPAN The The Construction of the Construction of the Nursing Care System for Nursing Care System for Chemical Sensitivity Syndrome Chemical Sensitivity Syndrome Patients at the Local Area Patients at the Local Area
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Nami Imai, Ph.D, RN Mie University, JAPAN The Construction of the Nursing Care System for Chemical Sensitivity Syndrome Patients at the Local Area.
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Nami Imai, Ph.D, RN
Mie University, JAPAN
TheThe Construction of the Nursing Care Construction of the Nursing Care System for Chemical Sensitivity Syndrome System for Chemical Sensitivity Syndrome
Patients at the Local AreaPatients at the Local Area
Introduction
Multiple Chemical Sensitivity (MCS)Multiple Chemical Sensitivity (MCS)
MCS patients have symptoms associated with low-level exposure to a variety of substances.
◆ Significant medical problem caused by environment
◆ 10% of the general population in North America
◆ Many cases switch from SHS to CS or MCS in Japan
◆ Not generally well known disorder in Japan
◆ Some physicians lack recognition of MCS in Japan
What’s happen in Japan?2001 ~ 2003
Investigation into the actual conditions
Background 1
Psychosocial aggravating factors of MCS in Japan
Specialized Hospital for SHS, CS
General Hospital
MCS
SHSCS
•A lack of knowledge illness•Role in the society and family
Be late for diagnosis
Can not treat
Can not go
Can not go•Poor stamina•Restricted movement•Economic crisis
Imai N, et al. J. Jpn Int. Illness Nurs. Soc. 2004
Why dose the condition aggravate?2004 ~ 2006
The Qualitative Method
Prolongation of exposure to toxic chemicals
Lack of knowledge about disorder
Difficulties establishing a diagnosis
Difficulties taking radical measures to improve the environment
Time axisMoving into the house diagnosis Taking measures
Imai N, et al. Nurs.& Health Sciences, 2008.
Background 2
Time course of the appearance of psychosocial aggravating factors of sick house syndrome in Japan
What can a nurse do? 2006 ~ 2008
The Intervened MethodThe Action Research
Consultation at Nursing Counseling Roomemail
telephone
counseling
Fax
Method 1
What are nurses’ roles for CS patients and people of related to CS patients?
Research I
To clarify users’ expectations of NCRAre there any effects by nursing intervention?
Research II
To verify the effect of nursing intervention for MCS
First counseling session• Check the health condition with QEESI• Interview with the user
If the users need more counseling, repeat counseling by nurses
Final counseling• Check of health condition with QEESI• Interview with the user • Evaluate the effect of the nursing interventions
Consultation at Nursing Counseling Room
Method 2
QEESIQuick Environment Exposure Sensitivity Inventory developed by Ashford and Miller (1998)
Symptom severity scale
The 10 items include, Each item 0-10 rating1 Head-related
2 Cognitive
3 Affective
4 Neuromuscular
5 Musculoskeletal
The Check of Health Status for Patients
6 Skin
7 Genitourinary
8 Gastro internal
9 heart /chest-related
10 Airway or mucous membrane-related
Tool
46%
22%
21%
11%
Contents of Demand to Nursing in NCR Information on the condition and treatment
Information that could improve the safety of daily living
Mental support
Action to promote social understanding of their situation
Users:70 , code:179
Users’ Demands to Nurse
46 %
22 %
21 %
11 %
Result 1
Nami Imai, QHR, Banff, 2008.
A F 29 beautician peer counseling, sauna
B F 36 office worker peer counseling, special doctor
safe water
Case A: SHS Case B: CS
Outcome of QEESI and main interventionResult 2
Nami Imai et al. Jpn J Clin Ecol Vol 17(1) 2008.
International Program of Psycho-Social Health Research, Podcast #52Living in a Chemical World: Psycho-Social Factors Aggravating the Symptoms of Sick House Syndrome
Appendix
What can nurses do in society? 2009 ~ 2013
The Intervened MethodThe Action Research
(Expansion Sphere of Activity to Regional Society)