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Roles of registered dietitians and cooks in providing dysphagia diet foods: A case study.
Get PDFapplication/pdf【要旨】嚥下調整食を導入した給食施設の事例から取り組みを整理し，管理栄養士および調理従事者の役 割について考察した。嚥下調整食の実施では，喫食者に適した食形態の設定や多職種による喫食状況の把 握，物性の安定と調理負担の調整が行われていた。特に，調理従事者の業務内容が従来の調理中心の業務 から拡大傾向にあり，施設職員，委託給食会社職員ともに嚥下調整食の調理方法・技術に関する研修のほ か，嚥下に関する知識研修や病棟訪問等に参加していた。今後，管理栄養士には，喫食者の栄養状態，摂 食・嚥下機能の維持・向上を目指した嚥下調整食の開発および質の向上に加えて，調理従事者の職務設計， 人材育成に関する職務遂行，委託給食会社との協力関係構築などの能力が求められると考える。Abstract: This study summarized the initiatives of a meal-catering facility that had introduced a dysphagia diet and considered the roles of registered dietitians and cooks. Implementing a dysphagia diet involves identifying the forms of food suitable for the patient and appointing a multi-disciplinary team for understanding their eating condition, stabilizing the physical properties of food, and adjusting the burden of cooking. Notably, the work done by cooking staff in the mealcatering facility tended to expand beyond conventional cooking-centered duties; together with the facility staff and subcontracted meal-catering staff, the cooking staff undertook training on cooking methods and techniques for dysphagia diet, and training to increase their knowledge about swallowing, as well as visits to wards. In the future, registered dietitians would be required to acquire skills involving designing the duty of cooking staff, executing the duties related to human resource development, and establishing cooperative relations with sub-contracted meal-catering companies. They would also need to develop and improve the quality of dysphagia diet aimed at maintaining and improving the nutritional status, feeding, and swallowing function of the patient.departmental bulletin pape
A Review of Literature on Medical Social Workers' Growth Stages and Challenges
Get PDFapplication/pdf【要旨】本稿はソーシャルワーカーの成長の促進要因と阻害要因を調査するための予備研究として、主に医 療ソーシャルワーカーの成長段階とその段階ごとの課題に加えて、離職と退職、業務困難性等に係る要因に ついて文献を用いて、整理し、ソーシャルワーカーの成長の促進や阻害に影響与える要因になり得る項目に ついて探索することが目的である。先行研究の整理により、MSW の成長段階とその区分、MSW の成長の段 階とその状態像、離職と退職、業務困難性にかかわる要因について、整理することができたが、それらの要 因と成長区分が具体的にどのようにかかわるかは、今後の課題である。Abstract: This paper is a preliminary investigation of factors that promote and inhibit the growth of social workers, namely the stages of medical social workers’ (MSW) growth and the obstacles they face at each step, as well as factors associated to turnover, retirement, and job difficulties. By organizing previous literature, we were able to sort out the MSWs’ stages of growth and classifications, the MSWs’ situation at each growth stage, and factors connected to turnover, retirement, and job difficulties. However, the precise relationship between these factors and growth stages is a future issue.departmental bulletin pape
Feelings of parents of children with medical complexity at elementary school enrollment
Get PDFapplication/pdf【要旨】本研究の目的は、医療的ケアを必要とする子どもの小学校就学に伴う親の思いを明らかにするこ とである。研究協力が得られた医療的ケアを必要とする子どもの親 4 名に半構造化面接を実施し、質的記 述的に分析を行った。その結果、【わが子の将来を考える】【わが子の希望を叶える決意】【 就学後も子ども 達と一緒に育つ期待感】【 家から出られない閉塞感】【希望が通らない就学への困難感】【周囲の人とのつな がりを支えに一歩踏み出す覚悟】のカテゴリーが生成された。親は、わが子の将来を考え、わが子の希望 を叶える決意で行動していた。さらに、その思いを後押ししてくれた幼稚園・保育所時代の子ども達と母 親達の存在が小学校就学を実現するための支えとなっていた。Abstract : This study aims to understand the feelings of parents of children with medical complexity when the children are to enroll in elementary school. Semi-structured interviews were conducted with four parents of children with medical complexity who expressed consent to the study participation. The interview data were qualitatively and descriptively analyzed. The analysis identified the following categories: ‘thinking about the future of their own child’, ‘decision to fulfill the wishes of their child’, ‘expectation for the child to grow up with other children also after school age’, ‘feelings of obstruction that their children cannot go out from the home’, ‘feelings of difficulty in being unable to let their children go to school as wished’, and ‘preparedness to take steps with support from the people around them’. Parents thought about the future of their children and acted with determination to fulfill the wishes of the children. Further, the parents were emotionally supported by the presence of the children and other mothers from kindergarten and nursery school days who supported the parents in the endeavor to realize the wishes of elementary school enrollment for their children.departmental bulletin pape
Trends in Physio-psychological Research in the Field of Education for Children with Disabilities. －Focusing on the Research that Utilizes the Heart Rate Response－
Get PDFapplication/pdf【要旨】障害児教育研究分野における研究発表より，生理心理学的指標の一つである心拍を活用した 17 論 文を抽出し，研究の動向について整理した。1993 年から 2003 年を中心に重症心身障害児を対象とした研 究，2005 年以降は超重症児を対象とした研究を中心に発表されてきていた。重症心身障害児を対象とした 研究の多くは，対象児の心理的状態の把握に心拍を評価指標と活用した研究であった。超重症児を対象と した研究では，心拍から推測する対象児の状態や変化から，指導，働きかけ，評価等の妥当性や関係性等 の検討を図り，対象児への関わりの手がかかりを得ることに着目している傾向が見られた。使用計測機器 は，2001 年までは心電図であり，2003 年以降はパルスオキシメーターを使用した研究が中心となった。Abstract: From publications of studies in the field of education and research on children with disabilities, we extracted 17 papers that utilized heart rate response, which is a physio-psychological indicator, and summarized the trends in research. Studies have been published mainly on children with severe mental and physical disabilities from 1993 to 2003 and on children with severe motor and intellectual disabilities-medical care dependent group (SMID-MCDG) since 2005. Most studies on children with severe mental and physical disabilities have used heart rate response as an evaluation index to determine their psychological state. In the studies of SMID-MCDG tended to focus on matters such as the validity of guidance, encouragement, and evaluation, and the relationship between them, based on the condition and changes of the child presumed from the heart rate response. These studies also focused on examining how to relate to the child. The main devices used to measure heart rate in the study were electrocardiograms until 2001 and pulse oximeters since 2003.departmental bulletin pape