Grant amount：\5070000 （ Direct Cost: \3900000 、 Indirect Cost：\1170000 ）

We evaluated patient education for socially vulnerable people (people living in poverty, people from foreign countries), who among tuberculosis patients in Japan are at a higher risk of quitting treatment. We clarified the characteristics of patients as seen from the perspective of the nurses and health workers supporting patients who received DOTS in the Airin district after checking out of the tuberculosis hospital ward. Targeting tuberculosis patients in the Airin district, we conducted interviews regarding patient education received during hospitalization and the effect of said education. For tuberculosis patients from foreign countries, from interviews with hospital ward nurses we identified the difficulties related to nursing. Based on this, we created a tuberculosis patient educational DVD that is both effective for socially vulnerable people and that also provides multiple foreign language options. We distributed this DVD to tuberculosis hospital wards throughout the country.

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Grant amount：\4810000 （ Direct Cost: \3700000 、 Indirect Cost：\1110000 ）

Long-term chemotherapy is required for patients with tuberculosis; however continuing to follow through with medication is arduous. The purpose of this study was to heighten patient awareness and improve adherence to medication regimens, as well as developing educational tools and programs to support patients in continuing their treatment. We determined the actual situation regarding education and environments for tuberculosis patients in hospitals throughout Japan. We made an educational DVD for patients based on these findings. Moreover, we developed and put into practice an educational program for patients which utilized this DVD. We distributed the DVD free of charge to leading tuberculosis hospitals nationwide. With the goal of evaluating the effectiveness of the DVD, we conducted a survey aimed at nursing staff and patients of hospitals where we had distributed the DVD.

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Grant amount：\14040000 （ Direct Cost: \10800000 、 Indirect Cost：\3240000 ）

The objective of this research was to develop of the early intervention model for families with children who were hospitalized in NICU. The network of NICUs nurses was constructed. We verified the useful of family assessment tool which focused family function with NICUs nurses. Moreover, we made the intervention medium and its guideline from visiting before childbirth. The implementation and evaluation of these outcomes constitute the orientation for succeeding research.

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Grant amount：\4030000 （ Direct Cost: \3100000 、 Indirect Cost：\930000 ）

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Grant amount：\3200000 （ Direct Cost: \3200000 ）

This study was conducted to clarify the status of children receiving oral steroid therapy and their families, and evaluate methods to support them for more independent living. Semi-structured interviews were performed in 7 children with nephrotic syndrome and their families with consideration to protect their privacy. Of these 7 children, 2 were taking oral steroids, 1 was scheduled to discontinue them, 3 had discontinued them, and 1 was taking an immunosuppressant at the interviews. In all children, the primary disease was being alleviated, but recurrence had been experienced, and treatment had been prolonged. One child taking steroids showed mild proteinuria, and 1 taking an immunosuppressant had developed proteinuria from immediately after a school excursion, which the child made 1 week before the interview. Of the 7 children, 4 contracted varicella, measles, mumps, and herpes after alleviation of symptoms. Since these infections may contribute to recurrence, their prevention is important During hospitalization and at discharge, explanations about the use of oral steroids and points of attention in daily lives were made mostly by physicians and infrequently by nurses. After discharge, most children avoided attending school or kindergarten while infections persisted as a measure to prevent infection, but gargling, hand washing, or wearing a mask in the crowd was not rigorously practiced, and reluctance of children to do things different from other children may underlie this poor compliance. Communication and cooperation between school and home are considered to have been adequate, and people around these children appeared to have helped them in their school activities. However, with prolongation of the disease, steroid therapy, and rest and dietary regimen, the children felt stress for not being able to behave as other children. The parents, seeing their children lapsing into such a state, worried about their mental and physical development, and gradually allowed them to be more active by their own judgment while continuing the treatment, but they did not appear to have gone to the point of expanding the range of the activities.

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Grant amount：\3600000 （ Direct Cost: \3600000 ）

The purpose of this research is three-fold : First, to clarify current conditions and problems of medical care and health care which surround the handicapped children going to the schools for handicapped children in Hokkaido. Secondly, to clarify the roles of the school nurses and the nurses who are in charge of the handicapped children and tackling medical care and health care? Thirdly, to develop the educational support for the handicapped children. The data was collected through the questionnaire and interviews from the year of 2001 to 2003. In 2003, the school teachers and dormitory staff at schools for handicapped children answered the questionnaire, and were interviewed afterward. The parents of the handicapped children, and the school nurses at the schools for handicapped children were interviewed in 2002 and 2003, respectively.
The survey revealed the following ; the children going to the school for handicapped children have various health problems. The school teachers working at schools for handicapped children need to observe the children and assess exactly their health conditions in order to keep the handicapped children healthy. They should also carry out the educational activities for the handicapped children. The special medical knowledge needed has been acquired by the individuals through their own efforts. The first problem the teachers have is the hesitation in deciding the treatments for children because they are not medical professionals. The second problem is their uneasiness toward the cooperation with the parents and the medical institutions. The role of the school nurse is to understand each child's health problems such as the type of handicap and illness. The school nurses seem to be in charge of health care of the children. It was suggested that the school nurse in the future should have the central role of the school for handicapped children to carry out medical care.
From the viewpoint of promoting medical care as the educational support centering the handicapped children, the following was suggested : the maintenance and improvement of organization, the enrichment of the training programs for the school teachers to apply the knowledge practically, the establishment of the cooperation system where timely advice and instruction can be obtained from medical professionals, the creation of medical care manuals including technique and method suitable for each child, and the clarification of the role of the nurse as an adviser about medical treatments.

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