Program for Promoting Self-Management of Health Status for Nursing Students Based on Oriental Medical Concepts

Saturday, 18 March 2017

Shu Chun Chien, PhD1
Yoshiko Wazumi, PhD2
Toshie Yamamoto, PhD3
Takeshi Matumoto, PhD, MSN4
Takashi Maeda, PhD5
Tomoko Katagiri, MSN5
Akiko Nagata, MSN, MN3
Fusako Kawabe, PhD6
(1)Center for Education and Research in Nursing Practice, Graduate School of Nursing, Chiba University, Chiba-shi, Japan
(2)Center for Education and Research in Nursing Practice, Graduate School of Nursing, Chiba University, Chiba, Japan
(3)Graduate School of Nursing, Chiba University, Chiba, Japan
(4)Center for Environment, Health and Field Sciences, Chiba University, Chiba, Japan
(5)Department of Nursing, Yamagata Prefectural University of Health Sciences, Yamagata, Japan
(6)Department of Fundamental Nursing, Chiba Prefectural University of Health Sciences, Chiba, Japan

Purpose

Most nursing curriculums include many courses spanning medical knowledge, technology, and nursing skills. However, our research has established that nursing students often show symptoms or signs of afflictions such as menstruation disorders, algomenorrhea, constipation, skin allergies, headaches, and so on. These symptoms or signs are known as the “pre-disease” stage (i.e., the stage before an illness is diagnosed) in Oriental medicine in Japan. It is worthwhile to help nursing students recognize the influence of these symptoms or signs and then make efforts to improve them through their daily lives. Based on one major concept of oriental medicine, chronic diseases are considered to be the result of our physical condition becoming unbalanced and turning into health disorders. The purpose of the current research is to apply this concept to develop, and examine the effectiveness, of a program aimed at helping to improve the symptoms or signs in the “pre-disease” stage of nursing students.

Methods

The subjects for this study included five female nursing students from University A, located in the Kanto region, and seven (three male, four female) students from University B, located in the Tohoku region. Concerning gathering data about the subjects, a combination of data-collecting wearable wrist bands, personal documents covering a span of about two weeks, and interviews were used to record daily life data, including such information as their waking and sleeping times, diet, exercise and important life events for at least six months.

Aside from uncomfortable symptoms or signs being confirmed through interviews, the physical condition of the subjects was also measured through Ryodoraku – a technique developed by Dr. Nakatani Yoshio that employs a machine to measure the electric potential difference of meridians on the skin in order to ascertain physical strength and the balance of the autonomic nerve system. Furthermore, an acupuncturist took each student’s pulse and advised them concerning how to apply finger pressure on acupuncture points to alleviate their discomfort. The relationships between the uncomfortable symptoms or signs, the results of the Ryodoraku measurements, and the daily life data were analyzed by time-series on an individual basis. Researchers reflected on the results with the subjects in order to help them recognize the relationships between their health problems and their daily lives.

 

Results

Of the five participants from University A, two were undergraduates and three were graduate students, whereas the seven participants from University B were all undergraduates. The participants were all in their 20s and 30s. Their symptoms and signs included algomenorrhea, constipation, menstrual irregularity, edema of the lower leg, feelings of cold, muscle stiffness of the shoulder, skin allergies, and gastrointestinal symptoms. Their lifestyles were all characterized by hard schedules replete with studies and extracurricular activities from their junior high school days until the present. The changes were reflected in the Ryodoraku scores.

The average scores corresponding to before, during (at an interval of 2.5 to 3 months after beginning), and at the end of the study for the two universities are compared. With the exception of case A’ at University B, all of the subjects’ average scores at first became higher and then returned to their initial levels at the end of the study because of the students’ busy schedules, including, for example, exams or job hunting. However, besides case B’ at University B, the balance of the autonomic nerve system of all subjects improved over the course of the period from the interval to the conclusion of the study. The symptoms or signs showed improvement if the subjects practiced the advised finger pressure on acupuncture points or changed their lifestyles.

The scores of University B were higher than those of University A. The researchers believe that because the deviation value of University A was higher than that of University B, the study assignments were more difficult for the subjects from University A, which influenced their daily lives in ways such as diet, rest, exercises and physical condition. Another likely reason considered was that as most subjects from University B lived together with their families they were able to receive support from their families for maintaining their physical status.

 

Conclusions

The results showed that the program could help nursing students by promoting self-management to improve their uncomfortable symptoms and signs with the assistance of the researchers. However, the demanding social lives of nursing students, which include not only studies but also such things as extracurricular activities and part-time jobs, obviously affect their private lives. Their lives were difficult to maintain in their present status. This also suggested that six months of support from researchers was not sufficient for the students to fully effect changes and master new lifestyles. Additional strategies need to be incorporated or developed in order to maintain the effects of the program.

Physical symptoms are affected by personal lifestyle, and are also reflected in an individual’s Ryodoraku measurements. Educating nursing students so that they can understand the relationship between symptoms and signs, lifestyles and visualization of their physical strength and the balance of the autonomic nerve system with Ryodoraku measurements is helpful for enabling them to change their lifestyles based on the concepts of Oriental medicine. This, in turn, will aid them in helping patients to improve their physical condition through natural, noninvasive care methods. It can also be a benefit to medical expenses.

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