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)

Patients Support System

TAKAOKA CLINIC at Tsu, Mie, JAPAN

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