The Construction of the Nursing Care System for

The Construction of the Nursing Care System for Chemical Sensitivity Syndrome Patients at the Local Area Nami Imai, Ph. D, RN Mie University, JAPAN

Introduction 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 SHS CS • A lack of knowledge illness • Role in the society and family Can not go Specialized Hospital for SHS, CS General Hospital Be late for diagnosis Can not go • Poor stamina MCS • Restricted movement • Economic crisis Psychosocial aggravating factors of MCS in Japan Can not treat Imai N, et al. J. Jpn Int. Illness Nurs. Soc. 2004

Why dose the condition aggravate? 2004～ 2006 The Qualitative Method

Background 2 Prolongation of exposure to toxic chemicals Difficulties taking radical measures to improve the environment Difficulties establishing a diagnosis Lack of knowledge about disorder Moving into the house diagnosis Taking measures Time axis Time course of the appearance of psychosocial aggravating factors of sick house syndrome in Japan Imai N, et al. Nurs. & Health Sciences, 2008.

What can a nurse do? 2006～ 2008 The Intervened Method The Action Research

Method 1 Consultation at Nursing Counseling Room email telephone Fax counseling What are nurses’ roles for CS patients and people of related to CS patients? Research I To clarify users’ expectations of NCR Are there any effects by nursing intervention? Research II To verify the effect of nursing intervention for MCS

Method 2　 Consultation at Nursing Counseling Room 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

Tool The Check of Health Status for Patients QEESI Quick Environment Exposure Sensitivity Inventory developed by Ashford and Miller (1998) The 10 items include, Each item 0 -10 rating 1 Head-related 6 Skin 　 7 Genitourinary 2 Cognitive 8 Gastro internal 　 9 heart /chest-related 3 Affective Symptom severity scale 　 10 Airway or mucous membrane-related 4 Neuromuscular

Result 1 Users’ Demands to Nurse Users: 70，code: 179 Contents of Demand to Nursing in NCR 　 　Information on the condition and treatment 46％ 　　　　　　　 　 　Information that could improve the safety of daily living 　　　 22％ 　 　Mental support 　　　　　 21％ 　 　Action to promote social understanding of their situation　　　 11％ Nami Imai, QHR, Banff, 2008.

Result 2 Outcome of QEESI and main intervention Case A: SHS Case B: CS A F 29 beautician peer counseling, sauna B F 36 office worker peer counseling, special doctor safe water Nami Imai et al. Jpn J Clin Ecol Vol 17(1) 2008. 　

Appendix International Program of Psycho-Social Health Research, Podcast #52 Living in a Chemical World: Psycho-Social Factors Aggravating the Symptoms of Sick House Syndrome

What can nurses do in society? 2009～ 2013 The Intervened Method The Action Research (Expansion Sphere of Activity to Regional Society)

Patients Support System Medical Doctors Supporters(Su pporting group) Dentist Public health nurse Midwife Beautician Architect Industrialist TAKAOKA CLINIC at Tsu, Mie, JAPAN

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