本田 仁

BACKGROUND: The present study aimed to investigate the association between the duration of anti-coronavirus disease 2019 (COVID-19) public health measures and the quality of life (QOL) and mental health of the Japanese public. METHODS: The present, nationwide, questionnaire-based, cross-sectional study was conducted in September 2021. The cumulative duration in days of anti-COVID-19 public health measures was calculated for each prefecture in the year prior to the survey, and multilevel linear regression analysis was used to determine the association between the duration of these measures and any impairment of QOL or mental health as assessed by the EuroQol 5-dimensions 5-levels (EQ-5D-5L) and the Kessler scale (K6). RESULTS: The study included 28 118 participants from all 47 prefectures. The median duration of public health measures of all prefectures was 179 days. Long-term duration of the measures (181-365 days) was not independently associated with low EQ-5D-5L (P = 0.128) or high K6 (P = 0.179) scores after adjusting for potential confounders (Graphical Abstract). CONCLUSIONS: Prolongation of the measures may not be associated with a deterioration in the QOL or mental health of the Japanese public. Nevertheless, it may be necessary to reconsider long-term public health measures given the potential they may have to cause collateral damage, such as socioeconomic one.

BACKGROUND: Few interventional studies of catheter-associated urinary tract infection (CAUTI) have been conducted to optimize indwelling urinary catheter (IUC) use in Japan. METHODS: The nurse-led, before-after study was conducted at a tertiary care center from June 2018 through May 2022. The intervention included 1) the provision of appropriate indications for IUC use, 2) prospective feedback to the primary care providers by ward nurses on unnecessary/inappropriate IUC use with two, separate interventional phases, the first involving intensive care units (ICU) only, the second involving ICU and general wards, and 3) proactive feedback by Infectious diseases physicians in the Infection Control department to the primary care providers regarding IUC discontinuation upon discharge from the ICU. RESULTS: During the first phase involving the implementation of the intervention only in the ICU, the indwelling urinary catheter-device utilization ratio (IUC-DUR) trend in the general wards decreased by 1.5 % (P = 0.01). However, the addition of the intervention to the general wards in the second phase led to a 2 % increase in the trend (P = 0.010). The CAUTI incidence in neither the ICU nor the general wards changed significantly. CONCLUSIONS: Although providing feedback on IUC removal at discharge from the ICU and appropriate indications for urinary catheter insertion can reduce inappropriate urinary catheter use, the nurse-led intervention alone was inadequate for reducing the CAUTI incidence.