YAMAMOTO YUKO

Purpose : To conduct a concept analysis of 'life review for elderly' and to examine it's utility for enhancing aspects of nursing practice. Methods : Relevant literature was identified using the search terms: life review, elderly, and aged. Six databases, PubMed, CINAHL, PsycINFO, SocINDEX, medical central magazine, and Japan Medical Abstracts Society were searched for the years 1990 through 2012. Meeting the criteria were 28 articles, which were analyzed using Rodgers's concept analysis model. Results : Extracted attributes of life review included: elderly repeated recall, integrated looking back on entire life span, and talking to others increased facial expressions. Antecedents of life review extracted were: physical factors and characteristics of the elderly, decline in mental and cognitive function, decrease in social interchange and existence of an expert with the skill to listen. Consequences of life review extracted were: reception of one's stage in life as old age and impending death; promotion of mutual understanding with others; comparing traditions with other generations, and noticing self-awareness, and maintenance of self-esteem. Conclusion : Life review for the elderly is regarded as a concept that when enacted promotes self-awareness that could otherwise be easily lost in the advanced age period and which promotes mutual understanding with others.

Aim: This systematic review evaluated the effects of telehome monitoring-based telenursing (THMTN) on health outcomes and use of healthcare services and compared them with the effects of conventional treatment in patients with severe and very severe chronic obstructive pulmonary disease (COPD). Methods: An extensive published work search of several databases was performed in May and October 2011. Randomized controlled trials and non-randomized controlled clinical trials were evaluated. Parameters included hospitalization rate, number of visits to the emergency department, exacerbations, mean number of hospitalizations, mean duration of bed days of care, mortality, and health-related quality of life by the duration of THMTN and COPD severity. A random effects model was applied. Risk ratio and mean difference were calculated. Heterogeneity was assessed using the I2 statistic. Results: Nine original articles involving 550 participants were identified in the meta-analysis. THMTN decreased hospitalization rates, emergency department visits, exacerbations, mean number of hospitalizations, and mean duration of bed days of care in severe and very severe COPD patients. Hospitalization rates and emergency department visits were comparable between patients undergoing THMTN of different durations. In addition, THMTN had no effect on mortality. Conclusion: THMTN significantly decreases the use of healthcare services however, it does not affect mortality in severe and very severe COPD patients. © 2012 Japan Academy of Nursing Science.