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Study Text — Nursing Care Skills/ Nursing Care Japanese Language — English Version in e e nu G The Japan Association of Certified Care Worker...

Study Text — Nursing Care Skills/ Nursing Care Japanese Language — English Version in e e nu G The Japan Association of Certified Care Workers October 2019  in e e nu G  はじめに 本書は、厚生労働省の補助事業（介護の日本語学習支援等事業）を活用して、 介護分野の特定技能１号の評価試験に対応する初めての学習用テキストとし て策定したものです。 2019 年４月に施行された在留資格「特定技能」の制度は、深刻化する人手 不足に対応するため、生産性向上や国内人材の確保のための取組を行っても なお人材を確保することが困難な状況にある産業上の分野において、一定の 専門性・技能を有する外国人材を受け入れる制度です。 介護分野において特定技能の在留資格で入国するためには、国際交流基金 が実施する日本語基礎テスト等の日本語試験のほか、厚生労働省が実施する 介護技能評価試験と介護日本語評価試験を受験し、合格することが基本とな ります。 今後、試験の実施国は拡大されていく予定ですので、介護分野で特定技能 により入国される方は、さらに増えていくことが見込まれます。そこで本書は、 介護技能評価試験と介護日本語評価試験に対応できるようにしつつ、介護現 場で働く上で、最初に習得しておいていただきたい内容を中心に作成いたし ました。 本書は、介護技能評価試験と介護日本語評価試験の受験対策として活用さ れることに加え、特定技能の在留資格で入国して介護現場で働かれる皆様が、 引き続き本書を手元に置き、ご活用いただけるような構成にしています。 本書が、 「日本の介護」を知る契機となり、その魅力を存分に感じていただ くものになること、さらに、介護分野の特定技能により入国して介護現場で ご活躍いただく際の一助となることを切に願っております。 公益社団法人 日本介護福祉士会 特定技能評価試験対応テキスト検討会 in e e nu G 1  How to Use This Book “Nursing Care Skills Evaluation Test Study Text — Nursing Care Skills/Nursing Care Japanese Language —” is a text to study in order to prepare for the Nursing Care Skills Evaluation Test and Nursing Care Japanese Language Evaluation Test. This book consists of “Nursing Care Skills” and “Nursing Care Japanese Language” to suit the standards of the evaluation test of specified skills in the area of nursing care. As the Nursing Care Japanese Language Evaluation Test will be given in Japanese, only the Japanese language is used in the “Nursing Care Japanese Language” section. The “Nursing Care Skills” section is divided into 4 parts in line with the test questions. PART 1 Basics of Nursing Care PART 2 Mechanism of Mind and Body PART 3 Communication Skills PART 4 Skills for Providing Daily Assistance ⿜⿜This book contains several illustrations to make it easier for you to imagine the scene, even if you have never worked at a care site. ⿜⿜The points that are especially important are marked with an icon. ⿜⿜Explanations are provided for difficult terms. Use your whole body for easier shifting. Explanation of terminology Base of support e Base of support refers to the area created by in connecting every point of contact of a person with the floor surface for the purpose of supporting u his/her body. If a person is standing with his/her feet apart, it is the area surrounding the outsides n of his/her soles. 2 G e  The “Nursing Care Japanese Language” provides you with a better understanding of Japanese language naturally as you answer the questions. The Nursing Care Japanese Language Evaluation Test is designed to confirm whether you have enough knowledge of Japanese used at a care site. In order to acquire the knowledge of Japanese necessary for working at a care site, it is more effective to study the nursing care Japanese language while also studying the content for the Japan Foundation Test for Basic Japanese or Japanese-Language Proficiency Test. ⿜⿜This section consists of “Words” (vocabulary), “Addressing and Conversing” (questions), and “Sentences” (questions) frequently used at a care site. ⿜⿜For the “Addressing and Conversing” and “Sentences,” questions have been developed using the expressions frequently used at a care site. in e e nu G 3 CONTENTS はじめに ･････････ 1 How to Use This Book ･････････ 2 Nursing Care Skills PART 1 Basics of Nursing Care CHAPTER 1 Human dignity and independence in nursing care 10 ･････････ CHAPTER 2  Role and professional ethics of care workers 16 ･････････ CHAPTER 3  Ensuring safety and risk management in nursing care 24 ･････････ PART 2 Mechanism of Mind and Body CHAPTER 1 Understanding of the mechanism of mind and body 42 ･････････ CHAPTER 2  Understanding of people in need of nursing care ･････････ ― Basic understanding of aging 68 in e u ― Basic understanding of disorder/disability/impairment n ― Basic understanding of dementia G e  CONTENTS PART 3 Communication Skills CHAPTER 1 Basics of communication 98･････････ CHAPTER 2 Communication with users 102 ･････････ CHAPTER 3 Communication with team members ･････････ 114 PART 4 Skills for Providing Daily Assistance CHAPTER 1 Nursing care related to assistance in walking/lifting/transferring 120 ･････････ CHAPTER 2 Nursing care at mealtimes 144 ･････････ CHAPTER 3 Nursing care related to elimination needs ･････････ 152 CHAPTER 4 Nursing care related to grooming 170 ･････････ CHAPTER 5  Nursing care related to bathing/ keeping clean 186 ･････････ CHAPTER 6 Nursing care related to housework in e u 198 ･････････ e n G CONTENTS Nursing Care Japanese Language Learn the words and phrases! Human body ･････････ 204 Position ･････････ 206 Diseases/Symptoms ･････････ 207 Nursing care related to assistance in walking/ lifting/transferring Words ･････････ 208 Questions (Addressing and Conversing) ･････････ 209 Nursing care at mealtimes Words ･････････ 212 Questions (Addressing and Conversing) ･････････ 214 Nursing care related to elimination needs Words ･････････ 217 Questions (Addressing and Conversing) ･････････ 218 Nursing care related to grooming Words ･････････ 221 in e u Questions (Addressing and Conversing) ･････････ 222 e n G  CONTENTS Nursing care related to bathing/keeping clean Words ･････････ 226 Questions (Addressing and Conversing) ･････････ 227 Nursing care related to housework Words ･････････ 233 Questions (Addressing and Conversing) ･････････ 234 Sentences Words ･････････ 240 Questions (Addressing and Conversing) ･････････ 242 Answers  Answers to the questions: “Addressing and Conversing” “Sentences” ･････････ 267 Answer sheet ･････････ 268 Presentation of the website "Nihongo o Manabou (Let's Learn Japanese)" for the study of Japanese language ･････････ 269 in e e nu G  in e e nu 8 G  PART 1 Basics of Nursing Care CHAPTER 1 H uman dignity and independence in nursing care CHAPTER 2 R ole and professional ethics of care workers CHAPTER 3 E nsuring safety and risk management in nursing care in e e nu G CHAPTER 1 Human dignity and independence in nursing care 1 Nursing care to support human dignity 1) Human dignity and respect for human rights Nursing care profession is a specialist profession that provides support to the people who have difficulties in daily living due to age and/or disability to enable them to continue their usual lifestyle. Human dignity is the basic concept in the provision of the support. Human dignity means that each person is respected as an individual. A person is respected and his/her human rights are protected even when he/she is in need of nursing care. 2) User-centric daily lifestyle Daily lifestyles differ from person to person, depending on their way of thinking and habits. Even if a person is in need of nursing care, it is the user himself/herself who takes the lead in daily living. Considering how the user wants to live, respecting his/her way of living and thinking, and providing support to help him/her live his/her usual life are the basics of nursing care. in e e nu 10 G Various lifestyles 1 PART Basics of Nursing Care CHAPTER 1 Human dignity and independence in nursing care 3) QOL (Quality of life) The QOL refers to the quality of a person’s daily living and that of his/her life. The QOL is a concept that includes mental wealth such as happiness and satisfaction of life and purpose of life. in e e nu G 11  4) Normalization Normalization is a concept that refers to people with disability, just like people without disability, living normally without being subjected to prejudice and with their human rights respected. It also refers to their continuing a normal lifestyle, maintaining their usual way without patience in the local society/community. 2 Self-independence support 1) Providing support to promote self-independence Self-independence support refers to the provision of support to a user to enable him/ her to live his/her usual life after selecting and deciding on the life he/she wants to live. Not only support related to moving, dressing, and other physical movements, but also support appropriate to his/her capabilities are provided. Respecting the user’s concept of values and what he/she is particular about, support is provided to increase the number of things he/she can do at his/her own will and with his/ her own ability to give him/her a sense of accomplishment. in e e nu 12 G 2) Self-choice and self-determination PART It is the user himself/herself who takes the lead in daily living. He/She will decide how 1 he/she wants to do something according to his/her values and the way he/she has lived so far. Basics of Nursing Care There are two kinds of independence: physical and mental. Even when he/she is in need of nursing care, he/she will independently choose and decide the style and method of daily living so that he/she can live his/her usual life. Which clothes do you want to wear today? CHAPTER 1 Human dignity and independence in nursing care I think I will wear that sweater. in e e nu G 13  3 Understanding of daily living 1) What are the activities of daily living? Activities of daily living differ depending on countries, cultures, and customs. There is a variety of lifestyles, depending on the will and values of people and what they are particular about. People wake up in the morning, change clothes, wash their face, have meals, go to the bathroom, take a bath, engage in recreational activities, and go to bed in the rhythm of life. Mealtime Teatime Taking a walk Taking a bath Changing clothes Sleeping Waking up Morning Night The person’s state of health, house, ability to do housework, family, community, and society are all related to his/her life. 2) Everyday life support provided by care workers in e With the full understanding of the user’s way of living, a care worker supports the user in living his/her usual life. nu A person tends to become passive in the way he/she thinks and acts when he/she is in need of nursing care. A care worker works to encourage the will of the user. e 14 G  e PART 1 Basics of Nursing Care CHAPTER 1 Human dignity and independence in nursing care in 15 e nu G CHAPTER 2 Role and professional ethics of care workers 1 Professional ethics of care workers 1) Consideration for privacy The user’s skin is exposed during bathing and toilet use. It is important for a care worker to give consideration for the privacy of the user so that he/she will not feel embarrassed. 2) Maintaining of confidentiality It is necessary for a care worker to obtain information on the user in order to provide appropriate care. He/She must not, however, disclose the personal information (age, address, clinical history, etc.) of the user to any third party without the user’s permission. A care worker must not spread the information on the user on the Internet, SNS, etc. without his/her consent. in e e nu 16 G 3) Prohibition of physical restraint PART Physical restraint means the restriction of a user’s physical movement. 1 Adverse effects of physical restraint Basics of Nursing Care Physical restraint has adverse effects such as the reduction of physical abilities and worsening of dementia symptoms of the user. Examples of the treatments that amount to physical restraint (1) Restrict movements by tying the body, (2) Put safety rails around the bed so that the hands, and feet. user cannot get off the bed by him/herself. CHAPTER 2 Role and professional ethics of care workers (3) Lock the door of the room to keep the (4) Have the user wear a restraint belt to user inside. keep him/her from standing. (5) Administer an excess amount of e psychotropic medication. nu in G e 17  4) Abuse Abuse means the violation of the human rights of the user. Five types of abuse (1) Physical abuse (2) Psychological abuse (3) Abandonment of To use violence on the To speak and behave nursing care, etc. user’s body. in a manner that (Neglect) will cause the user To leave the person in psychological trauma. need of nursing care unattended. (4) Economic abuse (5) Sexual abuse To obtain economic benefits wrongfully To commit indecent acts to the user. from the user. in e e nu 18 G  2 Interprofessional collaboration 1 PART 1) Team approach Basics of Nursing Care Various professionals other than care workers work as a team for a user, using their respective expertise. Care worker Doctor (Certified care Care manager worker, etc.) Dentist CHAPTER Social worker (Certified social worker, etc.) Nurse 2 Role and professional ethics of care workers Assisted living care/ Medical care nursing care User Meals/nutrition Rehabilitation Physical therapist (PT) Cook Registered dietitian Speech-language- Occupational hearing therapist (ST) therapist (OT) in e e nu G 19  2) Role and functions of other occupations (Professionals that perform medical activities) Medical activities are conducted based on medical knowledge and skills. Basically, care workers cannot be engaged in medical activities. Doctors and nurses are professionals that perform medical activities. Doctor Nurse A doctor diagnoses and treats diseases. A nurse, following the instructions given by the doctor, provides recuperative care and assists the doctor in providing medical care. (Rehabilitation professionals) Rehabilitation professionals, who provide functional recovery training, etc., include physical therapists, occupational therapists, and speech-language-hearing therapists. Physical therapist Occupational Speech-language- (PT) therapist (OT) hearing therapist (ST) in e u A physical therapist gives An occupational therapist gives A speech-language-hearing n training of physical abilities such training of activities necessary in therapist gives training to users as walking. daily living. who have difficulties in speaking e and swallowing (deglutition). 20 G (Professionals on diet) There are users for whom special care needs to be Registered PART dietitian taken about forms of meals, calories, etc. due to 1 diseases. A registered dietitian is a professional on food and eating. Basics of Nursing Care A registered dietitian develops nutritionally balanced menus. CHAPTER (Professionals who give consultations Care manager 2 Role and professional ethics of care workers and make adjustments regarding welfare Social worker (certified services) social worker, etc.) Care managers and social workers are professionals who develop support plans, give consultations, and make adjustments regarding services when users use welfare and other services. A care manager/social worker gives consultations to users, contacts the user’s family, and makes adjustments. in e e nu G 21  3 Care services 1) Overview of care services There are various kinds of care services. (1) Care service provided by home visits Care workers, etc. visit the home of the user to provide care service. Home visit care (home help service) and other services are available. (2) Care service provided to visiting care recipients in care facilities Service is provided to the user in care facilities during daytime hours. Day care (day service) and other services are available. (3) Care service provided to users living in care facilities Service is provided to users in care facilities Service in facilities for the elderly covered by public aid requiring long-term care (intensive care homes for the elderly), etc. is available. (1) Care service provided by home visits (2) Care service provided to visiting care recipients in care facilities Visit Visit Home help User’s home User’s home Day service, etc. services, etc. (3) Care service provided to users living in care facilities e Intensive care homes for the elderly, etc. nu in 22 G e 2) Care Process PART Care workers provide care in accordance with the care plan, aiming to support the self- 1 independence of the user. In the care process, a care plan is developed for each user. Basics of Nursing Care Basic flow of the care process (1) Assessment (2) Care plan development CHAPTER 2 Role and professional ethics of care workers Gather information on the user Develop the contents of the care and analyze the issues of daily plan to offer to the user. living. (4) Evaluation (3) Care plan implementation in e u Evaluate whether the contents of Provide care to the user based on the care plan are suitable for the the care plan. n user. G e 23 3 CHAPTER Ensuring safety and risk management in nursing care 1 Ensuring safety in nursing care 1) Importance of observation What does observation mean? Seems different Observation refers to carefully look at and find out the than usual…… state of the user. How come? Significance of observation What a care worker observes will be used to improve the life of the user. The things that have been observed are recorded and shared by all the staff. Method of observation I think your body is hot. Let (1)  There is information obtained by getting me take your temperature. involved with the user. (2) There is information obtained by measuring, e etc. His body is hot… nu in 24 G e 2) Health management of care workers PART Importance of health management of care workers themselves 1 It is necessary for a care worker to maintain his/her own health. It is not possible to provide better nursing care if the Basics of Nursing Care care worker him/herself is not healthy. CHAPTER For the maintenance of good health 3 Ensuring safety and risk management in nursing care (Prevention of lower back pain) It is easy for a care worker to suffer from lower back pain. So, please be careful. Lower back pain can be prevented with correct knowledge and implementation of such knowledge. Posture and lower back pain e Use of body mechanics can help This way of picking up things tends to in prevent lower back pain. put a burden on your lower back. e nu G 25  3) Use of the principles of body mechanics At the time of providing assistance in walking/lifting/transferring, it is necessary to ensure the safety of the user and reduce the burden on the care worker. Body mechanics refers to the way our body moves based on the relationship between bones and muscles. With the use of the principles of body mechanics, you can provide nursing care safely with a small amount of force. (1) Maintain a wide base of support and lower the center of gravity. Use of a cane can widen the base of support and increase stability. e Explanation of terminology in Base of support u Base of support refers to the area created by connecting every point of contact n of a person with the floor surface for the purpose of supporting his/her body. If a e person is standing with his/her feet apart, the base of support is the area surrounding the outsides of his/her soles. 26 G (2) Bring the center of gravity of the care worker and You can provide care that of the care recipient close together. PART with a smaller amount of 1 force if you are closer to the care recipient. Basics of Nursing Care CHAPTER (3) Use bigger muscles such as thighs. 3 Ensuring safety and risk management in nursing care You can provide nursing care easily by using your bigger muscles. Bigger muscles of The person is lifting the the lower thighs and box with his knee joints buttocks are used. kept straight, using only his lower back muscles. in e e nu G 27  (4) Tuck the user’s arms and legs closer to the center of his/her body as shown in the illustration. This will make the base of support smaller. (5) “Pull” the user toward you rather than “push” him/her. “Pulling” causes less friction. (6) Move your center of gravity as horizontally as possible. It is easier to in e u move things if you use your n whole body. 28 G e (7) Do not twist your body. Set your toes to the direction toward which you are pushing the item. 1 PART A bigger burden will be on your lower Basics of Nursing Care back if you twist your body. CHAPTER 3 Ensuring safety and risk management in nursing care (8) Use the principle of leverage. Create a fulcrum and you can turn a small amount of force into a big one. Fulcrum in e e nu G 29  Points to prevent lower back pain Use the abilities of the user: Confirm the state of the user and use his/her abilities. Use assistive devices: Use a lift, sliding board, etc. Use body mechanics. Review your lifestyle: It is important to engage in a moderate amount of exercise and have proper nutrition and rest. Lift Sliding board Mental health management It is necessary to maintain the mental health of care workers for them to keep engaging in care work. You may have worries and anxieties, but do not take it all on yourself. It is necessary for the health of mind and body to live a regular life. How to maintain mental health in e u Ensure time for meals and Find a way to get rid of Have a conversation/ n sleep. stress that is suitable to consultation with your e you. seniors and colleagues. 30 G 4) Infectious diseases and control measures PART Basic knowledge of infectious diseases 1 An infectious disease is an illness in which a pathogen, etc. enters the body and causes various symptoms. Basics of Nursing Care Users have low resistance to disease. Moreover, when people are living in a group, they have a higher chance of getting infected. Therefore, it is necessary for each care worker to have knowledge of infectious diseases. A person with low resistance to disease is more vulnerable to CHAPTER infectious diseases. 3 Ensuring safety and risk management in nursing care A healthy person is less vulnerable to infectious diseases. Kinds of pathogens Pathogens include viruses, bacteria, fungi, parasites, and others. Perspective of observation It is important to observe users as a control measure for infectious diseases. As per in the perspective of observation, if you find symptoms such as fever, vomiting, diarrhea, e u stomachache, rash, or pale complexion, it is important to report it to medical staff. e n G 31  Three factors of infectious diseases/principle of control measures The three factors of infectious diseases are the source of infection, route of infection, and host. An infectious disease spreads when the three factors are connected. The principle of infection control is to cut the chain off. The chain can be cut off by: (1) Removing the source of infection; (2) Blocking the route of infection; and (3) Improving the host’s (person’s) resistance to disease. Three factors of infectious diseases/principles for cutting them off Host People, Cutting it off. animals, etc. Cutting it off. Source of Route of infection infection Pathogenic Hands, microorganisms, vomitus, urine, feces, supplies, foods etc. Cutting it off. There are three basic rules for controlling infection. (1) Do not bring infection in. (2) Do not take infection out. (3) Do not spread infection. Kinds of routes of infection Droplet infection Airborne infection Contagious infection in e Influenza, etc. Tuberculosis, measles, etc. e nu Norovirus, E. coli O-157, G etc. 32 Kinds of sources of infection 1 PART Basics of Nursing Care Blood Body fluids (saliva, nasal vomitus, urine, feces, etc. mucus, etc.) CHAPTER Standard precautions The basic idea is that “the blood, body fluids, secretion, vomitus, urine, feces, wounds, 3 Ensuring safety and risk management in nursing care skin, mucous membranes, etc. of every patient must be treated as something that has a risk of infection.” Never touch blood, body fluids, vomitus, urine, feces, etc. with bare hands. Be sure to wear gloves when providing nursing care. Example of supplies used Gloves Vinyl apron Mask You need to wash your hands even if you are wearing a pair of gloves. in e e nu G 33  Correct way of wearing a mask Cover your face all the way from your nose to the bottom of your chin. How to change disposable gloves Throw them away with the dirty side inside. Throw them away in the designated place. Change them after each action. How to wash hands and points to remember You should wash your hands either with running water and liquid soap or with an alcohol-based antiseptic hand rub. Parts that are easy to get dirty Parts that are most vulnerable to insufficient hand washing e Parts that are often vulnerable to insufficient in hand washing of the thumbs, and wrists. e nu The parts easy to get dirty are fingertips, area between fingers, back of the hands, base 34 G Washing hands with running water and liquid soap 1 PART Basics of Nursing Care (1) Remove rings and (2) Wet your fingers with (3) Pour an appropriate watches. running water. amount of liquid soap on your palm. CHAPTER 3 Ensuring safety and risk management in nursing care (4) Rub your palms against (5) Rub and wash the back (6) Interlace your fingers to each other to create a thick of your hand with the palm rub and wash the area in lather and wash thoroughly. of your other hand (Both between the fingers of both hands). hands. (7) Wrap the thumb of one (8) Rub and wash the (9) Carefully rub and wash hand with the other hand fingertips of one hand all the way to both wrists. and rub and wash it (Both against the palm of the hands). other hand (Both hands). in e (10) Rinse well with running water. (11) Wipe off moisture with paper towel to dry your e nu G hands thoroughly. 35  Alcohol-based antiseptic hand rub (1) If your hands are visibly (2) Bend your fingers (3) Rub the palm of one soiled, first wash them with slightly and take an hand against that of the liquid soap, following the appropriate amount of other hand. recommended procedure sprayed antiseptic hand rub described on the previous on your hands. page. (4) Rub the fingertips and (5) Rub the back of one (6) Interlace your fingers to the back of the fingers of hand with the palm of the rub the area in between the one hand with the other other hand (Both hands). fingers of both hands. hand (Both hands). (7) Wrap the thumb of one (8) Carefully rub all the way (9) Rub until dry. hand with the other hand to both wrists. and twist and rub it (Both e hands). nu in 36 G e 5) Accident prevention and safety measures PART Users are vulnerable to accidents due to old age or disability. 1 [Prevention of falling and falling off] Basics of Nursing Care Walking/lifting/transferring activities are frequent in the life space of the user, which makes accidents easy to happen. Carefully observe the state of the Confirm whether the user’s clothes user. and footwear are appropriate. CHAPTER 3 Ensuring safety and risk management in nursing care There are times when the user cannot do Slippers can easily come off and they can easily what he/she usually can. make the wearer slip. If the legs of pants are too long, they tend to make the wearer trip on the bottom edge. Inspect the assistive devices before use. Out-of-order equipment can cause accidents. in e e nu G 37  Confirm the environment. It is easy to slip on a wet floor. It is easy to fall if you trip on a cord. Risk management Risk management refers to predicting possible risks, getting involved as an organization, and working to prevent accidents. The way of thinking about predicting risks and preventing whatever is preventable is important. Keeping records properly helps identify risks. It is essential to keep records to prevent accidents. Specific examples of risk management (1) While transferring from (2) Think why it happened. (3) Preventive measures the bed to a wheelchair, the ⇒ The brake was not ⇒ Make sure to confirm that user nearly fell. activated. the brake is activated the ⇒ Record the incident. next time onwards. e ⇒ Share the information in with everyone. e nu 38 G  Disaster preparedness measures PART A disaster refers to the damage caused by earthquakes, typhoons, fire, etc. Facilities 1 and communities regularly have a cooperation system for disasters and emergencies. It is important to be prepared for disasters to avoid panicking even in the case of a sudden Basics of Nursing Care disaster. Prepare necessary supplies. CHAPTER 3 Ensuring safety and risk management in nursing care Implement emergency drills. in e e nu G 39  in e e nu 40 G  PART 2 Mechanism of Mind and Body CHAPTER 1 U nderstanding of the mechanism of mind and body CHAPTER 2 U nderstanding of people in need of nursing care ─ Basic understanding of aging ─ Basic understanding of disorder/disability/ impairment ─ Basic understanding of dementia in e e nu G CHAPTER 1 Understanding of the mechanism of mind and body 1 Understanding of the mechanism of mind 1) Understanding of the mind Each person has his/her own feelings and ideas. The feelings, ideas, and methods of expression differ from person to person. The difference is related to the character of the person, the life he/she has lived, and the education he/she has received. The feelings and ideas change due to aging and are expressed as emotions and will. It is necessary for a care worker to understand the feelings of others. Emotions Being sorry e Being happy Being mad Having fun Changes in the state of mind are visible in facial expressions and attitudes. nu in 42 G e (Will) Will refers to a state of mind to positively do something. Care workers support users to live willingly. Will 2 PART I want to take a walk Mechanism of Mind and Body outside. (Stress) CHAPTER Stress refers to a state of strain in the mind and body. The causes of stress include noise, temperature and other physical factors, fatigue, shortage of sleep, hunger and other bodily 1 Understanding of the mechanism of mind and body factors, anxiety, fear, excitement, and human relations and other psychological/social factors. Causes of stress in e e nu G 43  (Memory) Memory means the ability to remember things without forgetting. Process of memory Recall Memorization Retention (To bring the (To memorize (To retain the information back new things) information) into your mind) Kinds of memory Short-term memory Temporary memory Memory of experiences and Episodic memory specific events Semantic memory Memory of knowledge Long-term memory Memory retained for a long time Memory that is Priming memory unconsciously remembered Memory that one’s body Procedural memory remembers in e e nu 44 G (Needs) Needs refer to a state of mind in which a person wants to get something. A. H. Maslow, a psychologist, advocated a five-level hierarchy of human needs (Maslow’s Hierarchy of Needs). 2 PART Maslow’s Hierarchy of Needs Mechanism of Mind and Body 5 Self-actualization needs Needs for maximizing one’s potential Social needs 4 Esteem needs Needs to be recognized by others 3 Love/belonging needs Needs to be involved with others CHAPTER 2 Safety needs 1 Understanding of the mechanism of mind and body Basic needs Needs to protect oneself 1 Physiological needs Needs to sustain life in e e nu G 45  2 Understanding of the mechanism of body 1)  Mechanism of sustaining life/homeostasis (body temperature, breathing, pulse, blood pressure, etc.) Homeostasis Homeostasis is a biological system in the body that tries to maintain a constant state even if there is a change in the environment. One example is the function that works to bring the body temperature back to normal by sweating to release body heat, when it rises because of the hot air temperature. Functions of homeostasis We sweat when it is hot. (Vital signs) Vital signs refer to the body temperature, breathing, pulse, blood pressure, etc. that indicate the symptoms of being alive. They are the indices that reflect the status of health and any unusual change. (1) Body temperature e Body temperature has a daily rhythm. It is higher during daytime hours and lower during in the night when you are asleep. u As there is a big difference among individuals, normal temperature differs from person n to person. 46 G e Parts of the body from which to measure body temperature and points to remember Armpit If a person suffers from paralysis, take the body PART temperature of the 2 unparalyzed side. Mechanism of Mind and Body Place the tip of Keep your arm the thermometer pressed firmly in your armpit. against your body, while taking the temperature. Others CHAPTER 1 Understanding of the mechanism of mind and body There are thermometers to measure the body temperature at the forehead or in the ear. in e e nu G 47  (2) Breathing Breathing is to take oxygen into the body and get rid of carbon dioxide. Breathing is done regularly and unconsciously. Respiratory rate changes due to various factors such as the age, activity status, mental status, physical condition, and whether the person has a disease or not. Check whether the person is having difficulty breathing and/or having phlegm and if he/ she is hearing odd sounds or not. If a person has extreme difficulty breathing, his/her lips and nails turn to bluish purple. This state is called cyanosis. Respiration rhythm waveform Normal Adult 12-18 times per minute The person is inhaling and exhaling regularly. in e e nu 48 G (3) Pulse Pulse is the movement of blood through arteries caused by heartbeats. Generally, the lower the age is, the higher the pulse rate is. Pulse rate goes down when you get older. Pulse rate changes due to various factors such as the age, activity status, mental status, PART physical condition, and whether the person has a disease or not. 2 Observe the number and rhythm of pulse and whether it is strong or weak. Mechanism of Mind and Body Places to measure pulse rate Temporal artery Brachial artery Locate the pulse on the wrist. Carotid artery Radial artery CHAPTER 1 Understanding of the mechanism of mind and body You can locate the pulse not only on the temporal region, neck, and elbow but also on the inside of the wrist, groin area, and instep. in e e nu G 49  (4) Blood pressure Blood pressure is the force of the blood sent from the heart pushing against the walls of blood vessels (arteries). Blood pressure changes throughout the day. Blood pressure changes due to various factors such as posture, activity status, mental status, and whether the person has a disease or not. Continuous hypertension increases the possibility of developing into a cerebrovascular disease and/or a heart disease. Relationship of the state of heart and blood pressure Systole of the heart Diastole of the heart Blood pressure: high Blood pressure: low Systolic blood pressure (the highest Diastolic blood pressure (the lowest blood pressure) blood pressure) Blood pressure when the heart is Blood pressure when the heart is relaxing contracting (systole) (diastole) in e e nu 50 G The blood pressure goes up when a person: 2 PART gets excited is short of sleep is straining in the toilet gets nervous Mechanism of Mind and Body experiences a sudden engages in sudden is suppressing an urge to change of temperature exercise defecate (or urinate) Diseases caused by hypertension Cerebral infarction CHAPTER Hypertensive Cerebral hemorrhage retinopathy 1 Understanding of the mechanism of mind and body Subarachnoid hemorrhage Angina pectoris Myocardial infarction Arteriosclerosis in e e nu G 51  2) Basic structure of the human body A human body can be divided into the head, cervix (neck), trunk (torso), upper limb (arms) and lower limb (legs). Head Chest Cervix (neck) Abdomen Upper limb Trunk (torso) Lower limb Palm Sole in e e nu 52 G  [Nervous system] The nervous system can be largely divided into the central nervous system and the peripheral nervous system. Central nerves (brain/spinal cord) PART The brain gathers information from the rest of the body, analyzes and makes judgments, 2 and gives orders to the rest of the body. The spinal cord is connected to the brain and makes its own judgment on the information Mechanism of Mind and Body and gives orders based on the function of relaying information from the brain to the rest of the body and vice versa. Peripheral nerves (cerebral nerves/spinal nerves) Peripheral nerves relay information between the central nervous system and the organs of the body. Distribution of Nerves Cerebrum CHAPTER Diencephalon (Interbrain) Mesencephalon Cerebral Brain 1 Understanding of the mechanism of mind and body (Midbrain) nerves Pons 12 pairs Cerebellum Medulla oblongata Central nerves Head Peripheral nerves Spinal cord Chest Spinal nerves Abdomen 31 pairs in e e nu G 53  Regions of the brain and their functions Cerebrum Diencephalon Thalamus (Interbrain) Hypothalamus (Central control of the autonomic nerves, control of body temperature and sleep patterns, etc.) Cerebellum (Coordination of body balance, Mesencephalon regulation of motor Brain stem (Midbrain) movements, etc.) Controls life-supporting Pons functions (such as Medulla oblongata regulation of heart rate, respiration, swallowing, etc.) in e e nu 54 G  Autonomic nerves The autonomic nerves act unconsciously and regulate the functions of internal organs. They consist of sympathetic and parasympathetic nerves. The sympathetic nerves act when the person is tense such as when the person is active or feeling anxiety, anger, stress, etc. PART The parasympathetic nerves act when the person is relaxing such as while sleeping and 2 resting. Mechanism of Mind and Body Activities of the autonomic nerves (sympathetic and parasympathetic nerves) Sympathetic Parasympathetic nerves nerves (Acting) (Resting) Pulse rate increases Heart Pulse rate decreases Peripheral blood Constrict Dilate vessels Goes up Blood pressure Goes down CHAPTER Dilate Pupils Constrict Decreases movement Intestinal tract Promotes movement 1 Understanding of the mechanism of mind and body Bronchi dilate Respiratory tract Bronchi constrict Increases Sweating Decreases The autonomic nerves control the functions of internal organs, etc. When the autonomic nerves are not working properly, your heart and other parts of your body are affected in various ways. in e e nu G 55  [Skeletal system] The skeletal system of the human body consists of a combination of big and small bones. The major functions of the bones include: (1) To support the body; (2) To play the part of the locomotor system; (3) To protect the internal organs; (4) To store calcium; and (5) Hematopoietic function. Physiologically, the human spine is curved in an S shape. Skeletal chart of a human Skull Sternum Cervical vertebrae Humerus Ribs Thoracic vertebrae Radius Ulna Femur Lumbar vertebrae in e e nu 56 G  [Muscular system] The muscular system is related to the maintenance of posture, locomotion, and the formation of internal organs. Back Front 2 PART Deltoid muscle Mechanism of Mind and Body Triceps brachii muscle Pectoralis major muscle Biceps brachii muscle Iliopsoas muscle Gluteus maximus muscle Biceps femoris muscle Quadriceps femoris muscle CHAPTER [Sensory organ system] 1 Understanding of the mechanism of mind and body When we see (sense of vision); hear (sense of hearing); smell (sense of smell); taste (sense of taste); and touch (sense of touch) things, our sensory organs receive various stimuli and send the information to the brain through sensory nerves. Mechanism of vision (2) Retina The retina is a thin layer of tissue that lines the fundus of the eye. It projects the image. in e (1) Crystalline lens The crystalline lens is transparent and shaped like a rugby ball. It adjusts to e nu (3) Optic nerves The optic nerves send the stimulation from the retina G focus on an object. to the brain. 57  Mechanism of hearing (2) Auditory ossicles (1) Tympanic membrane The auditory ossicles The tympanic membrane amplify the sound. receives sound waves as vibrations. (4) Auditory nerves The auditory nerves carry the signals to the auditory cortex of the cerebrum. (3) Cochlea The cochlea changes the vibrations into signals. in e e nu 58 G  [Respiratory system] The inhaled air passes through the respiratory tract. The oxygen is received in the lungs, and the carbon dioxide is discharged through the tract. The respiratory tract is the path the air takes from the nose to the lungs. PART Respiratory organs 2 Nasal cavity Mechanism of Mind and Body Pharynx Larynx Trachea Lung Bronchi CHAPTER 1 Understanding of the mechanism of mind and body in e e nu G 59  Coughs and phlegm When bacteria, house dust, and other foreign matters enter the respiratory tract, the human body tries to get rid of them through coughs and phlegm. Prolonged coughing and change in the color of the phlegm are signs of a problem. [Cardiovascular system] The cardiovascular system carries oxygen, nutrients, waste products, etc., which is circulated throughout the body through blood and lymph vessels. Heart The human heart is divided into four chambers. It keeps contracting and relaxing and pushes the blood continuously like a pump. Blood vessels and blood The arteries are blood vessels that carry blood that contains a lot of oxygen from the heart to the rest of the body. The veins collect blood that contains a lot of carbon dioxide and waste products from all corners of the body and carry it back to the heart and lungs. Capillaries are the branches of blood vessel between arteries and veins. in e e nu 60 G Pulmonary circulation and systemic circulation Systemic circulation Upper body Lungs PART Superior vena cava 2 Pulmonary vein Pulmonary circulation Mechanism of Mind and Body Pulmonary artery Aorta and its branches Left atrium Right atrium Left ventricle Right ventricle Inferior vena cava Systemic circulation CHAPTER Lower body 1 Understanding of the mechanism of mind and body In the pulmonary circulation system, deoxygenated blood changes to oxygenated blood. Systemic circulation and pulmonary circulation Arterial blood flows in the arteries and venous blood flows in the veins and circulate through the body, which is called systemic circulation. The circulation of blood from the heart to the lungs and back to the heart is called pulmonary circulation. Venous blood from the right ventricle of the heart flows through the pulmonary arteries to the lungs during the gas exchange, when it becomes arterial blood e and returns to the left atrium through the pulmonary veins. nu in G e 61  [Digestive system] The human digestive system consists of the gastrointestinal tract from the oral cavity to the anus (esophagus, stomach, small intestine, large intestine) and the organs that secrete digestive enzymes. The system digests and absorbs food, takes in necessary nutrients, and excretes the waste products of digestion as feces. Flow of food and functions of organs (2) Stomach Peristalsis begins when the food is sent to the stomach. The food is digested by the stomach fluid. (1) Esophagus The chewed (3) Small intestine and swallowed Food nutrients are absorbed. food passes through the esophagus into (4) Large intestine the stomach. Nutrients and liquid are further absorbed and feces are formed. (5) Rectum The accumulated feces stimulate the rectal walls and the urge to defecate occurs. (6) Anus The anal sphincter loosens in e u and the feces are excreted. e n 62 G  [Urinary system] The urinary system is responsible for removing waste from the body. Urine is formed in the kidneys and carried to the bladder through the ureters. It is temporarily stored in the bladder and then excreted out of the body through the urethra. 2 PART Mechanism of Mind and Body Kidney Renal pelvis Ureter Bladder Urethra CHAPTER [Endocrine system] 1 Understanding of the mechanism of mind and body The endocrine system is a system of glands that secrete hormones that regulate various functions of the body. Pituitary gland Pineal body Parathyroid gland Thyroid Thymus Adrenal gland Pancreas Ovary (female) Testis (male) in e e nu G 63  [Immune system] Immunity refers to the reaction to resist and protect the body against invading germs, viruses, and other pathogens that exist in the external environment. Lifestyle and state of mind will either enhance or lower immunity. Lifestyle and state of mind to enhance immunity Activities that enhance Factors that lower immunity: immunity: Moderate exercise Aging Immunity Laughing a lot Shortage of sleep Keeping the body warm Fatigue Well-balanced diet Strenuous exercise Psychological stress in e e nu 64 G 3) Mechanism of the human body related to rest and sleep 1. Need for rest and sleep To rest means to stop being active and to relax mind and body. Taking appropriate rest will help you recover from fatigue and serve as a source of a happy life. PART Sleep lets the brain take a break regularly. It is essential for the health of your mind and 2 body. Mechanism of Mind and Body Positive effects of good quality sleep Consolidation of Removal of fatigue from memories mind and body Increased immunity Relief of stress CHAPTER 1 Understanding of the mechanism of mind and body 2. Mechanism of sleep Everybody has an internal body clock that operates on a cycle of 24 hours, keeping a rhythm. The internal body clock is reset by the morning’s sunlight and starts keeping a regular rhythm. in e e nu G 65  3. Cycle of sleep A night’s sleep consists of the repetition of non-REM sleep (deep sleep) and REM sleep (shallow). During non-REM sleep, the brain is in a state of resting. During REM sleep, the brain is close to the state of being awake. It is said that you have dreams during REM sleep. Non-REM sleep REM sleep The brain is sleeping. The brain is not sleeping. You do not have dreams. You have dreams. 4. Characteristics of sleep in elderly people Sleeping hours become shorter. The length of non-REM sleep (deep sleep) becomes shorter, which makes them wake up frequently due to the urge to urinate, small noises, etc. in e e nu 66 G  e PART 2 Mechanism of Mind and Body CHAPTER 1 Understanding of the mechanism of mind and body in 67 e nu