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
2 Cognitive
7 Genitourinary
3 Affective
8 Gastro internal
4 Neuromuscular 9 heart /chest-related
Symptom severity scale
5 Musculoskeletal 10 Airway or mucous
membrane-related
Result 1
Users’ Demands to Nurse
11%
21%
46%
22%
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(Sup
porting group)
Dentist
NCR
Public health
nurse
Beautician
Midwife
Architect
Industrialist
TAKAOKA CLINIC at Tsu, Mie, JAPAN
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