九州大学 研究者情報
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藤田 君支(ふじた きみえ) データ更新日:2018.06.26

教授 /  医学研究院 保健学部門 統合基礎看護


主な研究テーマ
アジアの人工股関節患者の座式生活におけるQOLデータベースの構築
キーワード:人工股関節 アジア QOL
2015.04~2018.03.
強度表示型活動量計の携帯による糖尿病患者の身体活動量への効果
キーワード:糖尿病 運動療法 身体活動
2016.04~2018.03.
認知症高齢者の介護者におけるコンピテンシー
キーワード:高齢者 認知症 介護者 コンピテンシー
2016.06~2018.06.
人工股関節・膝関節患者の経年的QOL評価の集積と再置換予防に関する研究

キーワード:人工股関節、人工膝関節、再置換、QOL
2012.04~2015.03.
変形性関節症患者の手術前後のQOLとアクティビティに関する研究
キーワード:三次元動作解析、QOL、活動量、変形性関節症
2009.04~2012.03.
in vivo実験を代行する関節シミュレータによる深屈曲用人工膝関節の評価試験
キーワード:in vivo実験、QOL評価、人工膝関節、動作解析、リスク分析
2012.04~2015.03.
糖尿病患者における受診再開支援システムの開発-生活習慣記録機の活用-
キーワード:糖尿病、加速度計、血糖自己管理測定、行動変容
2005.04~2008.03.
長期療養施設における非薬物療法としてのユーモアセラピーモデルの開発
キーワード:ユーモアセラピー、認知症、介護施設
2006.04~2008.03.
人工股関節患者と人工膝関節患者の生活行動量と多面的なQOLの長期評価
キーワード:QOL、生活行動、人工股関節、人工膝関節
2009.04~2012.03.
従事しているプロジェクト研究
人工股・膝関節患者の経年的QOL評価の集積に関する研究
2013.03~2015.03, 代表者:藤田君支, 九州大学大学院医学研究院保健学部門
人工股関節患者のQOLとライフスタイルに関する国際比較.
研究業績
主要著書
1. 藤田 君支, よくわかる看護研究論文のクリティーク, 日本看護協会出版会, 2014.06, 本書は看護職や保健学領域の研究者向けを対象とした研究論文の包括的なクリティーク実践本である。.
主要原著論文
1. 藤田君支、牧本清子, 人工股関節患者が選ぶ生活の重要な領域と満足度の変化, 日本看護研究学会雑誌, 2016.06.
2. Kimie Fujita, Makimoto K, Mawatari M, Three-year follow-up study of health related QOL and lifestyle indicators for Japanese patients after total hip arthroplasty., J Orthop Sci., 10.1016/j.jos.2015.11.004., 21, 2, 191-198, 2016.04, BACKGROUND:In non-Western countries including Japan, activities requiring deep flexion of the hip joint, such as seiza (kneeling with calves tucked under the thighs and buttocks resting on the heels) and using squat toilets are commonly practiced. The purpose of this study was to assess longitudinal changes in traditional health-related quality of life measures and measures of physical functions associated with lifestyle for Japanese patients pre-surgery and after total hip arthroplasty.
METHODS:Consecutive primary total hip arthroplasty patients between July 2003 and November 2006 were eligible. Patients were measured preoperatively and at 6 weeks, 1 year and 3 years postoperatively. Patients completed the EuroQol 5D, the Western Ontario and McMaster Universities Osteoarthritis Index and items related to Japanese lifestyle activities such as squatting. Changes in these scale scores across the four time points were tested, and we examined predictive factors of EuroQol 5D score at 3-year follow-up using multiple linear regression.
RESULTS:Of 1103 eligible patients, 576 completed questionnaires at all four time points. By 6 weeks post-surgery, reductions in pain and improvements in physical function and stiffness became highly significant, and improvements continued to 3 years postoperative. In contrast, improvements were far more limited for items related to Japanese lifestyle functions such as seiza and use of a Japanese squat toilet, even 3 years after surgery. Predictive factors of EQ5D at 3-year post THA were WOMAC pain and physical function, seiza, age and comorbidity measured at 3-year post THA.

CONCLUSION:

The rate of improvement in QOL requiring deep flexion of the hip joint was much slower than that in QOL related to Western lifestyle. Our study suggests a need for lifestyle modification for THA patients in the other countries where kneeling and squatting are commonly performed..
3. Pi-Chu Lin, Fujita K, Su-Yu Chang, Yo-Yi Liu, Patient Life Experience and Activity of Daily Living before and after Total Knee Arthroplasty, Open Journal of Nursing, 2016(6):, 6, 6581-671, 2016.06.
4. Yuriko Myoji, Kimie Fujita, Masaaki Mawatari, Yasuko Tabuchi, Changes in sleep-wake rhythms, subjective sleep quality and pain among patients undergoing total hip arthroplasty, International Journal of Nursing Practice, 10.1111/ijn.12345, 21, 6, 764-770, 2015.12, [URL], We evaluated nocturnal sleep-wake rhythms and subjective sleep quality on the first postoperative night compared with the preoperative night in 34 patients who had total hip arthroplasty (mean age: 61.9 years; 82.4% female) under spinal anaesthesia. We also examined secondary factors related to sleep disturbances after surgery. Patients wore an accelerometer (actigraph) during the preoperative period and the first postoperative night to track sleep-wake rhythms. Secondary end-points were postsurgical pain and low back pain. Sleep parameters were measured objectively by actigraphy, and subjective sleep quality was measured by the Oguri-Shirakawa-Azumi Sleep Inventory, Middle-Aged and Aged Version and found to worsen significantly after surgery. Actigram data showed a reduction in actual sleep time from 353.7±121.2min preoperatively to 263.8±104.4min postoperatively. The data indicate that normalized continuous sleep time is important for patient healing and well-being and that postoperative sleep disturbance is related to low back pain more than to postsurgical pain..
5. Kimie Fujita, Zhenlan Xia, Xueqin Liu, Kiyoko Makimoto, Lifestyle and health-related quality of life in Asian patients with total hip arthroplasties., Nursing and Health Sciences, 2014.09.
6. 明時由里子, 藤田 君支, 田渕 康子, 腰椎麻酔下で人工股関節全置換術を受けた患者のメラトニン分泌リズムとストレス関連ホルモンとの関連, 日本看護研究学会, 2015139431, 37, 4, 73-81, 2014.09, 研究目的】腰椎麻酔下で人工股関節全置換術を受けた患者の尿中メラトニンを調査し,術後の分泌動態を明らかにする。さらに,ストレス関連ホルモン・疼痛および環境要因との関連を評価する。【研究方法】尿中メラトニン量は手術当日の22時,2時,6時に測定し,術後1日目朝に血清中のコルチゾール・アドレナリン・ノルアドレナリン量を測定した。【結果】分析対象者は33名(平均年齢61.6歳,女性が81.8%)で,腰椎麻酔手術後に64%の患者が尿中メラトニン量の変動がない,あるいは早朝に上昇する等の異常なメラトニン分泌リズムを示した。異常なメラトニン分泌リズムを示した患者とストレス関連ホルモンが異常値を示した患者は一致せず,メラトニン分泌リズムはストレス関連ホルモンによって影響を受けていないことが示された。術後の腰背部痛は創部痛より高く,ストレス関連ホルモンとの関連があり,術後の疼痛管理が重要である。.
7. Kimie Fujita, Kiyoko Makimoto, Riki Tanaka, Prospective study of physical activity and quality of life in Japanese women undergoing total hip arthroplasty.
, Journal of Orthopaedic Science , 18(1):45–53, 1, 45-53, 2013.01.
主要学会発表等
1. Kimie Fujita, Yuriko Myouji, Improvement of the physical activity and quality of life after primary total
knee arthroplasty:Two-year postoperative evaluation and comparison
with healthy persons, 18th East Asia forum nursing scolarship conference , 2015.02, Purpose
The purpose of this study was to determine objective changes in the physical activity and
quality of life (QOL) of patients before, and 6 and 24 months after undergoing total knee
arthroplasty (TKA). Furthermore, we compared the physical activity and QOL of the patients
24 months after TKA with that of healthy persons.
Design
This was a longitudinal study.
Methods
Twenty-seven participants were selected among patients who were indicated to undergo
primary TKA and patients who had undergone primary TKA 6 or 24 months prior. Physical
activities within 1 week were measured using a small pedometer with an accelerometer
(Lifecorder EX, Kenz, Japan) to determine the number of steps walked and the intensity of
physical activity (<3 and ≥3 metabolic equivalents [METs] h/week). The QOL was assessed
by conducting a self-reported questionnaire survey using the Short-Form 8-item (SF-8)
questionnaire and Oxford knee score (OKS).
Ethical considerations: The participants were informed that (1) study participation was
voluntary, (2) study participation would not affect their treatment, and (3) only aggregated
data would be presented. Written informed consent was obtained from all the participants.
The study was approved by the ethics committee of Saga University of Medicine.
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Results
This study included 3 men and 24 women, aged 73.6 ± 6.3 years (mean ± SD). The mean
number of steps walked and the intensity of physical activity ≥ 3 METs differed significantly
between before, and 6 and 24 months after TKA (p < 0.001). The number of steps walked
before TKA was 3461 steps/day; 6 months after TKA, 4914 steps/day; and 24 months after
TKA, 5133 steps/day. The intensity of physical activity ≥ 3 METs was 2.5, 5.9, and 6.9
h/week, respectively. Among the healthy persons (age- and sex-matched with the TKA
patients), the number of steps walked was 5948 steps/day, and the intensity of physical
activity ≥ 3 METs was 8.1 h/week. No significant difference was observed between the TKA
patients who had undergone TKA 24 months prior and the healthy persons. The preoperative
SF-8 scores (Physical Component Summary [PCS] score, 38.2 points; Mental Component
Summary [MCS] score, 49.3 points) greatly improved 24 months after TKA (PCS score, 45.3
points; MCS score, 52.6 points).
The total OKS improved 6 and 24 months after TKA compared with that before TKA.
However, of the patients, 44.4% had moderate to extreme difficulty in kneeling down and
getting up afterwards or they could not do it, and 29.6% answered the same for walking down
the stairs.
Conclusions
The physical activity and QOL of the patients improved 6 and 24 months after TKA, and the
patients had a relatively good recovery compared with healthy persons. However, at 24
months after TKA, patients still had difficulty in kneeling down and getting up afterwards and
walking down the stairs.
.
2. Kimie Fujita, Changes in the Euro-Qol and depression, and post-operative patient
satisfaction 5 years after total hip arthroplasty, 18th East Asia forum nursing scolarship conference , 2015.02, Purpose
Total hip arthroplasty (THA) is a widely accepted orthopedic surgical procedure performed to
relieve pain and improve physical functions. However, research on long-term quality of life
among THA patient is limited. The purposes of this study were to 1) examine changes in the
Euro-QOL (EQ5D) and depression in patients before THA and five years after THA and 2)
assess post-operative satisfaction and anxiety evaluated by self-administered questionnaire.
Design
This study is a longitudinal, quantitative, and descriptive study.
Methods
Consecutive patients going through primary THA at Saga University Hospital, Japan,
between July 2003 and November 2006 were eligible for the study. The preoperative
questionnaires included baseline demographic variables. Surgical procedure, diagnosis and
post-surgical complications requiring treatment were obtained from the medical record. The
study was approved by the ethics committee of Saga University. The EQ5D and depression
subscale of Arthritis Impact Measurement Scale(AIMS)2 were administered at the preoperative
period and post-operative at five years. Participants were also asked to rate the
original 10 items regarding post-operative satisfaction, such as “no pain of daily life” and
working. Higher scores indicate better satisfaction. In addition, 3 items about anxiety
regarding postoperative dislocation and loosening were asked for these participants. Higher
scores indicate stronger anxiety. Responses of these items were based on a 4-point Likert
scale.
Results
298
During the study period, 1004 preoperative patients agreed to participate. Of these, 236
participants did not return their questionnaires or were too many missing data after THA, and
100 participants were excluded from analysis because of operation of the other hip within five
years after THA. Sixty-hundred and sixty-eight participants completed both pre- and post-
THA surveys. The valid-response rate was 66.5%. The improvement in the mean scores for
the EQ5D and depression scales between the pre-operative and post-operative periods were
highly significant (p<0.001). The most of the postoperative satisfaction items showed high
mean scores. However, the “enjoy exercise” item had a low mean satisfaction score. In
addition, mean score of the anxiety of postoperative loosening was higher than that of
dislocation loosening.
Conclusions
Quality of life in participants who underwent surgery sustained improvement five years after
THA, and the postoperative satisfaction remained high. However, participants reported much
less satisfaction for exercise, and they were more concerned about loosening than dislocation.
In order to assess long-term QOL in THA participants, health professionals need to pay
attention to changes in patients’ concern over time..
3. 明時由里子, 藤田 君支, 中島史子, 井手衆哉, 65歳以上の人工膝関節患者の手術前後の生活活動量, 日本老年看護学会, 2014.06.
学会活動
所属学会名
九州慢性看護研究会
日本運動器看護学会
日本老年看護学会
日本慢性看護学会
日本看護研究学会
日本看護科学学会
日本糖尿病教育・看護学会
学協会役員等への就任
2013.09~2017.09, 日本看護研究学会, 評議員.
2013.09~2017.09, 日本老年看護学会, 評議員.
2014.04~2017.03, 日本慢性看護学会, 評議員.
2011.04~2017.03, 日本看護科学学会, 和文誌査読委員.
2015.04~2017.03, 日本看護研究学会九州沖縄地方会, 会長.
2015.04~2017.03, 日本看護研究学会九州沖縄地方会, 会長.
2011.04~2015.03, 日本看護科学学会, 和文誌査読委員.
2014.04~2016.03, 日本慢性看護学会, 評議員.
2013.09~2015.09, 日本老年看護学会, 評議員.
2013.09~2015.09, 日本看護研究学会, 評議員.
学会大会・会議・シンポジウム等における役割
2017.09.16~2017.09.17, 日本糖尿病教育・看護学会学術集会, 学術集会学会長.
学会誌・雑誌・著書の編集への参加状況
2009.06~2017.06, Japan Journal of nursing science, 国際, 査読委員.
2010.06~2017.06, 日本老年看護学会, 国内, 査読委員.
2008.06~2017.06, 日本看護研究学会, 国内, 査読委員.
2011.06~2017.06, 日本看護科学学会, 国内, 査読委員.
2009.06~2015.06, Japan Journal of nursing science , 国際, 査読委員.
2010.06~2015.06, 日本老年看護学会, 国内, 査読委員.
2008.06~2015.06, 日本看護研究学会, 国内, 査読委員.
2011.06~2015.06, 日本看護科学学会, 国内, 査読委員.
学術論文等の審査
年度 外国語雑誌査読論文数 日本語雑誌査読論文数 国際会議録査読論文数 国内会議録査読論文数 合計
2015年度 12 
2014年度   13 
その他の研究活動
海外渡航状況, 海外での教育研究歴
高雄医学大学, Japan, 2014.10~2014.10.
ハワイ大学, UnitedStatesofAmerica, 2015.03~2015.03.
台北医学大学, Taiwan, 2015.02~2015.02.
台北医科大学, Taiwan, 2014.04~2014.04.
研究資金
科学研究費補助金の採択状況(文部科学省、日本学術振興会)
2018年度~2022年度, 基盤研究(C), 分担, 認知症ワーキングケアラーのエンパワメントを高める教育支援プログラムの開発と検証.
2015年度~2017年度, 基盤研究(C), 分担, 中等度認知症高齢者の家族のためのレスパイトケアモデルの開発に向けた基礎的研究.
2016年度~2018年度, 挑戦的研究(萌芽), 分担, 肝移植レシピエントに対する術後の身体活動基準の確立に向けた基礎的研究.
2014年度~2018年度, 基盤研究(C), 分担, 人工股関節患者のライフスタイルの違いや豪雪寒冷地による影響と対策ツールの開発
研究.
2012年度~2014年度, 基盤研究(B), 分担, in vivo実験を代行する関節シミュレータによる深屈曲用人工膝関節の評価試験.
2015年度~2018年度, 基盤研究(C), 代表, アジアの人工股関節患者の座式生活におけるQOLデータベースの構築.
2012年度~2014年度, 基盤研究(C), 代表, 人工股・膝関節患者の経年的QOL評価の集積と再置換予防に関する研究.

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