労働科学のバックナンバー
2007/08/10発売号 (83巻3号)

出版社：労働科学研究所
発送予定時期：ご入金確認後 1～2週間
送料：100円 (1500円以上のご購入で送料無料)

現在在庫はありますが、ご入金のタイミングにより品切れとなる場合がございます。万が一品切れの場合は、ご注文はキャンセルし全額ご返金いたしますのでご了承ください。

■労働科学の目次

瀬尾明彦，堂本槙一郎，土井幸輝
寄りかかり型立位作業補助具の腰部と下肢の負担軽減効果
労働科学，83（3），97～106，（2007）

　本研究では，寄りかかり姿勢を取りやすくすることで立位あるいは座位での作業負担の軽減を目
指す新しい寄りかかり型立位作業補助具の効果を検討した。製造現場の立ち作業を模した作業を，補
助具に寄りかかった姿勢で作業する場合と通常の座位および立位で作業する場合とで比較した。その
結果，本補助具使用時は，通常座位に比べて腰部椎間板圧縮力が約25％，通常立位に比べて腰部の関
節モーメント比が約60％減少し，腰部負担が軽減されることが明らかになった。しかし下肢負担につ
いては，通常座位に比べて下肢活動量は約3倍と高いものの，通常立位と比べると下腿腫脹が約2.5倍
と大きく，下肢負担の軽減効果は限定的であることが明らかになった。（図９）（自抄）
キーワード :立位作業；寄りかかり型立位作業補助具；腰部負担；静的下肢負担 ;足底圧

Akihiko SEO，Shinichiro DOMOTO， Koki DOI
Effect of Leaning Aid for Standing Work on Low Back and Lower Leg Load
THE JOURNAL OF SCIENCE OF LABOUR，83（3），97～106，（2007）
　
　 This study investigated the effectiveness of a new leaning aid for reducing the loads
on the lower back and the lower leg while performing work while standing. One experiment
was conducted to draw a comparison between work performance while using the leaning aid
and normal sitting and standing work. The inclination angles of the aidﾕs seating surface
were 30 and 60 degrees relative to 0 degree as the horizontal seating face. Ten healthy
male subjects were asked to work under the following four working conditions: using the
30 and 60 degree leaning aids, during normal standing, and while in a sitting posture.
Each work period was 30 minutes. We used 2-dimensional static biomechanical analysis to
estimate the compression force on the lumbosacral discs and the low back moment ratio for
each condition. Low back load was evaluated on the basis of these estimated values. We
also measured foot pressure as an index of lower leg activity and monitored lower leg
swelling through the use of bioelectrical impedance measurement during work. We evaluated
lower leg load based on the above two sets of data. Regarding lower back load, the
compression force when using the aid decreased by about 25 percent compared to that
during sitting. The low back moment ratio when using the aid was reduced by about 60
percent compared with that during standing. In regard to lower leg load, the amount of
lower leg activity when using the aid was about 3 times larger than that when sitting.
However, lower leg swelling when using the aid was about 2.5 times larger than when in a
standing posture. These results suggest that lower back load can be decreased by the use
of our leaning aid. We also found that using the aid has a restrictive effect on reducing
lower leg load.

Key words : Standing work， Leaning aid for standing work， Low back load， Static lower
leg load, Foot pressure.

内藤堅志，阿部眞雄，飯田裕康，前原直樹，村上保夫
医療情報管理・伝達システムの運用と医療事故防止効果についての調査研究
－情報伝達および看護記録の実態と病棟業務との関連－
労働科学，83（3），107～137，（2007）

　紙カルテと各種伝票類による病棟医療業務の実態を解析し、現状の問題点と今後の方向性を検討し
た。対象病棟では、伝票処理用具（管理ボックス）が病棟内情報共有に役立っていた。一方、他の部
署への情報伝達・確認および各種記録類の作成が看護業務を圧迫していた。看護記録に関しては、記
録内容や時刻記録の不正確さなどの問題点が見出された。これらの記録実態の背景には、業務の煩雑
さや過密状況の存在が推測された。今後導入される総合的な医療情報システムでは、ベッドサイドで
の記録、および患者毎に集約されているlongitudinalな情報を、看護スタッフ毎の業務に合わせて
cross-sectionalな情報に変換・呈示し、現場での情報処理負担を軽減させることが重要課題であ
る。（図11，表９）（自抄）
キーワード：医療事故防止；病棟看護業務；医療情報処理；看護記録；記録過程

Kenshi NAITO, Masao ABE, Hiroyasu IIDA, Naoki MAEHARA, Yasuo MURAKAMI
A Study on Operations of Medical Information Management and Communication Systems and
heir Implications for Accident Prevention: Relation Between Actual Practices of
Transmitting Information and Keeping Nursing Records and Ward Nursing Services
THE JOURNAL OF SCIENCE OF LABOUR，83（3），107～137，（2007）

　Actual situations of ward medical services by means of paper-based medical charts and
various information slips were analyzed and related issues from the viewpoint of medical
accident prevention were discussed with a view to examining future directions toward
electronic medical information processing systems. We studied a relationship between
actual records of medical charts and nursing-care work through examining work tasks of
two nurses by field studies in a ward with 34-beds of a cardiovascular disease hospital
in Tokyo. In the study, nursing-care of those work, while tasks of general nursing-care
and leaderﾕs those, were observed in nine hours of day-time work by time-budjet studies.
In the hospital wards studied, information control boxes each indicating existing
information slips relating to a particular patient were used and contributed to sharing
care-related information and detecting newly generated information within each ward.
However, much time was being spent for transmitting and confirming information involving
other posts and for creating various nursing records. This resulted in hampering the
execution of primary nursing duties.
In keeping nursing records, many problems were noted as to inaccurate contents of the
records and inaccuracy of time recorded resulting from a variety of reasons, such as plan
entries after performing tasks, joint seal impressions after serial procedures, non-
placing of seals after performing procedures, trying to balance accounts, etc. As factors
behind these recording practices, cumbersome procedures and overloaded tasks could be
pointed out. Examples of trying to balance accounts were seen in cases where the formal
permissions from an attending physician were delayed due to inability to contact the
physician as to abrupt withdrawal of medication following the complaints of patients. In
such cases, recording of the withdrawal were done after prolonged delays. Delays in
communicating verbal instructions of physicians added to overloaded work due to redoing
the tasks instructed. It appeared necessary to establish recording systems allowing
entries at bed side with automatic time records and to secure flexible communication
routes for consulting physicians and other responsible persons regarding ward nursing
services. The need for introducing slip forms for recording verbal instructions received
was also suggested.

In developing comprehensive medical information systems (including electronic medical
records and ordering systems) it remains critical from the perspective of accident
prevention to transform and display the longitudinal information gathered and
individualized for each patient into the cross-sectional form arranged in accordance with
serial tasks performed by each member of the nursing staff. The information systems thus
reducing the information processing loads of the nursing staff are considered essential.

Key words: Prevention of a medical accident; Ward nursing servies; Medical information
processing; Nursing Documentation; Recording process