京都大学 / 0048 / 新制・論文博士 / 博士(医学) / 乙第13165号 / 論医博第2152号 / 新制||医||1029(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 篠原 隆司, 教授 宮本 享, 教授 近藤 玄 / 学位規則第4条第2項該当 / Doctor of Medical Science / Kyoto University / DFAM

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Adults with mental retardation (MR) experience a greater number of falls than their non-disabled peers. To date, efforts to understand the causes for these falls have primarily involved qualitative studies that use largely subjective measures to quantify stability. Performing a more objective biomechanical gait analysis may better explain the reasons for these fall accidents and provide repeatable measures that can be used for comparison to determine the effectiveness of interventions intended to reduce slip-related falls. A gait analysis was conducted to quantify normal walking and slip response characteristics for adults with MR as well as a group of non-disabled age- and gender-matched peers. Kinetic and kinematic data were collected and a number of variables relating to gait pattern, slip propensity, and slip severity were calculated to compare the differences between groups. Results showed that adults with MR exhibit slower walking speeds, shorter step lengths, and greater knee flexion at heel contact suggesting that their gait patterns share more similarities with the elderly than with healthy adults of an equivalent age. Unexpectedly, the MR group demonstrated a lower required coefficient of friction (RCOF) and slower heel contact velocity which, alone, would suggest a reduced slip propensity as compared with the healthy group. A greater peak sliding heel velocity and greater slip distance measures, however, indicate greater slip severity for the MR group. The findings of this study suggest that falls in this population may be attributed to delayed response to slip perturbation as measured by slip distances. / Master of Science

This descriptive study was done to provide information on the number of hours and clinical experience students received during nursing education which might equip them with skills required for mental retardation nursing. Registered Nurses Associations for each province assisted in the study by providing lists of nursing schools in their province. Of the 142 nursing schools having a graduating class in 1969, 140 were studied. The urgency of the problem was shown when it was noted that an estimated 3 percent of the population of Canada were mentally retarded. Several commissions have been done on this topic in the past decade in Canada. Some studies of this general nature have been done in the United States. Review of the literature indicated that no previous studies had been done on this topic in Canada. A questionnaire was constructed to obtain data relating to placement of mental retardation experience, hours of theory and clinical experience provided and the year of nursing education in which the experience occurred. Questionnaires were mailed to the schools, completed by them, and returned. It was found that diploma schools tended to provide between 0 to 8 hours of theory and clinical experience in mental retardation whereas university schools tended to offer up to 12 hours of experience. Most nursing education in mental retardation occurred in pediatrics or psychiatric programs or in combinations of these and other courses. Mental retardation nursing education tended to occur in the next to the last year of the program for all schools. Many schools, however, indicated that mental retardation experience was not included in the school curriculum at all. It appeared that very little theory and clinical experience in mental retardation was being given students enrolled in nursing schools in Canada. The relative lack of planned clinical experience with retarded individuals was surprising. Several problems and limitations were encountered in conducting the study, particularly concerning data collection and the tool used for data collection. The data had to be collected in two phases from two different sources, home schools and affiliate schools, to obtain accurate data. Studies could be done to focus attention on current problems in nursing the mentally retarded, related to the need for inclusion of theory and clinical experience in the curriculum of nursing schools. Studies could also be done to determine time allotment, placement and specific mental retardation content in current nursing programs. Qualitative studies could be done to show the possible effect of staff knowledge of mental retardation on the care provided to mentally retarded patients. This study was an attempt to show the need for review of nursing education programs in relation to the inclusion of mental retardation theory and clinical experience in the curriculum of nursing schools. / Applied Science, Faculty of / Nursing, School of / Graduate