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Family caregivers' sense of security benefits older adults who receive home care. Advance care planning (ACP) is reported to affect family caregivers' experience positively, but it might differ depending on family caregivers' kin relationships with the older adults. This study aimed to investigate whether ACP for older adults in home care settings is associated with family caregivers' sense of security and whether such an association depends on the family caregivers' status as spouses or adult children. Clarifying this association may offer practical support for implementing ACP while maintaining family caregivers' sense of security. This study was part of a prospective cohort study in Japan. The participants were older adults who used home-visit nursing services, their family caregivers, and the nurses who cared for them, recruited through the professional associations of home care nurses across Japan. Family caregivers answered a sense of security questionnaire, and the nurses were asked whether ACP was conducted. Data were collected three times from nurses and twice from family caregivers over a three-month period from August 2019 to June 2020. Multivariate logistic regression analyses were performed to examine the association between ACP implementation and positive changes in the sense of security scores after three months. Data from 169 cases were analyzed; 28.1% of the family caregivers were men and 55.6% were spouses. ACP was performed in 53.8% of the cases. The multivariate analysis showed an interactive effect between ACP implementation and family caregivers' kin relationships. For spouses, ACP was significantly associated with a positive change in their sense of security. For adult children, such an association was not found. Thus, ACP might have a positive effect on caregiving spouses' sense of security. Adult child caregivers, who often have multiple responsibilities and have difficulties facing their parents' physical decline, may need support in addition to ACP. [ABSTRACT FROM AUTHOR]

Enhancing the voluntary supportive actions of older adults towards other community‐dwelling citizens is an important measure for a healthy community. Volunteering action in adulthood is related to the volunteering actions of older adults' parents, which they remember from their youth. In this study, the association between parents' former voluntary supportive actions and the current voluntary supportive actions of older adults is explored. Questionnaires were distributed to community‐dwelling citizens aged 65 years and above, in Tokamachi city, Niigata Prefecture, Japan (response rate: 81.7%). Participants self‐reported their current voluntary supportive actions and reported on their parents' former voluntary actions during their youth. The results indicated that the current voluntary supportive actions of the study participants were related to the former voluntary actions of their parents (OR: 2.28, 95% CI: 1.62–3.20). Moreover, the participants were more likely to extend support in contexts which are more closely related to one's private life, only when their parents provided support in those private contexts. The study provides implications for the importance of considering life experiences when facilitating voluntary supportive actions and renders information on how unique strategies should to be implemented to involve individuals who are unfamiliar with volunteering actions. [ABSTRACT FROM AUTHOR]

Family caregivers provide long‐term, home‐based, informal medical care to patients with special healthcare needs. We examined whether informal care involving medical device use is associated with caregiver burden, considering potential risk variables as moderators. Data were collected from March to May 2019 through a Japanese public visiting care system. This system is offered to patients with severe chronic or intractable disease or impairment. After contacting government‐certified offices that provide visiting care systems, the offices that agreed to participate invited dyads of patients and caregivers to complete our questionnaire. To focus on new parameters other than the caregiver factor that had been clarified previously, we aimed to analyse the data from patient–caregiver dyads. Using a questionnaire‐based cross‐sectional design, we asked participants about caregiver and patient characteristics, care types, and caregiver burden using the Zarit Caregiver Burden Interview. Logistic regression analyses were conducted to test the association between caregiver burden and informal medical care. Data from 371 complete patient–caregiver dyads were analysed; 49.3% showed high caregiver burden, and 40.4% were administering at least one informal medical care procedure. Univariate analyses indicated a relationship between high caregiver burden among caregivers who slept less, provided care for longer periods daily, performed medical care procedures and cohabited with patients. Importantly, logistic regression analyses indicated a significant relationship between high caregiver burden and care involving multiple medical procedures (i.e. 4–6 procedures with medical devices; adjusted odds ratio (AOR) = 2.03, 95% confidence intervals (95% CI) = [1.01, 4.09]). In propensity‐matched participants (n = 314), results continued to show that multiple medical care procedures were significantly related to high caregiver burden (AOR = 2.19, 95% CI [1.14–4.22]). The effects of non‐medical informal care on caregiver burden were moderate. This result suggests that more intensive interventions are required for patients with multiple medical care needs to reduce caregiver burden. [ABSTRACT FROM AUTHOR]

Home clutter can adversely affect work performance, health and well‐being. Clinical‐level hoarding disorders usually manifest during early adolescence, so early detection and prevention of subclinical hoarding tendencies are essential. This study aimed to evaluate a community‐based programme for individuals with poor organising and decluttering skills who volunteered to receive education on how to organise their homes. We conducted an open‐label randomised controlled trial beginning in January 2016 in Tokyo. We enrolled 61 volunteers aged 12–55 years with problems with organising and decluttering. A workshop and home visit group (n = 30) attended four workshop sessions on organising skills and received a visit from a home organiser. The home visit only group (n = 31) only received the home organiser visit. The primary outcome was Saving Inventory‐Revised (SI‐R; Japanese version) scores. The secondary outcomes were Clutter Image Rating Scale and Rosenberg Self‐Esteem Scale (Japanese version) scores. Between‐group changes from baseline to 7 months were analysed using a general linear model. At follow‐up, the SI‐R scores of both groups had improved. The mean change from baseline in SI‐R scores was −20.8 (standard deviation = 9.8) and −13.1 (standard deviation = 14.3) in the workshop and home visit and home visit only groups, respectively. The estimated between‐group difference in SI‐R score changes from baseline (adjusted for baseline SI‐R score) was non‐significant at −5.7 (95% confidence interval, −12.4 to 0.9; p =.089). However, the difference was significant in the univariate model: −7.2 (95% confidence interval, −13.7 to −0.8; p =.029). Although both groups improved, after adjusting for baseline values and participant characteristics, there was no significant difference between the groups. Our results suggest that a workshop‐style educational intervention and assistance and advice from professional organisers may help to improve the living conditions of people with hoarding tendencies. [ABSTRACT FROM AUTHOR]

The social connection of mothers is important for the sound development of children and the prevention of child maltreatment. Understanding the attributes of mothers at risk of isolation enables community workers to support vulnerable mothers. This cross‐sectional study aimed to identify the socioeconomic predictors of isolation risk for mothers and was conducted in Japan between December 2018 and February 2019. The self‐administered questionnaire included the Social Connectivity of Mother Scale along with maternal age, marital status, employment status, education, number of children, years of child‐rearing experience, whether childcare or kindergarten was used, family structure, years of residence, housing type, family finances, and level of neighbourhood interactions. There were 510 valid responses (51.6%). In the multiple regression analysis, five socioeconomic characteristics were associated with mothers' low social connectivity: the standardised coefficient of the maternal age of 20–24 was −0.12 (p = 0.004), lack of childcare or kindergarten usage, −0.09 (p = 0.032), and poor family finances, −0.09 (p = 0.031); mothers' perception of neighbourhood interactions was found to be poor at −0.29 (p < 0.001). The model did not take into account the effects of family finances, and the scores were low when the highest level of education of the mother was junior high or high school. Mothers' perception of neighbourhood interactions was a significant predictor of isolation risk, along with maternal age, education level, and financial comfort. Our findings give policymakers, community workers, and community leaders an insight into the importance of cultivating interactions among neighbourhood communities. [ABSTRACT FROM AUTHOR]

Older adults' preference regarding where they want to spend their end‐of‐life (EOL) has been reported to be a significant predictor of the actual EOL location. Home‐care nurses have often been reported to try involving single older adults' neighbours in the support network of the older adults (community involvement activities) to allow them to stay at home. Hence, nurses' community involvement activities may be among the significant factors of older adults' preference to stay at home during EOL. Therefore, this study explored home‐care nurses' community involvement activities and its association with single older adults' EOL preference. A cross‐sectional questionnaire survey was conducted with older adults (aged 65 years or older) who lived alone and used home‐care nursing services for more than 6 months, their home‐care nurses, and managers of their home‐care nursing agencies. Questions included participants' characteristics, nurses' community involvement activities and older adults' preference to remain at home during EOL. We conducted multiple logistic regression analyses to explore the relationship between nurses' community involvement activities and older adults' preference to remain at home during EOL while controlling for their demographic variables. In total, 103 pairs of home‐care nurses and single older adults from 27 home‐care nursing agencies participated. Approximately 70% of older adults preferred to remain at home during EOL, and 50% of nurses implemented community involvement activities. Older adults' preference to remain at home during EOL was associated with implementation of community involvement activities (Odds Ratio [OR]: 3.4; 95% Confidence Interval [95%CI]:1.1–9.8), home‐care nurses' higher practical clinical ability (OR: 1.4, 95%CI:1.0–1.8), and older adult's longer use of home‐care nursing service (OR: 2.2, 95%CI:1.2–4.1). Community involvement activities may be essential in helping single older adults to stay at home as per their preference for EOL. [ABSTRACT FROM AUTHOR]

Aim: To identify the effects of authentic leadership, structural empowerment and forms of communication as antecedent factors of workplace social capital in nursing. Background: Enhancing workplace social capital for nurses by management requires identifying antecedent factors of workplace social capital focusing on work environment and relationships between members. Methods: In 2019, self‐administered questionnaires were sent to all nurses working on the general wards of two university hospitals in Japan. A multilevel analysis was conducted to evaluate relationships between perceived workplace social capital—the dependent variable—and authentic leadership, structural empowerment and forms of communication—the individual‐ and ward‐level independent variables. Results: Data from 463 nurses and 28 nurse managers were analysed (valid response rates = 38.0% and 58.3%, respectively). Their average age was 28.64 years (standard deviation: 7.00), and 93.5% were female. Ward‐level authentic leadership and semi‐formal communication were found to be significantly related to workplace social capital. Conclusion: More authentic leadership and communication to promote mutual understanding between members can foster workplace social capital among hospital nurses. These findings can help inform effective workplace training in hospitals. Implications for Nursing Management: Workplace social capital can be produced by improved management, environment and communication opportunities. [ABSTRACT FROM AUTHOR]

Employed cancer patients confront some challenges as they attempt to return to work after treatment. We aimed to identify correlates of return to work for cancer survivors in Japan, with an emphasis on employment status. Participants were 260 patients (aged <65 years) who had received a cancer diagnosis ≥1 year previously and who were employed at the time of diagnosis. Participants completed questionnaires at consultations at any Regional Cancer Center Hospitals in Yamagata, Japan between 28 November 2011 and 9 December 2011. Logistic regression analysis was used to identify correlates of return to work. Data cross-tabulation was used to evaluate relationships to workplace and income-changes by employment status. A high proportion of patients (75.8%) had returned to work. Non-regularly employed survivors were less likely to return to work (odds ratio = 5.03; 95% confidence interval, 1.18-21.35). Individuals with poor health, advanced-stage tumours, of advanced age and women were significantly less likely to return to work. Only 52.8% of non-regular employees continued to be employed, and their income decreased by as much as 61.1%. Social and financial support policies should be organised based on more intensive study of employment circumstances. [ABSTRACT FROM AUTHOR]

What is known and objective: We evaluated the effectiveness of warning letters published by the pharmaceutical regulatory agency in Japan on communication of drug safety and risk by quantitative analysis of the national health insurance claims database (NHICD). We then explored what factors may have affected risk communication. Methods: We measured the implementation rate of the hepatitis virus-monitoring test among methotrexate (MTX)-treated patients; a warning letter had been issued regarding the use of MTX, as it apparently activates the hepatitis virus. Data from the NHICD, which include 993% of Japanese residents, were used. A total of 4 933 481 patients with rheumatoid arthritis (RA) (January-June, 2010) were the focus of this study. Results: The implementation rate of the hepatitis virus-monitoring test increased from 14% before to 18% after the warning letter announcement. Logistic regression analysis suggested that the installation of a drug information management room is one of the important factors affecting risk communication. Further analysis revealed that the hepatitis virus monitoring rates in hospitals without drug information management rooms increased from 23% to 41% due to the issue of the warning letter. What is new and conclusion: The warning letter from the regulatory agency plays an important role in risk communication in hospitals without drug information management rooms. [ABSTRACT FROM AUTHOR]