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Background: The stigma perceived by many post-stroke persons hinders their social lives. A scale to measure stigma is needed to identify social problems related to stigma, and to evaluate effectiveness of interventions. Objectives: This study aimed to develop a Japanese version of the Stroke Stigma Scale (SSS-J), and confirm its utility by examining reliability and validity. Methods: Eighty community-dwelling post-stroke individuals were enrolled at six sites. After translating the scale into Japanese using back translation methods, psychometric properties of the rating scale, internal scale validity, and reliability were examined to fit the Rasch model. Criterion-related validity, construct validity, and test-retest reliability were examined using total scores transformed to logit. For test-retest reliability, 30 participants completed the SSS-J twice, one week apart. Results: Rasch analysis showed that the SSS-J had the best fit with 15 items on a 3-category rating scale. Item difficulty logits were -2.01 to 2.21, person ability logits were -4.69 to 0.62 (mean, -1.41), person reliability coefficient was 0.71 (separation index, 1.58), and item reliability coefficient was 0.96 (separation index, 5.04). For criterion validity, Spearman's rank correlation coefficient with the Center for Epidemiologic Studies Depression Scale was 0.51 (p < 0.001). For construct validity, Spearman's rank correlation coefficients with each subscale of the Stroke Impact Scale ranged from -0.36 to -0.16 (p = 0.002–0.126). For test-retest reliability, the intra-class correlation coefficient was 0.64 (p < 0.001). Conclusions: The SSS-J adapted to the Rasch model was reliable and valid. This scale can be used to quantitatively measure stigma among community-dwelling post-stroke persons in Japan. [ABSTRACT FROM AUTHOR]

Background: Work-family enrichment refers to the extent to which experiences in one role improve the quality of life in another role, and the bidirectionality indicates that benefits derived from work can be applied to family and vice versa. Parent nurses, that is, female nurses who are raising preschool children, play a major role at work and in the family. Thus, work-family enrichment is significant for them. The Work-Family Enrichment Scale cannot be generalized to parent nurses. This study was aimed at developing and psychometrically validating a draft Work-Family Enrichment Scale for Parent Nurses. Methods: A questionnaire survey was conducted among 1,090 parent nurses who were randomly sampled from hospitals with more than 200 beds in Japan. The survey evaluated (1) a draft Work-Family Enrichment Scale for Parent Nurses, (2) the Japanese version of the Work-Family Enrichment Scale, and (3) the Positive Spillover Scale. The scales were psychometrically evaluated for internal consistency, construct validity, and criterion-related validity. Results: Data from 503 participants (age, mean ± standard deviation [range] 35.5 ± 4.96 [23–47] years) were analyzed. Results of exploratory factor analysis, the work to family enrichment direction yielded five factors for 23 items: "emotional fulfillment," "efficiency," "ability to lead," "displaying industriousness," and "self-growth." Cronbach's alpha coefficients ranged from 0.862 to 0.914. In the family-to-work enrichment direction, there were five factors for 28 items: "help-seeking," "receptiveness," "expansion of one's horizon," "efficiency," and "emotional fulfillment." Cronbach's alpha coefficients ranged from 0.790 to 0.907. Additionally, the correlation coefficients reporting criterion-related validity were 0.685 and 0.619 with regard to the Japanese version of the Work-Family Enrichment Scale and 0.596 and 0.534 with the Positive Spillover Scale for the Work-to-Family Enrichment Scale and the Family-to-Work Enrichment Scale for Parent Nurses, respectively. Conclusions: The Work-Family Enrichment Scale for Parent Nurses has adequate reliability and validity and can be used as an effective measure to assess the positive aspects of work and family roles among female parent nurses. [ABSTRACT FROM AUTHOR]

Introduction: Health literacy (HL) is correlated with the risk of mortality and readmission during cardiac rehabilitation. However, the correlation between HL and utility-based health-related quality of life (HRQOL) scores has been poorly documented. Therefore, we examined the correlation between HL and utility-based HRQOL scores in participants undergoing cardiac rehabilitation. Methods: The data of 448 participants undergoing cardiac rehabilitation from the Kobe-Cardiac Rehabilitation Project for People Around the World (K-CREW) clinical trial were analyzed. Participants were divided into low and high HL cohorts. We used the 14-item Health Literacy Scale (HLS-14) to assess HL and the EuroQol 5-Dimension 5-Level (EQ-5D-5L) questionnaire to assess HRQOL at discharge. The utility scores of the EQ-5D-5L questionnaire were calculated. The median age was 71.0 [61.0–78.0] years, 75.7% of participants were male, and 60% had a low HL. Results: Median utility score was 0.88 [0.75–1.00]. Regarding the dimensions of the EQ-5D-5L questionnaire, more than 60% of participants responded positively to the severity level of "no problem." In the comparative analysis, the low HL cohort had a statistically significantly lower utility score than that of the high HL cohort (p-value = 0.03). The multivariate analysis revealed that the HLS-14 scores were not statistically significantly correlated with the utility scores. Conclusion: Participants with low HL had lower HRQOL in the comparative analysis. However, multivariate analysis revealed that HL was not statistically significantly correlated with utility-based HRQOL scores. Future studies should explore the influence of confounding or intermediate variables on the correlation between HL and HRQOL. [ABSTRACT FROM AUTHOR]

Background: The Great East Japan Earthquake and the subsequent Fukushima nuclear power plant accident in 2011 posed significant challenges to the educational sector, particularly affecting nursing students in the disaster area. However, to the best of our knowledge, there are no reports on the effects of the natural disaster coupled with the nuclear accident on the nursing students. Therefore, this study aimed to determine the impact of the Fukushima disasters on rate of academic failure events in nursing education. Methods: A retrospective cohort approach was conducted, focusing on 677 students from Soma Nursing School admitted between 2001 and 2017. Four failure events—failure to pass the national examination, student retention, suspension, and withdrawal from school—were compared between three time periods: pre-disaster, early peri-disaster, and later peri-disaster. This analysis was followed by a questionnaire survey among the students and an interview with faculty members to gain further insights. Results: Of the student cohort, 17% had at least one failure event. Students in the later peri-disaster phase faced an elevated failure rate at 29%. Variables such as being male, admission during later peri-disaster period, and local pre-admission residence played a significant role in these failure events in multivariate logistic regression analysis (adjusted odds ratio [95% confidence interval, p value]; 2.63 [1.49–4.64, < 0.001], 3.207 [2.00–5.15, < 0.001], and 1.84 [1.12–3.02, 0.02], respectively). Conclusions: This study highlights the impact of the Great East Japan Earthquake and the following nuclear accident on nursing education. The elevated failure rates in the later peri-disaster period emphasize the challenges posed by continuing disaster phases. Thus, there is a need for intensified and tailored strategies in nursing education in disaster-affected regions. [ABSTRACT FROM AUTHOR]

The European Health Literacy Survey Questionnaire (HLS-EU-Q47) is available in multiple languages, and shortened versions have also been developed. This study aimed to examine the reliability and validity of the short version of the questionnaire (HLS-Q12) developed for community-dwelling older adults in Japan. The HLS-Q12 was developed using 12 of the 47 items of the Japanese version of the HLS-EU-Q47. In this study, the survey was conducted by distributing self-administered questionnaires to community-dwelling individuals aged 65 years and older who consented to participate; their responses were collected by mail. The correlation between the HLS-Q12 and the HLS-EU-Q47 was tested to assess criterion validity. To test construct validity, nine novel hypotheses were proposed. We also conducted a confirmatory factor analysis of the HLS-Q12. Based on a resurvey after 5–7 days, test–retest reliability was examined using interclass correlation coefficients (ICCs) and Bland–Altman analysis. In total, 118 individuals provided valid responses to the questionnaire. The Spearman rank correlation coefficient between the HLS-Q12 and the HLS-EU-Q47 was r  = 0.98 (p  < 0.001), and eight of the nine hypotheses were supported. The ICC was 0.96 (p  < 0.001), and the 95% limit of agreement was −0.26 ± 5.9, suggesting no systematic error. Thus, the Japanese version of the HLS-Q12 was found to be reliable with high criterion validity and reproducibility. Hence, the HLS-Q12 is a useful scale for measuring health literacy among older adults in Japan. [ABSTRACT FROM AUTHOR]

Objectives: Hikikomori is commonly defined as a social condition in which individuals avoid social participation and relationships beyond their family members by confining themselves to a room or their house for 6 months or longer. Hikikomori has been predominantly considered a problem among young people; however, as the population is ageing, hikikomori has also emerged as a social issue among adults. Nevertheless, no comparative studies have examined the differences in the factors associated with hikikomori among teenagers/young adults and middle-aged/older adults. Thus, this phenomenon has not been thoroughly examined, and it remains unclear whether the risk factors vary between teenagers/young adults and middle-aged/older adults. Based on the Japan Cabinet Office's definition of hikikomori, this cross-sectional study evaluated the prevalence and related factors of hikikomori among the working age population (15–64 years), utilising univariate and multivariate analyses. The study also compared differences in the prevalence of and factors related to hikikomori between teenagers/young adults and middle-aged/older adults. Methods: We distributed self-administered questionnaires to individual participants and their families between 24 December 2020 and 18 January 2021. Results: Data from an anonymised sample of 3,092 individuals (split into two groups of 15–39 and 40–64 years) were subjected to analysis. The results revealed a hikikomori prevalence of 2.3% in the target population; the prevalence rate was 2.12% among individuals aged 15 to 39 years and 2.42% among those aged 40 to 64 years. The analysis demonstrated strong correlations between hikikomori and several factors, including unemployment, truancy, a history of psychiatric consultation or hospitalisation, being male and the absence of ibasho, which is defined as a place where individuals can feel peace, security, acceptance and belonging. The factors associated with hikikomori differed between teenagers/young adults and middle-aged/older adults. Conclusion: Our findings, thus, contribute to existing research by providing a comparative analysis of risk factors across different age groups. [ABSTRACT FROM AUTHOR]

This study examined the similarities/differences between the social phenotypes of Williams syndrome (WS) and autism spectrum disorder (ASD). As cultural norms may affect symptom evaluation, this study administered the Social Responsiveness Scale-2 to Japanese individuals with WS (n = 78, 4.4–44.0 years) and ASD (n = 75, 4.7–55.4 years). The scores for Social Motivation and Social Communication were significantly more severe in the ASD than WS group. Overall, the similarities and differences between the social phenotypes of the syndromes were consistent with the findings of a recent study conducted in the UK, except for the social awareness subscale score. This highlights the importance of cross-cultural investigations of WS and ASD. [ABSTRACT FROM AUTHOR]

This study investigated the impact of surgical treatment on the health-related quality of life (HRQOL) of Japanese patients with colorectal cancer (CRC). This three-institution cohort study included 106 Japanese patients with CRC (69 men; mean age: 62.6 ± 12.4 years; age range = 30–85 years). HRQOL was evaluated using the Short-Form 36-Item Health Survey version 2 one to two days prior to surgery (baseline) and four weeks after surgery. Clinical characteristics, social characteristics, and HRQOL at baseline were investigated. Physical functioning, role-physical, bodily pain, and social functioning decreased significantly at four weeks after surgery compared with baseline, whereas mental health significantly improved. Physical functioning and general health perception showed an especially strong relation with the six-minute walk test (6MWT) at four weeks after surgery and HRQOL scores at baseline. The cutoff value for the 6MWT for clinically relevant improvement was 552.5 meters for physical functioning (area under curve [AUC] = 0.780, 95% confidence interval [CI] = 0.692–0.867) and 480.3 meters for general health perception (AUC = 0.721, 95% CI = 0.626–0.817). Patients with CRC could potentially improve their postoperative HRQOL by increasing their walking capacity post-surgery, and they may need follow-up interventions after discharge such as physical rehabilitation to do so. The results provide a potential pathway for improving HRQOL of Japanese patients with CRC. [ABSTRACT FROM AUTHOR]

Background: Sarcopenia has been reported to be associated with short-term outcomes after gastric endoscopic submucosal dissection (ESD). The "strength, assistance with walking, rising from a chair, climbing stairs, and falls" (SARC-F) questionnaire has been widely used as a screening tool for sarcopenia; however, SARC-F combined with body mass index and age (SARC-F+EBM) has recently been reported to be more useful than SARC-F alone. This study aimed to investigate the association between sarcopenia, measured using SARC-F+EBM, and short-term outcomes after gastric ESD. Methods: Patients who underwent gastric ESD at our institution between May 2020 and June 2023 were included, and their medical records were reviewed retrospectively. A SARC-F+EBM score ≥ 12 indicated sarcopenia. We evaluated the incidence of adverse events and the length of hospital stay in the sarcopenia and non-sarcopenia groups. Results: Overall, 263 patients (64 and 199 in the sarcopenia and non-sarcopenia groups, respectively) were investigated. The incidence of adverse events with a Common Terminology Criteria for Adverse Events grade ≥ 3 was not significantly different between the sarcopenia and non-sarcopenia groups (6.2% vs. 8.5%, p = 0.791). The proportion of patients with an extended hospital stay (≥ 10 days) was significantly higher in the sarcopenia group than that in the non-sarcopenia group (12.5% [8/64] vs. 3.5% [7/199], p = 0.012). Multivariate analysis showed that sarcopenia and lesions that present technical difficulty in ESD were independent risk factors for extended hospital stays (≥ 10 days). Of the eight cases having extended hospital stays in the sarcopenia group, four were due to the management after gastric ESD, three were due to family circumstances, and one was due to decreased activities of daily living. Conclusions: Sarcopenia is not a predictor of adverse events associated with gastric ESD. However, patients with sarcopenia may be hospitalized for longer owing to non-ESD-related factors. [ABSTRACT FROM AUTHOR]

Accessible Summary: What is known on the subject?: Children and adolescents' mental health problems, such as autism spectrum disorder, anxiety disorder and attention‐deficit hyperactivity disorder, are a global public health concern, and nurses require advanced expertise and skills to properly care for this population.There is a gap between the required competencies and the actual skills and knowledge of CAMHN practitioners. Previous studies suggest that educational interventions for nurses are necessary to enhance the quality of care for children and adolescents with mental health problems. However, the corresponding evaluation indicators have not been verified, making it difficult to determine the most effective methods. What this paper adds to existing knowledge?: The present study developed the two‐factor (direct care for children and their family members and approach to the care environment) Clinical Competency Assessment Scale in Child and Adolescent Mental Health Nursing (CCAS‐CAMHN).We demonstrated that the assessment scale was reliable and valid, based on its adequate internal consistency and temporal stability, the acceptable range of its model‐fit indexes, and its good concurrent and divergent validity. What are the implications for practice?: The newly developed scale is useful for assessing nurses' competency and could help them identify their difficulties in CAMHN.The scale could contribute to the development of effective educational interventions to enhance the quality of care for children and adolescents with mental health problems. Introduction: Caring for children and adolescents with mental health problems, such as autism spectrum disorder, anxiety disorder and attention‐deficit hyperactivity disorder, requires expertise and skills. A quantitative clinical competency measurement tool in child and adolescent mental health nursing (CAMHN) is needed to evaluate the indicators of advanced expertise. Aim: The aim of this study was to develop a clinical competency assessment scale in CAMHN and evaluate its psychometric properties. Method: Scale items were derived from previous studies and adjusted based on cognitive interviews with five CAMHN experts. In total, 505 nurses in CAMHN from 29 hospitals in Japan participated in the self‐administered survey. The scale's construct validity, criterion‐related validity, internal consistency and test–retest reliability were assessed. Results: A two‐factor (direct care for children and their family members and approach to the care environment) scale was constructed. A secondary structural model showed that a two‐factor model fits best. The total score was significantly and positively correlated with excellence in nursing practice, amount of clinical experience and mental status. The overall scale exhibited good validity and reliability. Discussion: The scale is reliable and valid for assessing CAMHN clinical competency. Implications for Practice: The scale is useful for assessing nurses' competency and evaluating educational interventions' effectiveness for nurses. [ABSTRACT FROM AUTHOR]

Few authors have investigated sport-related concussion (SRC) awareness and knowledge among athletes in Japan. Sport-related concussion research is scarce among Asian compared with North American and European cohorts. To examine previous SRC history, level of SRC knowledge, and previous exposure to SRC education among collegiate athletes in Japan by the level of contact and access to medical staff. Cross-sectional study. Single-university study in Japan. A total of 2103 athletes (48 varsity teams) were contacted to participate in an anonymous survey. Data from athletes with (1) SRC history in the past 3 months, (2) persistent SRC symptoms, (3) nontraditional sports, or (4) incomplete surveys were excluded. As a result, data from 593 athletes representing 43 varsity teams were included in this analysis. Outcome measures were level of contact (contact [CON], limited contact [LTD], noncontact [NC]), access to medical staff (MEDYES, MEDNO), SRC knowledge (maximum score of 49), previous SRC history (self-report; yes, no), and previous SRC education (self-report; yes, no). The average SRC knowledge total score was 33.4 ± 6.1 (range, 18–48). The knowledge score in CON was higher than in LTD and NC (P <.001) and in MEDYES than MEDNO (median, MEDYES = 34.0, MEDNO = 32.0; U = 27 841.5, P <.001). Sport-related concussion history was statistically different by the level of contact (= 27.95, P <.001) and by access to medical staff (= 4.5, P =.034). The presence of an SRC history and previous SRC education contributed to higher SRC knowledge, independent of the level of contact and access to medical staff (P <.001). Japanese athletes who participated in CON sports had a higher prevalence of SRC history, higher knowledge, and greater exposure to SRC education than those in LTD or NC sports. Access to medical staff was associated with higher SRC knowledge. [ABSTRACT FROM AUTHOR]

Despite the well-documented link between child maltreatment (CM) and mental health, evidence suggests substantial variability in the post-traumatic sequelae of CM across cultures. The perceived acceptability of CM in one's community might moderate the association between CM and mental health, but little research has been conducted on it so far. This study examined how the perceived acceptability of CM may influence the relationship between CM experiences and post-traumatic symptoms in individuals from four different continents and if the pattern of associations is the same across countries. We recruited a sample of 478 adults from Cameroon (n = 111), Canada (n = 137), Japan (n = 108), and Germany (n = 122). We administered online questionnaires and performed multiple group moderation analyses for total CM, neglect, physical abuse, emotional maltreatment, sexual abuse, and exposure to domestic violence (DV). A significant positive main effect of CM on post-traumatic symptoms was found in the overall sample and in Cameroon; in Germany, only neglect and emotional maltreatment were positively associated to post-traumatic symptoms. Moderation effects were identified; the perceived acceptability of neglect in Cameroon and Germany and of exposure to DV in Cameroon had a dampening effect on the relationship between CM experiences and post-traumatic symptoms. Our findings confirm that CM experiences entail long-term post-traumatic sequelae that can vary across cultures and CM subtypes and further our understanding of this issue by showing that the perceived acceptability of CM may be an understudied moderator. [ABSTRACT FROM AUTHOR]

Background: Motor skills have been linked to executive functions (EFs) in children with developmental coordination disorder (DCD). However, the traits of other neurodevelopmental disorders (NDDs), such as attention-deficit/hyperactivity disorder and autism spectrum disorder, remain overlooked. Therefore, this study explored the association between motor skills, occupational performance, and mental health in older kindergarten children with DCD and other NDDs. Overall, 95 participants aged 5–6 years were included in this study and divided into four groups: DCD traits (DCD-t), DCD-t + NDD traits (DCD-t + NDD-t), NDD-t-only, and typically developing children. Motor skills, EFs, and mental health were assessed using the DCD Questionnaire (DCDQ-J) and Movement Assessment Battery for Children—Second Edition, School Assessment of Motor and Process Skills (S-AMPS), and the Strengths and Difficulties Questionnaire (SDQ), respectively. The DCD-t + NDD-t group exhibited a strong correlation between the S-AMPS motor skill score and the DCDQ-J fine motor skill score (r = 0.88, p < 0.001) and between the total DCDQ-J score and the SDQ Total Difficulties Score (r = −0.94, p < 0.001). The findings indicate that children with DCD-t and NDD-t are more likely to experience EF and mental health problems than those with DCD-t only. [ABSTRACT FROM AUTHOR]

Background: Having no or few confidants is found to be associated with more severe mental health problems and a higher prevalence of depression in adults, but research examining this association in adolescents is scarce. Social relationships may be particularly critical during adolescence, as it is an important developmental period during which vulnerability to mental health problems increases. The present study examined the relationship between having no or few confidants and anxiety/depressive symptoms in adolescents. Methods: Cross-sectional self-report survey targeting 7–12th grade students (age range: 12–18) was conducted in public junior and senior high schools in Mie and Kochi, Japan. Data from 17,829 students (49.7% boys) were analyzed. Associations between anxiety/depressive symptoms (12-item General Health Questionnaire; score range: 0–12) and the number of confidants (None, 1–3, or ≥ 4) were examined using multilevel regression analyses. The analyses were stratified by gender and school level (junior/senior high), and adjusted for experiences of being physically abused and bullied and the interactions of these experiences with the number of confidants. Results: Having no or 1–3 confidants was associated with more anxiety/depressive symptoms, compared to having ≥ 4 confidants (p < 0.001) in all stratified groups. Having no confidants was associated with more anxiety/depressive symptoms than having 1–3 confidants (p < 0.001); in senior high boys, no difference was observed between having no confidants and having 1–3 confidants. In addition, in senior high boys, victims of bullying who have confidants reported significantly less anxiety/depressive symptoms than the victims who have no confidants (p < 0.01). Conclusions: Adolescents who had no or few confidants had more anxiety/depressive symptoms. Attention needs to be paid to better identify these adolescents, and avenues to support them need to be established. [ABSTRACT FROM AUTHOR]

Aim: This study explored the relationship between language confidence and job satisfaction, the mediating role of workplace discrimination, and the moderating role of immigration duration among foreign-born nurses in Japan. Introduction: Job satisfaction is an important factor in preventing migrant nurses' turnover intentions; however, the relationships among language confidence, immigration duration, workplace discrimination, and job satisfaction among foreign-born nurses remain unclear. Methods: A cross-sectional study was conducted. Data were collected between June and August 2022 through an online survey of nurses who were born outside of Japan but were currently working as registered nurses in Japan. PROCESS v4.0 Macro for SPSS 28.0 was applied to analyze the effect of language confidence on job satisfaction, the mediator effect of workplace discrimination (model 4), and the moderator effect of immigration duration (model 15). Results: Data from 187 participants were analyzed. The results showed that 1) foreign-born nurses' language confidence was negatively correlated with workplace discrimination and positively correlated with job satisfaction; 2) workplace discrimination played a partially mediating role between language confidence and job satisfaction; and 3) immigration duration positively moderated the relationship between language confidence and job satisfaction. Conclusion: Foreign-born nurses with stronger confidence in their proficiency in Japanese perceived less workplace discrimination and higher job satisfaction. Workplace discrimination acted as a mediator in the relationship between language confidence and job satisfaction, and this relationship was strengthened with longer migration periods. Managers and policymakers should implement policies and strategies to combat workplace discrimination and provide tailored support to improve foreign-born nurses' job satisfaction, which may contribute to their retention in Japan. [ABSTRACT FROM AUTHOR]

Background: Depopulated and aging areas in Japan, the proportion of older people who die at home tends to be lower than the national average. We investigated the trend regarding their preference for dying at home and associated factors among older residents living in a village. Methods: We conducted a questionnaire-based cross-sectional study in February and June 2020, targeting residents of Mitsuse Village aged ≥ 65 years. We compared two groups for each factor, residents who preferred to die at home (Group H) and the remainder (Group O). Results: In total, 223 (62%) residents responded to the survey. Participants' median age was 77 years, and 44% were men. Group H accounted for 47% of the total. Univariate analysis showed that Group H was older (p = 0.010) and included a smaller proportion who used a private vehicle (p = 0.036), compared with Group O. Multivariate analysis showed that male sex and not having a primary care physician were associated with a preference for dying at home (p = 0.031 and p = 0.041). Availability of transportation, social isolation, family economic status, or knowledge of long-term care were not independent associations with a preference for dying at home. Conclusions: To fulfill the wishes of older people who prefer to die at home in depopulated areas of Japan, establishing better home medical, nursing, or long-term care systems with improved human and financial resources is essential. Further research on how to support individuals' preference for dying at home is needed. [ABSTRACT FROM AUTHOR]

Body mass index (BMI) is routinely used to ascertain health status, including activities of daily living (ADLs); however, the associations of ADLs with height and weight in older adults have not been elucidated. Therefore, we cross-sectionally investigated the correlations between ADLs and height, weight, and BMI in 155 participants aged 82 to 103 years and characterized the naïve Bayesian prediction for ADLs. Activities of daily living showed a significant negative correlation with height and weight and a positive correlation with age. In males, a shorter height was associated with an increased risk of falling and disability in phone calling independently, and losing weight was associated with an increased risk of disability in going out. Combining age, weight, and height improved the area under the receiver operating characteristic curve in the prediction of disability in going out and phone calling independently in males. Therefore, height and weight, not BMI, are potential predictors of ADL decline. [ABSTRACT FROM AUTHOR]

Background: In the recent years, a high risk of developmental delay not only in very low birth weight infants and late preterm infants but also in early term infants (37–38 weeks) have increasingly been reported. However, in Japan, there are virtually no studies regarding the development delays in early term infants. Methods: This study used the data from the Japan Environment and Children's Study (JECS), a birth cohort study conducted in Japan. Data were selected for analysis from the records of 104,065 fetal records. The risk of neurodevelopmental delays at 6 months and 12 months after birth was evaluated using multivariate analysis for infants of various gestational ages, using the 40th week of pregnancy as a reference value. Neurodevelopment was evaluated at 6 months and 12 months after birth using the Ages and Stages Questionnaires, Japanese translation (J-ASQ-3). Results: The proportion of infants born at a gestational age of 37 to 38 weeks who did not reach the J-ASQ-3 score cutoff value was significantly higher in all areas at both 6 months and 12 months after birth, when compared to that of infants born at 40 weeks. The odds ratio decreased at 12 months after birth compared to that at 6 months after birth. Conclusion: Early term infants in Japan are at an increased risk of neurodevelopmental delay at 12 months after birth. Significance: What's known on this subject: Early term infants with gestational ages of 37 to 38 weeks and not only premature babies may be at an increased risk of developmental delay. What this study adds: This study was conducted using data from a birth cohort of 104,065 fetal records. Early term infants had an increased risk of developmental delay at 6 months, and while the risk decreased by 12 months after birth, it was still high. [ABSTRACT FROM AUTHOR]

Formation of proper handwashing techniques and habits from childhood is important for disease prevention. However, there are few studies that comprehensively and longitudinally evaluate the effectiveness of handwashing education for kindergarteners. This study aims to evaluate the effectiveness of continuous handwashing education using multiple activities to improve handwashing practices and skills among first- to third-grade students at a kindergarten in central Japan. A quasi-experimental one group pre- and post-test design was used. The education program consisted of three activities: (i) a 1-day teaching session by a researcher in January 2021, (ii) a 1-month follow-up activity led by kindergarten teachers and (iii) a 1-month follow-up activity led by parents at home, both occurring from late January to late February 2021. The study used questionnaires and handwashing skill experiments to investigate the kindergarteners' handwashing practices and comprehensive handwashing skills (handwashing steps, handwashing time, rinsing time and areas of the hands left unwashed) before and after Activities 1, 2 and 3. Data were obtained from 56 kindergarteners (64.4%). Second and third graders showed a significant improvement in their handwashing practices after coughing or sneezing. With the exception of rinsing time, handwashing skills significantly improved in all grades after the 1-day teaching session. After 1-month follow-up activities, the number of areas left unwashed by first graders significantly decreased, and the score for handwashing steps significantly improved. This study indicated that continuous handwashing education is partially effective at improving and maintaining handwashing practices and skills, except for rinsing time, among kindergarteners of all grades. [ABSTRACT FROM AUTHOR]

In the lives of those who are the target of community health nursing, it is important to collaborate with individuals and communities to improve their quality of life. Herein, we aimed to determine the association between Internet use among older individuals and locomotive syndrome (LS), frailty, and sarcopenia. In this cross-sectional study conducted between July 2022 and March 2023, we recruited 105 community-dwelling older Japanese adults who participated in a care prevention project called "Kayoi-no-ba". All participants were divided into Internet and non-Internet user groups according to the classification of a previous study. We assessed LS (standing test, two-step test, and five-question Geriatric Locomotive Function Scale), frailty (through the Questionnaire for Medical Checkup of Old-Old), and sarcopenia (grip strength, normal walking speed, and skeletal muscle mass index) and made group comparisons between Internet users and non-users. Binomial logistic regression analyses were performed with Internet use as the independent variable and sarcopenia or LS as the dependent variables. The Internet and non-Internet user groups had 69 and 36 participants, respectively. The Internet user group comprised 65.7% of all participants, which was similar to that reported in a previous study of the same age group. Between-group comparisons showed significant differences in sarcopenia and LS items, whereas adjusted binomial logistic analysis showed a significant association between sarcopenia and Internet use. In summary, among LS, frailty, and sarcopenia, sarcopenia showed the highest association with Internet use. Older adults without sarcopenia having good physical functions, such as grip strength, walking speed, and skeletal muscle index, more likely used the Internet; while older adults with sarcopenia were less likely to use the Internet. This implied that Internet use may be associated with physical function. [ABSTRACT FROM AUTHOR]

Objectives. Cognitive functions in almost all domains are lower in patients with schizophrenia than those in healthy controls, with the severity of impairment differing between domains. Treatments are being developed to improve cognitive impairment in patients with schizophrenia. However, the pattern of cognitive impairment must be clarified to facilitate treatment. Therefore, this study aimed to classify the patterns of cognitive impairment in individuals and provide treatment suggestions. Methods. Patients with schizophrenia were recruited from two psychiatric hospitals in Japan. Demographic and psychopathological symptoms were assessed using the Positive and Negative Symptoms Scale for Schizophrenia and neurocognitive functions, using the CogHealth battery. The following domains were assessed: processing speed, visual attention, working memory, visual learning, and spatial attention. The scores were standardised and assigned as the same-aged average score. Hierarchical cluster analysis using Ward's method was performed based on CogHealth scores. Subsequently, one-way analysis of variance (ANOVA) and Tukey's multiple comparisons were performed to compare the variables in each cluster. Results. In total, 133 participants were classified into four clusters: Cluster 1 (n = 16), with severe cognitive impairment and psychiatric symptoms and the longest stay; Cluster 2 (n = 44), with moderate cognitive impairment and psychiatric symptoms; Cluster 3 (n = 42), with preserved cognitive function, except for spatial perception, and mild psychiatric symptoms; and Cluster 4 (n = 31), with only memory and spatial perception impairment and mild psychiatric symptoms. Implications. The clusters indicate that impairment may occur in all or selective domains. Selective domain impairments may be in spatial perception or in spatial perception and memory. Therefore, it is recommended that treatments for cognitive dysfunction are developed into four subsets considering an individual's cognitive features. [ABSTRACT FROM AUTHOR]

Aim: To explore the prevalence of social isolation among Japanese community‐dwelling older adults before and during the COVID‐19 pandemic as well as determine how family and friend connections before and during the pandemic affected frail older adults during the pandemic. Design: A cross‐sectional study. Methods: A total of 852 community‐dwelling older adults in Hokkaido and Tokyo, Japan were surveyed conducted between April and November 2021 using convenience sampling. The Lubben social network scale‐6, frailty screening index, and geriatric depression scale were used to assess social isolation, frailty and depression, respectively. A path analysis was conducted to evaluate the effect of social isolation on frailty. Results: Participants had a mean age of 76.8 ± 6.6 years. Overall, 46% and 59% of participants were socially isolated before and during the COVID‐19 pandemic, respectively. Frailty was found in 19% of participants during the pandemic. Friends and family connectedness before the pandemic had no direct relationship with frailty; only friend connectedness affected frailty indirectly via depression. Family connectedness during the pandemic had a significant, negative and direct relationship with frailty. Conclusion: The findings show that connectedness with family and friends is critical for older people's physical and mental health. Impact: Nurses in the community should consider these findings to reduce mental health problems and physical decline among older adults. It is important to identify older adults who are socially isolated from their families or friends and provide resources to help them build relationships within their communities. Patient or Public Contribution: Community centre staff and community volunteers assisted in data collection. The public was not involved in data analysis, interpretation or manuscript preparation. [ABSTRACT FROM AUTHOR]

Purpose: Providing support for older adults after spousal bereavement is crucial for psychological recovery through the grieving process and for promoting a healthy and happy remainder of life. The current study aimed to understand factors influencing well-being among Japanese community-dwelling older adults who experienced spousal bereavement by evaluating how their roles and activities affected their psychological well-being following the loss. Method: We conducted a cross-sectional, anonymous, self-administered questionnaire survey of 332 older adults who had experienced death of a spouse in later adulthood. Results: Identified factors that affected well-being after spousal loss were sex, ability to go out without assistance from others, long duration since spousal loss, having a hobby, and adopting a life-oriented approach to cope with bereavement. Well-being following spousal loss was influenced by participants' activities and roles. Conclusion: Findings of the current study provide potentially valuable suggestions for surviving spouses and their supporters when coping with grief following spousal loss. [Research in Gerontological Nursing, 17(3), 121–130.] [ABSTRACT FROM AUTHOR]

With the global trend towards longer life expectancies, there's an increasing emphasis on not just living longer, but also maintaining health and wellbeing into older age. This study explores the efficacy of Ninjin'yoeito (NYT) in the early stages of frailty, a critical period for preventive interventions. Taking account of the knowledge gap regarding the association between early frailty and NYT, we use data from workplace health checkups to examine the relationship between pre-frailty severity and NYT adaption. The objective of our research is to enhance the comprehension of early treatments using NYT to prevent the progression of frailty. A total of 314 employees of the Kyoto Industrial Health Association who received workplace health checkups between November 2021 and March 2023 and consented to this study were included in the analysis. Information on gender, age, body mass index (BMI), NYT-specific symptoms assessment, the Japanese version of the General Health Questionnaire-12 (GHQ-12), and the Kihon Checklist (KCL) were obtained. The correlation analysis revealed that there was a strong positive correlation between the number of applicable NYT indications and the GHQ-12 score (r = 0.5992, p < 0.0001). Similarly, a moderate positive correlation was observed between the number of applicable NYT indications and the KCL score (r = 0.5030, p < 0.0001). In the multivariate analysis, both GHQ-12 (β = 0.49, SE = 0.06, t = 7.66, 95% CI: 0.36 to 0.62, p = 0.000) and KCL (β = 0.54, SE = 0.12, t = 4.29, 95% CI: 0.29 to 0.79, p = 0.000) showed significant positive associations with the variance in the number of applicable NYT indications, indicating that higher scores on these measures were related to a greater number of indications. NYT has the potential to be utilized not only as a therapeutic intervention for frailty, but also as a preventive measure. [ABSTRACT FROM AUTHOR]

Objectives: More than half of women do not achieve appropriate gestational weight gain. Maternal body image may be an important factor associated with gestational weight gain. However, this association has not been thoroughly evaluated. We aimed to elucidate whether body image parameters before and during pregnancy are associated with gestational weight gain in Japanese women. Methods: This prospective cohort study was conducted at a hospital in Osaka, Japan from March 2020 to March 2021. We recruited women with singleton pregnancies in their second and third trimesters. Body image was assessed using the Pregnancy and Weight Gain Attitude Scale and additional questions. Gestational weight gain was classified as insufficient, appropriate, or excessive based on recommended ranges in Japan. One-way analysis of variance, chi-square tests, and multinomial logistic regression analyses were performed to identify factors associated with insufficient or excessive weight gain. Results: Of 266 enrolled women, 47 had insufficient weight gain and 100 had excessive weight gain during pregnancy. Risk factors for excessive gestational weight gain included a history of dietary restriction before pregnancy, negative attitudes toward gestational weight gain, and perception of body shape as fat and body shape dissatisfaction during pregnancy. Perception of body shape as thin during pregnancy was identified as a risk factor for insufficient gestational weight gain. Conclusions: Body image before and during pregnancy may be an important factor in preventing insufficient or excessive gestational weight gain in Japanese women. Healthcare professionals should consider body image when providing health guidance on weight management to pregnant women. Significance: What is Already Known? Body image is a possible factor in gestational weight gain. Compared to women in other countries, Japanese women of reproductive age tend to have a negative body image. What this Study adds? A history of dietary restriction before pregnancy and negative body image during pregnancy were associated with excessive gestational weight gain among Japanese women. Perception of body shape during pregnancy as thin was associated with insufficient gestational weight gain. Thus, even in a Japanese population, characterized by a majority of women with pre-pregnancy underweight or normal body mass index status, associations between negative body image and gestational weight gain were similar to those in other countries. [ABSTRACT FROM AUTHOR]

Background: The prevalence and risk factors of cholelithiasis in individuals with severe or profound intellectual and motor disabilities (SPIMD) are poorly characterised. Thus, we aimed to investigate the prevalence and risk determinants of cholelithiasis in a cohort with SPIMD under medical care in a residential facility. Methods: We categorised 84 patients in a residential hospital for persons with SPIMD into groups: those with (Group CL) and without (Group N) cholelithiasis. Gallstones were detected via computed tomography, ultrasonography or both. We evaluated gastrostomy status, nutritional and respiratory support, constipation, and bladder and kidney stones. Data were significantly analysed using univariate and multivariate logistic regression analyses. Results: The prevalence rate of cholelithiasis in our SPIMD cohort was 27%. There were no significant differences in sex, age, weight, height, or Gross Motor Function Classification System between the two groups. However, more patients received enteral nutrition (39.13% vs. 6.56%; P = 0.000751) and were on ventilator support (56.52% vs. 19.67%; P = 0.00249) in Group CL than in Group N. Enteral nutrition [odds ratio (OR) 10.4, 95% confidence interval (CI) 1.98–54.7] and ventilator support (OR 20.0, 95% CI 1.99–201.0) were identified as independent risk factors for the prevalence of cholelithiasis in patients with SPIMD. Conclusions: Patients with SPIMD demonstrated an increased prevalence of cholelithiasis, with a notable association between nutritional tonic use and respiratory support. Therefore, to emphasise the need for proactive screening, it is crucial to devise diagnostic and therapeutic strategies specific to patients with SPIMD. Further investigation is essential to validate our findings and explore causative factors. [ABSTRACT FROM AUTHOR]

Aim: To examine the effectiveness of the feedback from the Nurses' Care Coordination Competency Scale (NCCCS) application (app) used for self‐assessing the care coordination competency of intensive care unit (ICU) nurses in managing patients on life support. Methods: A non‐randomized open‐label study was conducted in Japan from November 2021 to March 2022. Participants were 318 ICU nurses from acute hospitals in Japan. They were divided manually into two groups based on their certification status. The intervention was immediate feedback on the results of the care coordination competency self‐assessment through the NCCCS app; the control group performed the NCCCS survey with no feedback. The primary outcome was an increase in the NCCCS score 1 month after the intervention. Mann–Whitney U test was used to compare the scores of the intervention and control groups. Wilcoxon's signed rank sum test was used to compare the scores in the first and second NCCCS surveys. Results: Forty‐one participants were lost to follow‐up, leaving 277 participants (intervention = 141, control = 136) for analysis. One month later, NCCCS scores similarly increased in both groups. For nurses with at least 5 years of ICU experience (n = 152), the NCCCS score increased in the intervention group (n = 75) (rising point mean: 4.8, standard deviation [SD]: 9.8) compared with that in the control group (n = 77) (rising point mean: 1.3, SD: 8.3) (p =.048). Conclusions: Feedback from the NCCCS app can improve care coordination behavior. However, a certain level of ICU experience may be required to translate feedback into improved behavior. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to clarify the relationship between depressive symptoms and infection prevention measures and daily lifestyle habits during the coronavirus disease 2019 pandemic among community‐dwelling Japanese older adults. Methods: This cross‐sectional study was conducted on older residents (age ≥65 years) living in the Tama area of Tokyo and Sapporo, Hokkaido, in 2021. A self‐administered questionnaire survey was conducted to collect data on demographics, the impact of the pandemic on physical condition, and depressive symptoms, infection prevention measures, and daily lifestyle habits during the pandemic. The Geriatric Depression Scale was used to assess depressive symptoms. Results: In total, 554 respondents were included in the analysis. The results of multiple logistic regression analyses revealed that refraining from going out and visiting medical institutions were associated with depressive symptoms. Furthermore, those who went out almost every day were less likely to have depressive symptoms than the others, those who exercised almost every day were less likely to have depressive symptoms than were those who almost never exercised, and those who slept 6–7 h were less likely to have depressive symptoms than were those who slept ≤5 h. Conclusions: The findings of the present study suggest the necessity of having a place where older adults with physical and lifestyle concerns can consult with healthcare providers in a location other than a medical institution, even during infectious disease outbreaks. In addition, increasing the frequencies of going out and independent exercise and sleeping 6–7 h may help prevent depression among older adults. [ABSTRACT FROM AUTHOR]

Background: Evidence-based practice (EBP) is essential for pharmacists to select and recommend over-the-counter (OTC) drugs in medical consultations (hereinafter referred to as OTC counseling). Objectives: This study examined the association between pharmacists' perceptions of EBPs and their implementation of OTC counseling. Methods: A web-based survey was conducted. Questions regarding pharmacists' perceptions of EBP and experience in OTC counseling were set, and respondents were asked to respond based on a 5-point scale ranging from 1 (strongly disagree) to 5 (strongly agree). The association between pharmacists' perceptions of EBP and experience in OTC counseling was examined by calculating Spearman's ρ using bivariate correlation analysis. Results: Responses were obtained from 250 pharmacists. Although 70% of respondents indicated that EBP improves service quality, only 39, 31, and 14% had knowledge of the EBP steps, conducted a literature search, and performed a critical appraisal, respectively. Regarding OTC counseling experience, only 31% of respondents indicated that "sufficient evidence information on OTC drugs has been obtained." Over 60% of respondents expressed the need for OTC usage guidelines and support tools and revealed that brand-specific purchases of OTC drugs make EBP difficult. An association was observed between pharmacists' perceptions of EBP and experience in OTC counseling. "Level of recognition of steps for practicing evidence-based medicine" was associated with the "need fulfillment level for evidence information" (ρ = 0.329, P < 0.001), "brand-specific purchases of OTC drugs" (ρ = 0.240, P < 0.001), "perception of product advertisement" (ρ = 0.227, P < 0.001), and "need for OTC guidelines" (ρ = 0.208, P < 0.001). Conclusions: Pharmacists' perceptions of EBP were associated with their experience in OTC counseling [ABSTRACT FROM AUTHOR]

With the International Commission on Radiological Protection's (ICRP) reduction in the radiation dose threshold for cataracts, evaluating and preventing radiation exposure to the lens of the eye among interventional radiology (IR) staff have become urgent tasks. In this study, we focused on differences in lens-equivalent dose (HT Lens) to which IR nurses in three hospitals were exposed and aimed to identify factors underlying these differences. According to analyses of time-, distance-, and shielding-related factors, the magnitude of the HT Lens dose to which IR nurses were exposed could be explained not by time or shielding but by the distance between the X-ray exposure field and the location of the IR nurse. This distance tended to be shorter in hospitals with fewer staff. The most effective means of reducing the exposure of the lenses of IR nurses' eyes to radiation is to position them at least two meters from the radiation source during angiography procedures. However, some hospitals must provide IR departments with comparatively few staff. In work environments where it is infeasible to reduce exposure by increasing distance, interventions to reduce time by managing working practices and investment in shielding equipment are also important. This study was not registered. [ABSTRACT FROM AUTHOR]

Japan has accepted nurses from Indonesia, the Philippines, and Vietnam under the Economic Partnership Agreement, but nearly half of them have already left the workforce. This study aimed to clarify the factors related to the job continuance of nurses who migrated to Japan under the Economic Partnership Agreement. Our goal was to explore factors specific to migrant nurses and to contribute to the development of support measures for them. This research was a cross-sectional study in which a web-based questionnaire and interview were conducted at a single point in time. Migrant nurses (n = 40) participated in the web-based questionnaire survey. Of those, nine nurses were also interviewed. Spearman's rank correlation coefficient was used to establish correlations, and qualitative descriptive analysis was used to analyse interviews. The questionnaire survey results revealed the content of work, human relationships in the workplace, the number of night shifts, and satisfaction with the balance between work and private life were significantly and negatively correlated with the Intention to Quit scale total score. All correlation coefficients were less than 0.5, indicating weak correlations. Three categories emerged from the interviews as positive factors related to job continuance: "generous support from the workplace", "beneficial nursing experience in Japan", and "determination to live in Japan". A good working environment, generous support from the supervisor and colleagues, high values of nursing in Japan, and desire to migrate to Japan were the factors that had a positive effect on migrant nurses' job continuance in Japan. Understanding the characteristics of migrant nurses and providing generous support will enable them to continue working in Japan. This study was not registered. [ABSTRACT FROM AUTHOR]

Mood, emotions, and alcohol use motives are risk factors for hazardous alcohol use among young people, but relevant research about students in Asia is scarce. In addition, it is necessary to identify risk factors not only in students who are already drinking dangerously, but also in students who are in the preliminary stages of dangerous drinking, but few studies have pursued risk factors for these different degrees of hazardous drinking. Therefore, the present study aimed to measure the risk-level-specific factors in Japanese college students. 1,067 college students were categorized by the risk level of their drinking habits, and the risk-level-specific factors for hazardous drinking were examined. Students who engaged in high-risk drinking, and those who were suspected of being alcohol-dependent, were predominantly males. These students' motives for alcohol consumption and expressions of anger were significantly stronger. In addition, they resorted to avoidant, accepting responsibility and emotion-focused strategies for coping with stress. The interesting findings are that positive mood states such as vigor and friendliness tended to be specifically higher in the risky drinking group. These results suggest that emotions such as anger and stress coping skills may be potential targets for preventive interventions against hazardous drinking. [ABSTRACT FROM AUTHOR]

Aim: The gut microbiota has emerged as a new intervention target for sarcopenia. Prior studies in humans have focused on the association between gut microbiota and skeletal muscle quantity, while the evidence on muscle function and quality is lacking. This study aimed to identify gut microbiota genera associated with skeletal muscle function, quantity, and quality in a general population of Japanese adults. Methods: This cross‐sectional study included 164 participants aged 35–80 years, women and men recruited from urban areas of Japan. Fecal samples were collected and analyzed using 16S rRNA gene amplicon sequencing. Skeletal muscle function was measured using handgrip strength and leg extension power (LEP), while skeletal muscle mass was estimated using bioelectrical impedance analysis. Phase angle was used as a measure of skeletal muscle quality. Multivariate linear regression analysis stratified by age group was used to examine the association between the dominant genera of the gut microbiota and skeletal muscle variables. Results: A significant association was found between Bacteroides and Prevotella 9 with LEP only in the ≥60 years group. When both Bacteroides and Prevotella 9 were included in the same regression model, only Bacteroides remained consistently and significantly associated with LEP. No significant associations were observed between skeletal muscle mass, handgrip strength, and phase angle and major gut microbiota genera. Conclusions: In this study, we observed a significant positive association between Bacteroides and leg muscle function in older adults. Further studies are required to elucidate the underlying mechanisms linking Bacteroides to lower‐extremity muscle function. Geriatr Gerontol Int 2024; 24: 53–60. [ABSTRACT FROM AUTHOR]

Aim: To clarify the state of screening and support systems for socially high‐risk pregnant women at obstetric facilities across Japan and identify the characteristics of facilities related to the implementation of screening. Methods: This cross‐sectional study used a self‐administered questionnaire. Participants were managers of hospitals, clinics, and midwifery birth centers handling deliveries in 47 prefectures across Japan. The questionnaire comprised items regarding the characteristics of participants and their facilities, service provision related to socially high‐risk women available at the facility, the number of specified pregnant women (tokutei ninpu) per year, methods of screening, and support systems within the obstetric facilities. Descriptive statistics and multivariate logistic regression analysis were performed using IBM‐SPSS version 24 for the association between facility characteristics and screening practices for socially high‐risk pregnant women. Results: Valid responses were received from 716 of 2512 obstetric facilities. Rates of specified expectant mothers per annual number of deliveries were identified as follows: perinatal medical centers (2.7%), general hospitals (1.6%), obstetrics and gynecology hospitals (1.0%), and clinics (0.8%). A total of 426 facilities (60.6%) reported screening all expectant mothers to identify socially high‐risk pregnant women. Multiple logistic regression analysis revealed that facility characteristics and service/care provision related to screening practices included availability of in‐hospital midwife‐led care and in‐hospital midwifery clinics (adjusted odds ratio 1.61; 95% CI [1.30, 1.47]), one‐on‐one care by midwife (1.73; 95% CI [1.15, 2.59]), multidisciplinary meetings within the facility (1.70; 95% CI [1.14, 2.56]), follow‐up support systems after discharge (1.90; 95% CI [1.17, 3.09]), and participation in the regional council for children in need of protection (2.33; 95% CI [1.13, 4.81]). Conclusions: Approximately 60% of surveyed obstetric facilities screen for socially high‐risk women. Increasing service provision at facilities may be necessary to implement screening. [ABSTRACT FROM AUTHOR]

Aim: Shift management and planning processes for shift‐working nurses are important for their continued work. This study aimed to determine the association between shift assignments, organizational justice, and their interaction with turnover intention among shift‐work nurses. Methods: This cross‐sectional study used an online questionnaire administered to Japanese nurses between January and February 2020. Enquiries pertaining to their daily start and end times for each shift type, the shift assignments, organizational justice, and their turnover intention were made. To examine the association with turnover intention, logistic regression analysis was performed with shift assignments, organizational justice, and their interaction terms as independent variables. Results: A total of 386 nurses participated in the final analysis. Of these, 161 nurses (41.7%) had turnover intention. Unequal work assignments and procedural justice were significantly associated with turnover intention. However, the interaction between these factors was not significant. Conclusion: The results suggest that procedural justice in the workplace and turnover intention are related, but in shift planning, even procedural justice cannot buffer unequal work from leading to turnover intention. This study provides valuable insights for nursing managers who manage the schedules of shift‐working nurses. [ABSTRACT FROM AUTHOR]

Aim: The lifestyle habits of young people are often associated with that of middle-aged and older adults, and intervention from a young age is important for the prevention of lifestyle-related diseases. Hypertension is a lifestyle-related disease, and an increasing number of patients are suffering from it. Therefore, in this study, we investigated the factors that cause fluctuations in blood pressure in university students. Subject and methods: The survey was conducted from 2011 to 2019 and included 14,720 male and 6,039 female university students. The questionnaire included items such as age, sex, weight control orientation, and lifestyle habits. Height, weight, and systolic and diastolic blood pressures were measured. Body mass indices (BMI) were calculated, and the participants were classified as underweight, normal body type, or obese. In addition, abnormal blood pressure (ABP) was defined as systolic/diastolic blood pressure above 120 and/or 80 mmHg. Results: A multivariate logistic regression analysis revealed that ABP was significantly associated with snacking (odds ratio, 95% confidence interval 0.68, 0.52–0.90) in males with underweight; sleep duration ≥ 6 h (1.10, 1.02–1.19), snacking (0.84, 0.75–0.96), and weight decreasing orientation (1.22, 1.12–1.32) in males with normal body types; exercise habits (0.75, 0.56–1.00) in females with normal body types. Conclusion: The present study revealed different risk factors by body type associated with ABP in Japanese university students. In particular, weight loss orientation in a standard-bodied male may be a risk factor for ABP. Our study suggests that interventions by body type may prevent lifestyle-related diseases. [ABSTRACT FROM AUTHOR]

Purpose Many Japanese women continue to work during pregnancy, but half of them quit work. Several symptoms and discomfort during pregnancy are known to interfere with daily life and to be a reason for taking sick leaves or retiring during pregnancy. However, little is known about the factors behind their motivation to continue working throughout pregnancy. Work engagement is a concept defined as "a positive, fulfilling, work-related state of mind characterized by vigor, dedication, and absorption of workers", and can predict positive work outcomes, such as job performance, job satisfaction and motivation. This study has two hypotheses: (1) job resources would be positively associated with work engagement, and (2) the perceived symptoms during pregnancy would be negatively associated with work engage- ment. Then, this study aimed to explore the factors associated with work engagement among Japanese pregnant women. Methods Between July and November 2019, a cross-sectional study was conducted at two general hospitals in the urban area of Tokyo. Pregnant women were recruited during antenatal health check-ups and asked to answer self-ad- ministered questionnaires after obtaining written informed consent. The eligibility criteria were having a single preg- nancy, being at ≥16 weeks of gestation, and being able to read and write Japanese. The outcome variable was work engagement using the 3-item version of the Utrecht Work Engagement Scale. Furthermore, work-related variables, such as job demands and job resources, perceived physical and mental symptoms, and demographic characteristics were obtained. To examine the relationships between the independent variables and work engagement, a bivariate analysis was conducted. Then, multivariate regression analysis was performed on the variables that were significantly associated with work engagement in the bivariate analysis. Results Of 252 participants at ≥16 weeks' gestation who agreed to participate, 226 completed the questionnaires. After excluding 86 women who were not working at the time of recruitment, the data of 140 working pregnant women were included in the analyses. Participants' age (mean ± standard deviation) was 33.1 ± 4.3 years, and the mean score of work engagement was 3.6 ± 1.3. The results of the multivariate analysis showed that the factors associated with a higher level of work engagement were higher supervisor support (β = 0.259, p = 0.008), higher job demands (β = 0.267, p = 0.006), higher sense of coherence (β = 0.276, p = 0.001), and higher age (β = 0.188, p = 0.024). As for the hypotheses, this study revealed that (1) job resources were positively associated with work engagement, and (2) the perceived symptoms during pregnancy were not associated with work engagement. Conclusion Higher supervisor support was significantly associated with a higher level of work engagement. The finding demonstrates the importance of social support in the workplace in promoting work engagement among pregnant women. [ABSTRACT FROM AUTHOR]

The current pre-/posttest pilot study investigated the impact of an individual nurse-led active listening intervention for spouses of individuals with depression (herein referred to as patients) on spouses' psychological states and patients' depressive symptoms. Sixteen couples participated in the study. Individual sessions were conducted over 10 weeks to help spouses express their thoughts and feelings. Psychological measurement scale scores did not change markedly postintervention for spouses; however, their subjective evaluations of the intervention were positive. In the qualitative analysis, spouses stated that they were able to express their thoughts and feelings and that the sessions were meaningful. Moreover, postintervention depressive scores of patients improved significantly. Findings suggest that the nurse-led intervention of active listening for spouses may provide a better environment for improving the depressive symptoms of patients. [Journal of Psychosocial Nursing and Mental Health Services, 61(12), 19–25.] [ABSTRACT FROM AUTHOR]

To investigate the factors that contribute to subjective quality of life (QOL) in adolescents with cerebral palsy (CP). We evaluated the subjective QOL in 51 adolescents with CP through interviews using the Japanese version of KIDSCREEN-27 (J-KIDSCREEN-27) and compared the scores with those of 60 typically developing adolescents. Correlations of subjective QOL with age, sex, the levels of functions (gross motor, manipulation, and communication), intelligence, the level of activity of daily living (ADL), and the type of educational support were examined. Thereafter, we investigated the predictors of the subjective QOL by multiple regression analysis. The total QOL scores and individual J-KIDSCREEN-27 domains were not significantly different from those of typically developing adolescents. Sex, manipulation and communication functions, and intelligence had no relationship with subjective QOL. Gross motor function and ADL level negatively correlated with satisfaction with the school environment. Multiple regression analysis revealed that higher age predicts lower psychological well-being, lower gross motor function predicts higher satisfaction with the school environment, and attending schools or classes for special needs predicts higher physical well-being. Seeking adequate support for mildly affected adolescents attending regular classes will be the key to further improving subjective QOL in adolescents with CP. [ABSTRACT FROM AUTHOR]

Purpose: Preoperative deep vein thrombosis (DVT) is a risk factor for postoperative venous thromboembolism (VTE), causing severe mortality. Early detection of preoperative DVT is essential to prevent postoperative VTE. However, little is known regarding preoperative DVT in patients undergoing major surgery. The present study aimed to determine the incidence and risk factors of preoperative DVT in patients admitted for total hip arthroplasty (THA). Methods: From August 2017 to September 2022, 243 patients admitted for THA at our institution were enrolled in this study. Patients medical records and preoperative laboratory data were retrospectively collected. According to the results of lower-limb ultrasonography, patients were divided into either the non-DVT (n = 136) or DVT (n = 43) group. The incidence of DVT and independent risk factors for preoperative DVT were investigated using univariate and multivariate logistic regression analyses. Results: The mean age was 74.0 ± 8.4 years. Preoperative DVT was diagnosed in 43 of the 243 (17.7%) patients. The risk of DVT was significantly high (p < 0.05) in patients with advanced age, increased D-dimer levels, and malnutrition status, as assessed by the Geriatric Nutritional Risk Index (GNRI). Multivariate analysis showed that advanced age, increased D-dimer level, and malnutrition status assessed by the GNRI were independent risk factors for preoperative DVT. Conclusion: A high incidence of preoperative DVT was observed in patients undergoing THA. Advanced age, increased D-dimer levels, and malnutrition assessed by the GNRI increased the risk of preoperative DVT. Screening high-risk subgroups for preoperative DVT is necessary to prevent postoperative VTE. [ABSTRACT FROM AUTHOR]

Menstrual and menstrual-related symptoms can significantly impact an individual's physical and psychological health. Understanding how these symptoms evolve over time is crucial to provide appropriate support and healthcare services to young women. This study aimed to investigate changes in menstrual and menstrual-related symptoms among first-year female university students. A prospective longitudinal design was used to compare the symptom profiles between two time points (three and nine months after admission). Out of 100 female university students, 30 responses were analyzed. Data on menstrual and menstrual-related symptoms were collected using standardized questionnaires focusing on menstrual status and the Menstrual Distress Questionnaire (MDQ); no notable changes occurred between the time points. Approximately half reported having irregular menstruation during the three time periods. Among the sub-scales, premenstrual "impaired concentration" showed a tendency to be lower, whereas menstrual "water retention" tended to be higher in timepoint 2 compared to timepoint 1. "Distractible" was found to be significantly lower in timepoint 2 compared to timepoint 1. There was a significant association between a sleep duration of <7 h and worsened MDQ scores. These findings may underscore the importance of providing comprehensive lifestyle and menstrual education to new university students, along with access to appropriate medical care. [ABSTRACT FROM AUTHOR]

Aim: The effects of statins on muscle health are not well established. Therefore, this study investigated the impact of statin use on muscle strength and mass recovery in patients with sarcopenia after stroke. Methods: This retrospective cohort study included stroke patients with sarcopenia hospitalized between 2015 and 2021 at a post‐acute rehabilitation hospital. Sarcopenia was diagnosed using handgrip strength and skeletal muscle mass index measured using bioelectrical impedance analysis according to the 2019 criteria of the Asian Working Group for Sarcopenia. The study outcomes included handgrip strength and skeletal muscle mass index at hospital discharge. We used multivariate analyses to examine whether statin use was independently associated with the outcomes. Statistical significance was set at P < 0.05. Results: Of the 586 patients enrolled, 241 (mean age 79.3 years, 44.4% men) presented with sarcopenia and were included in the analysis. Statin use was observed in 61 (25.3%) patients. Statin use was independently negatively associated with handgrip strength at discharge (β = −0.095, P = 0.032), but not with skeletal muscle mass index at discharge (β = 0.019, P = 0.692). Conclusions: Statin use was negatively associated with muscle strength recovery, but not with muscle mass in patients with sarcopenia who underwent rehabilitation after stroke. To maximize outcomes, sufficient consideration is needed for statin use in these patients. Geriatr Gerontol Int 2023; 23: 676–683. [ABSTRACT FROM AUTHOR]

The aim of this study was to examine the relative validity of the online Meal-based Diet History Questionnaire (MDHQ) for assessing the overall diet quality and quality of each meal type (breakfast, lunch, dinner and snacks). In total, 222 Japanese adults (111 for each sex) aged 30–76 years completed the online MDHQ and then the 4-non-consecutive-day weighed dietary record (DR). The diet quality was assessed using the Healthy Eating Index-2015 (HEI-2015) and Nutrient-Rich Food Index 9.3 (NRF9.3). For the HEI-2015, compared with the DR, the MDHQ provided high median values for breakfast (in women only) and dinner and low median values for snacks. There were no significant differences observed for overall diet and lunch. For the NRF9.3, the MDHQ provided higher median values for breakfast and dinner and a lower median value for overall diet than the DR in women, with no significant differences for lunch and snacks. In men, no significant difference was observed, except for overall diet (the MDHQ providing a lower median value). For the HEI-2015, median Spearman correlation coefficient was 0·43, with a range from 0·12 (snacks in women) to 0·68 (breakfast in men). For the NRF9.3, median Spearman correlation coefficient was 0·47, with a range from 0·26 (snacks in men) to 0·65 (breakfast in men). Bland–Altman plots showed wide limits of agreement and, in some cases, proportional bias. In conclusion, the online MDHQ showed an acceptable ability for ranking individuals according to the quality of overall diet, breakfast, lunch and dinner, but not snacks. [ABSTRACT FROM AUTHOR]

Background: Complementary and alternative medicine (CAM) are popular among women, and are used during their pregnancy in Japan. This study aimed to survey the prevalence of CAM use by healthy pregnant women as a health-care prescribed therapy or self-care and to investigate the factors associated with CAM use in Japan. Methods: In this cross-sectional study, pregnant women after 34 weeks of gestation were asked to respond to a questionnaire at the clinic or online. The questionnaire comprised questions on the participants' characteristics and their use of CAM for therapy and self-care. Descriptive statistics were calculated in the analyses, and bivariate and multivariate logistic analyses were performed to evaluate the associations between factors and CAM use. Results: A total of 394 women responded from three hospitals, two clinics, and two midwifery birth centers. CAM was received as treatment by practitioners during pregnancy by 75 women (19.0%). The following therapies were used: traditional Chinese medicine (7.9%), chiropractic (6.9%), moxibustion (6.4%), and acupuncture (5.3%). One or more types of therapy were used as self-care by 348 women (88.3%). Highly used CAM for self-care were: folic acid supplementation (75.4%), other supplements (51.5%), herbs (20.8%), and yoga (19.0%). Multiple logistic regression analyses revealed that the factors associated with CAM use as a therapy were midwifery birth centers for planned childbirth settings (adjusted odds ratio [AOR] 3.64, 95% confidence interval [CI] [1.69–7.83]) and pregnancy complications diagnosed (AOR 2.46, 95%CI [1.38–4.39]). The factors associated with CAM use for self-care were age 30–39 years (AOR 4.48, 95%CI [2.14–9.73]) and over 40 years (AOR 3.92, 95%CI [1.10–13.91]), junior college education or above (AOR 2.30, 95%CI [1.18–4.51]), and primiparas (AOR 3.82, 95%CI [1.86–7.86]). The most common source of information was the "Internet" (43.8%). Conclusions: Approximately 20% of Japanese pregnant women received CAM as therapy by practitioners, and the related factors were: tended to have baby at midwifery birth center and pregnancy complications. Almost 90% of respondents used CAM as self-care and the related factors were: older, had a higher educational level and tended to be primiparas. They used the Internet as their main source of information about CAM. Health care providers need to provide evidenced-based information on CAM and to help decision making to ensure safe and effective CAM utilization by pregnant women. [ABSTRACT FROM AUTHOR]

To examine the reliability and validity of the public transportation use assessment form (PTAF), which was developed for assessing the performance of tasks during public transportation use. Fifty consecutive patients admitted after a stroke to a convalescent rehabilitation hospital and received field-based practice for public transportation use were enrolled. A physical therapist (PT) and an occupational therapist (OT) independently evaluated actual participant performance using the PTAF. Its internal consistency, inter-rater reliability, and construct validity were examined against other clinical measures related to the ability to use public transportation. Cronbach's coefficient alpha for the internal consistency for overall PTAF was 0.84 and 0.88 for PTs and OTs, respectively. Cohen's weighted κ coefficient for the inter-rater reliability for each item ranged from 0.61 to 0.83. Intraclass correlation coefficients for the inter-rater reliability for the mean scores of the items comprising the PTAF were 0.90 for all 14 items, 0.76 for items required for train use only, and 0.88 for items required for bus use only. The correlation coefficients for the construct validity between PTAF and clinical measures ranged from 0.38 to 0.59 (p < 0.05). The PTAF showed sufficient internal consistency, intra-rater reliability, and construct validity. This study illustrated the inter-rater reliability of the public transportation use assessment form (PTAF), indicating that the PTAF can be used for reliable assessment independent of the rater. The PTAF showed good internal consistency, indicating that each item in the PTAF consistently assessed the ability of patients with stroke to use public transportation. The PTAF correlated with assessment tools such as walking ability, balance, motor paralysis, intelligence, and activities of daily living, indicating that it reflects the functions and abilities necessary to use public transportation. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to develop a scale to screen for eating disorders in female athletes. Methods: Preliminary survey: A total of 275 female athletes (mean age: 19.4 ± 1.0 years) and 7 female athletes diagnosed with eating disorders (mean age: 20.1 ± 2.5 years) were administered screening items prepared based on an existing scale, followed by exploratory factor analysis. Main survey: Six items, relating to three factors, were extracted, and 201 female athletes (mean age: 22.3 ± 4.8 years) and 6 female athletes diagnosed with current or a history of eating disorders (mean age: 18.8 ± 2.9 years) were queried. The diagnostic validity of the scale was then evaluated. Results: Preliminary survey: Questions (α = 0.71) were extracted from six items, relating to three factors, and collectively termed the University of Tokyo's eating disorders inventory in female athletes (TEDIFA). To determine the scale cut‐off score, ROC analysis was performed with the total score, and the cut‐off and gray zone scores were set at 13 and 11, respectively. Main survey: At the cut‐off score of 13, AUC, sensitivity, and specificity were 0.83 (p < 0.05), 75%, and 90%, respectively. Conclusions: The scale that was developed, TEDIFA, consisted of six items. The cut‐off scores were set at 11 for the gray zone (sensitivity: 75%; specificity: 56%; accurate diagnosis rate: 60%), and 13 for positivity (sensitivity: 75%; specificity: 90%; accurate diagnosis rate: 87%), demonstrating the reliability and validity of the scale. [ABSTRACT FROM AUTHOR]

Aims: This study aims to develop and examine the effectiveness of a support program for reducing moral distress of nurses, based on the moral case deliberation methodology, and to study the feasibility of its implementation. Methods: Study design was an intervention study with pre/post‐comparison. The support program included a short lecture and three moral case deliberation sessions for nurses working in an acute care hospital. The Measure of Moral Distress for Healthcare Professionals (MMD‐HP) and the Euro‐MCD (Moral Case Deliberation) 2.0 scale were used for pre/post‐comparison, using the Wilcoxon's signed‐rank test. Furthermore, post‐intervention interviews were conducted with consenting participants to determine the reasons for changes in pre/post‐intervention quantitative data. Of the 34 participants, 29 completed the post‐questionnaire and were included in the quantitative data analysis, and 27 were included in the qualitative data analysis. Results: The mean MMD‐HP total scores increased from 147.5 ± 61.0 to 159.3 ± 66.7, but not significantly (p =.375). The mean score of moral competence, a sub‐scale of the Euro‐MCD 2.0, increased significantly from 15.4 ± 2.4 to 16.4 ± 2.8 after the intervention (p =.036). A qualitative analysis revealed increased moral sensitivity to ethically difficult situations and improved analytical skills as the reasons for change in scores pre/post‐intervention. Conclusion: The results of the qualitative analysis suggested the effectiveness of the intervention. The moral distress score increased, although not significantly, and moral competence also increased, suggesting the participants' values changed after the intervention. It was found that the support program using MCD is expected to improve participants' moral competence. [ABSTRACT FROM AUTHOR]

This study aims to analyze associations between lifestyle-related factors and body mass index (BMI) and blood pressure (BP) in middle-aged and older people in Japan. An association analysis using a multilevel model with demographic and lifestyle-related factors as variables and with BMI, systolic blood pressure (SBP), and diastolic blood pressure (DBP) as outcomes was conducted. Among the modifiable lifestyle factors, we found a significant dose-response association for BMI and slower eating (fast: reference; normal: −0.123 kg/m2 and slow: −0.256 kg/m2). Consuming >60 g/d ethanol was significantly associated, before and after adjustment for BMI, with an increase in SBP of 3.109 and 2.893 mm Hg, respectively. These findings suggested that health guidance should focus on factors such as the eating rate and drinking habits. [ABSTRACT FROM AUTHOR]

Aim: To test a modified team‐based learning approach on undergraduate learning outcomes in an acute‐care nursing course in Japan. Design: Mixed‐methods. Methods: Students worked on three simulated cases, engaged in pre‐class preparation, completed a quiz and engaged in group work. We collected data on team approach, critical‐thinking disposition and time spent in self‐learning at four time‐points: before the intervention and after each simulated case. Data were analysed using a linear mixed model, a Kruskal–Wallis test and a content analysis. Data sources: We recruited nursing students attending a mandatory course in acute‐care nursing at University A. Data were collected at four time‐points between April and July 2018. Data from 73 of 93 respondents were analysed. Results: Team approach, critical thinking and self‐learning all increased significantly across the time‐points. Four categories emerged from students' comments: 'achievement of teamwork', 'sense of learning efficacy', 'satisfaction with course approach' and 'issues related to course approach'. The modified team‐based learning approach led to improvements in team approach and critical‐thinking disposition across the course. Conclusion: Incorporating team‐based learning into the curriculum not only contributes to team building but is also effective as a teaching method to improve student learning. Implications for the profession and/or patient care: The intervention led to improvements in team approach and critical‐thinking disposition across the course. The educational intervention also led to more time for self‐learning. Future studies should include participants from various universities and evaluate the outcomes over a longer period. [ABSTRACT FROM AUTHOR]

Background: In 2011, a nuclear accident severely affected many hospitals in Fukushima. Many nurses faced a dilemma of whether to evacuate voluntarily or keep working. This study examined the voluntary evacuation and returning of nurses and then suggested how nurse administrators can prepare for such situations. Methods: The study was conducted from July through September 2018. Eight hundred nurses who had been working prior to the incident in three hospitals in Koriyama and Aizuwakamatsu participated. Although both cities had higher-than-normal terrestrial radiation levels, Koriyama's level was three times higher. An anonymous questionnaire was administered, and individual interviews were conducted with participants. For statistical analyses, SPSS Statistics for Windows, version 25.0, was used. Results: Ultimately, 723 questionnaires were collected. The proportions of those who considered evacuating (33.1%) and who evacuated (8.1%) were significantly higher in Koriyama. The characteristics of the group who considered evacuation were being pregnant, living with an adult cohabitant, and/or living with small child (ren). The evacuated nurses were all female and had similar characteristics as the group that considered evacuating; however, the age of their children was not related. Four out of six interviewees contacted nurse administrators and/or colleagues and overcame their feelings of guilt when their superiors and colleagues welcomed them back to work. Conclusion: Nurse administrators should understand that, when a radioactive disaster occurs, individuals who are more likely to consider evacuation have conflicts between their personal life and professional responsibilities. Nursing departments should inform nurses of their policies in advance and respect individuals' decision to leave, supporting them when they return to work. Departments should also have a plan in place for managing with a temporarily reduced workforce. [ABSTRACT FROM AUTHOR]