Hiromi Nakamura-Thomas

Assessing interests in Japanese elders: a descriptive study.

This study investigated use of the Japanese Interest Checklist for the Elderly (JICE). An interview that followed administration of the checklist illuminated the reasons for interests among 65 participants. Examining the reasons behind levels of interest is a potential avenue of research that may add to our understanding of the nature of interests.

A Factor Analytic Study of the Japanese Interest Checklist for the Elderly

Purpose: The purpose of this study was to identify the interest patterns among Japanese older people. Method: This study of 967 healthy older people examined the factorial structure of the Japanese Interest Checklist for the Elderly (JICE) and also examined whether interest patterns differed across genders and two age groups of older people. Results: The rotated varimax factor analysis extracted six factors: Activities Parallel to Daily Living (APDL), Pleasurable Outings, Cultural/Educational Activities, Entertainment Activities, Nature-related Activities and Social Activities. Alpha coefficients indicated adequacy for APDL, Pleasurable Outings and Cultural/Educational Activities (that is, above 0.70). The other three factors had lower coefficients, near or above 0.60. Differences in the strength of interest within each of the factors were found when men and women and different age groups were compared. Conclusion: The results of this study indicate that the JICE adequately captures the interests of Japanese older people. Considered in the light of previous research, the results also suggest that valid assessments of interests must include items targeted to a relatively homogeneous group.

Relationship between Interests and Health-Related Quality of Life in Older People:

Objective: This study examined the relationship between interest responses and health-related quality of life in 324 healthy older Japanese people. Method: Instruments used in this study included the Japanese Interest Checklist for the Elderly (JICE) containing six factors with 25 activities, and the Medical Outcomes Study 36-Item Short Form Health Survey version 2 (SF-36v2). Spearmans rank correlation coefficient was used to test correlations between the three interest parameter scores (interest, current participation and future participation) of the JICE and SF-36v2 scores. Data were analysed for men and women separately to clarify gender-specific differences. Results: Among women, the physical component score in the SF-36v2 correlated significantly and positively with all three interest parameter scores for all factors other than Entertainment Activities in the JICE. Among men, the mental component score in the SF-36v2 correlated significantly and positively with the scores of the three interest parameters for Activities of Daily Living, Pleasurable Outings and Cultural/Educational Activities factors in the JICE. Conclusion: This study identified different correlations between interest responses in activities listed on the JICE and component scores on the SF-36v2 between men and women and demonstrated a new application of interest checklists in the physical domain of the occupational therapy.

International efforts to disseminate and develop the model of human occupation.

This paper documents efforts in Canada, France, Finland, Germany, Hispanoamerica, Israel, Japan, The Netherlands, and Taiwan to disseminate the Model of Human Occupation (MOHO). We aim to characterize the challenges involved, the strategies used, and the impact of these efforts in diverse cultural and social conditions.

Relationships between Interest, Current, and Future Participation in Activities: Japanese Interest Checklist for the Elderly:

Introduction: This study examined the relationship between interest, current participation, and desire for future participation in each activity listed in the Japanese Interest Checklist for the Elderly. Method: Data were collected from 375 community-dwelling older Japanese people through individual interviews using the revised Japanese Interest Checklist for the Elderly, which contains 25 activities. Responses in interest, current participation, and desire for future participation were analysed across activity and gender. Findings: Interest, current participation, and desire for future participation in activities correlated significantly and positively for both genders. Three different situations were identified: (1) participants could not currently participate in activities despite showing interest; (2) they were not currently engaged in activities but wished to participate them in the future; and (3) they preferred not to participate in the specific activities in the future, despite currently showing interest. Conclusion: There is a need for occupational therapists, therefore, to understand these findings in considering appropriate therapeutic options. Moreover, occupational therapists need to determine whether the person prefers not to participate in some activities, despite showing interest and/or participation in interests more generally.

Application of Occupational Self Assessment in Community Settings for Older People

ABSTRACT This study addressed the application of the Occupational Self Assessment (OSA v2.2) in community settings for older people. This study examined the relationship between scores in the OSA v2.2 and the Falls Efficacy Scale (FES), and compared the scores between groups based on their living arrangements (whether they lived with their family members or alone) and their engagement in household activities. Data from 260 community-dwelling older individuals were analyzed using Spearmans rank correlation coefficient and Mann–Whitney U test. This study identified that OSA v2.2 scores were significantly positively correlated with FES scores. There was no significant difference in the scores for participants living alone or with their family members. Participants who engaged in household activities had significantly higher total and skill domain scores on the OSA v2.2 than their counterparts. This study proposes an occupational therapy practice that supports occupational competence in daily activities, provides implications for future collaboration with physiotherapists, and implies the usefulness of the OSA v2.2 in community settings.

Japanese Community-Living Older Adults’ Perceptions and Solutions Regarding Their Physical Home Environments:

This study examined perceived causes of accidental falls, the solutions implemented, and differences in scores on the Falls Efficacy Scale (FES) based on experiences of accidental falls, implementation of solutions, and experiences of problems in participants’ current environments. Data were collected individually from Japanese community-living older adults. Of the 41 participants, 71% experienced accidental falls, 41.5% implemented solutions, and 39.0% experienced problems in their current environments. Some solutions were implemented, including both appropriate and inappropriate ones. The FES scores differed significantly based on experiences of problems in participants’ current environments, suggesting that a consultation-style intervention would contribute toward improved FES scores among clients experiencing problems in their current environments.

Occupation-based practice: A new momentum in Japan*

Japan has been a member of the World Federation of Occupational Therapists (WFOT) since 1972. It has the largest number of WFOT-approved education programmes in the world, currently at 160, and has the second-highest number of practising occupational therapists, at 75,000 (WFOT, 2016). The Japanese Association of Occupational Therapy recently celebrated its 50th anniversary, and has grown from an original 18 members to now more than 50,000. Occupational therapy in Japan was founded in 1965, introduced alongside physiotherapy and supported by the medical profession. Therefore, both professions adopted the medical model, with occupational therapy expected to contribute to rehabilitation of upper limbs and fine-motor skills, and physiotherapy expected to contribute to rehabilitation of lower limbs and mobility. International participants at the 2014 WFOT Congress in Japan may have perceived the similarity between the two professions in this respect. Occupational therapy practice in Japan has, since its inception, modelled aspects of its approach on that of the United States (USA) (Japanese Association of Occupational Therapists, 2017). The importance of implementing occupation-based practice (OBP) was stated in the American Occupational Therapy Association (AOTA) Report to the Executive Board in 2005 (AOTA, 2005). A more recentUS-wide internet survey sought to better understand national practice patterns regarding OBP and the factors that occupational therapists believe affect its use (Lloyd andGreen, 2016). Theoccupational therapists reported that 33%of their interventionswere purposeful, 30%were occupation based and 25% were preparatory. The survey revealed that occupational therapists were seeking both standardized measures of the value of OBP and more credible evidence of its effectiveness in contrast to purposeful or preparatory interventions. Impairment-based occupational therapy is still a predominant therapeutic approach in Japan, although the new momentum towards OBP is becoming more apparent. While there are no official data in terms of the ratio of impairment-based practice to OBP, a recent systematic review (Roll and Hardison, 2017) may reflect the current status in Japan. This reviewed 59 articles that addressed occupational therapy practices for adults with musculoskeletal conditions of the forearm, wrist and hand. The review found that the strongest evidence supports postsurgical early active motion protocols and splinting for various conditions, while few studies described an OBP intervention. While occupational therapists generally continue to struggle with implementing OBP (Fisher, 2013), there are few publications about OBP at present. However, given that engagement in occupation is the primary therapeutic agent and the goal of intervention, as Fisher (2013) states, it appears very probable that OBP will be increasingly used. Momentum towards implementing OBP in Japan has gathered over the past five years, and research and practice appears to reflect the views of the US survey’s participants concerning the need for measures and more credible evidence. This can be seen, for instance, in the development of an assessment instrument for measuring occupational dysfunction to provide OBP (Teraoka and Kyougoku, 2015) and studies showing evidence of the effectiveness of OBP (Tomori et al., 2014; Nagayama et al., 2017). It will be interesting to see if the approach is adopted more widely as research evidence increases.

Application of the comprehensive environmental questionnaire for older adults requiring support for community-living:

Introduction The Comprehensive Environmental Questionnaire for the Elderly (CEQ) was developed to measure satisfaction levels among community-dwelling older adults regarding their environment. The CEQ comprises 14 question items grouped into three factors, which are rated on a four-point Likert scale. To expand the applicability of the CEQ to community-dwelling older adults requiring support from long-term care and family members for their community-living, this study examined the factorial structure and scale system of the CEQ to verify its validity and reliability. Method Data were collected individually from 218 participants who receive no rehabilitative services but require homemaking services and/or support from family members. The factorial structure and scale system were examined using structural equation modeling and an item response theory (IRT) approach, respectively. Findings We obtained values between 0.93 and 0.66 for factor loadings, 0.98 for comparative fit index, and 0.97 for Tucker–Lewis index, which indicated a good to adequate fit. The value of root mean square error of approximation was 0.094, indicating a mediocre fit. The IRT analysis showed an accurate description of item function of the CEQ. Conclusion The CEQ was applicable to the present study population. Although the CEQ concept was confirmed, the questionnaire warrants further improvement.

Validity and reliability of the Japanese Interest Checklist for the Elderly

Introduction The validity and reliability of the Japanese Interest Checklist for the Elderly were examined. Method 687 participants responded, using the new scale system: ‘currently participate based on interest,’ ‘participate less because of health status’ or ‘no interest.’ The convergent and discriminant validity of the factorial structure were examined using two-stage Confirmatory Factor Analysis approaches. The discriminant validity and reliability of the scale system were examined using two-stage Item Response Theory approaches. Results The first Confirmatory Factor Analysis stage indicated values representing good (factor loadings: 0.99–0.75; Comparative Fit Index: 0.99; Tucker-Lewis Index: 0.98) to adequate (Root Mean Square Error of Approximation: 0.054) fit levels. Both the discriminant validity and convergent validity were identified to be high. The second Confirmatory Factor Analysis stage with a Path analysis and consideration of age and gender indicated values representing a good fit (factor loadings: 0.99–0.78; Comparative Fit Index: 0.99; Tucker-Lewis Index: 0.98; Root Mean Square Error of Approximation: 0.048). The first Item Response Theory stage indicated the values for the discriminant validity in the expected ranges; however, it displayed lower reliability in some activities. The second Item Response Theory state with the latent-class model-based multi-group Item Response Theory confirmed the pattern of invariance. Conclusion The factorial structure was valid across different groups of people. The scale system has to be improved.