Makoto Kyougoku

An analysis of structural relationship among achievement motive on social participation, purpose in life, and role expectations among community dwelling elderly attending day services.

Background. Achievement motive is defined as the intention to achieve one’s goals. Achievement motive is assumed to promote clients to choices and actions toward their valuable goal, so it is an important consideration in rehabilitation. Purpose. The purpose of this study is to demonstrate the structural relationship among achievement motive on purpose in life, social participation, and role expectation of community-dwelling elderly people. Methods. Participants were community-dwelling elderly people in day-service centers. A total of 281 participants (male: 127, female: 154) answered the self-administered questionnaire in cross-sectional research. The questionnaire was comprised of demographic data and scales that evaluated achievement motive, social participation, purpose in life, and role expectation. We studied the structural relationship established by our hypothesized model via a structural equation modeling approach. Results. We checked the standardized path coefficients and the modification indices; the modified model’s statistics were a good fit: CFI = 0.984, TLI = 0.983, RMSEA = 0.050, 90% CI [0.044–0.055]. Achievement motive had a significantly direct effect on purpose in life (direct effect = 0.445, p value < 0.001), a significantly indirect effect on purpose in life via social participation or role expectation (indirect effect = 0.170, p value < 0.001) and a total effect on purpose in life (total effect = 0.615). Discussion. This result suggests that enhancing the intention to achieve one’s goals enables participants to feel a spirit of challenge with a purpose and a sense of fulfillment in their daily lives.

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.

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.

Analysis of structural relationship among the occupational dysfunction on the psychological problem in healthcare workers: a study using structural equation modeling

Purpose. The purpose of this study is to demonstrate the hypothetical model based on structural relationship with the occupational dysfunction on psychological problems (stress response, burnout syndrome, and depression) in healthcare workers. Method. Three cross sectional studies were conducted to assess the following relations: (1) occupational dysfunction on stress response (n = 468), (2) occupational dysfunction on burnout syndrome (n = 1,142), and (3) occupational dysfunction on depression (n = 687). Personal characteristics were collected through a questionnaire (such as age, gender, and job category, opportunities for refreshment, time spent on leisure activities, and work relationships) as well as the Classification and Assessment of Occupational Dysfunction (CAOD). Furthermore, study 1 included the Stress Response Scale-18 (SRS-18), study 2 used the Japanese Burnout Scale (JBS), and study 3 employed the Center for Epidemiological Studies Depression Scale (CES-D). The Kolmogorov–Smirnov test, confirmatory factor analysis (CFA), exploratory factor analysis (EFA), and path analysis of structural equation modeling (SEM) analysis were used in all of the studies. EFA and CFA were used to measure structural validity of four assessments; CAOD, SRS-18, JBS, and CES-D. For examination of a potential covariate, we assessed the correlation of the total and factor score of CAOD and personal factors in all studies. Moreover, direct and indirect effects of occupational dysfunction on stress response (Study 1), burnout syndrome (Study 2), and depression (Study 3) were also analyzed. Results. In study 1, CAOD had 16 items and 4 factors. In Study 2 and 3, CAOD had 16 items and 5 factors. SRS-18 had 18 items and 3 factors, JBS had 17 items and 3 factors, and CES-D had 20 items and 4 factors. All studies found that there were significant correlations between the CAOD total score and the personal factor that included opportunities for refreshment, time spent on leisure activities, and work relationships (p < 0.01). The hypothesis model results suggest that the classification of occupational dysfunction had good fit on the stress response (RMSEA = 0.061, CFI = 0.947, and TLI = 0.943), burnout syndrome (RMSEA = 0.076, CFI = 0.919, and TLI = 0.913), and depression (RMSEA = 0.060, CFI = 0.922, TLI = 0.917). Moreover, the detected covariates include opportunities for refreshment, time spent on leisure activities, and work relationships on occupational dysfunction. Conclusion. Our findings indicate that psychological problems are associated with occupational dysfunction in healthcare workers. Reduction of occupational dysfunction might be a strategy of better preventive occupational therapies for healthcare workers with psychological problems. However, longitudinal studies will be needed to determine a causal relationship.

Development of the Final Version of the Classification and Assessment of Occupational Dysfunction Scale

Occupational therapy is involved in disability prevention and health enhancement through the prevention of occupational dysfunction. Although many occupational dysfunction scales exist, no standard method is available for the assessment and classification of occupational dysfunction, which may include occupational imbalance, occupational deprivation, occupational alienation, and occupational marginalization. The purpose of this study was to develop the final version of Classification and Assessment of Occupational Dysfunction (CAOD). Our study demonstrated the validity and reliability of CAOD in a group of undergraduate students. The CAOD scale includes 16 items and addresses the following 4 domains: occupational imbalance, occupational deprivation, occupational alienation, and occupational marginalization.

Development of the Assessment of Belief Conflict in Relationship-14 (ABCR-14).

Purpose Nurses and other healthcare workers frequently experience belief conflict, one of the most important, new stress-related problems in both academic and clinical fields. Methods In this study, using a sample of 1,683 nursing practitioners, we developed The Assessment of Belief Conflict in Relationship-14 (ABCR-14), a new scale that assesses belief conflict in the healthcare field. Standard psychometric procedures were used to develop and test the scale, including a qualitative framework concept and item-pool development, item reduction, and scale development. We analyzed the psychometric properties of ABCR-14 according to entropy, polyserial correlation coefficient, exploratory factor analysis, confirmatory factor analysis, average variance extracted, Cronbach’s alpha, Pearson product-moment correlation coefficient, and multidimensional item response theory (MIRT). Results The results of the analysis supported a three-factor model consisting of 14 items. The validity and reliability of ABCR-14 was suggested by evidence from high construct validity, structural validity, hypothesis testing, internal consistency reliability, and concurrent validity. The result of the MIRT offered strong support for good item response of item slope parameters and difficulty parameters. However, the ABCR-14 Likert scale might need to be explored from the MIRT point of view. Yet, as mentioned above, there is sufficient evidence to support that ABCR-14 has high validity and reliability. Conclusion The ABCR-14 demonstrates good psychometric properties for nursing belief conflict. Further studies are recommended to confirm its application in clinical practice.

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.

Occupational Experiences of and Psychological Adjustment by Family Members of Cancer Patients

Objective/Background This qualitative analysis aimed to provide valuable insight into the occupational experiences of and psychological adjustments by family members who act as palliative caregivers. In addition, we also aimed to investigate and clarify these complex experiences and formulate results that are both meaningful and important to the families themselves. Methods Families who had lost a family member (n = 9) and were part of a palliative treatment support programme were identified through introductions from healthcare workers. They were individually interviewed using both casual questioning and semistructured questionnaires. The data were analysed using the grounded theory approach. Results The following six core categories were identified using grounded theory analysis: (a) being overwhelmed by pressure, (b) occupation while living with the illness, (c) living without being overwhelmed by anxiety, (d) having difficulties in regulating emotions, (e) comforting memories of the occupational experiences, and (f) leading to a change in emotions. Conclusion Occupational experiences can play a significant role in the psychological adjustment of families of terminally ill cancer patients.

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.

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.