Naomi Ito

Validity and reliability of the Physical Activity Scale for the Elderly (PASE) in Japanese elderly people.

Aim:  In Japan, there are no valid and reliable physical activity questionnaires for elderly people. In this study, we translated the Physical Activity Scale for the Elderly (PASE) into Japanese and assessed its validity and reliability.

Adherence to self-care behavior and factors related to this behavior among patients with heart failure in Japan

BACKGROUND Adherence to self-care behavior is important for patients with heart failure (HF) to prevent exacerbation of HF. The aim of this study was to evaluate adherence, identify associated factors, and clarify the impact of previous HF hospitalizations on adherence in outpatients with HF. METHODS A total of 116 outpatients completed a questionnaire, including the Japanese version of the European Heart Failure Self-Care Behavior Scale, to assess adherence. RESULTS Regardless of previous hospitalizations, adherence to seek help if HF worsened was poor. Multivariate analysis adjusted for age and brain natriuretic peptide showed that diabetes mellitus and being employed were independent predictors of poorer adherence to self-care behavior (P = .03, P = .02, respectively), but the experience of previous HF hospitalizations was not a predictor. CONCLUSIONS Self-care strategies for HF should target patients with diabetes mellitus and employed patients. Further study is necessary to develop effective programs for such patients.

Validity and Reliability of the Japanese Version of the European Heart Failure Self-Care Behavior Scale

Background: It is important to assess the self-care behavior of patients with heart failure. However, in Japan, there is no valid and reliable scale for this purpose. The European Heart Failure Self-Care Behavior Scale (EHFScBS) is used to measure the self-care behavior of heart failure patients. The purpose of this study was to translate the EHFScBS into Japanese and evaluate its validity and reliability. Methods and results: A convenience sample of 116 outpatients with heart failure completed the Japanese version of the EHFScBS. Confirmatory factor analysis demonstrated the one-dimensionality of the scale. The Japanese version of the EHFScBS was significantly correlated with another scale, which was considered to evaluate the concept linked with the self-care behavior theoretically. These confirm its construct validity. Cronbachs alpha was 0.71, suggesting that internal consistency was satisfactory. Test–retest reliability was evaluated. The intraclass correlation coefficient of the scale was 0.69 and weighted kappa for individual items was 0.33–0.87, suggesting that test–retest reliability is adequate. Conclusions: The Japanese version of the EHFScBS was showed acceptable validity and reliability. It can be used to evaluate self-care behavior of Japanese patients with heart failure.

Prospective longitudinal evaluation of quality of life in patients with permanent colostomy after curative resection for rectal cancer: a preliminary study.

PURPOSE: The aim of this study was to evaluate health-related quality of life in patients with a colostomy immediately before and during the first year after surgery. SUBJECTS AND SETTING: Patients (aged ≥20 years) who were diagnosed with rectal cancer and scheduled to undergo curative surgery with a permanent colostomy were recruited for this study. Data were collected at 2 university hospitals in Tokyo. METHODS: Participants were asked to complete a self-administered questionnaire regarding health-related quality of life before surgery and a mailed or hand delivered questionnaire to evaluate quality of life at 2, 6, and 12 months after surgery using the Short Form–36 version 2. For patients who responded at all 4 time points, the scores at each time point were compared using paired t tests to examine longitudinal changes in quality of life after surgery. RESULTS: Mean quality-of-life scores in most domains before surgery and during the first year after surgery were lower than the normal control in the norm-based scoring method. Scores at 2 months after surgery were lower than those before surgery. At 12 months after surgery, however, quality-of-life scores improved almost to the level observed before surgery, with the exception of the score in the social functioning domain. Statistical differences in scores between the time points of the survey were observed in the role-physical, bodily pain, and mental health domains. CONCLUSIONS: These results suggest that patients with permanent colostomy after curative resection for rectal cancer need additional medical support and care before surgery and during the first year after surgery.

Response shift in quality-of-life assessment in patients undergoing curative surgery with permanent colostomy: a preliminary study.

The purpose of this preliminary study (N 13) was to investigate the impact of response shift in quality of life for cancer patients undergoing surgical resection with resultant permanent colostomy. Response shift was measured using a “then-test” approach. Quality of life was measured using the 36-Item Short Form Health Survey version 2 (Japanese version). Baseline data (pretest scores) were collected before surgery when subjects completed the 36-Item Short Form Health Survey. Two months after the surgery, subjects were asked to respond again to the 36-Item Short Form Health Survey to assess their postsurgery quality-of-life (posttest score) level and their presurgery quality-of-life level (then-test score). Norm-based scoring for pretest, posttest, and then-test scores for each of the 36-Item Short Form Health Survey domains was calculated. Response shift was assessed by the difference between pretest and then-test scores and effect size. Findings revealed that a moderate but significant response shift was observed in the bodily pain domain. A small response shift was observed in the role physical and vitality domains. The then-test score was higher than the pretest score. The same trend was observed in all other domains except general health. The results indicate that the unit of comparison in the subjects was changed by surgery. Knowledge of these phenomena would allow a better understanding of quality of life of these subjects.

Translation and Validation Study of the Japanese Versions of the Coronary Revascularisation Outcome Questionnaire (CROQ-J)

Background and aims: Assessing the health related quality of life (HRQOL) in patients with a disease specific scale is essential. The purpose of this study was to develop the Japanese version of the coronary revascularisation outcome questionnaire (CROQ), a disease-specific scale to measure HRQOL before and after coronary revascularisation. Methods: The English version of the questionnaire was translated into Japanese; some terms were revised, and some items were eliminated to suit the Japanese medical environment. Eight patients filled out the questionnaire, which was then analyzed for face validity. In the field study, subjects were recruited from a university hospital in Tokyo, and questionnaires were given to fill out. In terms of statistical analysis, factor analysis, internal consistency, known-groups validity, concurrent validity with using Short-Form36 (SF-36) and Seattle Angina Questionnaire-Japanese version (SAQ-J), and test–retest reliability were assessed. Results: Informed consents were obtained from 356 patients, and out of 325 patients responded in the field study (91.3%). The factor structure of CROQ-Japanese version (CROQ-J) was similar to that of the original version. Cronbachs α ranged from 0.78 to 0.92. The concurrent validity was mostly supported by the pattern of association between CROQ-J, SAQ-J, and SF-36. Patients without chest symptoms had significantly higher scores of CROQ-J than those with chest symptoms. On the basis of analysis of the test–retest reliability, intra-class correlation coefficients were close to 0.70. Conclusions: The Japanese translation of CROQ is a valid and reliable scale for assessing the patients HRQOL in CAD.

Attitude of outpatients with neuromuscular diseases in Japan to pain and use of analgesics

The prevalence of pain and its impact on outpatients with neuromuscular disease, and their attitude towards the use of analgesics were studied. Seventy-eight outpatients at the university hospital, Tokyo, diagnosed with Parkinsons disease, spinocerebellar degeneration, amyotrophic lateral sclerosis, or multiple sclerosis were asked whether they had experienced pain in the preceding week. The Brief Pain Inventory, Japanese version was used to interview participants reporting pain, about its intensity and interference with activities, the way they dealt with it, attitudes to pain and use of analgesics, and desire for treatment. Forty-six participants experienced pain in the preceding week (59%). The mean pain intensity was 4.1 out of 10, and 20% of participants reported that the degree of interference with mobility was at least 6 out of 10. Most participants dealt with their pain without medication, by changing posture frequently or massage. Approximately 80% of participants regarded pain as something they should endure. Half of the participants wanted more information on methods for pain relief. Approximately 80% of participants were anxious about adverse reactions of analgesics. These findings suggest that medical staffs should provide appropriate information and educate their patients.