Sachiyo Murashima

Perinatal immunization education improves immunization rates and knowledge: A randomized controlled trial

OBJECTIVES To determine if providing perinatal immunization education positively changes the immunization status of infants, influences the infant immunization knowledge, attitudes and beliefs of mothers and affects the intent to vaccinate children in Japan where immunization education is limited. METHODS Pregnant women were recruited from three sites in Tokyo, Japan and were assigned to two intervention (pre- or postnatal education) groups and a control group. The immunization status of infants was assessed and a written survey was performed before and after the intervention. RESULTS Among 119 study participants, 106 subjects replied to the post-survey. The intervention groups (34.3%) had higher immunization rates in infants at three months of age than the control group (8.3%) (P=0.005); however, no differences were observed between the prenatal (29.4%) and postnatal groups (38.9%) (P=0.40). The percentage of women intended to vaccinate their infants was higher in the intervention groups (61.4%) compared to the control group (33.3%) (P=0.01). The improvement in score for basic knowledge was higher in the intervention groups, particularly in the prenatal group (mean±S.D.: 3.4±1.8) compared to the control (1.9±1.9) (P=0.003). CONCLUSIONS Perinatal immunization education improved the immunization status of infants, increased the womens knowledge on immunization and intention to vaccinate their infants.

Expansion of discharge planning system in Japan: Comparison of results of a nationwide survey between 2001 and 2010

BackgroundIn response to the rapid aging of the population in Japan, many care systems have been created in quick succession. Establishment of discharge planning departments (DPDs) in hospitals is one of them. In this study, we compared the distribution and characteristics of DPDs and the characteristics of the hospitals that have DPDs between 2001 and 2010 in Japan.MethodsWe mailed a questionnaire about the characteristics of hospitals and existence and situation of DPDs to all general hospitals with 100 or more general beds in 2001 and in 2010.ResultsIn 2001, of the 3,268 hospitals queried, 1,568 (48.0%) responded and 1,357 (41.5%) were selected for data analysis. In 2010, among 2,600 hospitals, 940 hospitals (36.1%) responded and 913 (35.1%) met the inclusion criteria. The percentage of hospitals with DPDs increased from 30% to more than 70% between the two surveys. More departments were under the direct control of the hospital director and more physicians participated in discharge planning activities in 2010 than in 2001. In 2001, private hospitals and hospitals with an affiliated institution or agency tended to have a DPD; however, the relationship between these factors and the presence of a DPD had disappeared in 2010. Larger hospitals and hospitals with more nurses per patient tended to have a DPD both in 2001 and 2010.ConclusionsSince 2008, the establishment of a DPD has been directly connected to medical fees so hospital administrators might have recognized the DPD as a “necessary and paid for” department. Having a DPD was the majority’s policy in Japan, and we must recognize the importance of quality assurance through DPDs from now on, especially in small hospitals.

Anxiety and depression after thoracic aortic surgery or coronary artery bypass

Background: although the outcome of thoracic aortic surgery has improved remarkably, mortality remains high, and mental distress is often present. Psychological outcomes of coronary artery disease have been increasingly researched but few studies have been conducted in thoracic aortic surgery patients. Objective: to compare the psychological outcomes of patients undergoing thoracic aortic surgery with those of patients undergoing coronary artery bypass grafting. Methods: a questionnaire was mailed to 190 patients who underwent thoracic aortic surgery or coronary artery bypass, at 1–5 years postoperatively. Psychological outcomes were assessed using the hospital anxiety and depression scale. Results: 128 patients responded; 49 had aortic surgery and 79 had coronary artery bypass. The incidence of borderline or significant anxiety was 14% in thoracic aortic surgery patients and 16% in coronary bypass patients; depression was present in 28% and 20%, respectively. Psychological outcome scores in the 2 groups did not differ significantly. Emergency surgery was associated with depression after aortic surgery, and symptoms such as chest pain and fatigue were associated with both anxiety and depression after coronary artery bypass. Conclusions: some psychological problems remain in the midterm following thoracic aortic surgery. While we expected a more psychologically compromised outcome in the thoracic aortic surgery group, psychological outcomes were quite similar to those in coronary artery bypass patients. The similarity of the profiles of both groups suggests that thoracic aortic surgery patients have a parallel course of midterm psychological improvement following surgery.

Exploring the ideal combination of activity satisfaction and burden among health promotion volunteers: a cross-sectional study in Japan

BackgroundHealth promotion volunteers (HPVs) who are expected to function as leaders in promoting community health in Japan feel both satisfaction and burden associated with their community engagement activities. The purposes of this study were 1) to describe the prevalence of volunteers with differing levels of activity satisfaction and burden; 2) to examine the association between satisfaction and burden with activity involvement and persistence, and life satisfaction; and 3) to explore associated factors by satisfaction/burden levels among Japanese HPVs. The research question for this study was as follows: What is the relationship between activity satisfaction and burden among HPV?MethodsA mail-in self-administered questionnaire survey was distributed to 604 HPVs in the cities of Konan and Koka, Shiga Prefecture, central Japan, in September 2005. Questions encompassed demographic data, variables regarding HPV activity such as organizational environment, social support, and the relationship with the neighborhood association, and overall satisfaction and burden related to the activity.ResultsThe analyzed sample comprised 422 HPVs. Those with high satisfaction/low burden represented the largest number of study participants (group A; 38.4%). HPVs with high satisfaction/high burden (group B), low satisfaction/low burden (group C), and low satisfaction/high burden (group D) represented 23.0%, 11.1%, and 27.5% of participants, respectively. HPVs in groups A and B reported a greater total number of activities undertaken than those in group C. However, HPVs in group A had higher life satisfaction than those in groups C and D. Multinomial logistic regression analysis used to explore group differences showed that HPVs in group B had lower initial motivation and received less social support from colleagues, and those in group C felt the head of the neighborhood association was uncooperative. Those in group D had lower initial motivation, rated their organizational climate as worse, and considered the head of the neighborhood association uncooperative compared with group A.ConclusionsWe found that feeling satisfied and lightly burdened facilitated HPVs’ active participation in community-based activities. Findings suggest the importance of improving activity environments surrounding HPVs.

Quality of nursing doctoral education in seven countries: survey of faculty and students/graduates

AIMS This study aimed to compare the findings of the quality of nursing doctoral education survey across seven countries and discuss the strategic directions for improving quality. BACKGROUND No comparative evaluation of global quality of nursing doctoral education has been reported to date despite the rapid increase in the number of nursing doctoral programmes. DESIGN A descriptive, cross-country, comparative design was employed. METHODS Data were collected from 2007-2010 from nursing schools in seven countries: Australia, Japan, Korea, South Africa, Thailand, UK and USA. An online questionnaire was used to evaluate quality of nursing doctoral education except for Japan, where a paper version was used. Korea and South Africa used e-mails quality of nursing doctoral education was evaluated using four domains: Programme, Faculty (referring to academic staff), Resource and Evaluation. Descriptive statistics, correlational and ordinal logistic regression were employed. RESULTS A total of 105 deans/schools, 414 faculty and 1149 students/graduates participated. The perceptions of faculty and students/graduates about the quality of nursing doctoral education across the seven countries were mostly favourable on all four domains. The faculty domain score had the largest estimated coefficient for relative importance. As the overall quality level of doctoral education rose from fair to good, the resource domain showed an increased effect. CONCLUSIONS Both faculty and students/graduates groups rated the overall quality of nursing doctoral education favourably. The faculty domain had the greatest importance for quality, followed by the programme domain. However, the importance of the resource domain gained significance as the overall quality of nursing doctoral education increased, indicating the needs for more attention to resources if the quality of nursing doctoral education is to improve.

The tsunami's impact on mortality in a town severely damaged by the 2011 Great East Japan Earthquake.

This study identifies the relationship between tsunami damage and mortality through a demographic pyramid of a town severely damaged by the tsunami following the Great East Japan Earthquake of 11 March 2011. It uses cross-sectional data collection. Volunteers visited all households, including shelters, and asked residents about the whereabouts of family members and neighbours. The information was collated with lists of evacuees and the dead to confirm the whereabouts of all residents about 50 days after the disaster. Demographic pyramids for the whole population based on pre- and post-disaster data were drawn. In all, 1,412 (8.8 per cent) were dead or missing, 60.2 per cent of whom were aged 65 and over and 37.5 per cent aged 75 and over, suggesting that the very old should be located beyond the reach of tsunamis. The mortality rate of children was lower than that in other studies, which may indicate the efficacy of disaster evacuation drills.

Relationship between patient group participation and self-care agency among patients with a history of cardiac surgery: A cross-sectional study

Background Little is known regarding the influence of participation in patient groups on self‐care in patients with a cardiac surgery history. Objectives To investigate the relationship between patient group participation and self‐care among patients with a cardiac surgery history. Methods Participants were 956 patients with cardiac surgery history from a patient group. Information on self‐care agency, patient group participation, and health status was collected through a self‐administered questionnaire. Results There were 566 valid responses. Participants were mostly male (76.4%), and the mean age was 70.6 years. A high social support level from a patient group was associated with each subscale of the self‐care agency as follows: self‐care operations (odds ratio [OR] 1.08, 95% confidence interval [CI] 1.04–1.12), adjusting ones condition (OR 1.04, 95% CI 1.01–1.07), and attention to self‐care (OR 1.05, 95% CI 1.02–1.07). Conclusions Patient group participation may promote self‐care performance in patients with a cardiac surgery history.

Promoting the Use of Visiting Nurse Services for Patients Discharged From Hospital Evaluation of a Japanese Municipality’s Model Project

A project to encourage the adequate use of visiting nurse services (VNS) after discharge was conducted by “K” City, Japan. Eligible individuals were inpatients of general hospital ready for discharge and assessed as potentially needing VNS, and their out-of-pocket fees for VNS within 1 month following discharge were covered by the city. To clarify this project’s effect, patient/family’s intention to use VNS and the utilization of VNS at each time point were evaluated. Eighty-eight residents used the project. Before initial hospitalization, less than one quarter of users had recognized the necessity of VNS. Many participants (88.6%) continued to use VNS even after the completion of the project period despite having to cover the VNS cost by themselves, indicating that this project had a positive impact on appropriate VNS use.