Takashi Naruse

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.

On- and post-treatment symptom relief by repeated instillations of heparin and alkalized lidocaine in interstitial cystitis.

To examine outcomes of intravesical instillations of heparin and alkalized lidocaine in patients with interstitial cystitis.

Who was concerned about radiation, food safety, and natural disasters after the great East Japan earthquake and Fukushima catastrophe? A nationwide cross-sectional survey in 2012.

Background Disaster-related concerns by sub-populations have not been clarified after the great East Japan earthquake and the Fukushima nuclear power plant incidents. This paper assesses who was concerned about radiation, food safety, and natural disasters among the general population in order to buffer such concerns effectively. Methods The hypothesis that women, parents, and family caregivers were most concerned about radiation, food safety, and natural disaster was tested using a varying-intercept multivariable logistic regression with 5809 responses from a nationwide cross-sectional survey random-sampled in March 2012. Results Many people were at least occasionally concerned about radiation (53.5%), food safety (47.3%), and about natural disaster (69.5%). Women were more concerned than men about radiation (OR = 1.67; 95% CI = 1.35–2.06), food safety (1.70; 1.38–2.10), and natural disasters (1.74; 1.39–2.19). Parents and family care needs were not significant. Married couples were more concerned about radiation (1.53; 1.33–1.77), food safety (1.38; 1.20–1.59), and natural disasters (1.30; 1.12–1.52). Age, child-cohabitation, college-completion, retirement status, homemaker status, and the house-damage certificate of the last disaster were also associated with at least one concern. Participants from the Kanto region were more concerned about radiation (2.08; 1.58–2.74) and food safety (1.30; 1.07–1.59), which demonstrate similar positive associations to participants from Tohoku where a disaster relief act was invoked (3.36; 2.25–5.01 about radiation, 1.49; 1.08–2.06 about food safety). Conclusions Sectioning the populations by gender and other demographics will clarify prospective targets for interventions, allow for a better understanding of post-disaster concerns, and help communicate relevant information effectively.

Sources of perceived social support associated with reduced psychological distress at 1 year after the Great East Japan Earthquake: Nationwide cross-sectional survey in 2012

Lack of social support has been associated with a higher level of psychological distress after disasters, but its relative associations with sources of support such as neighbors, friends, family, and others, are underreported. The present study assessed the associations of social support with psychological distress according to support source among the general population 1 year after the Great East Japan Earthquake.

Individual and organizational factors related to work engagement among home-visiting nurses in Japan

AIM The increasing number of elderly people has caused increased demand for home-visiting nurses. Nursing managers should develop healthy workplaces in order to grow their workforce. This study investigated the work engagement of home-visiting nurses as an index of workplace health. The aim of the present study was to reveal factors contributing to work engagement among Japanese home-visiting nurses. METHODS An anonymous, self-administered questionnaire was sent to 208 home-visiting nurses from 28 nursing agencies in three districts; 177 (85.1%) returned the questionnaires. The Job Demands-Resources model, which explains the relationship between work environment and employee well-being, was used as a conceptual guide. The authors employed three survey instruments: (i) questions on individual variables; (ii) questions on organizational variables; and (iii) the Utrecht Work Engagement Scale (Japanese version). Multiple regression analyses were performed in order to examine the relationships between individual variables, organizational variables, and work engagement. RESULTS Nurse managers and nurses who felt that there was a positive relationship between work and family had significantly higher work engagement levels than others. The support of a supervisor was significantly associated with work engagement. Nurses in middle-sized but not large agencies had significantly higher work engagement than nurses in small agencies. CONCLUSION Supervisor support and an appropriate number of people reporting to each supervisor are important factors in fostering work engagement among home-visiting nurses.

Who prefers to age in place? Cross-sectional survey of middle-aged people in Japan

Preference for aging in place among middle‐aged people is an important element in estimating the future needs for community services of disabled older adults. Drawing on Litwak and Longinos typologies of relocation, the present study investigated the characteristics of middle‐aged adults who prefer to age in place and those who prefer to move, at two levels of disability: being unable to walk alone and being bedridden.

Relational coordination among home healthcare professions and goal attainment in nursing care

AIM To examine whether interprofessional coordination is related to goal attainment in home visit nursing care. METHODS Self-administered questionnaire surveys were administered to home visit nursing agencies in Chiba Prefecture, Japan, from July to December 2014. Nurses evaluated their interprofessional coordination with professional groups (nursing colleague and managers, home doctors, care managers, home care workers, visiting therapists, day service and day care professionals, visiting bath professionals, and short stay professionals) using the Japanese version of the Relational Coordination Scale (RCS-J). Goal attainment across all clients during the most recent 3 months was measured with a rating scale ranging from incompletely attained (0) to completely attained (10). Data were analyzed with multivariate logistic regression analysis. RESULTS A total of 83 nurses in 14 agencies responded, and data from 74 nurses were analyzed. The mean RCS-J and goal attainment scores were 3.59 (standard deviation = 0.47) and 6.51 (1.40), respectively. The RCS-J scores of the low and high goal attainment groups were 3.41 (0.46) and 3.73 (0.42), respectively. Multivariate logistic regression analysis revealed that RCS-J scores were positively associated with goal attainment (odds ratio, 5.71; 95% confidence interval, 1.65-19.79). CONCLUSION The finding of this study suggest that well-coordinated professionals may fulfill client needs better than poorly coordinated professionals do. Future research is needed to determine whether similar results are obtained in individual clients using a well-validated goal attainment scale.

Effects of Nonnursing Assistance on Home Visit Nurses’ Time Spent In Japan: One Group Repeated Pretest-Posttest Trial

To determine means of improving the efficiency of home nursing services, we conducted an experimental pretest-posttest study to compare the time spent by home visiting nurses (HVNs) on providing care with or without assistance. HVNs’ job-related satisfaction levels were also compared. Forty-four clients in six visiting nursing offices in Fukuoka prefecture were selected for this study, which was conducted between July 2009 and January 2010. With assistance, HVNs’ total care time and time spent performing trivial tasks decreased and time spent on communicating or teaching increased. Furthermore, HVNs were more satisfied with providing care than with their usual visits. We conclude that introduction of a skill mix might improve home visiting nursing service efficiency through shortening the HVNs’ length of stay at a client’s home.

Characteristics of family caregivers with sleep dissatisfaction in Japan: identification using CHAID dendrograms.

The rapid increase in the population of the elderly has raised several social issues. The current study focused on sleep dissatisfaction in family caregivers to identify family caregivers with a heavy care burden. This study aimed to detect the characteristics of caregivers who are most likely to have sleep dissatisfaction. A chi-squared automatic interaction detection technique was used to analyze data collected from 92 research care managers who collected demographic and sleep dissatisfaction information from 280 caregivers and their care recipients. Caregivers whose care recipients were unstable and bedridden were most likely to have sleep dissatisfaction. When care recipients were not stable or non-bedridden, had severe dementia symptoms, and were physically independent, their caregivers were the second most likely to have sleep dissatisfaction. When care recipients were not stable or non-bedridden, had moderate dementia symptoms, and did not need help in transferring, their caregivers had the lowest risk of sleep dissatisfaction. Although many recent studies have found a high prevalence of insomnia among the elderly, describing the characteristics of caregivers who are most likely to have sleep dissatisfaction is a significant challenge. When care recipients are physically independent, the severity of the recipients dementia symptoms relates to the caregivers dissatisfaction with his/her sleep. In physically dependent care recipients, the severity of the recipients dementia did not contribute to the caregivers dissatisfaction with his/her sleep.

Diseases that precede disability among latter-stage elderly individuals in Japan.

Understanding causes of disability among elderly individuals is an important public health issue, particularly because of the increasing rate of disabled elderly individuals and the social costs in a rapidly aging society. Accordingly, we aimed to describe the diseases that precede disability and investigate the types of diseases that are related to severe disability among Japanese elderly individuals aged over 75 years. Using claim data from the latter-stage elderly healthcare system and long-term care insurance system, we identified 76,265 elderly individuals over 75 years old who did not qualify as disabled on April 1, 2011. Among them, 3,715 elderly individuals who had been newly qualified as disabled between April 1, 2011 and March 31, 2012 were selected. Disease codes from the medical claim data in the 6 months prior to disability were collected. All descriptions were developed separately for six groups divided by gender and disability level (low, middle, and high). The results of the ordinal logistic analysis including sex and age revealed that men tended to have significantly higher levels of disability (β = 0.417, p < 0.001) than women. Cerebrovascular disorder (CVD) was the most common disease in almost all age and disability level groups. In low-level disability groups, cancer in men (12.8%) and arthropathy and fracture in women (11.9% and 13.5%, respectively) were as common as cerebrovascular disorder (12.2% and 9.7%, in men and women, respectively). Stroke was the most common disease for all genders and disability levels. The diseases preceding low-level disability differed by gender. This study demonstrated the need to consider arthropathy and fracture as well as CVD in order to prevent disability.