Yumi Iwamitsu

The experience of burnout among home caregivers of patients with dementia: relations to depression and quality of life.

Caregivers of patients with dementia often experience chronic and emotional strains, which may lead to emotional exhaustion and burnout. The objective of this study was to examine the relationships between burnout, depression, and quality of life in home caregivers of patients with dementia. The participants were 84 home caregivers (39 male; 45 female), and they were asked to complete three questionnaires: the Beck Depression Inventory Second Edition (BDI-II), the WHO Quality of Life 26 (WHO-QOL26), and the Pines Burnout Measure (BM). Results from a bivariate correlation showed that BM scores significantly correlated with the scores on BDI-II and WHO-QOL26. Results from ANOVA comparing the level of burnout with the scores on BDI-II and WHO-QOL26 revealed that there were differences between the burnout groups and the scores on BDI-II and WHO-QOL26. The higher levels of burnout were found to correspond to higher levels of depressive symptoms and lower QOL. These findings suggest that caregiver intervention to reduce burnout might benefit from strategies to reduce depression and increase QOL.

The Relation Between Negative Emotional Suppression and Emotional Distress in Breast Cancer Diagnosis and Treatment

Our objective was to investigate differences in emotional distress between negative emotional suppression and expression patients in the progress of medical treatment, including the operation. We studied the differences in affective response between patients who suppress negative emotion and those who express negative emotion by using Profile of Mood States (McNair, Lorr, & Droppleman, 1971) at four sessions: (a) at the first visit to the clinic, (b) immediately after being told the diagnosis of breast cancer, (c) after the operation, and (d) at 3 months after discharge. Our results showed that emotional suppression patients tended to report more emotional distress (in particular, anxiety, depression, and anger) than did emotional expression patients on 3 sessions, the exception being after the operation. Also, patients who suppress anger and anxiety felt strong psychological distress. We suggest that it is essential to encourage suppressive patients to express both negative and positive emotion clearly and appropriately.

Subjective experiences of family caregivers of patients with dementia as predictive factors of quality of life.

Background:  The aim of the present study was to investigate predictive factors of quality of life (QOL) in home caregivers of patients with dementia.

Predictors of Psychological Distress After Diagnosis in Breast Cancer Patients and Patients with Benign Breast Problems

OBJECTIVE The objective of this study was to determine how age and psychological characteristics assessed prior to diagnosis could predict psychological distress in outpatients immediately after disclosure of their diagnosis. METHODS This is a longitudinal and prospective study, and participants were breast cancer patients and patients with benign breast problems (BBP). Patients were asked to complete questionnaires to determine levels of the following: trait anxiety (State-Trait Anxiety Inventory), negative emotional suppression (Courtauld Emotional Control Scale), life stress events (Life Experiences Survey), and psychological distress (Profile of Mood Status) prior to diagnosis. They were asked to complete a questionnaire measuring psychological distress after being told their diagnosis. We analyzed a total of 38 women diagnosed with breast cancer and 95 women diagnosed with a BBP. RESULTS A two-way analysis of variance (prior to, after diagnosis × cancer, benign) showed that psychological distress after diagnosis among breast cancer patients was significantly higher than in patients with a BBP. The multiple regression model accounted for a significant amount of variance in the breast cancer group (model adjusted R(2) = 0.545, p < 0.001), and only trait anxiety was statistically significant (β = 0.778, p < 0.001). In the BBP group, the multiple regression analysis yielded a significant result (model adjusted R(2) = 0.462, p < 0.001), with trait anxiety and negative life changes as statistically significant factors (β = 0.449 and 0.324 respectively; p < 0.01). CONCLUSIONS In both groups, trait anxiety assessed prior to diagnosis was the significant predictor of psychological distress after diagnosis, and might have prospects as a screening method for psychologically vulnerable women.

Psychological characteristics and subjective symptoms as determinants of psychological distress in patients prior to breast cancer diagnosis

Goals of workThe objective of this study was to determine how psychological characteristics, subjective symptoms, a family history of breast cancer, and age impact psychological distress in outpatients at the first hospital visit prior to breast cancer diagnosis.Materials and methodsParticipants were prediagnosed women with complaints of breast symptoms who either came to our hospital directly, or with a referral from another clinic. Patients were asked to complete questionnaires to determine the following: trait anxiety (State-Trait Anxiety Inventory), negative emotional suppression (Courtauld Emotional Control Scale), life stress events (Life Experiences Survey), and psychological distress (Profile of Mood States). We examined subjective symptoms (lumps, pain, abnormal nipple discharge, or deformed nipple) and family history of breast cancer based on answers to the interview sheet filled out by patients on their first visit. We analyzed a total of 154 patients who completed the questionnaires out of 237 eligible patients.Main resultsA significant model was obtained by multiple regression analysis (adjusted R2 = 0.574, p < 0.01) in which the standard partial regression coefficients for trait anxiety, suppression of anxiety, negative life change events, positive life change events, and subjective symptoms were statistically significant (β = 0.623, 0.133, 0.155, 0.108, and 0.124, respectively; p < 0.05).ConclusionsPsychological distress prior to diagnosis was higher in patients who had high trait anxiety, suppression of anxiety, many life stress events, and subjective symptoms. In particular, trait anxiety had a large impact on psychological distress, underscoring the need for and importance of adequate psychological care.

The psychological responses of outpatient breast cancer patients before and during first medical consultation.

OBJECTIVE The purpose of this study was to qualitatively examine the content of the psychological responses in interviews with breast cancer outpatients receiving initial medical consultation. METHOD The participants were 180 people who visited the breast cancer outpatient clinic at Kitasato University Hospital between November 2004 and August 2005. The remaining 176 participants (39 breast cancer patients and 137 benign tumor patients; average age +/- SD: 50.7 +/- 12.4 years) were analyzed. Two clinical psychologists carried out the interview, asking the participants to speak freely about their anxieties, worries, thoughts, and feelings up until the medical examination. This study used a content analysis of interviews to chronologically examine psychological response of cancer patients seeking medical consultation at three points in time. RESULTS Patients at the time of their first outpatient breast cancer consultation experience negative feelings before the examination, directly influenced by the suspicion of cancer. These include anxiety and worries, fear, evasion, depression, and impatience. These tendencies do not change at the time of consultation. However, in addition to negative feelings, some people also possess positive feelings, either simultaneously or at a different point in time. Further, many patients tend to talk at length about psychological responses before seeking treatment, understanding the process they went through to come to seek treatment as an important event. SIGNIFICANCE OF RESULTS It is important for medical workers to bear in mind the psychological conflicts that patients may undergo before seeking treatment and ensure that sufficient communication takes place.

Statistical Image Analysis of Psychological Projective Drawings

We propose statistical image analysis for psychological projective drawings to facilitate assessing the reliability of the projective drawing making the determination of its validity difficult. Standard analysis involves (1) drawing a picture, (2) scanning the drawing, (3) dividing the drawing, (4) analyzing the gray level histogram moment (GLHM), (5) applying spatial gray level dependence method (SGLDM), (6) applying the gray level difference method (GLDM) for the drawing, and (7) interpreting the drawing. To demonstrate the proposed procedure, we used the tree test (Baum test). Three adults were presented with blank A4 paper and asked to draw a picture of a tree with fruit on it. Drawings were analyzed by statistical image analysis and results interpreted clinically.

A report that Fukushima residents are concerned about radiation from Land, Food and Radon

The Great East Japan Earthquake and subsequent TEPCO Fukushima Daiichi nuclear disaster occurred on 11 March 2011, which caused the leakage of radioactive materials into the environment. In this study, we report public concerns about radiation in Fukushima and Tokyo almost one year after the nuclear disaster. We examined the public concerns by analyzing the data from 1022 participants, 555 in Fukushima and 467 in Tokyo. They were asked whether they were concerned about radiation from some of six different types of sources, which could be answered in a binary way, ‘yes’ or ‘no’. We found not only similarities, but also significant differences in the degrees of concerns between Fukushima residents and Tokyo ones. Fukushima residents more concerned about radiation from land, food and radon in larger rate than that of Tokyo ones, while Tokyo residents were concerned about radiation from medical care. Residents in neither location were concerned about radiation from space. Our results suggested that careful risk communication should be undertaken, adaptively organized depending on location and other factors, e.g. comprehension about radiation, presence of the experience of evacuation, and also age and gender of the people.

Exploration of factors related to hara-kiri as a method of suicide and suicidal behavior

OBJECTIVE The objective of this study was to explore factors associated with hara-kiri as a method of suicide and suicidal behavior in contemporary Japan. METHODS A retrospective study was conducted on medical records of 421 patients (174 male; 247 female) who were considered suicidal and treated at the Kitasato University Hospital Emergency Medical Center in Japan between January 2006 and March 2008. We compared hara-kiri and all other methods regarding sociodemographics and clinical features of all suicidal patients. RESULTS Instances of hara-kiri suicide attempt had the highest proportion of males (63%) among all suicide and suicidal behavior. One-way analysis of variance revealed significant differences between hara-kiri and other suicide attempt methods in the age of the suicidal patients. Result of multiple logistic regression analysis indicated that those who attempted hara-kiri suicide were likely to be male, be diagnosed with schizophrenia, survive, and be married. CONCLUSION Our findings indicate that hara-kiri as a method of suicide and suicidal behavior remains prevalent in Japan, and the study findings also suggest that both clinical and cultural factors might play a role in hara-kiri as a method of suicide and suicidal behavior.

Knowledge and impressions regarding the concept of mutation among Japanese university students

Although the term mutation is frequently used in genetic counseling, it may carry negative connotations and create misunderstanding. Our objective was to investigate the relationship between the impressions regarding three Japanese terms mutation of gene, change of gene, and lesion of gene as well as to investigate the depth of understanding regarding mutation. A total of 175 university students and auditing students were included and responded to two questionnaires that were Impressions regarding the term in the semantic differential method and Knowledge about the concept of mutation. In factor analysis, three factors (Value, Change Rate, and Intention) were extracted. Participants were divided into three groups depending on their knowledge, and a two‐way analysis of variance (Term × Knowledge Group) was conducted on the factor score for each. Results showed that the main effect of the ‘Term’ was significant for the Value Factor and that interaction was significant for the Change Rate Factor, and that the main effect of Knowledge Group was significant for the Intention Factor. The findings suggest that healthcare professionals should demonstrate an awareness of varying impressions of the different terms used to refer to the identical concepts of mutation. This is of particular importance when communicating with patients and their families.