Nurse intervention process for the thoughts and concerns of people with cancer at the end of their life: A structural equation modeling approach.

Over the last decade, the importance of Advanced Care Planning has been recognized in Japan. However, it is still difficult for healthcare providers and patients to verbalize how they want to spend the last days of their lives and what unfinished business they have left to accomplish. This study aimed to clarify how nurses intervened to assist patients with cancer at the end of life to express their thoughts and concerns. Twenty-four nurses were interviewed regarding how they intervened for patients' thoughts and concerns, and data were analyzed qualitatively using a modified grounded theory approach. A 25-item scale was selected, and the questionnaires, which included the scale, were distributed to nurses in general wards, palliative care units, and home visiting nurse services. A total of 1864 responses were analyzed. Factor analysis and structural equation model analysis were used, and three factors were identified: "assessment and intervention," "basic care," and "knowledge and communication," which led to the formulation of an intervention structure model for uncovering thoughts and concerns. These results indicate the importance of basic care and communication during interventions for patients.

The Effect of Nurses' Characteristics and Motivation on the Development of Their Career Intentions.

The aim of this study is to enrich nursing education by clarifying the relationship between personality traits, motivation, and career paths in professional nursing. This cross-sectional study surveyed 150 nurses from a polyclinic in Japan that performs internal medicine and surgery. The survey covered several aspects of personality, work motivation, and career development using the Ten-Item Personality Inventory, Work Motivation Scale, and Nurses' Job Career Scale. The demographics of the participants were also recorded. Multiple regression analysis revealed that the personality traits extraversion and agreeableness had a direct and positive impact on nurses' interest in team collaboration, but not on career development. Interest in career improvement was related to conscientiousness as a power toward purpose and openness as an aspect of curiosity. Conscientiousness and openness were indirectly related to the development and adjustment of interpersonal relationships and self-capability development through interest in career improvement. Interest in patient support positively impacted the implementation and pursuit of quality nursing. The findings highlight the need to account for individual differences in personality and motivation to support nurses' success during their nursing education and in the workplace.

Validity and reliability of Psychiatric Nurse Self-Efficacy Scales: cross-sectional study.

OBJECTIVES: To develop the Psychiatric Nurse Self-Efficacy Scales, and to examine their reliability and validity. DESIGN: We developed the Improved Self-Efficacy Scale (ISES) and Decreased Self-Efficacy Scale (DSES) using existing evidence. Statistical analysis was conducted on the data to test reliability and validity. SETTING: The study's setting was psychiatric facilities in three prefectures in Japan. PARTICIPANTS: Data from 514 valid responses were extracted of the 786 responses by psychiatric nurses. OUTCOME MEASURES: The study measured the reliability and validity of the scales. RESULTS: The ISES has two factors ('Positive changes in the patient' and 'Prospect of continuing in psychiatric nursing') and the DSES has three ('Devaluation of own role as a psychiatric nurse', 'Decrease in nursing ability due to overload' and 'Difficulty in seeing any results in psychiatric nursing'). With regard to scale reliability, the Cronbach's alpha coefficient was 0.634-0.845. With regard to scale validity, as the factorial validity of the ISES and DSES, for the ISES, χ2/df (110.625/37) ratio=2.990 (p<0.001), goodness-of-fit index (GFI)=0.962, adjusted GFI (AGFI)=0.932, comparative fit index (CFI)=0.967 and root mean square error of approximation (RMSEA)=0.062; for the DSES, χ2/df (101.982/37) ratio=2.756 (p<0.001), GFI=0.966, AGFI=0.940, CFI=0.943, RMSEA=0.059 and Akaike Information Criterion=159.982. The concurrent validity of the General Self-Efficacy Scale was r=0.149-0.446 (p<0.01) for ISES and r=-0.154 to -0.462 (p<0.01) for DSES, and the concurrent validity of the Stress Reaction Scale was r=-0.128 to 0.168 for ISES, r=0.214-0.398 for DSES (p<0.01).Statistical analyses showed the scales to be reliable and valid measures. CONCLUSIONS: The ISES and DSES can accurately assess psychiatric nurses' self-efficacy. Using these scales, it is possible to formulate programmes for improving psychiatric nurses' feelings of self-efficacy.

Cancer disclosure to friends: Survey on psychological distress and perceived social support provision.

OBJECTIVE: To determine the factors associated with the degree of distress experienced by patients with cancer before disclosing their cancer diagnosis to a friend and their perceptions of social support upon disclosure. METHODS: Adult patients with cancer participated in a cross-sectional Internet-based survey on their behaviour when disclosing their diagnosis to a selected friend, degree of distress before this disclosure and perceived social support upon disclosure. RESULTS: Of 473 eligible respondents, around half were middle-aged (40-59 years) and around half were men. Having a younger age (20-39 years), being a woman and delaying disclosure were factors associated with greater pre-disclosure distress. Most participants perceived receiving emotional support upon disclosure. Telling a close friend or a female friend and early disclosure timing were associated with perceived social support, although this varied by social support type. CONCLUSION: Younger patients and women may need more support in deciding to disclose their cancer diagnosis to friends. Selection of to whom to disclose this information and disclosure timing should be considered to achieve more desirable outcomes. In addition to selective disclosure-including planning and scheduling-communication skills may be required for effectively disclosing a cancer diagnosis and achieving favourable results following this disclosure.

Development and validation of the Cancer Knowledge Scale for the general population: An item response theory approach.

OBJECTIVE: To develop and validate a new measure of cancer knowledge for members of the general population who have never been diagnosed with cancer. METHODS: Initially, 20 items were generated to measure cancer knowledge. After expert refinement and cognitive interviews, 11 items remained and were completed by 1,076 adults with no history of cancer. Responses were assessed using an item response theory (IRT) approach and differential item functioning. RESULTS: Items were analyzed using a two-parameter logistic IRT model. Two items with tetrachoric correlation coefficients>0.8 and one item with a discrimination parameter>2.0 were excluded. The final eight items demonstrated a good range of discrimination (1.13 to 1.86) and difficulty (-1.11 to 0.85). No meaningful differential item functioning by participant attributes was detected for these eight items. CONCLUSION: The Cancer Knowledge Scale appears to be a reliable and valid measure for the general population. PRACTICE IMPLICATIONS: The eight-item scale could be used to assess the effects of psychoeducational programs, including those on cancer knowledge, for members of the general population with no cancer history.

Attitudes related to social distance between commissioned welfare volunteers (minsei-iin) and people with mental illness.

Objective: This study explored the factors influencing commissioned welfare volunteers' (CWVs) attitudes toward mental illnesses and how their attitudes correlated with their social distance from people with mental illness. Materials and Methods: Data from 223 CWVs were analyzed statistically. Factor extractions for the Image for Mental Illness Scale (IMI) and Social Distance Scale (SDS) were calculated. We examined the relations between factors in IMI and SDS. Results: CWVs' attitudes were classified as Understanding (understanding of the condition), Secure (feelings of safety in the presence of those with mental illness), and Activity (reactions to the behaviors of people with mental illness). Social distance from those with mental illness was classified as Public and Private Interactions. CWVs' interactions with people with mental illness were significantly influenced by feeling Secure in the presence of the latter. Low Public and Private Interactions were influenced by older age. CWVs' "experience in providing consultations for mental illness" led to the avoidance of Private Interactions. Conclusion: CWVs should feel safe when involved in Public or Private Interactions with individuals with mental illness. CWVs reported a preference for a higher level of social distance from people with mental illness.

Exploration of the factors related to self-efficacy among psychiatric nurses.

The average length of hospital stay in the psychiatric ward is longer, and the risk of patient-to-nurse violence is higher than that in other departments. Therefore, psychiatric nurses' work environment may differ from that of other nurses. The factors related to psychiatric nurses' self-efficacy may also differ from those of general workers or other nurses. Mental health care that considers the characteristics of psychiatric nurses requires exploration of self-efficacy unique to psychiatric nurses. This cross-sectional study aimed to explore the distinct factors related to psychiatric nurses' self-efficacy. The developed 24 items related to improvement in self-efficacy and 25 items related to decrease in self-efficacy were examined. The Generalized Self-Efficacy Scale was used to measure the validity of the factors. To extract the factors of self-efficacy, data from 132 nurses and assistant nurses who provided informed consent were analyzed, and the reliability and validity of the factors were calculated. The factors associated with improvement in self-efficacy were "Positive reactions by patients," "Ability to positively change nurse-patient relationship," and "Practicability of appropriate nursing." The factors associated with decrease in self-efficacy were "Uncertainty in psychiatric nursing" and "Nurses' role loss." The Cronbach's α for all factors exceeded .70. Of the five factors, four had significant weak-to-moderate correlations with the Japanese version of the Generalized Self-Efficacy Scale; therefore, the validity was quantitatively confirmed with four factors. Interventions based on these four factors may improve psychiatric nurses' self-efficacy. Additionally, it is possible that this tool assesses the unique facets of self-efficacy rather than psychiatric nurses' general self-efficacy. Interventions to improve psychiatric nurses' self-efficacy based on the characteristics of psychiatry are needed.

Relationship between global and segmental dynamics of poly(butylene oxide) studied by broadband dielectric spectroscopy.

Relationship between segmental relaxation and normal-mode relaxation has been studied for molten poly(butylene oxide)s having various molecular weights by broadband dielectric spectroscopy over a wide temperature (T) range. We found that T dependence of the segmental relaxation time, τs, was weaker than the normal mode time, τn, at high T(>250 K ∼ Tg + 50 K), and the τn/τs ratio systematically decreased with increasing temperature. This high temperature complexity, whose mechanism has not been discussed in detail so far, was quantitatively explained by assuming the two step processes: local conformation change of polymers (elementary process) occurs first, and then the motion of a segment unit (second process) occurs. It was also found that the elementary process was strongly correlated with the experimentally observed ß-relaxation.

Psychometric properties of the Japanese version of the Clinical Outcomes in Routine Evaluation-Outcome Measure.

This study examined the reliability and validity of the Japanese version of the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM), a standardized, brief, but comprehensive outcome measurement. The target population consisted of 1684 Japanese company employees, hospital staff, and university students. A confirmatory factor analysis proved that our data fit the factor structure of the original CORE-OM. We also examined its internal consistency, test-retest reliability, convergent validity, and sensitivity in discriminating between clinical and nonclinical samples. After demonstrating these results, we discuss how the Japanese version of the CORE-OM can be used both in clinical and research settings.

Psychosocial factors affecting the therapeutic decision-making and postoperative mood states in Japanese breast cancer patients who underwent various types of surgery: body image and sexuality.

OBJECTIVE: We conducted an empirical study to clarify how psychosocial factors (e.g. body image and sexuality) influence therapeutic decision-making and to identify the factors that affect post-operative mood states in Japanese women who underwent various types of surgery. METHODS: One hundred and two patients who had undergone surgical treatment for breast cancer participated in this study. Twenty-five patients had undergone mastectomy, 67 breast conserving treatment and 11 skin-sparing mastectomy and immediate breast reconstruction. The participants were evaluated based on a battery of questionnaires including value estimates of decision-making factors, a shortened version of the Profile of Mood States and self-efficacy. RESULTS: The patients regarded the possibility of cure and recurrence of cancer as well as the physician's support as important, regardless of the treatments they had chosen. The patients that had immediate breast reconstruction placed significantly more importance on their body image and sexuality (i.e. physical appearance, attractiveness to partner and self-evaluation of femininity and sexuality) than the mastectomy patients. After surgery, the former group tended to have a more negative mood on the shortened version of the Profile of Mood States than the latter group. Degree of self-efficacy had a marked influence on the patients' mood after surgery. CONCLUSIONS: This study suggests the importance of discussing body image and sexuality that has tended to be disregarded in therapeutic decision-making situations in breast cancer patients in Japan. Self-efficacy is a crucial variable for improving mood after treatment.