Development and psychometric validation of an educational support assessment scale for novice home healthcare nurses.

BACKGROUND: Educational support quality is an essential factor in determining the education of novice home healthcare nurses. This study developed a scale to assess the educational support provided by home healthcare agencies among novice home healthcare nurses. METHODS: Hypothetical components were derived from a literature review, including experiential learning theory. Expert panels evaluated the initial scale items, and the scale was tested with 3000 agencies from April to June 2022. A total of 627 valid responses were analyzed. RESULTS: Exploratory factor analysis produced a four-subscale structure consisting of 34 items that supported the hypothesized components. Cronbach's alphas ranged 0.889 to 0.961, and the intraclass correlation coefficients ranged 0.703 to 0.905 in the test-retest survey. CONCLUSIONS: The educational support assessment scale developed for novice home healthcare nurses is valid and reliable. Managers in home healthcare agencies should apply the results of assessments using the scale to improve their human resource development.

The association between burnout and multiple roles at work and in the family among female Japanese nurses: a cross-sectional study.

Female nurses experience work-family conflict due to performing multiple roles, leading to burnout. Thus, this study aimed to verify the association between burnout and the multiple work and family roles performed among Japanese female nurses. The data for 2,255 nurses at 23 Japanese hospitals obtained from the Work Environment for Nurses Study in Japan were used. The variables included burnout, demographic information, additional work roles, and child-rearing or caregiving. Half of the nurses were categorized under the "no-role" group (NRG), approximately a quarter under the "work-role" group (WRG), 16% under the "family-role" group (FRG), and 7.3% under the "multiple-role" group (MRG). Compared to the NRG, the FRG and MRG showed statistically lower emotional exhaustion (B=-0.79, p<0.05; B=-0.94, p<0.05, respectively) and depersonalization (B=-0.80, p<0.05; B=-1.09, p<0.05, respectively). Personal accomplishment was not statistically different among the four groups. Burnout was relatively low among nurses with family roles, suggesting that family roles may have a positive spillover effect on work-related emotions.

Association between nursing practice environment and sense of coherence among staff nurses: A cross-sectional study in Japan.

AIM: This study aimed to investigate the association between work environment and sense of coherence among staff nurses. BACKGROUND: In Antonovsky's salutogenetic theory, factors that causes stress are not always harmful when people's sense of coherence is high. Although the effects of sense of coherence have repeatedly been confirmed, few studies have examined factors that increase sense of coherence. METHODS: We used cross-sectional data (N = 6172) surveyed in 2017 from a 2-year longitudinal study in 2016 and 2017. Multiple group structural equation modelling was conducted for years of nurse experience of different groups. RESULTS: Work environment subscale scores for nurses with less than 5 years of experience ranged from 2.3 to 2.9 and for those with more than 5 years, from 2.1 to 2.7. The averages of sense of coherence for the groups were 36.9 and 39.7, respectively. For both groups, there was a statistically significant association between work environment and sense of coherence. CONCLUSIONS: Improvement of nurses' work environment may increase sense of coherence, leading to improvements in health. IMPLICATIONS FOR NURSING MANAGEMENT: The study suggests that nurse managers should improve the work environment to increase sense of coherence of staff nurses, leading to improved health for any length of a nurse's experience.

Socioeconomic Status and the Sense of Coherence among Japanese People Living with HIV.

People living with HIV (PLWH) are forced to live with multiple and severe stressors. Focusing on sense of coherence (SOC), which is a concept of salutogenic and stress coping capacity, is useful in PLWH support. This study aimed to examine the association between SOC and socioeconomic status (SES) for Japanese PLWH. Methods: This study used data from the HIV Futures Japan national survey, which is an online survey with a cross-sectional design. This survey of PLWH in Japan was conducted from July 2013 to February 2014 and December 2016 to July 2017, resulting in 1422 valid responses. The mean age (SD) was 38.6 years (8.3). The 13-item SOC scale score was divided into two groups, based on Japanese standard score in a previous study, and logistic regression analysis was performed. Results: Education levels were indirectly associated with SOC through occupation. Compared to freelance-profession/self-employed, "unemployed job seekers" (OR [95%CI] = 2.16 [1.16, 4.04]) and "homemaker/recuperating/student" (2.09 [1.09, 4.02]) were directly related to poor SOC, regardless of income. Also, there is a clear SOC disparity in income (compared to ">8 million yen/year", "<1 million yen/year" was 2.94 [1.46, 5.92], and "1−2.99 million yen/year" was 2.49 [1.33, 4.68]). Conclusion: It became clear that there is a relationship between SOC and SES. The results of this research provide important evidence for health promotion measures for PLWH.

The development and validation of the Japanese version of job satisfaction scale: a cross-sectional study on home healthcare nurses.

OBJECTIVE: A reliable and valid tool is required to assess home healthcare nurses' job satisfaction for evaluating and improving the work environment and clinical practice of home healthcare. This study aimed to develop and examine the Japanese version of the Home Healthcare Nurses' Job Satisfaction Scale (HHNJS-J). The Home Healthcare Nurses' Job Satisfaction Scale (HHNJS) was translated into Japanese; a backward translation was performed until equivalence between the original and the backward-translated HHNJS was confirmed. Subsequently, a mail survey was conducted among 409 home healthcare nurses from 154 home healthcare agencies in Japan. We evaluated construct validity through Confirmatory Factor Analysis (CFA), and criterion-related validity and internal consistency were also tested. RESULTS: The CFA revealed a second-order seven-factor structure and adequate internal consistency, although, the fit of the data to the factor structure was moderate. As per the goodness-of-fit indices of the final model of the CFA, the comparative fit index was 0.89 and root mean square error of approximation was 0.06. This newly translated scale can be used to assess the job satisfaction of home healthcare nurses within Japan. The HHNJS-J evaluated acceptable reliability and validity among Japanese home healthcare nurses and had application in clinical practice in Japan.

A study on the examination of sense of coherence-related factors in Japanese junior high school students and their mothers.

This study examined the relationship between the sense of coherence (SOC), which is conceptually the ability to successfully cope with stress, of Japanese junior high school students and their mothers, and investigated SOC-related factors among the students. We analyzed self-reported data from 134 junior high school students (aged 12-14 years) and their mothers (average age: 45.5 ± 4.1 years), based in an urban area of Japan. We found a weak correlation between the SOC total scores of female students and their mothers; further, few subscales showed weak correlations. However, the SOC of male students was not correlated with that of their mothers, including the three subcomponents that constitute the SOC. The results of multiple regression analysis indicated that the SOC of female students was negatively associated with ASD-related characteristics, sensitivity to evaluation, and avoidant help-seeking style, and positively associated with a sense of belonging to the school. However, male students' SOC showed a negative relationship with excessive response to evaluation and a strong sense of parental control. To improve SOC in adolescents, it is necessary to consider their gender differences and support them, both at home and school.

Reliability and validity of the Japanese version of the Person-Centered Care Assessment Tool.

AIM: To evaluate the reliability and validity of the Japanese version of the Person-Centered Care Assessment Tool (P-CAT-J) in a Japanese long-term care setting. METHODS: This was a cross-sectional survey using self-administered questionnaires distributed among the nurses or care staff of 2000 special nursing homes randomly selected nationwide using stratified random sampling according to each prefecture's ratio of numbers of facilities. The internal consistency of the tool was calculated using Cronbach's α and construct validity was assessed using confirmatory factor analysis. The criterion-related validity of the scale was based on the partial correlation between the possible outcomes of person-centered care (PCC). RESULTS: In total, 324 samples were analyzed after excluding samples with incomplete P-CAT-J. Cronbach's α value for the entire P-CAT-J was adequate, although internal consistency values for each factor were not strong. Confirmatory factor analysis revealed an acceptable value after adjusting for error variables. The partial correlation coefficients among workplace satisfaction, quality of care, PCC implementation and total P-CAT-J score were significantly correlated. CONCLUSIONS: The overall P-CAT-J was developed with good reliability and acceptable criteria based on the responses of long-term care staff in Japan. The P-CAT-J has the potential for international comparison and can provide long-term care staff with PCC examples to learn relevant actions and concepts. Geriatr Gerontol Int 2022; 22: 344-349.

[HIV-related public stigma and knowledge regarding the campaign slogan "undetectable=untransmittable" among Japanese people].

Objectives　This study targeted adult males and females living in Japan with the following three objectives. The first was to clarify the public stigma toward people living with HIV (PLWH). The second was to clarify changes in public stigma by gathering information about the "undetectable=untransmittable" (U=U) campaign. The third was to clarify the relationship between changes in public stigma and contributing factors, and the experiences of PLWH.Methods　We conducted a cross-sectional online survey in September, 2019 for male and female internet research monitors in their 20s to 60s who were heterosexual, not HIV-positive, and not acquainted with PLWH. In total, the results from 2,268 people were analyzed. Public stigma toward PLWH was measured by a modified vignette for PLWH using a social distance scale for people with mental illness. The social distance scale included "becoming a neighbor," "greeting and talking," "asking them to take care of your children," "becoming friends," "becoming colleagues at work," and "marrying your relatives." We provided information on "U=U" to participants and then evaluated the changes in acceptance of each social distance factor into four categories: "unacceptable," "acceptable ⇒ unacceptable," "unacceptable ⇒ acceptable," and " acceptable."Results　All items in the social distance scale except "greeting and talking" exhibited significantly positive changes (male odds ratio 1.76 to 4.18, female odds ratio 2.25 to 7.00) after providing information. The factor most often deemed "unacceptable" was "marrying your relatives," in 57.5% of men and 58.1% of women; 37.0% of men and 37.3% of women answered "asking them to take care of your children;" and 19.0% of men and 11.1% of women answered "becoming friends." Multinomial logistic regression analysis demonstrated that experience with PLWH in both men and women was associated with "marrying your relatives." The experience of watching television and listening to radio programs, watching movies and plays, and reading books related to PLWH was significantly related to the category of "unacceptable" compared with "acceptable." (Male odds ratio 0.38 to 0.63, female odds ratio 0.50 to 0.56).Conclusion　The acceptance of PLWH was low in personal matters, such as family and child-rearing. The explanation of "U=U" improved acceptance in each social distance factor. Independent experiences, such as viewing, appreciation, and reading about PLWH, improved acceptance.

The association between workplace social capital and authentic leadership, structural empowerment and forms of communication as antecedent factors in hospital nurses: A cross-sectional multilevel approach.

AIM: To identify the effects of authentic leadership, structural empowerment and forms of communication as antecedent factors of workplace social capital in nursing. BACKGROUND: Enhancing workplace social capital for nurses by management requires identifying antecedent factors of workplace social capital focusing on work environment and relationships between members. METHODS: In 2019, self-administered questionnaires were sent to all nurses working on the general wards of two university hospitals in Japan. A multilevel analysis was conducted to evaluate relationships between perceived workplace social capital-the dependent variable-and authentic leadership, structural empowerment and forms of communication-the individual- and ward-level independent variables. RESULTS: Data from 463 nurses and 28 nurse managers were analysed (valid response rates = 38.0% and 58.3%, respectively). Their average age was 28.64 years (standard deviation: 7.00), and 93.5% were female. Ward-level authentic leadership and semi-formal communication were found to be significantly related to workplace social capital. CONCLUSION: More authentic leadership and communication to promote mutual understanding between members can foster workplace social capital among hospital nurses. These findings can help inform effective workplace training in hospitals. IMPLICATIONS FOR NURSING MANAGEMENT: Workplace social capital can be produced by improved management, environment and communication opportunities.

Factors Influencing Sense of Coherence: Family Relationships, High School Life and Autism Spectrum Tendency.

Adolescence is marked by significant life stress. Recently, school refusal and dropouts as well as suicide among Japanese adolescents have increased. Sense of coherence (SOC) is recognized as a competency that helps people deal with stress. The purpose of this study was to examine the factors influencing SOC in male and female high school students. We conducted a survey with 203 pairs of high school students and their mothers, in Tokyo, to explore their SOC, family relationships, school belonging, and autistic traits. Analysis of the data revealed a weak relationship between female students' SOC and that of their mothers, and no relationship between male students' SOC and their mothers' SOC. Feelings of acceptance and recognition from teachers improved students' SOC, irrespective of gender. Low SOC in mothers had a negative impact on female students' SOC, and children's lack of imagination (an autism spectrum tendency) had a negative impact on male students' SOC. This study revealed the importance of support at home and school according to the needs of both genders.

Difficulties of fathers whose families evacuated voluntarily after the Fukushima nuclear disaster.

The Fukushima nuclear disaster in 2011 resulted in radiation exposure, and many evacuees felt anxious of its health risks. However, little is known about the difficulties faced by fathers whose families evacuated voluntarily. Therefore, the aim of the present case study was to clarify the difficulties and concerns of fathers whose families evacuated voluntarily after the Fukushima nuclear disaster. Eleven fathers in Fukushima were interviewed between 14 December 2014 and 25 February 2015. Four themes emerged: (i) seeking a safe place away from radiation exposure; (ii) burdens of a double life; (iii) feelings of isolation and perceived deterioration of health; and (iv) deciding on whether to continue voluntary evacuation. Fathers were anxious about radiation exposure, similar to mothers, and faced work-family conflicts from the voluntary evacuation of their families, including financial, physical, and mental sacrifice. Half of the fathers did not express their difficulties to others. Our findings identified a new type of conflict between people of a community who did/did not choose voluntary evacuation. Occupational health nurses should understand fathers' feelings of isolation and monitor their health to prevent the development of stress-related diseases.

Examining Posttraumatic Growth Among Bereaved Family Members of Patients With Cancer Who Received Palliative Care at Home.

OBJECTIVE: The present study examines the factor structure of the Japanese version of the Posttraumatic Growth Inventory (PTGI-J) among bereaved family members who lost loved ones to cancer after home-based palliative care in Japan. It evaluates the relationships between total score, each PTGI-J domain, and participants' having a religious belief, gender, age, relationship to the patient, and time since patient death. PROCEDURE: Bereaved family members (n = 849) completed the PTGI-J and a demographic questionnaire. The factor structure was tested using confirmatory factor analysis (CFA), and univariate analysis was used to test hypotheses. RESULTS: Confirmatory factor analysis showed that the current sample moderately fitted to both 4-factor and 5-factor models. Univariate analysis revealed that having a religious belief and gender were associated with all domains and total PTGI-J score. Age, time since patient death, and relationship to the patient showed significant differences with the domains of PTGI-J. CONCLUSION: Clinicians may be able to adjust the support they provide based on patients' personal characteristics. Future research should look at the mechanisms of PTG by examining the role of rumination, social support, and emotional distress among bereaved family members of patients with cancer.

Quality of death, rumination, and posttraumatic growth among bereaved family members of cancer patients in home palliative care.

OBJECTIVE: The current study was designed to test the hypothesis that quality of death (QOD) and intrusive and deliberate rumination are associated with posttraumatic growth (PTG) among bereaved family members of cancer patients in home palliative care. METHODS: Data were collected from 805 bereaved family members of cancer patients who died at home in Japan. We used a cross-sectional design and participants completed Good Death Inventory, Event-Related Rumination Inventory, and PTG Inventory. Structural equation modeling was used to test the hypothesized relationships. RESULTS: A direct pathway from QOD to PTG was significant. We also found significant indirect pathways between QOD and PTG via deliberate rumination soon after the death and recent deliberate rumination. CONCLUSIONS: Clinicians should provide high-quality end-of-life care with the goals of achieving a good death for terminally ill cancer patients and supporting the experience of PTG in bereaved family members after their loss.

Recreational drug use and related social factors among HIV-positive men in Japan.

This study aims to determine the relationship between recreational drug use in HIV-positive males in the past year and socio-economic factors and/or social support networks in Japan. A national online survey in a cross-sectional study was conducted by HIV Futures Japan project from July 2013 to February 2014. Of the 1095 HIV-positive individuals who responded, 913 responses were determined to be valid; responses from the 875 males were analysed. A total of 282 participants used addictive drugs (32.2%) in past year. New psychoactive substances were used by 121 participants (13.8%), methamphetamine or amphetamine by 47 (5.4%), air dusters/sprays/gas by 31 (3.5%), 5-methoxy-N,N-diisopropyltryptamine (5MeO-DIPT) by 16 (1.8%) and cannabis (1.0%) by 9. Multiple logistic regression analysis was performed with the use of alkyl nitrites, addictive drugs, air dusters and thinners, which are low illegality, as dependent variables. We found that the odds ratio (95% confidence interval) for use among participants with full-time and temp/contracted/part-time employees compared to management/administration professions were 2.59 (0.99-6.77) and 2.61 (0.91-7.51). Also, a correlation was observed between alkyl nitrites and new psychoactive substances and usage rates in people engaged in few HIV-positive networks. It is necessary to develop targeted policies for drug use prevention and user support among HIV-positive men and to support and provide care for drug users who are isolated or have a narrow HIV/AIDS support network.

Application of the eight-item modified medical outcomes study social support survey in Japan: a national representative cross-sectional study.

PURPOSE: This study aimed to create a Japanese version of the eight-item version of modified medical outcomes study social support survey (mMOS-SS), investigate psychometric property, and determine the standard values for Japanese citizens by using a nationally representative sample from the general population. METHODS: A stratified two-stage sampling was conducted with 4000 Japanese men and women who were in the age group of 25-74 as of January 01, 2014. From February to March 2014, placement method was conducted using self-administered questionnaire. Consequently, 2067 questionnaires were gathered (a collection rate of 51.7%). Thus, the target of analysis was 952 males and 1100 females. RESULTS: The results of factor analysis showed that each of the samples exhibited two types of factors, i.e., emotional and instrumental, just as was the case with the original version. The Cronbach's alpha ranged from 0.90 to 0.95 for each of the samples for both total score and the subscales. On comparing the groups by married versus unmarried and living alone versus not living alone, those not living alone and married people had significantly higher scores (p < 0.05) for each group except for married females less than 50 years. There was a significant positive correlation among mental health, life satisfaction, and self-rated health. CONCLUSION: This study revealed that the eight-item Japanese version of the mMOS-SS had the same psychometric properties as those found in the research results of the English version.

A Japanese version of the Pearlin and Schooler's Sense of Mastery Scale.

The aims of this research were to develop a Japanese version of Pearlin and Schooler's Sense of Mastery Scale (SOMS) and evaluate its reliability and validity. This survey targeted 4,000 men and women aged 25-74 living in Japan as of January 1, 2014, categorized them according to the region and size of the city in which they lived, randomly extracted 200 municipalities, and randomly extracted individuals after categorizing for sex and age based on the resident registries of each municipality. 2,067 survey responses were collected (response rate 51.7%). We used weighted 7-item (SOMS-7) and 5-item (SOMS-5) versions that excludes two reverse items (item6 and 7) from SOMS-7 of the SOMS. From the item analysis, the item-total correlation coefficients of the two reverse items (items 6 and 7) were .03 and .34. The Cronbach's alpha coefficient was also .69 in SOM-7 and .77 in SOMS-5. The partial correlation coefficients between SOMS and the sense of coherence, mental health inventory, self-rated health, and life satisfaction were all significant (p < 0.001). The SOMS showed high construct validity. SOMS-5 has sufficient reliability.

[Nationally representative score of the Japanese language version of the 13-item 7-point sense of coherence scale].

OBJECTIVES: The amount of research relating to evaluation of intervention programs with regard to sense of coherence, a concept of salutogenic stressor coping capacity, is increasing in Japan. However, a nationally representative score of the Japanese version of the sense of coherence scale has not yet been reported. The aim of this study was to describe the 13-item, 7-point Japanese sense of coherence scale (SOC-13), with scoring by sex and age group, and to examine the relationships between the score and locality and city size. METHODS: Four thousand Japanese men and women were selected by stratified random sampling, and a cross-sectional, self-administered questionnaire survey was conducted using the placement method. Responses were obtained from 2,067 individuals (response rate: 51.7%). This study analyzed 956 men and 1,107 women (mean age [standard deviation]: 50.0 [14.3]). RESULTS: The mean score on the SOC-13 was 59.0 (12.2) in all participants, 59.1 (11.8) in men, and 58.9 (12.5) in women. No significant difference was found between men and women (P=0.784). ANOVA and multiple comparison for age difference showed a clear relationship (P<0.05) between higher age and a higher SOC-13 score. Moreover, the results of main and interaction effects in ANCOVA, with independent variables for locality (11 segments) and city size (four segments), were not significant when controlled for age. CONCLUSION: A nationally representative score for the Japanese SOC-13 was acquired. In future research, application of the SOC-13 in Japan for clinical studies is anticipated based on the nationally representative score.

Comprehensive health literacy in Japan is lower than in Europe: a validated Japanese-language assessment of health literacy.

BACKGROUND: Health literacy, or the ability to access, understand, appraise and apply health information, is central to individuals' health and well-being. A comprehensive, concept-based measure of most dimensions of health literacy has been developed for the general population in Europe, which enables comparisons within and between countries. This study seeks to validate this tool for use in Japan, and to use a Japanese translation to compare health literacy levels in Japan and Europe. METHODS: A total of 1054 Japanese adults recruited through an Internet research service company, completed a Japanese-language version of the 47-item European Health Literacy Survey Questionnaire (HLS-EU-Q47). The survey was administered via an online questionnaire, and participant demographics were closely matched to those of the most recent Japanese national census. Survey results were compared with those previously reported in an eight-country European study of health literacy. RESULTS: Internal consistency for the translated questionnaire was valid across multiple metrics. Construct validity was checked using confirmatory factor analyses. The questionnaire correlated well with existing scales measuring health literacy and mental health status. In general, health literacy in the Japanese population was lower than in Europe, with Japanese respondents rating all test items as more difficult than European respondents. The largest difference (51.5 %) was in the number of respondents finding it difficult to know where to get professional help when they are ill. CONCLUSIONS: This study translated a comprehensive health literacy questionnaire into Japanese and confirmed its reliability and validity. Comparative results suggest that Japanese health literacy is lower than that of Europeans. This discrepancy may be partly caused by inefficiency in the Japanese primary health care system. It is also difficult to access reliable and understandable health information in Japan, as there is no comprehensive national online platform. Japanese respondents found it more difficult to judge and apply health information, which suggests that there are difficulties in health decision-making in Japan. Numerous issues may be linked to lower levels health literacy in Japan, and further studies are needed to improve this by developing individual competencies and building supportive environments.

Sense of coherence in mothers and children, family relationships and participation in decision-making at home: an analysis based on Japanese parent-child pair data.

Children in early adolescence and their mothers were studied to clarify the association between a child's sense of coherence (SOC) and its mother's SOC, the quality of family relationships as gauged by the mother, and the child's positive life experiences at home. An anonymous self-administered group questionnaire was given to all 1540 students of a high school in Tokyo, and a similar questionnaire was sent by mail to their legal guardians. Responses were received from 1505 students (response rate: 97.7%) and 989 legal guardians (response rate: 64.2%); questionnaires completed by legal guardians who were the mothers of the students were paired with the corresponding child's questionnaire. The SOC scores of mothers and students were calculated, and hierarchical multiple regression analysis was performed with the student's SOC as a dependent variable. Results for boys revealed that a mother's SOC was directly related to the child's SOC, regardless of family relationships and participation in decision-making at home. For girls, a mother's SOC was related to family relationships and was indirectly related to the child's SOC through the child's participation in decision-making at home. Results revealed that for both boys and girls, a mother's SOC had an effect on the child's SOC, and this corroborates the hypothesis of Antonovsky.

A causal relationship between sense of coherence and psycho-social work environment: from one-year follow-up data among Japanese young adult workers.

The aim of this study was to use longitudinal data and investigate by sex the following four hypotheses on the relationship between sense of coherence (SOC) and work environment (WE): (i) a bidirectional cause-effect relationship exists; (ii) WE is the cause and SOC is the effect; (iii) SOC is the cause and WE is the effect; and (iv) no cause-effect relationship exists. Male and female subjects between the ages of 20 and 40 living in Japan were selected as subjects by two-stage stratified random sampling, and self-administered questionnaires were sent by mail between January and March 2007 (Time 1). A follow-up was conducted in the same way from January to March of 2008 (Time 2). Responses were obtained from 3,965 individuals (follow-up ratio: 82.6%). This study analyzed 1,291 males and 933 females who were at least 25 years old at Time 1 and who worked the same job in both time periods. The analysis was performed using a cross-lagged model under structural equation modeling. The second hypothesis was selected for both males and females based on the outcome of nested model comparisons. That is, a temporal cause-effect relationship was observed between SOC and WE for both males and females, with WE as the cause and SOC as the effect.