The Role of Filial Piety in Dyadic Recruitment of Chinese American Parents With Type 2 Diabetes and Their Adult Children.

INTRODUCTION: Type 2 diabetes (T2D) is prevalent among Asian Americans, yet limited health care studies report on the recruitment and retention of this population. This study focuses on recruiting Chinese American dyads for family support of T2D management. METHOD: This is a descriptive study using active and passive recruitment strategies. Dyads consist of parents with T2D and their adult children without diabetes. All materials are culturally tailored and available in Chinese. RESULTS: The final sample included 54 dyads. There were characteristic differences among parent participants in English language proficiency and education levels. Filial piety manifested as respect and care for one's parents among Chinese American families contributed to recruitment success. DISCUSSION: This article shares strategies for recruiting Chinese American dyads to explore family support dynamics for T2D self-management. The findings potentially add to current knowledge about culture, nursing, and health care.

Validation of the Japanese version of the quality of life-Alzheimer's disease for nursing homes.

OBJECTIVES: This study aims to validate the Japanese version of Quality of Life-Alzheimer's Disease for Nursing Homes (QOL-AD NH). This is the modified version of QOL-AD, initially developed for residents living with dementia in long-term care settings. METHODS: Psychometric assessment was conducted in a sample of 101 residents and their professional care staff to obtain self-ratings and proxy-ratings of QOL, respectively. Residents' behavior was observed using Dementia Care Mapping (DCM) method, and their mood/engagement (ME) value was evaluated as a proxy measure of QOL. RESULTS: Self-ratings were higher than proxy-ratings (t = 10.22, p<.001), with moderate correlation (r=.51, p<.001) and strong internal consistency (α=.87 for both). The exact agreement between the two groups was 38.23%. Convergent validity was confirmed with ME value and positive engagements of DCM. Exploratory factor analysis was performed for further validity testing. Three factors - self and life overall, social environment, and physical and psychological health, accounted for 85.9% of the total variance with Cronbach's α of .87, .73, .90, respectively. CONCLUSION: Using a validated Japanese version of the QOL-AD NH may help assess the QOL of older residents living in long-term care settings to improve the continuum of care for dementia.

Adapting the Australian Environmental Assessment Tool-High Care (EAT-HC): Experiences and Practical Implications From Germany, Japan, and Singapore.

BACKGROUND: Assessing the built environment in nursing homes is part of several established instruments. Measurements are primarily published in English, so there is a need for cross-cultural adaptation to be able to use them in other countries. This procedure should be carried out alongside translation guidelines to ensure successful adaptation not only for assessments that capture complex constructs, such as the built environment, but also for assessments to be applied in healthcare in general. OBJECTIVE: This article presents different approaches to adopt the Australian Environmental Assessment Tool-High Care (EAT-HC) based on the World Health Organization (WHO) guidelines for instrument translation. The comparison of these processes should provide implications for further adaptations of the instrument. METHODS: The adaptation processes carried out in Germany, Japan, and Singapore were compared using thematic analysis. Steps taken to achieve linguistic validation and to adopt the tool were analyzed qualitatively in the context of overarching needs for adjustment. RESULTS: Every perspective adapted the WHO guidelines for their respective purposes of applying the EAT-HC. The order of steps varied, but elements to validate the results with the instruments' creators and to ensure validity were included in all three countries. For items that might be challenging, we detected possible reasons that might help future adaptors manage this process more efficiently. CONCLUSION: The EAT-HC benefits from adaptation alongside the WHO guidelines in terms of enhancing the quality of translation and feasibility of application. Individual supplementary adaptation steps allow the identification of culture-specific needs for application in other countries.

Japanese Translation and Validation of the Environmental Assessment Tool-Higher Care.

OBJECTIVE: The purpose of this study was to translate the Environmental Assessment Tool-Higher Care (EAT-HC) into Japanese and validate its use in small-scale group living facilities in Japan. BACKGROUND: Environment of a facility is shown to improve its residents' quality of life (QOL). Japan's "welfare-based nursing homes for the elderly" are gradually shifting to a small-scale group living concept called group care units (GCUs). However, there is no appropriate environmental tool available for evaluating GCUs. The application of valid environmental assessment tools brings about a better understanding of the nature of good environments and the relationship between environments and outcomes for residents living with dementia. METHODS: The study had a mixed method design conducted in several steps, covering translation and adaptation. The translation phase involved (1) forward translation and (2) backward translation. The adaptation phase involved (3) content validity and homogeneity reliability and (4) concurrent validity and interrater reliability. RESULTS: 71 Items (92%) met the acceptable level of content validity (item-content validity index [CVI] > .79) and had good scale-CVI of .88. Concurrent validity was confirmed between .65 and .78 (p < .001). For reliability test, the internal consistency of six subscales was between .88 and .98. Overall interobserver agreement was 90.3%. Intraclass correlation coefficients were .80-.98 (p < .001), and homogeneity reliability coefficient for all items was >.76 (p < .01). CONCLUSIONS: Validation of the EAT-HC-Japanese Version (EAT-HC-JV) was confirmed as an appropriate tool for environmental assessment to enhance the QOL in Japan's GCUs. For future study, we plan to modify the EAT-HC-JV to adapt to Japanese cultural aspects in order to increase its usability in Japan.