Adaptation and measurement invariance of the 13-item version of Patient Activation Measure across Japanese young adult cancer survivors during and after treatment: A cross-sectional observational study.

The 13-item version of the Patient Activation Measure (PAM-13) is a frequently used measure that gauges the level of self-management in an individual. However, its applicability across Japanese young adult (YA) cancer survivors during and after their treatment remains unclear. This study confirmed the psychometric properties and measurement invariance of the Japanese version of PAM-13 across them during and after treatment. We used cross-sectional observational data collected through an online survey from 500 survivors in January 2022. We determined feasibility, internal consistency, concurrent validity against physical fatigue and depression, and known-groups validity regarding educational level. Structural validity was also found using Rasch analysis for survivors both during and after treatment. Furthermore, measurement invariance of the PAM-13 was examined using multiple-group structural equation modeling. Rasch fit statistics were acceptable for the unidimensional structure of PAM-13. It was found to be internally consistent for survivors during (McDonald's omega: 0.88, item-total correlations: 0.48-0.62) and after treatment (McDonald's omega: 0.90, item-total correlations: 0.32-0.72). The PAM-13 was concurrently valid with physical fatigue (Pearson's product-moment correlation coefficients: -0.25 and -0.18 for survivors during and after treatment, respectively) and depression (Pearson's product-moment correlation coefficients: -0.20 and -0.19 for survivors during and after treatment, respectively). Known-groups validity showed that survivors after treatment with a higher educational level reported a higher patient activation score than those with a lower educational level (p = 0.001); however, there was no difference due to the education level between survivors during treatment. The configural and metric invariance of the PAM-13 were confirmed, but scalar invariance was rejected. It was found that the PAM-13 is applicable for Japanese YA cancer survivors during and after treatment. However, given the lack of scalar invariance in the PAM-13, the scores of particular items between YA cancer survivors during and after treatment should be interpreted with caution.

Impact of flexible work arrangements on job resignation after cancer diagnosis among Japanese young adult cancer survivors.

PURPOSE: Many workers had flexible work arrangements during the COVID-19 pandemic. This study aimed to identify the association between flextime and remote working and job resignation among Japanese young adult cancer survivors after diagnosis. METHODS: This cross-sectional observational study was conducted using an online survey with 401 Japanese young adult cancer survivors diagnosed with adult-onset cancer and aged 20-39 years at the time of the survey in January 2022. A multivariable Cox regression analysis was performed to analyze the impact of flextime and remote working on job resignation. RESULTS: In the sample, 264 participants (65.8%) were female, and 185 (46.1%) had been diagnosed with cancer between 1 and 5 years ago. After adjusting for potential confounders, the multivariable Cox regression analysis revealed that young adult cancer survivors using remote working only (HR 0.44, 95% CI 0.21-0.96, p = 0.04) and both flextime and remote working (HR 0.37, 95% CI 0.21-0.64, p < 0.01) experienced a lower risk of job resignation after cancer diagnosis compared to those who did not use flextime and remote working. CONCLUSIONS: Young adult cancer survivors who used remote working only or remote working combined with flextime could reduce their risk of job resignation after a cancer diagnosis. IMPLICATIONS FOR CANCER SURVIVORS: This study showed that having the option of remote working can be important for young adult cancer survivors' continuing employment. Furthermore, social welfare systems need to promote a workplace culture and climate that allows remote working.

Associated Factors of Psychological Distress among Japanese NICU Nurses in Supporting Bereaved Families Who Have Lost Children.

PURPOSE: This study aimed (1) to examine the current status of psychological distress experienced by neonatal intensive care unit (NICU) nurses in supporting bereaved families, (2) to identify the factors associated with psychological distress, and (3) to understand the professional characteristics of nurses experiencing high psychological distress by comparing the study results with those of pediatricians. METHODS: We sent questionnaires to 64 NICUs. The psychological distress of nurses was classified into two groups based on the frequency of psychological distress experienced and analyzed using the χ2 test and Fisher's exact test. A multiple logistic regression analysis was used to investigate the factors related to psychological distress. RESULTS: Of the 384 nurse respondents, 190 (49.5%) reported having supported bereaved families, 169 of who were included in the analysis. A total of 123 nurses (72.8%) reported high levels of psychological distress. Our study revealed that the use of coping methods is associated with high psychological distress. The comparison with pediatricians revealed that nurses were significantly more likely to be female and had fewer years of working experience. Nurses were also significantly more likely to use coping methods and to experience high psychological distress. CONCLUSION: Clarifying the coping methods for psychological distress in supporting bereaved families may be necessary, and nurses need to identify appropriate coping methods. In nursing education, information on psychological distress related to children's deaths and bereavement care should be conveyed from the early stage and nurses must obtain preliminary knowledge. The creation of a bereavement follow-up system is recommended.