The relationship between healthcare workers' attachment styles and patient outcomes: a systematic review.

PURPOSE: To examine whether attachment styles of healthcare workers influence the quality of their relationships with patients, or impact patients' health outcomes. DATA SOURCE: Literature database searches on the CINAHL, Cochrane Library, Embase, MEDLINE and PsyCinfo, and hand searching of reference lists of the retained articles. STUDY SELECTION: Original empirical studies reporting an analysis of the relationship of interest were selected for review. DATA EXTRACTION: Estimates of association between healthcare workers' attachment style and patients' health outcomes were extracted. RESULTS OF DATA SYNTHESIS: Results from 13 studies were mixed in terms of which attachment styles related to patients' perceptions of care or health outcomes, and the evidence overall was of poor quality and methodologically heterogeneous. However, there is limited evidence that secure attachment styles of healthcare workers have little or a negative effect on patients' health outcomes or perceptions in the short term but in the long term have a more positive effect. Conversely, insecure styles tend to have a positive effect in the short term but little or a negative effect on long-term relationships. Studies which used self-report attachment measurements tended to report stronger associations with patients' outcome measurements than studies using the interviewer rated Adult Attachment Interview. CONCLUSION: It is unclear whether or not there is a relationship between attachment style of health workers and patients' health outcomes. Further research using consistent data collection tools, especially in relation to the attachment measurement construct selected, and analysis methods across studies is required to draw recommendations for clinical practice.

Development and psychometric evaluation of a Japanese scale to assess depression severity: Himorogi Self-rating Depression Scale.

OBJECTIVE: The 17-item Hamilton Rating Scale for Depression (HAMD-17) is the most widely used instrument to assess depression severity, but it has a number of limitations in clinical use. There is no depression scale designed for Japanese culture that has been shown to be valid. This study aimed to develop a Japanese depression scale, the Himorogi Self-rating Depression Scale (HSDS), and to assess psychometric properties of it. METHODS: Data were collected using the HSDS and the HAMD-17 from 204 outpatients of psychiatric clinics. Follow-up data were collected three times with an interval of at least 4 weeks, and reliability and validity were longitudinally observed. RESULTS: Principal component analysis found a uni-factorial nature for both scales. The HSDS indicated stronger factor coefficients and a larger variance than the HAMD-17. ROC analysis showed high ability to distinguish between the presence and absence or remission of depression. High convergent validity and reliability coefficients were consistently indicated. CONCLUSIONS: Although the convenience sample restricts generalisability of the findings and only a single instrument was used as a standard for comparison, reliability and validity for the HSDS was supported. The HSDS is suggested as a substitute for the HAMD-17 in clinical use.

A Japanese scale to assess anxiety severity: development and psychometric evaluation.

OBJECTIVE: This study developed a Japanese self-rating anxiety scale, the Himorogi Self-rating Anxiety Scale (HSAS), and tested psychometric properties of its use in Japanese psychiatric patients. METHODS: The process of developing the scale consisted of an intensive literature review, assessment of existing instruments, and detailed discussion on the content of the newly developed scale. Data for psychometric evaluation were collected from 419 outpatients of psychiatric clinics. The Hamilton Rating Scale for Anxiety Interview Guide (HAMA-IG) and the Sheehan Patient Rated Anxiety Scale (SPRAS) were used as standards against which the HSAS was compared. RESULTS: Confirmatory factor analysis revealed a unifactorial nature for the HSAS and fewer insignificant items in the HSAS than the HAMA-IG and the SPRAS. Cronbach's alpha and test-retest coefficients indicated sufficient reliability. High correlation with the HAMA-IG and the SPRAS indicated evidence of convergence for the HSAS. ROC analysis showed high ability to distinguish between the presence and absence or remission of anxiety. Analysis of descriptive data suggested a larger dynamic range for the HSAS than the HAMA-IG and the SPRAS. CONCLUSIONS: The HSAS is a brief scale to assess anxiety severity, demonstrating evidence of good psychometric properties. It is recommended for use in research and clinical practice.

A Japanese version of the Perceived Stress Scale: cross-cultural translation and equivalence assessment.

BACKGROUND: This paper describes the development of a Japanese version of the Perceived Stress Scale (PSS), and examines the equivalence between the original and translated version. The PSS is one of the few instruments to measure a global level of perceived stress, and has been widely used in a range of clinical and research settings. The PSS has already been translated into several languages, but there is no validated Japanese version. METHODS: A forward-backward procedure was implemented. Multiple forward and backward translations were produced, and a panel of reviewers verified conceptual and semantic equivalence between the source and final versions. Non-professional translators who were not brought up in bilingual families were used in order to enhance representativeness of language in the target populations. The PSS was administered to 222 native English speakers and the Japanese version (PSS-J) to 1320 native Japanese speakers. RESULTS: Factor analysis showed similar factor loadings of the items and satisfactory factorial agreement between the PSS and PSS-J. Cronbach's alpha coefficient was high for both versions and for each factor. CONCLUSION: It is concluded that the PSS and PSS-J are substantially equivalent and suited for use in comparative cross-cultural studies.

A Japanese version of the Rosenberg Self-Esteem Scale: translation and equivalence assessment.

OBJECTIVE: A Japanese version of the Rosenberg Self-Esteem Scale (RSES) was developed through the forward-backward translation procedure. METHODS: Married couples consisting of a native English speaker and a native Japanese speaker acted as translators to enhance the representativeness of language in the target population. Multiple translations were produced, and a panel of reviewers identified problems in conceptual and semantic equivalence between the original scale and the translated version. The Japanese version was altered accordingly with reference to alternate Japanese forms from the original English to Japanese translations. The altered translation was again retranslated into English, and problematic differences were checked. This forward-backward process was repeated until satisfactory agreement had been attained. The RSES was administered to 222 native English speakers, and the developed Japanese version (RSES-J) was administered to 1320 native Japanese speakers. RESULTS: Factor analysis revealed nearly identical factor structure and structural coefficients of the items between two sets of data. Target rotation confirmed the factorial agreement of the two scales in different cultural groups. High Cronbach's alpha coefficients supported the reliability of test scores on both versions. CONCLUSION: The equivalence between the RSES and the RSES-J was supported in this study. It is suggested that the RSES and the RSES-J are potential tools for comparative cross-cultural studies.

Translation and equivalence assessment for a Japanese version of the modified parental nurturance scale: a comparative study.

BACKGROUND: This paper reports on the modification of the Parental Nurturance Scale (PNS), translation of the modified version (PNSM) from English to Japanese, and equivalence assessment between the PNSM and the translated version (PNSM-J). The PNS was modified so as to enable its use in nurturance studies where the prime source of nurturance might vary between respondents. METHOD: It was translated into Japanese through the forward-backward translation procedure. With attempting to enhance representativeness of language in the target populations, translators used were married couples that consisted of a native English speaker and a native Japanese speaker. Multiple translations were produced and used to make a single Japanese version. A panel of reviewers identified problems in conceptual and semantic equivalence between the original and the translated versions. The Japanese version was altered accordingly with reference to alternate Japanese forms from the original English to Japanese translations. The altered translation was again re-translated into English and problematic differences were checked. This forward-backward process was repeated until satisfactory agreement was attained. The PNSM was administered to 222 native English speakers and the PNSM-J to 1320 native Japanese speakers. RESULTS: Factor analysis and target rotation revealed a nearly identical factor structure and factor loadings of the items of the PNSM and PNSM-J between the different cultural groups. High Cronbach's alpha coefficient supported the reliability of the test scores on both versions. CONCLUSION: The equivalence between the two scales was supported. It is suggested that the PNSM and PNSM-J are suitable tools for comparative cross-cultural studies.

A Japanese version of the perceived stress scale: translation and preliminary test.

This paper describes the development of a Japanese version of the Perceived Stress Scale (PSS). Four independent Japanese translations were made and used to develop a single Japanese version. This was back-translated into English. Discrepancies between the original and the back-translation were identified. The Japanese version was altered accordingly, and again back-translated. This forward-backward process was repeated until satisfactory agreement was attained. The PSS was administered to 38 native English speakers and the Japanese version (PSSJ) to 23 native Japanese. High Cronbach's alpha coefficient was shown for both versions. Factor analysis revealed that the PSS and PSSJ showed an almost identical factor structure. Therefore, the equivalence between the PSS and PSSJ and the validity for each scale was underpinned.