[Childcare and housework performed by fathers with infants and related factors].

Objective　The aim of this study was to identify the status regarding childcare and housework performed by fathers with infants (one and two years old, first child), as well as related factors.Method　An online survey of fathers with infants across Japan was administered in October 2020. The survey items encompassed basic attributes, work conditions, and child-rearing information, as well as items from the Quality of Marriage Index (QMI), Work-Family Conflict Scale (WFCS), and a Japanese version of the K6 screening tool. The frequency of performing childcare and housework was divided into two groups, frequent and infrequent, and furthers into four groups based on the combination of frequent and infrequent childcare and housework. Multiple logistic regression analysis was performed with the frequent/infrequent childcare group, the frequent/infrequent housework group, and the four groups by childcare and housework each as dependent variables.Results　Responses were obtained from subjects in 44 prefectures, with 406 responses used for analysis. Frequently performed items for childcare and housework were hugging, playing together, and taking out trash. Infrequent performed items were making hospital visits, ensuring children's regular medical examinations and vaccinations, preparing meals, and sleeping.　The results of the multiple logistic regression analyses demonstrated that the groups citing the frequent performance of childcare tasks were correlated with participation in parenting/father-directed classes, the use of parental leave, wives engaged in formal employment, work requiring less than 10 hours of overtime per month, the highest level of education (junior high school, high school, junior college, vocational school, or technical school: non-university graduate), low WFCS scores, and high QMI scores. The groups citing the frequent performance of housework were associated with not living with grandparents, shift work, participation in parenting/father-directed classes, household yearly income of 6 million yen or more, highest level of education (non-university graduate), wife engaged in formal employment, wife's health condition (normal, poor, very poor), and high QMI scores. The subjects were divided into four groups: frequent childcare-frequent housework (38.4%), frequent childcare-infrequent housework (14.0%), infrequent childcare-frequent housework (19.5%), and infrequent childcare-infrequent housework (28.1%). Among the four groups, the highest correlation was observed for participation in parenting/father-directed classes, overtime hours, wife's work status, and QMI scores.Conclusion　To promote participation in parenting, fathers should be encouraged to care for children more frequently and help with housework. As such, introducing support methods in classes for fathers is a necessary step toward this objective.

[Development of the Family Empowerment Scale for Parents with Toddlers].

Objectives　This study aimed to develop the Family Empowerment Scale for Parents with Toddlers (FES-P) and to examine its validity and reliability.Methods　A draft version of the scale was prepared based on a literature review and interviews with experts. Next, we conducted a web-based structured questionnaire survey of 800 parents (400 men and 400 women) with children aged 1 to 3 years, across Japan, and then verified the validity and reliability of the FES-P. The repeatability and stability by the retest method were examined as well.Results　We analyzed the data of the 825 individuals (412 men and 413 women) who answered the survey. Exploratory and confirmatory factor analyses revealed that the optimum solution that can interpret each factor could be obtained with five sub-factors and 26 question items. We confirmed that the five sub-factors were "relationships within the family," "sense of efficacy with regard to parenting," "relationships with the community," "sense of achievement as a parent," and "recognition and combined use of services." Good-fit values were obtained, with GFI=.878, AGFI=.852, CFI=.943, and RMSEA=.044, and construct validity was confirmed. The Cronbach's alpha coefficient was .96 for the entire scale and .85 to .92 for the sub-factors; the scale was deemed to have sufficient internal consistency. Further, the total score of the FES-P was positively correlated with the Family APGER score (r=.562, P<.001), scale measuring feelings about parenting (r=.620, P<.001), and generalized self-efficacy scale (r=.318, P<.001). For test-retest reliability, the intra-class correlation coefficient was r=.876 for the entire scale and r=.794 to .876 for the sub-factors, indicating stability and reproducibility.Conclusion　This study developed the FES-P, consisting of five sub-factors and 26 items and showing good validity and reliability. The five sub-factors were cross-correlated constructs. "Sense of efficacy with regard to parenting" and "sense of achievement as a parent" consisted of items related to individual empowerment, "relationships within the family" and "relationships with the community" consisted of items related to relationships with others, and "recognition and combined use of services" consisted of items related to social resources.

[Examination of the effects of a role-playing training program for the improvement of planning and management skills of public health nurses].

Objectives　The Japan Health Insurance Association (JHIA) conducts training in each branch facility to improve the ability of public health nurses (PHNs). The headquarters of the PHNs of JHIA and the researchers conducted a training program for leaders of PHNs at each JHIA branch. The goal of the program was to create a training plan using role-play to acquire facilitation skills. This study aimed to examine the effects of training.Methods　The study was designed in accordance with the Instructional Designs. The training goals were as follows: (1) understanding the role of facilitation and the facilitator in the debriefing session after the role-play, (2) understanding facilitation techniques, (3) being confident in performing as facilitators in the debriefing session; and (4) conducting the debriefing sessions using facilitation skills. The evaluation of the training was based on the Kirkpatrick model from the viewpoint of confidence in using facilitation, knowledge of facilitation, and conduct of training and utilization of facilitation technology. Questionnaire evaluations were conducted three times before the training, immediately after the training, and three months after the training. In August 2016, 4.5 hours of training were conducted in one day.Results　There were 79 participants in the training group. The mean points of knowledge and confidence were 2.6-3.6 before training, 6.3-7.9 after training, and 6.0-6.9 at 3 months after training. The participants rated their interest in three questions of the training as high as 8.1-8.6. In addition, 64.6% of participants held a role-play session at each branch within three months of the initial training. In the role-play session planned by the participants, the practitioners implemented the explanation of the purpose and the rules at each branch 96.1% and 98.0%, respectively. Participants who had attended facilitation training prior to our program scored higher points of knowledge and confidence before and after three months. Three months after the training, 79 participants responded to the question of the role of the facilitator in role-playing. The descriptions were categorized into "opinions on the basics and planning of role-play training" and "opinions on the roles in retrospectives."Conclusion　The participants evaluated the training contents and the materials used as appropriate, and their knowledge and confidence in facilitation improved after the training. To maintain and improve facilitation skills, the educational system needs to implement training using role-playing at each branch consistently.

[Recognition of developmental disorders and the information sources among the Japanese adult population].

Objectives　This study aimed to examine methods of providing information to improve the recognition of people with developmental disorders by comparing recognition of developmental disorders among education and health care professionals within the general public.Methods　A cross-sectional internet-based survey was conducted in January 2016. The subjects were Japanese adults aged between 20 and 69 years. Of all the respondents, 418 were males and 424 were females. The questionnaire was used to assess recognition of the names of developmental disorders and to determine the corresponding methods through which the information was obtained. We analyzed cognitive states by classifying the respondents by occupation (education and health care professionals) and by whether the subject had a developmental disorder or was a family member or friend of a person with a developmental disorder separately.Results　The percentage of respondents that reported having heard about developmental disorders was 91.5%. However, only 26.5% reported having provided some form of support to people with developmental disabilities. The percentages of education and health care professionals who were aware of developmental disorders were close to 100%; however, only 63.9% and 42.9%, respectively, could cite how they had become aware of developmental disorders. With regard to the sources of information on developmental disorders, the most frequent answers were television and radio programs (67.1%), followed by the internet. Of all the respondents, 11.3% had heard about developmental disorders in a school setting and 9.9% had heard about the disorders in the workplace.Conclusion　To increase understanding of developmental disorders among education and health care professionals, basic and in-service education must be improved. Furthermore, it is important to provide information on developmental disorders through the media.

The Development and Psychometric Testing of the Scale of Cultural Sensitivity of Health Care Professionals in Japan.

INTRODUCTION: The development of cultural sensitivity is essential for health care professionals but there are few tools to measure this quality in Japan. The purpose of this study was to develop a scale of cultural sensitivity for Japanese health care professionals and examine its reliability and validity. METHOD: A draft scale was created through conceptual analysis and a questionnaire was completed by 515 health care professionals and 1,322 college students. Exploratory and confirmatory factor analyses were used to determine suitable scale items and examine model fitness. RESULTS: The four-factor 18-item scale showed acceptable model fitness. Cronbach's α coefficient exceeded .90 and correlation coefficients for criterion-related validity were over .29. Construct validity was confirmed by the significantly higher score of the cross-culturally experienced groups. The intraclass correlation coefficient was .642 (professionals) and .722 (students). DISCUSSION: This reliable and valid scale for Japanese health professionals and college students may be used to evaluate training programs to increase their cultural sensitivity.

Investigation of the possibility of using an augmented reality-based endotracheal aspiration simulation tool for nursing education.

AIM: We developed an augmented reality technology-based endotracheal aspiration simulation tool (the AR tool) consisting of three modes: a mode for nursing students to learn endotracheal aspiration by themselves (learning mode); a mode for repeated practice (practice mode); and a mode for confirmation testing (test mode). This study aimed to compare the learning outcomes of the AR tool with traditional training mannequins and identify potential uses and improvements of the AR tool. METHODS: We invited students, and faculty members from the three universities who agreed to cooperate in conducting this study. Fifty-four students and nine faculty members agreed to participate in this study. The students were divided into two groups. One group was to study with the AR tool and the other group was to study with the traditional half-body training mannequin for suction. The students in both groups were asked to demonstrate endotracheal aspiration on another full-body type training mannequin which could be used as a patient with a tracheostomy (Skill test). Group interviews with faculty members focused on the topic of the AR tool's potential use in nursing education and improvement needed. RESULTS: There was little significant difference in the skill test results of endotracheal aspiration of students in both groups. The students and faculty members both expressed an interest in the AR tool. They said it was suitable for self-study of endotracheal aspiration. CONCLUSIONS: This AR tool is an effective teaching tool for learning the sequence of endotracheal suctioning, although there are some areas that need improvement.

[Current status of collaboration with public health services by occupational health nurses, and related factors].

OBJECTIVES: The Japanese government launched a project to facilitate collaboration between public health services and occupational health services with the aim of promoting overall health and wellbeing. However, collaboration at the practitioner level, including professionals who develop health support activities, has not yet been achieved. This study was conducted to clarify the actual state of collaboration between public health services and occupational health nurses as well as the factors related to their experiences with such collaboration. It also aimed to gather suggestions for promoting collaboration between occupational health nurses and public health and occupational health services. METHODS: A self-administered questionnaire-based survey was conducted in 2017, targeting 2,574 occupational health nurses belonging to the Japan Society for Occupational Health. Survey items included basic attributes, recognition of the need for collaboration and the reasons behind it, whether or not they had collaboration experience, and self-study and learning experiences. RESULTS: Of the 756 nurses surveyed, 34.0% had experience collaborating with public health services and 80.8% felt such collaboration was necessary. Experience of collaboration was related to the number of years of experience as an occupational health nurse, experience reading guidelines and participating in workshops and study groups organized by public health services, opportunities to receive guidance, and recognition of the need for collaboration. CONCLUSION: Because only a few respondents had experience collaborating with public health services and some did not even recognize the need for such collaboration, it was deduced that occupational nurses might have few opportunities to collaborate with public health services and may find it difficult to recognize the need for such collaboration. This finding suggests that occupational nurses may be able to promote collaboration with public health services by reinforcing learning from life events. A mechanism should be created to obtain information on public health services. Furthermore, opportunities can be provided for those with experience in collaboration to communicate with those with no experience through specific examples of such teamwork.

Presenteeism in college students: reliability and validity of the Presenteeism Scale for Students.

OBJECTIVE: Presenteeism is the impaired work performance due to health problems. We aimed to develop a Presenteeism Scale for Students (PSS), and to reveal the existence of presenteeism among students. METHODS: Students (n = 5,701) in 4 national universities in Japan were recruited via the school-based health examination. Moreover, 122 students participated in a 2-week interval test-retest to examine the reliability and criterion-related validity of the PSS. RESULTS: Of the students, 59.2% indicated some health problems. Allergy was most prevalent health problems, affecting 35.7% of the whole students. Students with emotional problems had higher degree of presenteeism than those with the other problems. The Cronbach's α of the work impairment score of the PSS was 0.90. The Spearman's coefficient for the test-retest score was 0.80 (P < 0.001). Regarding criterion-related validity, Spearman's coefficient between the work impairment score of the PSS and summary score of the SF-36 was -0.60 (P < 0.001). CONCLUSIONS: These findings suggest that the PSS can be expected to be useful for assessment of students with presenteeism. Furthermore, we found that the majority of students have some health problems, and proposed that the issue of presenteeism on campus should be addressed.

The effectiveness of a sex education program facilitating social skills for people with intellectual disability in Japan.

BACKGROUND: Sex education should include social skills, such as those that allow individuals to relate, socialize, and communicate with others, to assist people with intellectual disability (ID) to live life fully in the community. OBJECTIVES: We administered and investigated the effects of a program involving 8 interactive sex education sessions that were aimed at improving the social skills of people with ID. METHODS: Participants were 17 people with ID and 17 control group participants in Japan. The evaluation was conducted with a questionnaire based on KiSS-18 (Kikuchi's Scale of Social Skills: 18 items; Kikuchi, 2007 ). RESULTS: The score of KiSS-18 in the experimental group was 55.4 ± 12.9 before the administration of the program, as compared to a mean of 61.8 ± 13.2 after the program. A significant increase was identified. There was no significant difference between the first and second average score in the control group. CONCLUSION: The sex education program involving social skills training for people with ID had significant effects.

[Characteristics of factors associated with risk of future smoking among high school students: toward a consideration of more effective education for smoking prevention].

PURPOSE: This study aimed to develop more effective smoking prevention education in high schools by analyzing differences in factors related to smoking, such as recognition of dangers among the three groups at risk of future smoking. METHODS: The research was conducted by surveying 747 first year high school students (311 boys and 436 girls) in 4 high schools from 3 prefectures in the Kinki area. The questionnaire used covered sex, smoking behavior, future smoking intention, confidence to refuse pressure to smoke, knowledge concerning smoking, recognition of the dangers of smoking, subjective morality, self-esteem, relationship with smokers and intention to encourage others to stop smoking. The subjects were classified into three groups according to the risk of future smoking stratified by the intention to smoke in the future and smoking behavior at the present and in the past. Differences in each item between groups were examined by the chi square test, ANOVA, and multiple comparisons. RESULTS: In the high risk group, the following were observed: low confidence in refusing cigarettes, strong tendencies to romanticize smoking and conceived beneficial effects, low subjective morality and low intention to encourage others to stop smoking. Moreover, girls tended to be more positive than boys regarding all items except self-esteem. In addition, there were significant differences between the low risk group and the high risk group and between the low risk group and the middle risk group in all items except self-esteem. On the other hand, there was no significant difference between the middle risk group and the high risk group about knowledge concerning smoking, and intention to encourage others to stop smoking. CONCLUSIONS: The results suggested similar tendencies for middle risk group and high risk group students for knowledge concerning smoking, recognition concerning smoking and intention to encourage others to stop smoking. Because the middle risk group accounts for about 20 percent of all students, it is necessary to consider the features of this group when developing additions to the current materials for smoking prevention classes in high schools.

[A framework for assessing essential public health nursing skills and achievement levels required for students graduating from schools that provide education for obtaining a license as a public health nurse in Japan].

PURPOSES: This study aimed to develop a framework for essential skills and the achievement levels necessary for students graduating from schools that provide education for obtaining a license as a public health nurse (PHN) in Japan. METHODS: Two rounds of questionnaire-based investigations using the Delphi methodology were conducted. Subjects were 197 PHNs from municipalities or companies and 146 nurse educators from universities, colleges, junior colleges, or technical nursing schools. RESULTS: (1) The essential skills framework consisted of three (macro, intermediate and micro) levels. Macro-level items were based on the principle of justice, a primary pillar of health care: (A) community assessment to identify health problems; (B) solving and improving particular health problems in collaboration with people to enable them to promote their own health; (C) promoting equitable access and distribution of community resources for health and daily living. Micro-level items had four achievement levels: (I) independent; (II) instructor-guided; (III) laboratory exercise; (IV) theoretical understanding. Micro-level items for A and B had two domains for achievement: individual/family and group/community. (2) In the first round over 70% of respondents said "very important," "important" or "acceptable" for all micro-level items. In the second round, over 90% said all micro-level items fit within macro and intermediate-level items. (3) In the second round, micro-level items attained 70% consensus among PHNs and nurse educators were 71 of 93 (76.3%). Micro-level expression was used for adjustment and the final framework of essential skills yielded 3 macro, 8 intermediate and 59 micro-level items and 95 levels of achievement. (4) In the final framework, the level of achievement for "individual/family" (Macro-level A and B) was almost level I, and for "group/community" almost II or III. The number of micro-level items at level IV for C was 14 of 21 (66.7%). (5) Compared with PHNs, educators generally assigned a more advanced achievement level for the same skill. CONCLUSIONS: This framework offers more clarity to the content and competency of practice and thus should be useful for basic and continuing PHN education. The assumption driving this study was the necessity to improve the nursing educational system, and develop an appropriate curriculum for the PHN national licensure.

[Concept analysis of presenteeism and its possible applications in Japanese occupational health].

The purposes of this systematic review were to define the concept of presenteeism in accordance with Rodgers' concept analysis methods and to examine the possibility of applying the concept to Japanese occupational health. Using presenteeism as a search term, articles were selected from the MEDLINE, PsycINFO and Japana Centra Revuo Medicina databases. The definitions, antecedents, and consequences of presenteeism were extracted from the selected articles and were examined in order to determine how presenteeism was used in the literature. A total of forty-four articles published from 1955 to 2005 were selected for analysis. Based on the extracted definitions, four attributes of presenteeism were identified, and presenteeism was defined as "a self-rated measurable loss of work performance due to health problems in the workplace." Antecedents of presenteeism were classified into occupational and personal factors. These factors affected the decisions of workers with health problems regarding whether or not to go to work. Consequences of presenteeism were the aggravation of quality of life and health status, increases in health-related costs, adverse effects on colleagues, increases in occupational accidents, and deterioration of the quality of products and services. Therefore, the reduction of presenteeism is considered to be an important challenge for occupational health professionals. Possible applications of the concept of presenteeism in Japanese occupational health are the following: 1) measurement of presenteeism and examination of its related factors, 2) identification of factors that discourage workers from taking adequate sickness absenteeism, and 3) design of occupational health activity plans and the evaluation of such activities. In order to measure presenteeism in Japan, it is necessary to introduce Euro-American instruments suitable for the purpose of measuring presenteeism and to develop new measures. Occupational health professionals can incorporate assessments of presenteeism in their occupational health activities by considering not only the individual state of presenteeism, but also the state of the entire organization and interaction among workers' health problems, occupational factors, and personal factors. Moreover, if the loss of work performance due to presenteeism is converted to financial loss, it is considered that the necessity and the validity of workplace-based health activities will be clarified.

Evaluation of an emergency treatment training program for occupational health nurses.

OBJECTIVES: The purpose of this study was to evaluate the appropriateness and usefulness of the first aid training program developed for occupational health nurses (OHNs) to improve their basic skills of first aid treatment. METHODS: This was a case-control study. The subjects were 69 nurses who were stationed in workplaces in Japan (intervention group: n=35; waiting-list control group: n=34). The training program was developed using the method of instructional design (ID) and composed of basic life support (BLS) training, basic first aid training, and simulation training. This study was conducted from April to August 2012. The training was evaluated using the Kirkpatrick model of training evaluation: level 1 (reaction), level 2 (learning), level 3 (behavior), and level 4 (results; this level was omitted). For level 1, the training contents were evaluated on a visual analog scale (VAS) of 0 to 10 points on the basis of whether the programs' contents were interesting, understandable, and applicable in the workplace. For level 2, a knowledge test (15 true/false questions) was used. For level 3, the practical application of activities relating to the emergency system was evaluated. RESULTS: There were no significant differences in the attributes and characteristics of the subjects of the workplaces between the intervention and the waiting-list control groups. The score for reaction (level 1) were 8.5-9.7 points. In the knowledge test (level 2), there was no significant difference in the score before training between the intervention (11.0 points) and the waiting-list control groups (11.1 points). However, the score three months later showed a significant difference between the intervention (12.5 points) and the waiting-list control groups (11.0 points). The score after training was significantly higher than the score before the training that the intervention group received. For evaluation of behavior (level 3) three months later, the ratios of implementation of management and review of necessary items, review of task, and discussion with OHNs on emergency systems were significantly high in the intervention group. CONCLUSIONS: The evaluation of the first aid training programs for OHNs in this study showed high satisfaction of the participants and indicated improved knowledge and contributions to the waiting-list control group. We consider the contents of the program as appropriate.

The economic impact of loss of performance due to absenteeism and presenteeism caused by depressive symptoms and comorbid health conditions among Japanese workers.

We aimed to determine the economic impact of absenteeism and presenteeism from five conditions potentially comorbid with depressive symptoms-back or neck disorders, depression, anxiety, or emotional disorders, chronic headaches, stomach or bowel disorders, and insomnia-among Japanese workers aged 18-59 yr. Participants from 19 workplaces anonymously completed Stanford Presenteeism Scale questionnaires. Participants identified one primary health condition and determined the resultant performance loss (0-100%) over the previous 4-wk period. We estimated the wage loss by gender, using 10-yr age bands. A total of 6,777 participants undertook the study. Of these, we extracted the data for those in the 18-59 yr age band who chose targeted primary health conditions (males, 2,535; females 2,465). The primary health condition identified was back or neck disorders. We found that wage loss due to presenteeism and absenteeism per 100 workers across all 10-yr age bands was high for back or neck disorders. Wage loss per person was relatively high among those identifying depression, anxiety, or emotional disorders. These findings offer insight into developing strategies for workplace interventions on increasing work performance.

Adaptation and validation of the Japanese version of the Health Education Impact Questionnaire (heiQ-J) for the evaluation of self-management education interventions.

AIM: In many countries, health education interventions are popular; however, few valid measures exist for evaluation of multifactorial interventions. The aim of the present study was to translate and culturally adapt the widely-used 8 scale Health Education Impact Questionnaire (heiQ) for the evaluation of the Japanese Specific Health Consultation (SHC) in people with metabolic syndrome. METHODS: A draft was generated using a standardized forward and back translation protocol with independent translators and consensus meetings. Pilot testing included cognitive interviews (n = 12) resulting in question refinements. To explore psychometric properties, 250 participants aged between 40 and 64 years (retest = 116) completed the Japanese version of the heiQ (heiQ-J) and comparator scales, mental health and vitality scales of the Medical Outcomes Study 36 item Short-Form Health Survey, Sense Of Coherence scale, and Social Support Measurement scale. RESULTS: Cognitive interviews revealed that the translation was understood as intended by participants. Internal consistency (α) was good to very good for all scales (0.70-0.88) and test-retest intraclass correlation coefficients were high (≥ 0.83). Concurrent validity was supported by high correlation with like scales and weak correlation with dissimilar scales. CONCLUSION: The translated and adapted heiQ-J has good face and concurrent validity and is reliable. The heiQ-J is likely to be a useful measure of the quality and impact of the SHC and return valuable data to clinicians and commissioners of health education in Japan.