Emergent use of Twitter in the 2011 Tohoku Earthquake.

INTRODUCTION: Social networks play an important role in disaster situations as they have become a new form of social convergence that provides collective information. The effect of social media on people who experienced disaster should be assessed. Hypothesis In this study, Twitter communication during the Great East Japan Earthquake of March 11, 2011 was assessed. The hypothesis of this study was that usage of Twitter had psychological effects on victims of the disaster. METHODS: A cross-sectional questionnaire survey was carried out in cooperation with a major Japanese newspaper three months after the disaster, and 1,144 volunteer participants responded. They were asked about their health, area of residence, property damage they had experienced, information sources they used at the time of the disaster, and their usage of Twitter. Further, the Twitter users were divided into two groups-with and without disaster experience. Their psychological effects relating to feelings of relief, stress or anxiety that they experienced in using Twitter were compared between two groups, and Twitter's psychological risk of disaster experience was estimated as an odds ratio. RESULTS: Twitter users in this study tended to reside in disaster-affected areas and thought Twitter was a credible information source during the time of the disaster. The psychological effect of Twitter differed based on participants' disaster experience and gender. Females with disaster experience reported more feelings of relief and stress as a result of using Twitter compared to females who did not experience the disaster. On the other hand, males with disaster experience only reported more stress experiences as a result of using Twitter compared to those without disaster experience. CONCLUSION: Twitter users with disaster experience had a higher usage of Twitter than those without disaster experience. Social media might have had a material psychological influence on people who experienced disaster, and the effect differed by gender. Regardless of gender, negative feelings were transmitted easily among people who experienced the disaster. It was anticipated that the application of Twitter in a disaster situation will be expanded further by taking these findings into consideration.

Communications Through Contemporary Tools of Information and Communication Technology: Cross-sectional Study Evaluating Health Among Separated Family Members.

BACKGROUND: The number of single-living workers separated from their spouses and families has been increasing due to the need to create a balance between life and work. Workers are assigned everywhere in globalized workplaces while also caring for their family members in the context of Japan's aging society. At the same time, the mental and health status of persons living separately from their families is a matter of concern. The development of interpersonal communication means using information and communications technology (ICT) tools and the internet is remarkable, enabling simultaneous 2-way communication across distances and national borders. The easy accessibility to simultaneous communication is expected to improve the psychosocial status of isolated family members. OBJECTIVE: This study aims to clarify the health benefits of ICT by using a psychosocial health assessment, the characteristics of ICT tools, and the frequency of communication among the workers and their families who live separately. METHODS: This was a cross-sectional study planned and conducted in Japan. Study participants, including adults who live separately from other family members or have separately living family members due to work, were recruited to answer a web response survey about ICT usage status, health status, and life and society evaluation. This study recruited 73 participants divided into 2 groups by their communication tools and frequencies, and their separated life, health, and psychosocial status were statistically compared. RESULTS: Among the 73 study participants, 15 were categorized in the high communication-skilled (HCS) group that used both types of ICT tools to communicate frequently: "live," such as video chat and voice call, and "nonlive," such as SMS text message service and email. A simple comparison between the HCS and reference groups showed significant differences in the cohesion with the neighborhood (P=.03), perceived social position (P=.01), and happiness (P<.001); however, there were no significant differences in the health (psychological distress, P=.08; self-rated health, P=.07), lifestyle (drinking, P>.99; current smoking, P=.37), and dyadic trust in family members living separately (P=.80). Further, in a multivariate regression analysis adjusted for confounding factors, such as educational history, age, gender, and job status, poor subjective health showed a prevalence odds ratio of less than 1 (OR 0.17, 95% CI 0.03-1.02). The HCS group showed significant positive relationships in the cohesion score with the neighborhood (P=.01; ß=2.40, 95% CI 0.56-4.24), perceived social position (P=.03; ß=1.17, 95% CI 0.11-2.23), and happiness score (P=.002; ß=1.46, 95% CI 0.58-2.34) in the same multivariate regression models. CONCLUSIONS: This study suggested that people who frequently communicate with separated family members by taking advantage of various ICT tools can maintain a better mental state and better social relations among those who live alone and are separated from their families.

Evaluation of a Tool that Enables Cancer Patients to Participate in the Decision-Making Process during Treatment Selection.

BACKGROUND: Patient participation in decisions related to their treatment is strongly recommended. This study was conducted to develop and evaluate a support tool that can help patients make decisions related to their own treatment. METHODS: Twenty cancer patients who were hospitalized for first-line treatment were enrolled. Before hospitalization, a 'Check sheet on treatment selection', which contained 14 questions, was distributed to patients and/or their families. After hospitalization, the attending physician explained the treatment while referring to the written check sheet. At discharge, patients' responses to the 'Questionnaire on check sheet and treatment selection' were collected to evaluate the utility of the check sheet. Finally, the 'Questionnaire of the check sheet' was handed to the attending physician to evaluate. RESULTS: Of the fourteen patients who responded to the questionnaire, all indicated that the check sheets were helpful for decision-making and that using the sheets empowered them to ask their doctors questions. Only one person felt uncomfortable with compiling the check sheet. Physicians stated that the check sheet facilitated patient decision-making and improved communication with patients. However, some felt that this activity increased the administrative burden of medical professionals. CONCLUSION: Almost all patients stated that the present check sheet was useful as a decision support tool and facilitated communication between doctors and patients. Before incorporation into general clinical practice, this increased benefit should be weighed against the potential extra administrative workload imposed on clinicians.

Rapport between Cancer Patients and Their Physicians is Critical for Patient Satisfaction with Treatment Decisions.

BACKGROUND: Cancer patients' satisfaction with their treatment decisions has been demonstrated to be associated with improved health outcomes, but few studies of this issue have been conducted in Japan. OBJECTIVE: To explore key factors in enhancing patient satisfaction, we assessed the association between their satisfaction and their relationships with their physicians. METHODS: We conducted cross-sectional questionnaire surveys among patients who had received cancer treatment. One source was outpatients from a cancer center hospital, and the other was through the website of Japan's most popular newspaper. The questionnaire included demographic questions and general self-rated life status issues, such as peace of mind, quality of life, daily activities, family relationships, rapport with attending physician, assessment of the physician's explanations, and feelings of happiness during the previous week. RESULTS: Of 576 respondents, 383 subjects said they were satisfied and 193 dissatisfied. It was confirmed that the online survey was comparable to the paper-based survey in examining patient satisfaction. The dissatisfied group included more females and fewer subjects who were forced to retire from jobs than the satisfied group. The patients in the satisfied group had a more favorable subjective opinion of their recent life. The patients in the dissatisfied group received more chemotherapy and had more side effects than those in the satisfied group. Assessment of the physician's role showed significant differences between the two groups; the patients in the satisfied group felt more than those in the dissatisfied group that their physicians' explanations of treatment were sufficient and were satisfied with their rapport with their physicians. Multiple logistic regression analysis revealed that rapport with physicians was a significant factor (odds ratio=3.79, 95% CI=2.25-6.39). CONCLUSIONS: Rapport between physicians and patients is one of the most important factors in patient satisfaction with treatment decisions.