Family Caregivers' Needs in Long-Term Care Facilities: A Descriptive Qualitative Study.

PURPOSE: To explore the needs of family caregivers (FCs) and how these are addressed in long-term care facilities (LTCFs). METHOD: A descriptive qualitative study was performed, using semi-structured interviews with 23 FCs from seven LTCFs in Japan. RESULTS: Inductive content analysis revealed three main themes: Coexistent Needs Related to Residents' and FCs' Own Well-Being, Means by Which FCs Promote Residents' and Their Own Well-Being, and Managing Conflicting Needs by Prioritizing and Compromising. FCs recognized that their needs relate to the well-being of residents and themselves, and both needs coexist. To address these multifaceted needs, FCs engaged in various activities while seeking support. However, limited availability of means often made it challenging to meet multiple needs simultaneously, leading FCs to manage these conflicting needs by prioritizing or compromising. CONCLUSION: The current study underscores the significance of comprehensive support that simultaneously addresses FCs' conflicting needs, rather than approaching each need separately. [Research in Gerontological Nursing, xx(x), xx-xx.].

[A Multicenter randomized comparative study of dementia nursing practice skills development programs for nurses in acute care hospitals: A Comparison of person-centered care and dementia-type-specific programs].

PURPOSE: The present multicenter randomized controlled trial explored the effectiveness of a person-centered care program (intervention group) and a dementia-type-specific program (control group) for nurses in acute-care hospitals. METHODS: Seven hospitals in Prefecture A were randomly allocated to two groups (an intervention group and a control group), and a study of these groups was conducted from July 2021 to January 2022. RESULTS: A total of 158 participants were included in the study: 58 in the control group and 100 in the intervention group. In a comparison of assessment values immediately after the course, three months later, and six months later for both the intervention and control groups, "expertise in dementia nursing," "medical expertise in dementia, " and "confidence in nursing older people with dementia" were all significantly higher than before the course. Significant improvements in the intervention group's "knowledge of dementia" and "sense of dignity" on the ethical sensitivity scale were found immediately after the course compared to baseline, three months later, and six months later and were also significantly greater than the control group in terms of the amount of change. In the control group's "unique care tailored to cognitive function and the person," there were significant improvements in the ratings immediately after the course and three and six months after the course compared to baseline, with significantly greater amounts of change than in the intervention group. CONCLUSION: The person-centered care program for nurses led to improvements in the knowledge about dementia and awareness of the dignity of ethical sensitivity. In addition, the type of dementia program had a significant influence on medical knowledge and unique care tailored to the cognitive function and the individual patient. Further outcome evaluations of physical restraint rates as a quality of care in nursing practice are needed.

Experiences and attitude of task shifting and task sharing of physicians, nurses, and nursing assistants in hospitals: a qualitative systematic review protocol.

OBJECTIVE: The objective of this review is to explore the experiences and attitudes of physicians, nurses, and nursing assistants regarding task-shifting and task-sharing in hospitals. INTRODUCTION: Despite multiple health care professionals performing overlapping tasks, the need for effective task-shifting and task-sharing remains a concern. Understanding task-shifting and task-sharing experiences, as well as the attitudes of health care providers in hospitals, is essential for providing safe and patient-appropriate care with limited human resources. INCLUSION CRITERIA: Qualitative studies that examine the experiences and attitudes of physicians, nurses, and nursing assistants in hospitals regarding task-shifting and task-sharing will be included. The review will include physicians, advanced practice nurses who are nurse practitioners or clinical nurse specialists, registered nurses, and nursing assistants. Midwives, pharmacists, occupational therapists, physical therapists, and students will be excluded. METHODS: PubMed, MEDLINE, CINAHL, PsycINFO, Cochrane Database, and Web of Science will be searched as part of a 3-step search strategy. We will search for unpublished research and gray literature using Google Scholar and ProQuest Dissertations and Theses. Inclusion criteria will be studies published in English or Japanese from the time each database was established to the present. The methodological quality of all studies will be evaluated by screening against the inclusion criteria and by at least 2 critical evaluations using the standardized JBI checklist. Synthesized results will be pooled by meta-aggregation and published as a ConQual Summary of Findings. REVIEW REGISTRATION: PROSPERO CRD42023409612.

Factors affecting the critical appraisal of research articles in Evidence-Based practices by advanced practice nurses: A descriptive qualitative study.

AIM: To describe factors affecting critical appraisal of research articles in evidence-based practice by certified nurse specialists who were advanced practice nurses in Japan. DESIGN: A descriptive qualitative study. METHODS: Fourteen certified nurse specialists with master's degree were included by a snowball sampling to maximize the variety of specialty fields for advanced practice nurses in Japan. Individual semi-structured interviews were conducted between November 2016 and March 2017. Interview guides included the experience of evidence-based practice and learning about critical appraisal. RESULTS: The following four aspects were identified as factors affecting the critical appraisal of research articles in evidence-based practices-individual beliefs and attitude, learning status, organizational readiness and availability of research evidence. Each factor included both positive and negative aspects for critical appraisal in evidence-based practice. PATIENT OR PUBLIC CONTRIBUTION: If advanced practice nurses acquire knowledge/skills of critical appraisal, they would be able to select more appropriate care. This will increase to improve the health-related outcome for patients or populations.

Effective situation-based delirium simulation training using flipped classroom approach to improve interprofessional collaborative practice competency: a mixed-methods study.

BACKGROUND: Interprofessional collaborative practice competency (ICPC) is key to providing safe, high-quality, accessible, patient-centred care. Effective delirium management, particularly, requires a multi-component intervention, including the use of interprofessional teams at care point. This research aims to investigate the effectiveness of the flipped classroom approach for improving ICPC in simulation-based delirium case management. METHOD: An embedded mixed-methods study was designed to investigate the effects of the flipped classroom approach on health professionals' performance in delirium management. The study population comprised nine health professionals (three physicians, nurses, and pharmacists each). They used pre-class study materials about delirium management via a digital learning platform before a simulation case training session. A readiness assurance process test was conducted on key concepts, covered in the pre-class study material. Participants were randomly assigned to three teams, each of which included health professionals. Each team participated in a simulation case scenario. For the quantitative outcome measures, the Chiba Interprofessional Competency Scale (CICS29), a validated scale for measuring competencies of interprofessional practice, was used before, after, and three months after the educational intervention. The qualitative component consisted of a post-training questionnaire and semi-structured focused group interviews about the impact of the flipped classroom approach. RESULT: The CICS29 measured after the intervention and three months after was noted to be significantly higher than before the intervention. Three semi-structured focused group interviews were conducted (n=9), which, upon analysis revealed that the flipped classroom approach effected on four stages of Bloom's taxonomy level. A total of nine categories and 17 subcategories were identified corresponding to four levels of the revised Bloom's taxonomy: remember (1), understand (12), apply (23), and analyse (3). CONCLUSION: The simulation-based skill training using flipped classroom approach can be an effective method for improving ICPC for health professionals. In this approach, an elevated level of cognitive activity is practiced in the Bloom's taxonomy, and the participants worked on an application-based case simulation that promoted higher level learning and engagement in interprofessional collaborative practice. This approach also established a basic common language of delirium assessment and management, thus facilitating communication among health professionals and improving ICPC.

Long-term body weight change assessed by non-contact load cells under the bed in older people with and without eating assistance: a preliminary study.

Utilizing automatic daily body weight (BW) measurements may be helpful for assessing nutritional status and detecting underlying diseases particularly in older people who require nursing care. This preliminary study aimed to verify effectiveness of eating assistance for maintaining BW in older people using a contact-free load cells under the bed (Bed Sensor System: BSS). BW was measured every night for 3 months in eight nursing home older people with severe cognitive and physical dysfunctions. Body composition of the subject's trunk and each limb was measured using a segmented multi-frequency bioelectrical impedance analyzer (BIA). A monthly BW loss was estimated as a slope of linear regression of the daily BW plot. BSS successfully measured daily BW for the study period in all participants. The 4 residents with eating assistance gained slightly more weight, while the 4 residents without eating assistance lost weight. There was a significant difference between the two groups in the monthly BW change (- 0.79 ± 0.51 kg/month versus 0.20 ± 0.49 kg/month, P = 0.030). None of the BIA-derived parameters was associated with the monthly BW change. BSS revealed effectiveness of eating assistance to maintain BW in nursing home residents with severe cognitive and physical dysfunctions.

[Effectiveness of programs developed for nurses to improve dementia nursing intervention ability in an acute care setting].

PURPOSE: The number of hospitalizations of older patients with dementia who require medical treatment has increased and delirium or physical restriction have become problems in the acute care setting. Dementia nursing intervention ability developing program by e-learning assumed the quality improvement of dementia medical care and the nursing of older patients with dementia based on person-centered aimed at reduction of body restriction. The purpose of this study was to validate the effectiveness of the developed e-learning programs for nurses in the acute care setting of seven to one nursing standards. METHOD: This study was conducted between April and December 2020. This study was introduced to the floor nurse of the hospital for suitable application. Interested nurses were asked to attend "Developing programs for Dementia nursing intervention ability (4 weeks)" at four different time points (1) before attendance (baseline), post-attendance (1 month later), (3) practiced 3 months post-attendance, and (4) practiced 6 months post-attendance. A questionnaire to evaluate program effectiveness asked about consciousness of the dementia nursing with four items on "Interest in nursing of people with dementia and so on (four items)".In the evaluation on the person-centered dementia care, using the Self-assessment Scale of Nursing Practice for Elderly Patients with Cognitive Impairment, the Approach to Dementia Questionnaire - Japanese Edition (19 items). In the evaluation of ethics, ethical sensitivity scale for clinical nurses (19 items), self-efficacy on reduction of the physical restriction (six items). A statistical analysis was conducted using the Bonferroni test as the multiple test method to compare baseline values with the values obtained 1, 3, and 6 months later. RESULTS: A total of 70 subjects were analyzed in this study. They belonged to different wards including the surgical and internal wards from where 60 subjects (85.7%) were recruited. The average clinical experience of the nurses was 13.5±9.5 years. The degree of self-efficacy was assessed in terms of attaching mitten type gloves as a physical restraint to avoid the pulling of tubes used for intravenous feeding, central veins, normal feeding, etc. by the patients and so on. Most patients had cognitive functional disorder, including dementia [n = 30 (42.9%)]. The self-assessed scale of nursing practice for elderly people with cognitive impairment, which aimed to promote person-centered care in an acute care hospital, revealed that the total score of each of the Approaches to Dementia Questionnaire - Japanese Edition significantly increased just after intervention (1 month) in comparison to baseline, and 3 months and 6 months after intervention. CONCLUSION: This study indicated that the program developed to improve dementia nursing intervention ability significantly increased the above-mentioned evolution and consciousness of nurses after the intervention program (1 month), followed by 3 months and 6 months later. Along with ethical sensitivity, practice aimed at person-centered care was also found to improve. It was suggested that the intervention program of this study was effective and that nurses could easily learn using their respective free time and practice.

Sustainable nurse-led care for people with dementia including mild cognitive impairment and their family in an ambulatory care setting: A scoping review.

AIMS: This review aimed to determine the characteristics of a nurse-led intervention for people with dementia including mild cognitive impairment and their family in an ambulatory care setting. BACKGROUND: Enhancing the role of nurses in a multidisciplinary team of ambulatory care follow-up after a diagnosis of dementia is thought to lead to successful dementia care. DESIGN: This is a scoping review. DATA SOURCES: MEDLINE, CINAHL, EMBASE, Cochrane, JBI, Japan Medical Abstracts Society, PsycINFO and Web of Science were searched on 14 March 2019. REVIEW METHODS: This scoping review was conducted using the Joanna Briggs Institute methodology, followed the PRISMA-ScR checklist and considered studies that included interventions conducted by nurses and included outcomes regarding dementia symptoms or family care burden. RESULTS: Eleven studies were included. Of these, all interventions were multifactorial and reported effective results. Educational interventions were most common, and the content of education included the characteristics of dementia and how to interact with patients with dementia. The roles of nurses included caregiver education, assessment, care plan creation for continuous monitoring and team building. CONCLUSION: This scoping review suggested that effective nurse-led interventions in the ambulatory care of people with dementia are continuous patient and family supports, primarily caregiver education within multidisciplinary teams.

Reliability and validity of the Japanese version of the 4A's Test for delirium screening in the elderly patient.

Although many screening tools for delirium are available, delirium is still occasionally overlooked or misdiagnosed. One of the reasons for this is the lack of brief screening tools that do not require specialized training to use. The 4 'A's test (the 4AT) is a validated screening tool for delirium that can be administered in a very short time without specialized training. Herein, we evaluated the reliability and validity of the Japanese version of the 4AT (the 4AT-J). A total of 150 patients aged ≥ 65 years were enrolled. Their demographics and clinical characteristics were obtained within 24 hr of their hospitalization. On each patient's high-risk day of developing delirium, the 4AT-J was administered by a nurse, and the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-Ⅴ) and the Japanese version of Delirium Rating Scale-Revised-98 (DRS-98-J) were administered by a psychiatrist. Our analyses revealed that when a cut-off score of 4, the 4AT-J showed high sensitivity and specificity. The Cronbach's α-coefficient was similar to that of the original version. A receiver operating curve analysis showed sufficient power of the 4AT-J to discriminate delirium. The 4AT-J showed adequate reliability and validity for delirium screening in elderly patients.

Exploring Barriers and Benefits of Implementing Interprofessional Education at Higher Health Professions Education Institutions in Japan.

In the 1990s, interprofessional education (IPE) was introduced to health professionals in higher education; it has come to be regarded as a standard learning method. However, major barriers remain regarding its introduction and smooth operation. This study conducted a questionnaire survey at educational facilities for health professionals in Japan; it developed scales to measure the recognition of barriers to and benefits of IPE implementation. We surveyed chairpersons responsible for 2,690 courses in Japanese health education facilities. We used for analysis the responses related to 767 courses (valid response rate, 28.5%). In all, 216 courses (28.7%) implemented IPE. We conducted exploratory factor analysis and developed scales for measuring the recognition of barriers to IPE implementation (15 items) and its benefits (11 items). We observed a significant relationship between the state of IPE implementation and recognition of barriers to and benefits of IPE. Using information and communication technology and faculty development for faculty members would be effective in removing the barriers to IPE implementation.

The positive effect of student-oriented clinical clerkship rounds employing role-play and peer review on the clinical performance and professionalism of clerkship students.

Background: Role-play (RP) and peer review (PR) are occasionally used in training and evaluating communication skills in clinical clerkship (CC). Thus, we evaluated the effect of combining RP and PR during student-oriented CC rounds.Methods: Clerkship students conducted medical interviews with and performed physical examinations on their patients, which were reviewed by five peer students who observed their performance while role-playing as senior physicians or patients' families. The peer reviewers then provided feedback to the students. The performance of the students was evaluated based on a mini-clinical evaluation exercise (Mini-CEX) and a professionalism mini-evaluation exercise (P-MEX) before and after the rounds by two attending physicians. After the CC, the students responded to questionnaires about the rounds.Results: Seventy-five students completed the rounds, and the duration of each round was 41.7 ± 7.1 min. Their communication skills and professionalism abilities on Mini-CEX and P-MEX showed significant improvement after the rounds. Improvements in medical interviewing and physical examinations were also noted. Additionally, the students recognized the importance of multiple viewpoints in patient care through experiences of the rounds.Conclusions: Combining RP and PR with CC rounds improves the students' clinical performance and professionalism and promotes their awareness of the importance of multiple viewpoints in patient care.

Exploring sociodemographic factors related to practice, attitude, knowledge, and skills concerning evidence-based practice in clinical nursing.

AIM: This study aimed to explore sociodemographic factors related to evidence-based practice (EBP) competency in Japanese nurses in university hospitals. METHODS: In March 2016, a survey was distributed to 843 clinical nurses who directly provide nursing care at two university hospitals in Japan. Multiple regression analyses were conducted on data received from 472 nurses using the Evidence-Based Practice Questionnaire (Japanese version). RESULTS: Sociodemographic factors related to EBP competency were experience with conducting nursing research as a part of continuing education, education about EBP, advanced practice certification (certified nurse specialists/certified nurses), and years of experience in clinical nursing. These factors differed across the four subscales of the questionnaire: Practice, Attitude, Knowledge of Research and Practice, and Skills of Research and Practice. Specifically, experience with two or more nursing research activities was significantly positively associated with Attitude and Knowledge/Skills Concerning Research and Practice of EBP, but not related to the implementation of EBP itself. Advanced practice certification was significantly positively associated with Practice and Attitude of EBP. CONCLUSIONS: Our study quantitatively identified sociodemographic factors including experience with conducting nursing research and advanced practice certification status that were found to be related to EBP competency and these factors were differently associated with the four subscales of the Evidence-Based Practice Questionnaire (Japanese version). EBP education should depend on nurses' levels of EBP competency, and nursing educators and managers need to be cognizant of their nurses' sociodemographic factors when providing EBP education.

Job satisfaction and related factors of nurses in university hospitals: Focusing on collaborative competency factors.

AIM: This study aimed to clarify the association between nurses' job satisfaction, interprofessional collaborative competency and other related factors in university hospitals in Japan. BACKGROUND: Enhancing a team's function in the university hospital setting requires strengthening each professional's competency: high-level professional competency leads to high job satisfaction. METHODS: In 2014, self-administered questionnaires were sent to all nurses working at two university hospitals in Japan. A multivariate analysis of variance was conducted to evaluate the relationship between job satisfaction as the response variable and interprofessional collaborative competency and other variables as the independent variables. RESULTS: Data from 913 nurses were used in the present analysis (response rate: 60.4%). Two factors from the Chiba Interprofessional Competency Scale 29 (factor 1: attitudes and beliefs as a professional; factor 5: attitudes and behaviours that improve team cohesion) and opportunities for information exchange with other professionals outside the hospital had significant relationships with job satisfaction. CONCLUSION: Strengthening interprofessional collaborative competency and increasing opportunities for information exchange with professionals outside the hospital would improve nurses' job satisfaction in university hospitals. IMPLICATIONS FOR NURSING MANAGEMENT: Interprofessional collaborative competency and opportunities for information exchange with other professionals are worth the attention of nursing administrators.

The unlearning process of senior clinical nurses in rehabilitation wards.

AIMS: The aim of this study was to create a model and verify its fitness for focusing on unlearning of senior clinical nurses who transferred from acute to rehabilitation wards. BACKGROUND: The processes by which nurses with experience in acute wards acquire expertise in rehabilitation wards, the 'process of unlearning', have not yet been clarified. DESIGN: This research used a cross-sectional study. METHODS: Content analysis of interview data of 23 senior clinical nurses was used to reveal factors constituting nurses' unlearning and a base model was created. Data were collected between May - September 2016. For its verification, categories extracted through content analysis were used as latent variables and subcategories as observation variables. The model's fit was confirmed through a survey of 5,435 senior clinical nurses from July to September 2017. RESULTS: We extracted six categories-'awareness', 'conflict', 'discard', 'acquisition', 'acceptance' and 'establishment'-and 22 subcategories of the factors constituting unlearning and created a base model. The effective response rate in the survey for verifying the fitness of the base model was 20.2%. The base model generally fulfilled the fitness, but we further studied the model fit with the data and modified it to comprise five categories, excluding 'acceptance', with 16 subcategories. The fitness of the modified model further improved. Through revalidation, we confirmed that the modified model satisfies the goodness of fit. CONCLUSION: Our findings add to the development of rehabilitation nursing skills of nurses transferred from acute to rehabilitation wards in a Japanese community-based integrated care system. IMPACT: This study revealed the unlearning process of senior clinical nurses. The unlearning process identified in this study contributes to knowledge and skills acquisition specific to nurses specializing in rehabilitation. It will be used for developing a re-education programme for rehabilitation nurses in the future.

Changes in the Health Condition after Using a Service Dog of a Person with Complete C5 Spinal Cord Injury: A Qualitative Single Case Study.

BACKGROUND: We report the changes in the health condition after using a service dog of a person with a complete C5 spinal cord injury (SCI). CASE: A 48-year-old married man began using a service dog after suffering a complete C5 SCI. We conducted a semi-structured interview based on the International Classification of Functioning, Disability, and Health (ICF) rehabilitation sets to describe the change in the participant's experience after using a service dog. The interview was converted into written form, and information regarding the changes in the participant's health condition was extracted. These data were categorized by similarity and then classified by the ICF conceptual framework. DISCUSSION: The participant experienced multiple changes in his health condition after using a service dog. These included the following factors from the ICF - "Body Function" category: "increased vitality and motivation," "emergence of self-affirmation," and "physical improvement." Health changes form the "Activities and Participation" category included: "emergence of new roles," "increased resilience," "expansion of moving area," "acquisition of activities incorporated with a service dog assist," "emergence of autonomous health management," "expansion of relation with other people," and "expansion of social activity." The participant experienced "reduction of psychological barriers," categorized under "Personal Factor," and "expansion of support environment," categorized under "Environmental Factor."

Impact of nurse-assisted patient turning at different sleep stages on the quality of subsequent sleep.

BACKGROUND: Nursing care performed during sleep, including nurse-assisted patient turning, is one of the factors that deteriorates sleep quality but is necessary for pressure ulcer prevention. Thus, it is important to determine when nurseassisted patient turning has the least impact on sleep quality. AIM: The aim of this study was to clarify the impact of nurseassisted patient turning at different sleep stages and to determine the optimal timing of this aspect during sleep. METHODS: The experiment, which consisted of healthy men in their 20s and 30s, was performed over four successive nights per subject. The first night was dedicated to environment adaptation, and the 2nd to the 4th nights were randomly assigned for shallow sleep intervention, deep sleep intervention, and non-intervention. On the intervention day, nurse-assisted patient turning was conducted twice. Overnight sleep conditions were measured by polysomnography (PSG). The PSG waveform transmitted to a tablet was analyzed in real time to determine the stage of sleep. The patient was turned when he entered the planned stage of sleep. RESULTS: The study analyzed fourteen (14) subjects. Shallow sleep time, deep sleep time, and sleep resumption time after nurse-assisted patient turning were compared among the three groups of non-intervention day, shallow sleep intervention day and deep sleep intervention day. There was no significant difference in the shallow and deep sleep time among the three groups. However, sleep resumption time after nurse-assisted patient turning was significantly shorter on the deep sleep intervention day than on the shallow sleep intervention day (p = textbf 0.033). CONCLUSIONS: This study has novelty in examining the impact of nurse-assisted patient turning performed at different sleep stages on subsequent sleep using objective indicators. The study suggested that a deep sleep state is the optimal timing of nurseassisted patient turning due to the short time to sleep resumption.

The development and validation of the Evidence-Based Practice Questionnaire: Japanese version.

AIM: To develop and test the validity and reliability of a Japanese version of the Evidence-Based Practice Questionnaire. METHODS: The Evidence-Based Practice Questionnaire was translated into Japanese, and a back-translation was performed. In March 2016, the survey was conducted among 843 nurses in 2 university hospitals in Japan. After 2 weeks, the same questionnaire for test-retest reliability was distributed to 197 nurses. We evaluated construct validity by factor analysis: convergent, discriminant, criterion-based and known-group validity, and reliability (internal consistency via Cronbach' alpha and test-retest reliability). RESULTS: A total of 533 (66%) of nurses who agreed to our study returned the completed questionnaire, and 108 nurses (55%) agreed to the test-retest. Factor analysis confirmed that the original model of the Evidence-Based Practices Questionnaire was not statistically appropriate for Japanese nurses. Therefore, the final version of the Japanese version adopted 18 items and 4 subscales including practice, attitudes, and knowledge/skills related to research and practice. In the final version, the validity and reliability were moderate (Cronbach alpha = .90). CONCLUSION: The Japanese version of the Evidence-Based Practices Questionnaire is a reliable and valid tool and can be used to assess evidence-based practice, attitudes, and research knowledge/skills in Japan.

Effect of IPE on Medical Profession Education and Expectations of Pharmacists-From the Perspective of Nurses.

On January 1, 2015, the Interprofessional Education Research Center (IPERC) was opened at the Graduate School of Nursing at Chiba University, while being positioned as one of the Inohana Campus High Functionality Initiatives by the university. As the result of the establishment of an education research center in the nursing graduate school, various changes are coming into view. In particular, the active participation of young instructors of the medical, nursing, and pharmacology departments and university hospital in interprofessional education (IPE) efforts deserve special mention. In addition, IPE training with treatment participation, which had been a pending matter for many years, is being implemented on a trial basis in the university hospital ICU and pediatric departments starting this year. During this training, treatment plan proposals will be conducted in cooperation with university hospital specialists. IPE is also having a great influence on the formation of curriculums in each department. A factor behind this is the awareness of issues by young instructors such as whether practical training fully utilizes the team building, conference management, and joint learning ability being nurtured at IPE. IPE is unable to perform fundamental education without influencing professional education, and professional education also cannot help but change into "training of specialists with the ability to make contributions considered necessary as a specialist under any circumstances", The degree to which instructors in these three departments can together support curbing of resistance to this change and promoting transformation of values is considered key.

Development of a new measurement scale for interprofessional collaborative competency: The Chiba Interprofessional Competency Scale (CICS29).

The purpose of this study was to refine the items on a scale measuring interprofessional collaborative competency that was developed by the authors in an earlier pilot study. A questionnaire-based study was conducted with a sample of 2133 health professionals using the reformulated questionnaire. Construct validity was tested by comparing the survey results with a covariance structure analysis and the domains of interprofessional collaboration competencies presented in previous studies. A second survey was conducted 2 weeks later with a sample of 571 nursing professionals, using the same survey form to test its reliability. We constructed a model comprising 29 observed variables and six latent variables (the Chiba Interprofessional Competency Scale: CICS29), and obtained the following values for the model's goodness of fit: GFI = 0.925, AGFI = 0.908, CFI = 0.950, RMSEA = 0.049. With regard to reliability, we obtained scores ranging from 0.65 to 0.77 for the intraclass correlation coefficients of the six domains. Compared with the interprofessional collaboration scales indicated in previous studies, the CICS29 was found to have subsumed the key concepts that should be configured as interprofessional collaboration competencies. The CICS29 appeared to have satisfactory levels of reliability and validity and is recommended as a scale for measuring competencies of interprofessional practice.

Development of an interprofessional competency framework in Japan.

This article presents a project that aimed to identify a set of competencies (domains and statements) to prepare Japanese students and healthcare practitioners for collaborative practice. The Japan Association for Interprofessional Education (JAIPE) has started a government-funded project to formulate its interprofessional competency framework, in cooperation with professional organisations (e.g. Japan Society for Medical Education) in healthcare and social sciences. This three-year project is underway as part of the Initiative to Build up the Core Healthcare Personnel programme of Mie University. This project consists of five stages: literature review, data collection, prototype development, consensus formation, and finalisation. Our efforts will culminate in Japan's first interprofessional competency framework, with consensus from relevant academic societies and other stakeholders. We hope that the involvement of stakeholder participation will improve the usability of the final interprofessional competency framework.