Evaluation of a Japanese brief CBT-I administered by a nurse: a pilot study.

AIM: The aim of this pilot study is to evaluate a Japanese version of brief Cognitive Behavioral Therapy for Insomnia (CBT-I) and contribute to primary care which leads to prevention of a lifestyle-related disease or a psychiatric disorder. METHOD: A single-arm study in nine patients with chronic insomnia who were under the pharmacotherapy was executed. The Insomnia Severity Index (ISI), the Athens Insomnia Scale (AIS), and the European Quality of Life 5 Items (EQ-5D) were assessed at the beginning of intervention, at the end of intervention, and after 12 weeks. FINDINGS: There were no patient dropouts nor adverse events. The average change in ISI score was -7.33 (95% CI: -10.31 to -4.36) at post-treatment and -6.11 (95% CI: -8.20 to -4.03) at the 12-week follow-up point (Cohen's d = 2.25). The AIS score improved as well, and the EQ-5D score improved after 12 weeks. The safety and efficacy of the brief CBT-I were suggested.

Worries of independent older people regarding health and daily life: a survey of residents of a rural town in Japan.

The purpose of the study was to analyze the worries of independent older people regarding health and daily life. We collected data from 259 people who responded to the free descriptive questionnaire and analyzed it qualitatively and inductively. Thirteen categories derived from the results were classified into 6 types of worries: health worries, life function worries, daily life worries, long-term care worries, family relationship worries, and future life worries. Promoting the prevention of "long-term care status," the need for physical nursing care, in a super aging society, where the population of 65 years or older is more than 21% of all of the population, requires consideration of not only measures to deal with physical symptoms, but also measures to deal with psychological aspects, and social aspects.

Effects of fatigue on immune function in nurses performing shift work.

OBJECTIVES: We investigated the effects of fatigue on NK cell function and lymphocyte subpopulations in nurses performing shift work using a longitudinal design. METHODS: Fifty-seven female nurses engaged in shift work at a hospital in Japan were selected for our study cohort. The hospital used a counterclockwise rotating three-shift system. Night shifts followed day shifts after a seven-hour interval. Immune parameters measured at the beginning of the day shift through to the end of the night shift were compared between two groups stratified by their level of fatigue. Statistical differences were evaluated after adjusting for baseline immune values and other demographic features. RESULTS: Subjective feelings of fatigue increased progressively from the beginning of day shifts to the end of night shifts. From the beginning of day shifts to the end of night shifts, NK cell activity and CD16(+)CD56(+) lymphocytes decreased, while CD3(+) and CD4(+) lymphocytes increased. The group with the greater increase in fatigue showed a larger decrease in NK cell activity and a larger increase in CD4(+)lymphocytes when compared with the group reporting less fatigue. These findings did not change after adjusting for demographic factors and sleep hours. CONCLUSION: Our data suggest that shift work has deleterious effects on NK cell function and that the effects depend on the degree of fatigue. Proper management of shift work may lessen fatigue in workers and also ameliorate many health problems experienced by shift workers.