[Development of a New Resilience Scale for Parents of Children with Profound Intellectual and Multiple Disabilities].

Objetives: As the first step forward building a supporting system for the Parents of Children with Profound Intellectual and Multiple Disabilities (PIMD) at home, we developed a new resilience scale that can be used by multiple professionals to understand the situation of those parents and to provide the necessary support. METHODS: First, we collected scale items on the basis of our previous study as well as related reports in the literature. These items were then screened by the research team with knowledge and experience in supporting those parents, finally, 37 items were generated. Then, we asked the parents of children with PIMD who were of elementary school age and above in the Kanto-Shinetsu area to complete a questionnaire. Out of 477 questionnaires sent, 193 were refused, and the data were statistically analyzed. RESULTS: Exploratory factor analysis revealed that the scale was made up of the following seven factors. 1) Understanding and awareness of the child, 2) Empowerment by the child, 3) Use of specialists, 4) Interest and concern in something other than the child, 5) Emotional adjustment, 6) Maintenance of lifestyle balance, and 7) Request for assistances. Cronbach's alpha coefficient of each factor was calculated. The validity was also confirmed by determining the relationship of resilience with parents' well-being. CONCLUSIONS: The results suggest that the new resilience scale for parents of children with PIMD developed in this study can be a reliable instrument for assessing resilience in Japanese parents of a child with such disabilities.

Psychological distress after the Great East Japan Earthquake and Fukushima Daiichi Nuclear Power Plant accident: results of a mental health and lifestyle survey through the Fukushima Health Management Survey in FY2011 and FY2012.

BACKGROUND: On 11 March 2011, the Great East Japan Earthquake followed by a gigantic tsunami hit the Pacific coast of Northeast Japan (Tohoku) and damaged Tokyo Electric Power Company's Fukushima Daiichi Nuclear Power Plant, causing a radiation hazard in the entire Fukushima Prefecture. The radiation dose exposed either externally and internally in Fukushima residents have been evaluated to be low so far and it is hardly believed that they may have any direct radiation risk on physical condition. The purpose of this report is, therefore, to describe results of a mental health and lifestyle survey intended to facilitate adequate care for residents who are at a higher risk of developing mental health problems after the complicated accident. PARTICIPANTS AND METHODS: The target population of this survey is the residents of evacuation zones including Hirono Town, Naraha Town, Tomioka Town, Kawauchi Village, Okuma Town, Futaba Town, Namie Town, Katsurao Village, Minamisoma City, Tamura City, Yamakiya district of Kawamata Town, and Iitate Village. The targeted population was 210,189 in fiscal year 2011 (FY2011) and 211,615 in fiscal year 2012 (FY2012). Questionnaires have been mailed since January 2012, and subsequently, January 2013, 10 and 22 months after the disaster. Among of them, children 63.4%, adults 40.7% for FY2011, and children 41.0%, adults 29.7% for FY2012 responded to the questionnaires mailed. RESULTS: Sociodemographic data showed that many evacuee households were separated after the disaster and had to move several times. K6 was used in this survey to estimate general mental health. The proportion (14.6% in FY2011 and 11.9% inFY2012) of adults who scored above the K6 cut-off (≥13) for general mental health was higher than usual, indicating severe mental health problems among evacuees. The proportion (21.6% in FY2011 and 18.3% inFY2012) of adults who scored above the cut-off (≥44) of PTSD checklist (PCL), reflecting traumatic symptoms, was almost equal to that of the workers after the 9.11 World Trade Center attacks. These results also indicate the presence of severe traumatic problems among evacuees. The proportions of children (4-6 years old) and children of primary school age (6-12 years old) who scored above the cut-off (≥16) of Strengths and Difficulties Questionnaire (SDQ) reflecting the mental health status in children, 24.4% and 22.0% in the survey of FY2011, were double the usual state respectively, whereas 16.6% in children of 4-6 years old and 15.8% in children of 6-12 years old in FY2012 were 1.5 times. These findings also disclosed the presence of severe mental difficulties in children, with relative improvement year by year. CONCLUSION: As revealed by the present mental health survey, the earthquake and tsunami followed by the nuclear accident caused psychological distress among residents in Fukushima prefecture. Continuous survey and mental care programs are required.

Attitudes and practices of breast cancer consultations regarding sexual issues: a nationwide survey of Japanese surgeons.

PURPOSE: To investigate doctors' current practices and attitudes and correlates of sexuality-related consultations in clinical encounters. METHODS: A nationwide, self-administered mail survey was conducted with 1,313 board-certified Japanese breast surgeons in August 2001. Surgeons were asked about their experiences regarding consultations about sexual issues, attitudes toward sex-related statements, and advice to a patient's hypothetical question on having sex after undergoing breast cancer treatment. RESULTS: Of the surveyed sample, 635 surgeons (50.3%) responded. Of these surgeons, 32.4% had been consulted about sexual issues by patients or families. Multiple logistic regression analysis suggested that female respondents (P < .01), respondents whose hospitals conduct a large number of breast cancer operations annually (P < .01), and respondents who agreed that "Surgeons have a professional responsibility to deal with patients' sexual issues" (P < .01) were significantly more likely to be consulted. Respondents who agreed that "If any sexual problem exists, patients will raise the topic before surgeons ask them" were less likely to be consulted (P < .05). Respondents' attitudes toward the sex-related statements showed that, although the majority recognized the importance of patients' sexuality-related concerns, they did not necessarily think that surgeons had a professional responsibility to deal with them. Regarding their advice in response to the question of "Are there any particular things to be careful about when having sex after surgery?", 32.8% answered "nothing in particular." CONCLUSION: This study shows that talking about sex-related topics is still repressed in patient-doctor encounters in Japan. It is an urgent matter to increase doctors' awareness and clinical skills to deal with patients' sexual issues.

The association between breast surgeons' attitudes toward breast reconstruction and their reconstruction-related information-giving behaviors: a nationwide survey in Japan.

BACKGROUND: Breast reconstruction after breast cancer surgery has come to be regarded as an achievable treatment option to improve patients' quality of life. Although it has been pointed out that surgeons' information-giving behaviors affect women's decision to undergo breast reconstruction surgery, little is known about the factors that influence these behaviors. This study investigated Japanese surgeons' reconstruction-related information giving to patients and the factors that affect these behaviors. METHODS: A nationwide postal survey of 1313 board-certified Japanese breast surgeons was conducted. In the questionnaire, surgeons were asked about their reconstruction-related information-giving behaviors and their attitudes toward six hypothetical critical statements regarding breast reconstruction. RESULTS: Among 635 responding surgeons, 199 (31.3 percent) answered that they did not give reconstruction-related information at all when explaining breast cancer treatment options, and 291 (45.8 percent) stated that they selectively choose patients with whom they provide information based on patients' backgrounds such as age and marital status. Results from the multiple logistic regression analysis indicated that respondents who agreed to the statements "Breast reconstruction may delay the detection of local recurrence," "The aesthetic results of reconstructed breasts are not worth the cost and effort involved," "Breast reconstruction is a luxury," and "Surgeons should pursue breast conserving surgery rather than breast reconstruction" showed significantly decreased likelihood to give reconstruction-related information to patients. CONCLUSION: Surgeons need to be aware of the adverse effect that their own attitudes and values with regard to breast reconstruction may have on a patient's ability to choose treatment options.