Perceptions and practices of Japanese nurses regarding tobacco intervention for cancer patients.

BACKGROUND: We investigated the perceptions and practices regarding tobacco intervention among nurses, as improvement of such practices is important for the management of patients who smoke. METHODS: Self-administered questionnaires were delivered by hospital administrative sections for nursing staff to 2676 nurses who were working in 3 cancer hospitals and 3 general hospitals. Of these, 2215 (82.8%) responded. RESULTS: Most nurses strongly agreed that cancer patients who had preoperative or early-clinical-stage cancer but continued to smoke should be offered a tobacco use intervention. In contrast, they felt less need to provide tobacco use intervention to patients with incurable cancer who smoked. Most nurses felt that although they assessed and documented the tobacco status of cancer patients, they were not successful in providing cessation advice, assessing patient readiness to quit, and providing individualized information on the harmful effects of tobacco use. In multivariate analysis, nurses who received instruction on smoking cessation programs during nursing school were more likely to give cessation advice (odds ratio, 1.61; 95% confidence interval, 1.15-2.26), assess readiness to quit (1.73, 1.09-2.75), and offer individualized explanations of the harmful effects of tobacco (1.94, 1.39-2.69), as compared with nurses who had not received such instruction. CONCLUSIONS: The perceptions of Japanese nurses regarding tobacco intervention for cancer patients differed greatly by patient treatment status and prognosis. The findings highlight the importance of offering appropriate instruction on smoking cessation to students in nursing schools in Japan.

Reliability and validity of the Japanese version of the Support Team Assessment Schedule (STAS-J).

OBJECTIVE: The aim of this project was to develop an appropriate and valid instrument for assessment by medical professionals in Japanese palliative care settings. METHODS: We developed a Japanese version of the Support Team Assessment Schedule (STAS-J), using a back translation method, and tested its reliability and validity. In the reliability study, 16 nurses and a physician who work in a palliative care unit evaluated 10 hypothetical cases twice at 3-month intervals. For the validity study, external researchers interviewed 50 patients with matignancy and their families and compared the results with ratings by the nurses in the palliative care unit. RESULTS: Our results with hypothetical cases were: interrater reliability weighted kappa = 0.53-0.77 and intrarater reliability weighted kappa = 0.64-0.85. In the validity study comparing nurse evaluations and the results of interviews with patients and families, complete agreement was 36-70%, and close agreement (+/-1) was 74-100%. As a whole, weighted kappa were low: between -0.07 and 0.51. Our results were similar to those in the United Kingdom and Canada. SIGNIFICANCE OF RESULTS: Although this research was conducted under methodologically limited conditions, we concluded that the STAS-J is a reliable tool and its validity is acceptable. The STAS-J should become a valuable tool, not only for daily clinical use, but also for research.