Primary care patient experience and cancer screening uptake among women: an exploratory cross-sectional study in a Japanese population

Background

Patient experience and clinical quality, which are represented by preventive care measures such as cancer screening, are both widely used for the evaluation of primary care quality. The aim of this study was to examine the association between patient experience and cancer screening uptake among women in a Japanese population.

Methods

We conducted a cross-sectional mail survey. The questionnaire was sent to 1000 adult female residents randomly selected from a basic resident register in Yugawara town, Kanagawa, Japan. We assessed patient experience of primary care using a Japanese version of Primary Care Assessment Tool (JPCAT) and uptake of breast and cervical cancer screening.

Results

The overall response rate was 46.5%. Data were analyzed for 190 female participants aged 21–74 years who had a usual source of primary care. Multivariate logistic regression analyses revealed that the JPCAT total score was significantly associated with uptake of breast cancer screening [odds ratio (OR) per 1 standard deviation increase = 1.63; 95% CI 1.11–2.41], but not with uptake of cervical cancer screening (OR per 1 standard deviation increase = 1.47; 95% CI 0.97–2.24).

Conclusions

Patient experience of primary care was associated with uptake of breast cancer screening among Japanese women. The results of our study might support the argument that patient experience of primary care and the clinical process of preventive care, such as breast cancer screening, are linked.

     

Screening for malnutrition in community dwelling older Japanese: Preliminary development and evaluation of the Japanese Nutritional Risk Screening Tool (NRST)

Background

Early and effective screening for age-related malnutrition is an essential part of providing optimal nutritional care to older populations.

Objective

This study was performed to evaluate the adaptation of the original SCREEN II questionnaire (Seniors in the Community: Risk Evaluation for Eating and Nutrition, version II) for use in Japan by examining its measurement properties and ability to predict nutritional risk and sarcopenia in community-dwelling older Japanese people. The ultimate objective of this preliminary validation study is to develop a license granted full Japanese version of the SCREEN II.

Participants

The measurement properties and predictive validity of the NRST were examined in this cross-sectional study of 1921 community-dwelling older Japanese people.

Measurements

Assessments included medical history, and anthropometric and serum albumin measurements. Questions on dietary habits that corresponded to the original SCREEN II were applied to Nutritional Risk Screening Tool (NRST) scoring system. Nutritional risk was assessed by the Geriatric Nutrition Risk Index (GNRI) and the short form of the Mini-Nutritional Assessment (MNA-SF). Sarcopenia was diagnosed according to the criteria of the European Working Group on Sarcopenia in Older People.

Results

The nutritional risk prevalences determined by the GNRI and MNA-SF were 5.6% and 34.7%, respectively. The prevalence of sarcopenia was 13.3%. Mean NRST scores were significantly lower in the nutritionally at-risk than in the well-nourished groups. Concurrent validity analysis showed significant correlations between NRST scores and both nutritional risk parameters (GNRI or MNA-SF) and sarcopenia. The areas under the receiver operating characteristic curves (AUC) of NRST for the prediction of nutritional risk were 0.635 and 0.584 as assessed by GNRI and MNA-SF, respectively. AUCs for the prediction of sarcopenia were 0.602 (NRST), 0.655 (age-integrated NRST), and 0.676 (age and BMI-integrated NRST).

Conclusions

These results indicate that the NRST is a promising screening tool for the prediction of malnutrition and sarcopenia in community-dwelling older Japanese people. Further development of a full Japanese version of the SCREEN II is indicated.

     

Factors associated with quality of life among married women in rural China: a cross-sectional study

Purpose

Specific medical and living conditions in rural China may predispose people there to a poor quality of life. This study aimed to evaluate factors affecting the quality of life among married women in rural China.

Methods

This cross-sectional study was conducted in rural areas of Liaoning Province in China. Out of the 3900 married women, 3163 (81%) completed the questionnaire survey. Quality of life was assessed using the WHOQOL-BREF scale. Sociodemographic factors, such as monthly income, and living and health conditions, such as left-behind status, stress (quantified by the Perceived Stress Scale), and coping styles (assessed by the Simplified Coping Style Questionnaire) were collected through self-reported questionnaires. Hierarchical multiple regression was used to explore the factors related to quality of life.

Results

The mean scores of quality of life were 14.08?±?2.27 for the domain of physical health, 11.78?±?2.28 for psychological health, 13.07?±?2.69 for social relationships, and 12.26?±?2.67 for environmental conditions. Older age, having chronic diseases, being left-behind, sense of marriage insecurity, and stress were all negatively associated with quality of life scores, whereas a higher monthly income was associated with higher scores. Coping styles could be moderating factors in the relationship between stress and quality of life.

Conclusions

Overall, married women living in rural China had relatively low scores for quality of life. Improving family income, providing access to affordable and high-quality medical care, facilitating couple communication, and promoting active coping styles could be intervention strategies to improve the quality of life of these rural residents.

     

Rasch analysis of the Personal Wellbeing Index

Purpose

The Personal Wellbeing Index (PWI) is used internationally to measure subjective well-being. While numerous studies have reported on the psychometric properties of the PWI using classic test theory, the current paper provides additional psychometric evaluation using the Rasch measurement model.

Method

The responses to the PWI items of 593 healthy adults living in Australia or Canada were analysed using Rasch analysis. Assessed were overall model fit was assessed, individual person fit and item fit, reliability, differential item functioning (DIF), unidimensionality, targeting, and response format.

Results

Results indicate excellent psychometric properties of the PWI, provided the religion/spirituality item is excluded. The seven-item PWI showed good model fit (overall item–trait interaction χ ² = 70.59, df = 63, p = 0.24), excellent person separation (PSI = .89), no item or person misfit, and no DIF for country or gender, and unidimensionality was supported. In addition, only very mild disordered thresholds were observed for the ‘safety’ item, indicating that overall, the 11-point response format was suitable for this population.

Conclusion

It is recommended that the religion/spirituality item not be included in the aggregated or averaged total score in Western context and that caution should be used in comparison across different groups where the eight-item version has been used.

     

The role of perceived pollution and health risk perception in annoyance and health symptoms: a population-based study of odorous air pollution

Objectives

Health effects associated with air pollution at exposure levels below toxicity may not be directly related to level of exposure, but rather mediated by perception of the air pollution and by top-down processing (e.g., beliefs that the exposure is hazardous). The aim of the study was to test a model that describes interrelations between odorous air pollution at non-toxic exposure levels, perceived pollution, health risk perception, annoyance and health symptoms.

Methods

A population-based questionnaire study was conducted in a Swedish community of residents living near a biofuel facility that emitted odorous substances. Individuals aged 18–75 years were selected at random for participation (n = 1,118); 722 (65 %) agreed to participate. Path analyses were performed to test the validity of the model.

Results

The data support a model proposing that exposure level does not directly influence annoyance and symptoms, and that these relations instead are mediated by perceived pollution and health risk perception.

Conclusions

Perceived pollution and health risk perception play important roles in understanding and predicting environmentally induced annoyance and health symptoms in odorous environments at non-toxic levels of exposure.

     

Correlation of emotional labor and cortisol concentration in hair among female kindergarten teachers

Objectives

The purpose of this study was to explore whether two types of emotional labor, surface acting and deep acting, are related to hair cortisol concentration among kindergarten teachers.

Methods

Surface acting and deep acting over the last month were measured with the Chinese version of the emotional labor scale in 43 kindergarten teachers. Hair samples with 1 cm in length were cut from their posterior vertex region to represent cortisol excretion over one month. Cortisol concentrations were analyzed with high-performance liquid chromatography–tandem mass spectrometry.

Results

Positive association of emotion labor with hair cortisol concentration was significant for surface acting (r = 0.34, p < 0.05) and not significant for deep acting (r = 0.14, p > 0.05).

Conclusions

More surface acting showed to be associated stronger with stress responses or higher HPA axis activity.

     

Survey of electric bidet toilet use among community dwelling Japanese people and correlates for an itch on the anus

Objectives

We conducted a survey to investigate the use of bidet toilets among community dwelling Japanese people and explored the correlates for an itch on the anus.

Methods

A questionnaire-based survey was conducted among a convenience sample of individuals, who were derived from outpatients and employees of Kameda Medical Center, and students and employees of two technical colleges.

Results

A total of 4,963 respondents were evaluated in this study, 55 % of whom used bidet toilets either before or after defecation, and at least 30 % of bidet users washed the anus before defecation, partly to aid defecation. Men rather than women, and older people (aged ≥50 years) rather than younger people used bidets more actively. Logistic regression analysis showed that the correlates for an itch on the anus included male sex, younger age, washing the anus before defecation, warmer water for washing the anus after defecation, and the frequency of fecal leakage.

Conclusions

Nearly, one-third of bidet toilet users washed the anus before defecation. An itch on the anus may be associated with the active use of bidets.

     

Do measures of depressive symptoms function differently in people with spinal cord injury versus primary care patients: the CES-D,PHQ-9, and PROMIS<Superscript>®</Superscript>-D

Purpose

To evaluate whether items of three measures of depressive symptoms function differently in persons with spinal cord injury (SCI) than in persons from a primary care sample.

Methods

This study was a retrospective analysis of responses to the Patient Health Questionnaire depression scale, the Center for Epidemiological Studies Depression scale, and the National Institutes of Health Patient-Reported Outcomes Measurement Information System (PROMIS^®) version 1.0 eight-item depression short form 8b (PROMIS-D). The presence of differential item function (DIF) was evaluated using ordinal logistic regression.

Results

No items of any of the three target measures were flagged for DIF based on standard criteria. In a follow-up sensitivity analyses, the criterion was changed to make the analysis more sensitive to potential DIF. Scores were corrected for DIF flagged under this criterion. Minimal differences were found between the original scores and those corrected for DIF under the sensitivity criterion.

Conclusions

The three depression screening measures evaluated in this study did not perform differently in samples of individuals with SCI compared to general and community samples. Transdiagnostic symptoms did not appear to spuriously inflate depression severity estimates when administered to people with SCI.

     

Retrospective observation of mental disorders during postpartum period: Results from the Singapore mental health study

Background

The perinatal period has been identified as a period of vulnerability for various disorders (particularly anxiety and depressive disorders), which have been associated with negative outcomes for both mother and infant. The current study utilized data from the Singapore Mental Health Study (SMHS) to examine the temporal relationship between mental disorders and the perinatal period, as well as associated risk factors.

Methods

Life table estimation method was used to derive the estimated hazard rate for any mood or anxiety disorders following pregnancy. Multivariate logistic regression was used to examine the association between socio-demographic factors and onset of mental disorders after the first pregnancy.

Results

Among women with children (n?=?2278), 1.5 % were found to have an onset of any mental disorder (i.e., mood disorders, anxiety disorders, alcohol use disorders), within 2 years after pregnancy. A peak in hazard rate was noted at approximately 1 year following pregnancy for anxiety disorders but not mood disorders. Women who were married, employed and physically healthy were less likely to have had developed any mental disorder.

Conclusions

The prevalence of mental disorders during pregnancy and postpartum was found to be low among women with children in our community sample, with increased vulnerability following delivery. The results offer some insight into the occurrence of mental disorders during the perinatal period among women in Singapore.

     

The Australian longitudinal study on male health-methods

Background

The Australian Longitudinal Study on Male Health (Ten to Men) was established in 2011 to build the evidence base on male health to inform policy and program development.

Methods

Ten to Men is a national longitudinal study with a stratified multi-stage cluster random sample design and oversampling in rural and regional areas. Household recruitment was conducted from October 2013 to July 2014. Males who were aged 10 to 55 years residing in private dwellings were eligible to participate. Data were collected via self-completion paper questionnaires (participants aged 15 to 55) and by computer-assisted personal interview (boys aged 10 to 14). Household and proxy health data for boys were collected from a parent via a self-completion paper-based questionnaire. Questions covered socio-demographics, health status, mental health and wellbeing, health behaviours, social determinants, and health knowledge and service use.

Results

A cohort of 15,988 males aged between 10 and 55 years was recruited representing a response fraction of 35 %.

Conclusion

Ten to Men is a unique resource for investigating male health and wellbeing. Wave 1 data are available for approved research projects.

     

A new adaptive home-based exercise technology among older adults living in nursing home: A pilot study on feasibility,acceptability and physical performance

Objectives

To explore the feasibility and acceptability of a new home-based exercise technology among older adults and to evaluate its efficacy on physical performance measures.

Design

Longitudinal clinical trial.

Setting

Oak Hammock at the University of Florida, a nursing home located in Gainesville, Florida.

Participants

Twelve pre-disabled older adults (≥75 years) living in a nursing home with a Short Physical Performance Battery (SPPB) score between 6 and 9 and no diagnosis of dementia.

Intervention

Thirty minutes of light intensity exercise (aerobic, strength and balance) two times per week for four weeks using a home-based physical activity technology called Jintronix.

Measurements

Feasibility and acceptability were assessed through a 9-item self-administered questionnaire and by exploring the percentage of quality of movements and time performing exercise which was calculated automatically by Jintronix technology. Physical performance measures were assessed through the SPPB score at baseline, after 4 weeks of intervention and after 3 months from the completion of the intervention.

Results

Twelve older adults (80.5±4.2 years old) performed light intensity exercise with Jintronix for a total of 51.9±7.9 minutes per week. Participants reached 87% score of quality of movements in strength and balance exercises, a global appreciation score of 91.7% and a global difficulty score of 36%. Compared to baseline, there was a significant improvement in SPPB score at the end of the intervention and at 3 months following the completion of the exercise program (0.67±0.98 and 1.08±0.99 respectively, p-value <0.05).

Conclusion

Jintronix technology is feasible and acceptable among pre-disabled older adults without dementia living in nursing home and is beneficial in improving their physical performance.

     

Körperliche Aktivität zur Stärkung kognitiver Ressourcen

Background

Nursing care insurance funds are supposed to deliver preventive services in nursing homes. The strengthening of cognitive resources is considered as one field of action.

Aim

The preventive effectiveness of physical activity on cognitive performance in nursing home residents shall be evaluated.

Methods

A systematic search was carried out in the databases MEDLINE, the Cochrane Library, EMBASE, CINAHL, PsycINFO and PEDro. Results were combined in random-effects meta-analyses.

Results

Taking into account 13 primary studies, it was shown that those participating in physical activity showed statistically significant greater cognitive performance compared to controls (SMD = 0.43, 95% CI 0.20–0.66, p = 00002). Subgroup analyses suggest that nursing home residents with different cognitive impairments might benefit from long-lasting physical activity interventions. Due to the high risk of bias in included studies, the results must be interpreted with caution.

Conclusion

Physical activity might be effective in the inpatient care setting. Further studies with longer intervention periods are required.

     

Resilienzförderung

Background

Nearly every second person suffers from mental illness at some point in their life. In this regard, stress-induced illnesses play a central role. Stress cannot be avoided; thus, interventions that promote resilience in the face of stress are particularly significant.

Objective

The paper gives a short overview of the current status quo in the development of evidence-based resilience interventions.

Materials and methods

The chosen method is a narrative review that takes into account papers with relational resilience constructs such as concept analysis, systematic reviews, and empirical studies of international resilience research.

Results

Currently, the main challenge for program developers is to identify valid protective factors within resilience research which match the target and target group of a special intervention.

Conclusion

There is a need for systematic reviews to systematize heterogeneous resilience studies. Based on such reviews, the selection of protective factors that should be promoted in an intervention can be justified.

     

QOL and sociodemographic factors among first-time parents in Japan: a multilevel analysis

Purpose

The present study aimed to examine the relationship between sociodemographic factors and domains of quality of life (QOL) among married adults in Japan who were either rearing or expecting their first child. Our research focus was on whether different sociodemographic variables interacted with each other in predicting the first-time parents’ QOL.

Method

In total, 4374 (mean age = 34.9 years, SD = 8.4, range 18–71) community-based married couples pooled from two surveys provided their sociodemographic information (i.e., age, years of education, and annual income) and responded to the brief version of the QOL instrument developed by the World Health Organization (WHOQOL-BREF in Psychological Medicine 28(3):551–555, 1998).

Results

Series of multilevel regression analyses revealed that household annual income and education were associated with all domains of QOL, and other sociodemographic variables worked in a domain-specific manner. In addition, the effect of educational attainment on psychological domain was significant for mothers only, whereas the effects of household income on psychological and environmental domains were stronger for the younger (below age 26) than the older (over 43) couples.

Conclusion

The effects of sociodemographic factors at couple as well as individual levels on the first-time parents’ QOL were examined for the first time in Japan using couple data. In addition to corroborating previous findings on the main effects concerning these variables, the present study demonstrated the complex patterns of interaction across different levels. These findings provide evidence for the need for financial and health measures targeted at specific parent populations.

     

Family characteristics and health-related behaviours influence physical fighting involvement in late adolescence: a study from 13 to 17 years of age

Aim

We aimed to assess the contribution of early characteristics in adolescence as associated factors of later involvement in physical fighting.

Subject and methods

Based on data from a cohort of adolescents, we evaluated 1,687 participants, recruited in public and private schools in Porto, Portugal. Information on social and behavioural characteristics was collected using the same self-administered questions at 13 and 17 years of age. Logistic regression was used to estimate the magnitude of associations.

Results

In both genders, physical fighting was significantly associated with living in a sole parent family, in particular only with the mother, and with early grade retention. Also, early cigarette smoking and alcohol drinking initiation were significantly associated with later involvement in fights.

Conclusion

Our results show that family characteristics and modifiable behavioural trajectories are important determinants of later involvement in physical fighting.

     

Organizational justice and insomnia: a prospective cohort study examining insomnia onset and persistence

Purpose

Insomnia is one of the most common health problems and causes a large social burden. Psychosocial work-related factors are reported to be associated with both insomnia onset and insomnia persistence. However, the association between organizational justice (OJ) and insomnia remains unclear. The objective of this study was to examine the effect of OJ on insomnia persistence, as well as insomnia onset.

Methods

A prospective cohort study with a 1-year observational period was conducted. Self-reported questionnaire data from 1588 employees were analyzed. OJ was measured using the Japanese version of the OJ questionnaire, which has four components (distributive, procedural, interpersonal, and informational). Insomnia was assessed with the Athens Insomnia Scale. Logistic regression analysis was used to explore the effects of OJ on insomnia.

Results

Among non-insomniac subjects at the baseline (n = 1236), low overall OJ was a risk of insomnia onset even after adjustment for lifestyle and work-related variables (adjusted odds ratio 0.66; 95% confidence interval 0.51–0.85). The procedural, interpersonal, and informational justice components were also associated with insomnia onset. Among insomniac subjects at the baseline (n = 352), low overall OJ, as well as the procedural and interpersonal justice components, was associated with insomnia persistence. Although these associations became insignificant after adjustment, the interpersonal justice component showed a marginally significant association with insomnia persistence (p = 0.058).

Conclusions

OJ, especially interpersonal justice, was revealed as an associated factor for both insomnia onset and persistence. These findings may provide useful information for prevention of insomnia among working population.

     

Transcultural adaptation and validation of the Mexican version of the kidney disease questionnaire KDQOL-SF36 version 1.3

Purpose

To translate the Kidney Disease Quality of Life Short Form 36 (KDQOL-SF36) v1.3 questionnaire into the Spanish language, adapt it culturally, and validate it in the Mexican population.

Methods

The translation and transcultural adaptation were performed according to the recommendations of RAND Health (translation/pilot test/back-translation). We used coefficient alpha to determine the internal consistency, intra- and interobserver intraclass correlation coefficients (ICCs) to determine the test–retest reliability, and Pearson correlation coefficients to confirm the construct validity.

Results

The questionnaires were applied to 194 Mexican on haemodialysis. In total, 37.6 % lived in the northern region of Mexico, 28.9 % lived in the southern region, and 33.5 % lived in the central region. The average age was 54 ± 16 years, and 54.6 % were male. The intra- and interobserver ICCs were ≥0.7 for most dimensions evaluated (range 0.5–0.9). The internal consistency was acceptable, with coefficient alpha values ≥0.7 for 12 of the 18 dimensions (range 0.4–0.9). The construct validity was acceptable, especially in the generic component SF36, with correlation coefficients >0.5 for most dimensions.

Conclusions

Psychometric testing indicated that the Mexican version of the KDQOL-SF36 provided valid and reliable scores that were similar to the results obtained with the original English version.

     

A nested case-control study on type-specific persistent HPV infection in Uyghur women

Aim

To investigate the features of type-specific persistent HPV infection and the associated risk factors in Uyghur women.

Subjects and methods

From September 2012 to August 2013, Uyghur women who underwent opportunistic screening for cervical cancer at the People’s Hospital of Xinjiang Uygur Autonomous Region were recruited during the baseline investigation. After testing for HPV infection and genotyping, 300 women with chronic cervicitis and 300 women negative for HPV were enrolled in the nested case-control study. Information came from the sample subjects interviewed using questionnaires and follow-up study.

Results

The type-specific persistent HPV infection rate was 25.50 % (65/255). The top five most common HPV types were HPV16 (48.00 %), HPV18 (31.03 %), HPV58 (28.30 %), HPV52 (23.40 %) and HPV45 (21.43 %). The risk of type-specific persistent HPV infection was increased 4.81-fold for HPV16 compared with non-HPV16. Compared with transient HPV infection, menopause and not using condoms were risk factors for persistent infection.

Conclusion

The risk factors for persistent HPV infection for Uyghur women included having HPV16 infection, having menopause and not using condoms. Regular screening and close follow-up should be carried out in this high-risk population.

     

Familienhebammen im System Früher Hilfen

Background

During the last 10 years, family midwives have become increasingly integrated into the Early Intervention System in Germany. As representatives of the health care professions and based on a trusting relationship with vulnerable families, they use several strategies to promote positive health behavior and health conditions.

Objectives

The aim of the study was to obtain insight into subjective theories of family midwives, which influence their dealings with families and taking a guiding role for the families.

Methods

Following a qualitative research approach, 13 family midwives were interviewed. The interviews were interpreted according to methods recommendations by Witzel.

Results

Structural circumstances influence family midwives’ subjective theories of good quality. In spite of disclaiming controlling function, family midwives who work directly with representatives of child welfare services, by trend follow the aims of child welfare services. Family midwives working in conjunction with a private agency emphasize their strategies of health promotion.

Conclusion

Family midwives can be supported in their strategies of health promotion. Association with a private agency seems to be helpful for maintaining the salutogenetic perspective of midwives.

     

Dietary diversity and cognitive function among elderly people: A population-based study

Objectives

To explore associations of dietary diversity with cognitive function among Chinese elderly.

Design

This cross-sectional study was conducted in 2011-2012, data were analyzed using multiple linear regression and logistic regression models.

Setting

community-based setting in the 23 provinces in China.

Subjects

8,571 elderly participants, including 2984 younger elderly aged 65-79 and 5587 oldest old aged 80+ participated in this study.

Measurement

Intake frequencies of food groups was collected and dietary diversity (DD) was assessed based on the mean of DD score. Cognitive function was assessed using the Chinese version of Mini-Mental State Examination (MMSE), and cognitive impairment was defined using education-based cutoffs. Information about socio-demographics, lifestyles, resilience and health status was also collected.

Results

Poor dietary diversity was significantly associated with cognitive function, with β (95% CI) of -0.11(-0.14, -0.08) for – log (31-MMSE score) and odds ratio (95% CI) of 1.29 (1.14, 1.47) for cognitive impairment. Interaction effect of age with DD was observed on cognitive impairment (P interaction=0.018), but not on–log (31-MMSE score) (P interaction=0.08). Further separate analysis showed that poor DD was significantly associated with increased risk of cognitive impairment in the oldest old (p<0.01), with odds ratio (95% CI) of 1.34 (1.17, 1.54), while not in the younger elderly (p>0.05), with OR (95% CI) being 1.09 (0.80, 1.47) in the fully adjusted model. Similar results were obtained when DD was categorized into four groups.

Conclusions

Poor dietary diversity was associated with worse global cognitive function among Chinese elderly, and particularly for the oldest old. This finding would be very meaningful for prevention of cognitive impairment.