The influence of home-rearing environment on children's behavioral problems 3 years’ later

journal articl

A One-Message Question in a Structured Interview: Investigating Psychological Needs of Children and Adolescents with Eating Disorders Directed toward Their Mothers

The purpose of this study was to investigate the psychological needs of children and adolescents with eating disorders (ED) directed toward their mothers. Patients with ED have low self-assertion and various abnormal eating behaviors. Therefore, mothers face difficulty in understanding their children's psychological needs, and the mother-child relationship is sometimes strained. We developed a One-Message Question (OMQ)-structured interview. The OMQ was easy to answer, and it helped the patients with ED. We examined the relationship between psychological needs and illness phase of the children and adolescents, and we discuss the viability of implementing the OMQ in clinical settings. The subjects were 23 patients and their parents. Their parents were just asked about the patients' background. The mean age of the patients was 15.8 years, and the average age of ED onset was 13.5 years. The EDs were anorexia nervosa (n＝20) and bulimia nervosa (n＝3). The phases of patients' illness were identified as anorexic (n＝5), bulimic (n＝7), chronic (n＝3), and stable (n＝8). All subjects provided specific responses to the OMQ-structured interview. Data analyses revealed the following seven categories of patients' psychological needs directed toward their mothers:attachment, cooperation in meeting their goals, longing for love, changing attitude toward family members, respect for self-reliance, expression of apology, and expression of appreciation. These findings suggested that the OMQ-structured interview may prove useful for mothers to understand their children's psychological needs and may encourage positive interactions as a foundation for future recovery

因果関係モデルによる腎移植レシピエントのQOLの分析

The purpose of this study is to analyze the structural relationship among the components of quality of life of kidney transplant recipients by using a causal model. The subjects were 329 recipients who had regular checks-up following transplantation in seven general hospitals in Tokyo, Gunma, Aichi, Okayama, and Hiroshima, and agreed to participate in this study. Ferrans and Powers's Quality of Life - Index Kidney Transplant version was used to measure perceived quality of life. The self-administered questionnaires were handed over to the subjects, who completed the instrument on the spot. After that, the answers were collected immediately. The factor analysis and the covariance structure analysis were used to make clear the structural relationship among the components of quality of life. The results of data analysis were as follows : (1) Five components of quality of life were extracted ; socio-economic functioning, family ties, emotional support, physical health, and peace & happiness. (2) The scores in the family ties dimension and the physical health dimension were higher than in the others, and the score in the socio-economic functioning dimension was the lowest. (3) The physical health showed the starting point in a causal model. (4) The physical health influenced the family ties and the socio-economic functioning. (5) The socio-economic functioning strongly influenced the peace & happiness and the emotional support. (6) The family ties influenced the socio-economic functioning, the emotional support, and the peace & happiness. Therefore, it was conceivable that it was particularly important to make approaches for the physical health, the family ties, and the socio-economic functioning dimensions to improve quality of life.本研究は，因果関係モデルによって，腎移植後レシピエントのQOLの構成要素間の関係を明らかにすることを目的としている。対象者は，東京，群馬，愛知，岡山，広島の7医療機関に外来通院中で，研究に同意が得られた329名の腎移植後のレシピエントである。レシピエントのQOLに関するデータは，Ferrans＆PowersのQuality of Life Index―Kidney Transplant versionの測定用具を用いて収集した。収集は外来受診時に行い，対象者に自己記入式質問紙を配布し，その場で記入してもらった後，直ちに回収した。データ分析は，QOLの構成要素と構成要素間の因果関係を明らかにするために，因子分析と共分散構造分析を行った。分析結果は以下の通りである。すなわち、(1)QOLの構成要素として，社会・経済的な機能，家族の絆，情緒的な支え，身体の健康，安らぎと幸福の5つが抽出された。(2)「家族の絆」と「身体の健康」についての得点が高く，「社会・経済的な機能」についての得点が最も低かった。(3)因果関係モデルにおいて，「身体的な健康」が原点となっていた。(4)「身体的な健康」は，「家族の絆」と「社会・経済的な機能」に影響を及ぼしていた。(5)「社会・経済的な機能」は，「安らぎと幸福」と「情緒的な支え」に強く影響を及ぼしていた。(6)「家族の絆」は，「社会・経済的な機能」，「情緒的な支え」，「安らぎと幸福」に影響を及ぼしていた。したがって、レシピエントのQOLを高めるために，「身体的な健康」，「家族の絆」，「社会・経済的な機能」の側面に働きかけていくことが特に重要であると考えられた

The Relationships among Internalized Stigma, Sense of Coherence, and Personal Recovery of Persons with Schizophrenia Living in the Community

We investigated (i) the relationships among internalized stigma (IS), sense of coherence (SOC), and the personal recovery (PR) of persons with schizophrenia living in the community, and (ii) how to improve the support for these individuals. A questionnaire survey on IS, SOC, and PR was sent by mail to 270 persons with schizophrenia living in the community who were using psychiatric daycare services, of whom 149 responded and 140 were included in the analysis. We established a hypothetical model in which IS influences PR, and SOC influences IS and PR, and we used structural equation modeling to examine the relationships among these concepts. The goodness of fit was acceptable. Our findings suggest that rather than directly promoting PR, SOC promotes PR by mitigating the impact of IS. It is important for nurses/supporters to support individuals with schizophrenia living in the community so that they have opportunities to reflect on their own experiences through their activities and to share their experiences with peers. Nurses/supporters themselves should also reflect on their own support needs. Our findings suggest that this will lead to a reduction of IS and the improvement of SOC, which will in turn promote personal recovery

A Study of Psycho-pathology and Treatment of Children with Phagophobia

Phagophobia is a disorder characterized by a conditioned excessive fear of eating and is initiated by an event such as vomiting or choking. During childhood, vomiting often occurs as a result of infection or overeating, and painful experiences bring about maladaptive eating behavior like food refusal. There have been few reports of phagophobia, and patients have sometimes been misdiagnosed with anorexia nervosa (AN). The objective of this study was to elucidate the psycho-pathology and current treatment of patients with phagophobia by analyzing case studies. We describe 6 cases with phagophobia. Patients with strong obsessions were refractory to treatment, indicating that evaluation of premorbid personality is crucial to the prognosis. It is important to classify this disorder according to psycho-pathology into "post-traumatic type" and "gain-from-illness type" to make a treatment plan. A solution focused approach is also effective for patients and their family. Paying close attention to these conditions and to the diagnostic concept referred as "hagophobia" is useful in achieving these aims

Oil-in-water emulsion lotion providing controlled release using 2-methacryloyloxyethyl phosphorylcholine n-butyl methacrylate copolymer as emulsifier

AbstractLotion is a useful vehicle for active ingredients used to treat skin disease because it can be applied to the scalp, can cover large areas of skin, and it is easy to spread due to low viscosity. An emulsion lotion (EL) containing 2-methacryloyloxyethyl phosphorylcholine n-butyl methacrylate copolymer (PMB) as an emulsifier that provides controlled-release was developed. Diphenhydramine (DPH) was used as a model drug. Formulation with 5% DPH, 5% soybean oil, and 4% PMB in water was emulsified using a high-pressure homogenizer. Polysorbate 80 (TO) was used instead of PMB for comparison. They were applied in vitro to Yucatan micropig intact or stripped skin at a practical dose (2μL/cm2). For stripped skin, penetration of DPH from 4% PMB EL was slower than that from 1% TO EL; results for intact skin were similar. The same phenomenon was observed with application to rabbit skin in vivo. When 4% PMB EL dried on the skin, it made a thin film matrix incorporating the oil phase, which controlled the release of DPH. The release rate could be controlled by the ratio of oil phase to PMB. The EL with PMB shows promise as a vehicle for long-acting treatment of skin diseases

Changes in Attitudes of Japanese Doctors toward Complementary and Alternative Medicine—Comparison of Surveys in 1999 and 2005 in Kyoto

We surveyed the attitudes of Japanese medical doctors toward complementary and alternative medicine (CAM) in 1999. It is supposed that the situation concerning CAM has been changing recently. The aim of the present study is to survey the attitude of doctors toward CAM again, and to examine changes in attitude over the last 6 years. The attitudes of medical doctors belonging to the Kyoto Medical Association toward CAM were surveyed by a structured, self-administered questionnaire in 1999 and 2005. The results showed that the doctors familiar with the term “CAM”, practicing CAM therapies, and attending meetings or training courses related with CAM, increased significantly from 1999 to 2005. The doctors who possessed knowledge of CAM also increased significantly from 1999 to 2005. Almost all doctors believed in the effectiveness of Kampo (Japanese traditional herbal medicine) and acupuncture. The number of doctors who believed in the effectiveness of aromatherapy and ayurveda increased significantly in 2005, compared with 1999. In the near future, 58% of doctors desired to practice CAM therapies. In conclusion, the numbers of doctors who practice CAM therapies, possess CAM knowledge and desire to practice such therapies have increased over the last 6 years in Japan

Importance and usefulness of evaluating self-esteem in children

Self-esteem is the "feeling of self-appreciation" and is an indispensable emotion for people to adapt to society and live their lives. For children, in particular, the environment in which they are raised contributes profoundly to the development of their self-esteem, which in turn helps them to adapt better to society. Various psychologists have provided definitions of self-esteem, and examined methods of objectively evaluating self-esteem. Questionnaire-style assessment methods for adult include Rosenberg Self-Esteem Scale and Janis-Field Feeling of Inadequacy Scale, and these for children include Coopersmith Self-Esteem Inventory, Pope's 5-Scale Test of Self-Esteem for children, and Kid- KINDL®. Other methods include Ziller Social Self-Esteem Scale and Implicit Association Test. The development of children's self-esteem is heavily influenced by their environment, that is, their homes, neighborhoods, and schools. Children with damaged self-esteem are at risk of developing psychological and social problems, which hinders recovery from low self-esteem. Thus, to recover low self-esteem, it is important for children to accumulate a series of successful experiences to create a positive concept of self. Evaluating children's self-esteem can be an effective method for understanding their past and present circumstances, and useful to treat for children with psychosomatic disorders

The research on the problems of health care and living of the aged (Pursuing the cases of home treatment given to the elderly patients for one year after their discharge)

退院後の生活に目を向けた適切な退院指導がなされることは、高齢患者が安心して在宅療養を送る上で、重要な意味を持つ。そこで病院から在宅療養に移行した70歳以上の高齢者の抱える問題を4回に渡って1年間調査し、これまでに退院時、3ヵ月後、6ヵ月後の調査結果を報告した。本稿では1年を通じて回答のあった53名について健康と生活上の問題の変化を分析し、考察した。在宅療養に移行した高齢者の健康状態と生活上の問題は、ほぼ一致して退院後6ヵ月から1年後までに変化を認め、特に日常生活上の問題は著しく増加した。その原因として病状の悪化との関連が考えられた。また、高齢者の問題についての意識は、研究者の専門的な問題意識に比べて低かった。従って入院中に退院後の生活を予測することには限界があり、今後は退院指導の充実と伴に在宅サービスとの連携が重要であることを認めた。We planned to make emerge the problems felt by the elderly patients of 70 years and over given home treatment. As a means of our research, four times a year we sent a questinnaire to the aged who had been discharged. After collecting the answers of the questionnaires, we decided to focus on the 53 elderly patients who answered all four questionnaires, and then tried to make their problems emerge. The contents of the questionnaires were about their health care in a year and how their daily life changed. We can see that the condition of the elderly patients under home treatment and their living problems have changed almost without exceptions six months to a year after their discharge. Especially the number of the problems in their daily life increased remarkably. These results might be considered to be caused by the aggravation of their diseases. In addition, the elderly patients are not as conscious of their own problems as a specialist with a critical mind. Therefore, there is a limit to estimating the change in lifestyle of a discharged patient while they remain hospitalized. We consider it essential to get full discharge-care closely connected with home service for elderly patients