Coping Behaviors and Collaboration among Staff of Multiple Occupation Classifications during Norovirus

In December 2012 a norovirus infection outbreak occurred in the Orthopedic Surgery Ward of Hospital A in Japan. This study aims to establish details of coping behaviors used by nurses, physicians, physiotherapists, and pharmacists of the facility, and examine the issues involved in infection control by team collaboration as well as the ways employed to deal with the infections. Participants in this study were thirty-seven medical professionals who were working in the Orthopedic Surgery Ward of Hospital A at the time the infection outbreak occurred, and who were still working there when the interviews were conducted. Interviews were conducted from January to April 2015, and the data from the interviews were analyzed using the “Trend Search 2008” text mining software. As a result of the analysis it was found that the nurses primarily communicated information by passing messages to the nurses who took over the duty at shift changes, but did not pass on the information to staff in other occupations or to the ward as a whole. The nurses clearly remembered that the ward was closed and it was a difficult experience, but did not remember details of the patients they were in charge of. The physicians clearly remembered individual patients they were in charge of, but they were not aware of the situation and state throughout the ward. The findings suggest that this difference is due to the differences in the occupational nature and sense of values of the staff involved. It is also found that physiotherapists did not feel a sense of crisis about the norovirus outbreak because they felt the patients in the ward appeared to be in better condition than patients in other wards, and that pharmacists lacked communication with staff in other occupations because they usually have heavy workloads. In concept mappings of physicians, physiotherapists, and pharmacists, the keyword places in the center of the maps, and is linked to and . Because the nurse plays a central role to report information among the four occupations, nurses should be aware of and assigned to play the role to coordinate team collaboration

日本語版攻撃的行動に対する態度尺度（J-ATAS）の信頼性と妥当性：日本の認知症ケアにおける適用可能性の検討

　本研究では、ヨーロッパ5 カ国4 言語で信頼性と妥当性が検証されたthe Attitudes Towards Aggression Scale（ATAS）の日本語版（J-ATAS）を作成し、その信頼性と妥当性を検討し、本邦の認知症ケアにおける適用可能性について考察した。主成分分析の結果、J-ATAS は英語版の5 因子構造とはならず、3 因子構造を示した。また、内的整合性の評価では、第1 因子においては概ね良好な値が得られたが、 第2 因子では十分とは言えず、第3 因子に関しては低い結果しか得られなかった。さらに3 つの因子の相関パターンは、‘否定的態度’と‘肯定的態度’の2 つに分かれる可能性が示唆された。以上のことから、現段階におけるJ-ATAS は、ATAS の日本語版として本邦で活用するには、十分な信頼性・妥当性を有しているとは言えない結果となった。認知症の人の攻撃的行動に対する我が国のスタッフの態度を測定するには、J-ATAS およびその開発プロセスの課題を踏まえた新たな尺度を開発する必要がある

Cognitive behavioral therapy with interoceptive exposure and complementary video materials for irritable bowel syndrome (IBS): protocol for a multicenter randomized controlled trial in Japan

BackgroundThere is growing evidence of the treatment efficacy of cognitive behavioral therapy (CBT) for irritable bowel syndrome (IBS). CBT is recommended by several practice guidelines for patients with IBS if lifestyle advice or pharmacotherapy has been ineffective. Manual-based CBT using interoceptive exposure (IE), which focuses on the anxiety response to abdominal symptoms, has been reported to be more effective than other types of CBT. One flaw of CBT use in general practice is that it is time and effort consuming for therapists. Therefore, we developed a set of complementary video materials that include psycho-education and homework instructions for CBT patients, reducing time spent in face-to-face sessions while maintaining treatment effects. The purpose of this study is to examine the effects of CBT-IE with complementary video materials (CBT-IE-w/vid) in a multicenter randomized controlled trial (RCT).MethodsThis study will be a multicenter, parallel-design RCT. Participants diagnosed with IBS according to the Rome IV diagnostic criteria will be randomized to either the treatment as usual (TAU) group or the CBT-IE-w/vid + TAU group. CBT-IE-w/vid consists of 10 sessions (approximately 30 min face-to-face therapy + viewing a video prior to each session). Patients in the CBT-IE-w/vid group will be instructed to pre- view 3- to 13-min videos at home prior to each face-to-face therapy visit at a hospital. The primary outcome is the severity of IBS symptoms. All participants will be assessed at baseline, mid-treatment, post-treatment, and follow-up (3 months after post assessment). The sample will include 60 participants in each group.DiscussionTo our knowledge, this study will be the first RCT of manual-based CBT for IBS in Japan. By using psycho-educational video materials, the time and cost of therapy will be reduced. Manual based CBTs for IBS have not been widely adopted in Japan to date. If our CBT-IE-w/vid program is confirmed to be more effective than TAU, it will facilitate dissemination of cost-effective manual-based CBT in clinical settings