Development of a Reflective Ability Scale for Clinical Nurses

[Background] Enhancement of reflective ability leads to improved nursing practice and individual growth. This study aimed to develop a reliable, validated scale that can effectively assess the reflective ability of clinical nurses. [Methods] Study participants were 1,872 nurses. We developed an anonymous self-administered questionnaire consisting of 33 original scale items and used it to conduct a survey. The scale was developed based on a construct validity study using item analysis, exploratory factor analysis, and confirmatory factor analysis. Reliability was estimated with Cronbach’s α values. Criterion-related validity was assessed using Pearson’s correlation analysis. [Results] There were 1,292 responses (response rate, 69.0%). Responses from 1,262 subjects with no missing data were analyzed (valid response rate, 97.7%). Based on the item analysis and exploratory factor analysis, we developed a trial scale model with 3 factors and 25 items. We named the first factor (Factor 1) “Recall Their Own Nursing Practice,” the second factor (Factor 2) “Reflect on Their Own Nursing Practice” and the third factor (Factor 3) “Expand Their Own Nursing Practice”. This model was modified based on modification indices from the confirmatory factor analysis. A model with 3 factors and 19 items was developed. It had acceptable fit indices (goodness of fit index = 0.914; adjusted goodness of fit index = 0.890; comparative fit index = 0.949; root mean square error of approximation = 0.070). Cronbach’s α coefficients were 0.962 for all scale items, 0.922 for Factor 1, 0.918 for Factor 2, and 0.885 for Factor 3. The correlation coefficient between the model and the Professional Identity Scale of Nurses was 0.506 (P < 0.01). [Conclusion] We developed a reflective ability scale consisting of 3 factors and 19 items. We demonstrated its construct validity, reliability, and criterion-related validity. This scale can effectively assess the reflective ability of nurses

Association between sarcopenia and low back pain in local residents prospective cohort study from the GAINA study

[Background] Low back pain (LBP) is one of the most common ailments that people experience in their lifetime. On the other hands, Sarcopenia also leads to several physical symptoms and contributes to reducing the quality of life of elderly people.The purpose of this study is to investigate the association between sarcopenia and low back pain among the general population. [Methods] The subjects included 216 adults (79 men and 137 women; mean age, 73.5 years) undergoing a general medical examination in Hino, Japan. Skeletal muscle index (SMI), The percentage of young adults’ mean (%YAM) of the calcaneal bone mass using with quantitative ultrasound (QUS) method and walking speed were measured, and subjects who met the criteria of the Asian Working Group for Sarcopenia were assigned to the sarcopenia group. Subjects with decreased muscle mass only were assigned to the pre-sarcopenia group, and all other subjects were assigned to the normal group. Then, we compared the correlations with low back pain physical finding. The Oswestry Disability Index (ODI) and the low back pain visual analogue scale (VAS) were used as indices of low back pain. Statistical analysis was performed among three groups with respect their characteristic, demographics, data of sarcopenia determining factor, VAS and ODI. We also analysed prevalence of LBP and sarcopenia. We investigated the correlations between ODI and the sarcopenia-determining factors of walking speed, muscle mass and grip strength. [Results] Sarcopenia was noted in 12 subjects (5.5%). The pre-sarcopenia group included 38 subjects (17.6%), and the normal group included 166 subjects (76.9%). The mean ODI score was significantly higher in the sarcopenia group (25.2% ± 12.3%; P < 0.05) than in the pre-sarcopenia group (11.2% ± 10.0%) and the normal group (11.9% ± 12.3%). %YAM and BMI were significantly lower in the sarcopenia group than in other groups (P < 0.05). A negative correlation existed between walking speed and ODI (r = −0.32, P < 0.001). [Conclusions] The results of this study suggested that decreased physical ability due to quality of life in residents with LBP may be related to sarcopenia

The Risk Factor of Worsening Low Back Pain in Older Adults Living in a Local Area of Japan: The GAINA Study

Background: Several factors, particularly osteoporosis, obesity, and a lack of exercise, contribute to low back pain (LBP). This observational longitudinal cohort study to identify the risk factors for worsening low back pain. Methods: We sent a self-administered questionnaire and a consent form for this study to 1,450 subjects aged > 40 years in Hino, Japan. Baseline assessments of 273 individuals undergoing medical check-ups were conducted from 2014 to 2016. The subjects were divided into Group A (no change or improvement in LBP) and Group B (worsening LBP). LBP was assessed using a visual analog scale; body mass index (BMI), bone mineral density, skeletal muscle index (SMI), standing posture, and habitual exercise frequency were also evaluated. We defined, habitual exercise as nontherapeutic exercise (e.g. swimming, walking, physical exercise and work out). Results: Overall, 81.2% subjects performed habitual exercise in Group A, a greater number of subjects than the 40.8% in Group B. BMI, SMI, and bone mineral density (BMD) were not significantly different between the two groups. Lack of exercise was a significant risk factor for worsening of LBP. On the other hand, the lack of osteoporosis treatment was significantly different between subjects with worsening LBP despite habitual exercise and those who did not perform habitual exercise. Conclusion: Although habitual exercise is useful to prevent LBP, it may not necessarily be useful for those with a lack of osteoporosis treatment. Although exercise is typically posited to prevent LBP, it may not be effective in preventing LBP associated with osteoporosis

Relationship of Physical Activity to Self-Care Agency and Physical Condition Among Older Adults in a Rural Area

[Background] Maintaining physical activity is important for older adults. “Self-care agency” is the ability to perform self-care, which is defined as people following their own will, managing themselves, and maintaining activities. We investigated the relationship among physical activity and self-care agency, demographic factors and physical condition in older adults. [Methods] Self-care agency was assessed by using the Self-Care Agency Questionnaire developed for Japanese patients with chronic diseases. Among 175 older adults aged 65 years or older living in a rural area, responses from 83 who performed physical activities were analyzed. Correspondence analysis was conducted to characterize demographic factors and self-care agency. [Results] A higher proportion of women than men were engaged in physical activity. Irrespective of age and sex, many of the participants performed stretching exercises, walking, radio exercises, TV exercises, and participated in community circles. Participants who engaged in physical activities had significantly higher self-care agency scores than inactive participants. Among the active participants, the self-care agency score was significantly higher for women than men (P = .04) and was also significantly higher for participants aged ≥ 75 years compared to those aged < 75 years. Individuals with a high self-care agency tended to participate in local programs and perform brief physical activities at home. [Conclusion] Physically active older adults demonstrated high self-care agency. Their activities were easily carried out in their daily lives, with activities varying by age and sex. Support from community health experts is needed to promote suitable physical activity among older adults tailored for age and sex, especially among older adults who have low self-care agency