論文

Aim: This study aimed to identify factors related to the psychological safety of Japanese home care nurses (HCNs). Methods: This cross-sectional study recruited Japanese HCNs. The HCNs completed a questionnaire based on the Japanese version of the Psychological Safety Scale at their home care nursing agency (HCN agency) from May to July 2022; the responses were analyzed to determine the characteristics of the HCNs and HCN agencies. Multiple regression analysis was conducted to determine the factors associated with HCNs’ psychological safety. Results: This study included 145 HCNs from 73 HCN agencies. The mean age of the HCNs was 43.46 years, and the mean score on the Japanese version of the psychological safety scale was 27.19. Psychological safety was significantly associated with HCNs’ perceptions of follow-up systems for adverse events (β =.355, p <.001), perceptions of management’s attitude toward problem-solving (β =.309, p <.001), and management’s efforts to create a consultative environment (β =.183, p =.009). Furthermore, psychological safety was negatively correlated with agency-level factors, including the average number of visits per month by HCNs (β = −.184, p =.012) and the use of social networking services (SNS) for business communication in daily work (β = −.173, p =.018). Conclusions: Supportive management practices are crucial to shaping the psychological safety of Japanese HCNs, whereas heavy workloads and frequent SNS use for communication may hinder it; thus, organizational improvements and workload adjustments are necessary.

新型コロナウイルス感染症(COVID-19)感染拡大(コロナ禍)が地域住民や地域活動に及ぼす影響とポストコロナ社会での住民主体型地域活動再興へ向けた課題の検討に資することを目的とした。2023年2月～3月に、神奈川県A市の1地区の自治会所属世帯(1400世帯)を対象に、世帯の中で「地域での活動・行事に参加している/関心がある者」1名へコロナ禍における困りごと、心理的ストレス指標(Kessler Psychological Distress Scale:K6)を用いた心理的ストレスなどについて質問紙調査を行い、318名より有効回答を得た。同市においてコロナ禍前より市から事業承認を受け、地域住民を対象とした地域活動である「地域の縁側」を実施している運営6団体(17名)を対象に、「コロナ禍での[地域の縁側]の活動再開や継続のための取り組み」などについて半構成的面接を行った(調査期間:2022年10月～2023年3月)。その結果、質問紙調査では、対象の70%近くが地域活動への参加頻度の減少を経験しており、K6を用いた精神的健康評価では31.5%が支援を必要とする中等症以上のストレスを有していることが分かった。半構成的面接では、コロナ禍での「地域の縁側」活動継続のための取り組みとして、「運営メンバー間での意見交換」「自分たちの活動が担う社会的役割の再確認」「活動再開/継続のメリットとリスクの検討」「活動再開/継続のための情報収集」「コロナ禍で自分たちが活用できる資源の検討」「コロナ禍での新しい活動場所/方法の検討と実践」などの【自分たちの活動への社会的役割認識を根本とした柔軟で臨機応変な取り組み】が行われていることが分かった。

Unintentional injury in children is a worldwide public health problem, as it increases the health burden and is a leading cause of death among children. It is important to understand the differences between different age groups of children in regard to unintentional injury, in order to effectively implement child safety education. The present study aimed to determine the current trends of unintentional injury in children, and to identify the differences between different age groups of children with regard to unintentional injury. We identified 1,521 children who attended an 18-month health checkup (18-month group), and 1,368 children who attended a 36-month health checkup (36-month group), between January 1, 2014 and December 31, 2014. The rate of hospital visits associated with unintentional injury was 10.6% (161/1,521) in the 18-month group, and 13.1% (180/1,368) in the 36-month group. In both groups, present/past illness was associated with hospital visits, and in the 36-month group, hospital visits were more common in boys than in girls. The number of unintentional injuries that occurred outdoors was higher in the 36-month group than in the 18-month group. Unintentional injuries resulting from accidental ingestion and falls were more common in the 18-month group, while unintentional injuries resulting from turning over were more common in the 36-month group. In conclusion, the number of hospital visits for unintentional injury might be higher, and the number of preventive actions taken by mothers might be lower, among children attending the 36-month health checkup than among those attending the 18-month health checkup.

© 2019 Japan Academy of Nursing Science Aim: To investigate the association between children and their families' daily life routines and the implementation of safety practices in their homes. Methods: A cross-sectional study was conducted using a self-administered questionnaire among parents of 3-year-old children, who visited a public health center in Tokyo for their health checkups. Associations between the implementation of safety practices and family and children's basic daily routines were assessed using a multivariate logistic regression. Results: Data from 336 parents were analyzed. Three items were found to be significantly related to the non-implementation of safety practices, such as “television-watching behavior: after 8:00 p.m.” (adjusted odds ratio = 1.88, p =.02), “washing hands: not every time after getting home” (adjusted odds ratio = 2.24, p =.02), and “Family Routines Inventory: lower score” (a measurement of the routinization of a family's daily life; adjusted odds ratio =.83, p =.01). Conclusion: The cumulative results suggest that the lack of safety practices implementation signify nonadherence to daily routine practices by parents.

AIM: To investigate the relationship between maternal mindfulness and maternal anxiety 1 month after childbirth. METHODS: A cross-sectional design was used, featuring anonymous questionnaires that were completed between July and December 2014 at two Japanese hospitals. The participants (n = 151) completed the Mindful Attention Awareness Scale (Japanese version) and the State-Trait Anxiety Inventory Form X (Japanese version). The data analysis was carried out by using a hierarchical multiple regression. RESULTS: The state and trait anxiety scores showed significant relationships with mindfulness, the mother's age, and the perceived difference between the expectations of motherhood before childbirth and the reality of post-partum daily life. Furthermore, the amount of average sleep time in the past week (including naps) showed a negative association with the state anxiety score, whereas the marital relationship showed a positive association with trait anxiety. Finally, at 1 month post-partum, the mothers with greater mindfulness scores showed lower anxiety. CONCLUSIONS: Improvements in mindfulness could help mothers to reduce their post-partum anxiety.

Patient safety incidents (PSIs) prevention is important in healthcare because PSIs affect patients negatively and increase medical costs and resource use. However, PSI knowledge in homecare is limited. To analyze patient safety issues and strategies, we aimed to identify the characteristics and contexts of PSI occurrences in homecare settings. A prospective observational study was conducted between July and November 2017 at 27 Japanese homecare nurse (HCN) agencies. HCNs at each agency voluntarily completed PSI reports indicating whether they contributed to PSIs or were informed of a PSI by the client/informal caregiver/other care provider during a period of three months. A total of 139 PSIs were analyzed, with the most common being falls (43.9%), followed by medication errors (25.2%). Among the PSIs reported to the HCN agencies, 44 were recorded on formal incident report forms, whereas 95 were reported as PSIs that required a response (e.g., injury care) but were not recorded on formal incident report forms. Most PSIs that occurred when no HCN was visiting were not recorded as incident reports (82.1%). Developing a framework/system that can accumulate, analyze, and share information on PSIs that occur in the absence of HCNs may provide insights into PSIs experienced by HCN clients.

This study investigated lifestyle changes and the self-reported mental health status of Japanese community residents during the COVID-19 pandemic. Differences in demography, daily lifestyle changes, and approaches to problem solving were analyzed in two age cohorts (<60 vs ≥60 years). The prevalence of moderate/increased psychological distress was 31.7%, with no significant difference between the cohorts. Compared with the pre-COVID-19 era, more than 80% of the participants stopped eating out and spent more time at home, and more than 70% used public transport less frequently. There were significant differences between the cohorts for the time spent at home, opportunities to eat meals outside of home, and shopping in stores. Participants aged under 60 years were less likely to use television and newspapers or to consult a family doctor. Those aged over 60 years were less likely to consult friends/colleagues or to use the Internet/social networking services. Identifying the risk factors for psychological distress is warranted for implementing measures to maintain and improve the physical and mental health of residents.

Background: Coronavirus disease 2019 disrupted the delivery of public maternal and child health services to caregivers of preschool children, leading to decreased opportunities for injury prevention education. We aim to 1) explore the timing, content, and methods of providing injury prevention information desired by pregnant women and mothers and 2) identify mothers who experienced difficulty in obtaining injury prevention information owing to reduced maternal and child health services. Methods: From March 24 to 29, 2022, we conducted a population-based cross-sectional study and web-based survey. Of the registered monitors of the internet research company Rakuten Insight, 675 mothers raising their first child aged 0–2 during the COVID-19 period (February 2020 to March 2022) were included in the analysis. Results: Over half of the mothers wanted injury prevention information throughout their pregnancy. They preferred receiving information through traditional face-to-face services provided by local governments, such as antenatal classes or checkups. However, 34.1% of mothers said they did not obtain the information they needed; this was particularly true of unemployed mothers, had children aged 0–1, and had children with illnesses requiring hospital visits. Conclusions: Mothers who could not obtain injury prevention information were originally disadvantaged mothers concerning access to information. The decrease in maternal and child health services may have widened this information gap. These findings can inform recommendations for caregivers, particularly those susceptible to information gaps during emergencies, and offer insights into future injury prevention education strategies.