Aim To develop an end‐of‐life care management scale to assess care for older adults who wish to remain at home, and examine its reliability and validity. Methods An item pool was created based on a literature review, and the 46‐item, tentative version of end‐of‐life care management scale was developed. Next, a cross‐sectional survey was conducted with 2583 care managers using a self‐reported questionnaire. An exploratory factor analysis was used to evaluate the scale's internal consistency using Cronbach's alpha. Intra‐rater reliability was evaluated using the correlation with a repeat test. Construct validity and criterion‐related validity were determined using a confirmatory factor analysis, and correlations between this scale and previous scales, respectively. Results Valid responses were obtained from 477 care managers. Exploratory factor analyses identified 23 items from four factors: “further the teamwork to realize the individual's wishes,” “rapid care planning that anticipates changes in the situation,” “support to family members preparing for end‐of‐life care at home” and “support to become familiar with the older adult's views of life, death and suffering.” Cronbach's alpha was 0.819 for the entire scale and ≥0.709 for each factor. The intraclass correlation coefficient of the test–retest ranged from 0.756 to 0.863. The correlation coefficients between the previous scales and the entire scale ranged from 0.569 to 0.795 ( P < 0.001). Conclusions The scale showed acceptable internal consistency and concurrent validity. Care managers' use of this scale might improve quality of care management and fulfil older adults' wishes to remain at home during the end‐of‐life period. Geriatr Gerontol Int 2023; 23: 131–140 .
Aim To verify the reliability and validity of a Japanese version of the Rathus Assertiveness Schedule in novice nurses to contribute to nursing management. Background An adequate scale is needed to measure the assertiveness and the effect of assertion training for Japanese nurses and to compare them with those in other countries. Methods Rathus Assertiveness Schedule was adapted to Japanese with back-translation and its validity was examined in 989 novice nurses. Results The Japanese version showed a high coefficient of reliability in a split-half reliability test (r = 0.76; P < 0.01). The coefficient of reliability of Cronbach's alpha was high (r = 0.84; P < 0.01) indicating high internal consistency. The similarity with the concept of stress coping was shown. We extracted eight principal factors using factor analysis with varimax rotation. Elements of these factors were similar to those of the original Rathus Assertiveness Schedule. Conclusion The Japanese version of Rathus Assertiveness Schedule was verified.
Abstract Aim: This prospective cohort study aimed to clarify the relationship between the level of assertiveness and the incidence of burnout in novice nurses in their first year at university hospitals and to obtain indices of assertion training in order for them to avoid burnout. Methods: The subjects were 1203 novice nurses working at 20 university hospitals in Japan who gave informed consent to participate in this research. The questionnaires were completed by 949 novice nurses in June 2003, and they were divided into two cohorts to observe the incidence of burnout, which was investigated in June 2004. Results: At the baseline, we obtained responses from 1030 novice nurses (85.6%) who had agreed to join the study. Ninety‐two (20.5%) of the novice nurses experienced burnout and 43 (7.2%) experienced serious burnout. Both high and low levels of assertiveness score tended to high incidence rates of burnout. Multiple logistic regression analyses showed that the factors affecting burnout were lack of senior nursing staff support and very low and low levels of assertiveness, and those affecting serious burnout were male gender, hospital location in Tokyo, and very low and low levels of assertiveness. Conclusions: Novice nurses tend to burn out easily when their assertiveness scores are too low or too high. The ideal value of the assertiveness score seems to be medium.
The aim of this study was to evaluate the correlation between the mental health status of caseworkers at welfare offices and factors affecting mental health (i.e., working conditions, participation in training courses and workshops, lifestyle habits, presence of illness, social support, and self-efficacy).The welfare offices in Japan (1,230 locations) were arranged in descending order according to their establishment and region. Systematic sampling was then conducted to select 20% (n =246) of the welfare institutions for this study. A total of 1,230 caseworkers on welfare (five from each institution) were administered anonymous self-completed questionnaires. The questionnaires involved the General Health Questionnaire (GHQ)-28 Japanese version and questions regarding basic attributes, working conditions, social support (i.e., family, friends, superiors, and colleagues), participation in training courses and workshops, presence of illness, lifestyle habits, mental health, and self-efficacy. Subjects were divided into the following 2 groups: low-score group (GHQ-28 score ≤5) and high-score group (GHQ-28 score ≥6). Data were analyzed using a t-test, χ(2) test, and Fisher's exact test. The GHQ-28 high- and low-score groups were considered gender-specific dependent variables due to the sex differences observed in the univariate analysis. Significant variables in the univariate analysis were considered independent variables in the multiple logistic regression analysis (forward stepwise selection).Five hundred and six people (410 male and 96 female) provided valid responses. Most respondents had poor mental health (66%, high-score group; 34%, low-score group). Both men and women who worked ≥10 hours/day had significantly poorer mental health than individuals who worked ≤9 hours/day. Individuals with low self-efficacy had significantly poorer mental health compared to people with high self-efficacy. Men who were able to maintain moderate hours of sleep and received support from colleagues, friends, and family had good mental health. Among women, mental health deteriorated with age. Furthermore, women who devoted most work time to home visit had good mental health.The mental health of caseworkers at welfare offices can be improved by reducing overtime work hours, ensuring sufficient hours of sleep for each worker, and fostering supportive communication and self-efficacy in the workplace. Furthermore, sex differences should be considered when assessing the mental health of workers at welfare offices in Japan.
