Details of a Researcher - Nagata, Satoko

Papers - Nagata, Satoko

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外来看護師が患者の在宅療養支援ニーズに気づくための観察・実践の重要度と実施状況

前田明里,　永田智子

日本在宅ケア学会誌 25 ( 2 ) 191 - 199 2022.03

Research paper (scientific journal), Joint Work, Last author, Accepted

Readiness for Hospital Discharge Scale 日本語版の信頼性・妥当性の検討

関野瑞希, 永田智子

日本健康学会誌 88 ( 1 ) 24 - 35 2022.01

Research paper (scientific journal), Joint Work, Last author, Accepted

外来での在宅療養支援カンファレンスの実施に向けた体制づくりのプロセス

佐々木美瑠, 田口敦子, 松永篤志, 山内泰子, 山内悦子, 永田智子

日本医療マネジメント学会雑誌 22 ( 2 ) 88 - 94 2021.09

Research paper (scientific journal), Joint Work, Last author, Accepted

地域保健活動における主要用語の定義：デルファイ法を用いた全国調査

永井智子, 梅田麻希, 麻原きよみ, 三森寧子, 遠藤直子, 江川優子, 小林真朝, 佐伯和子, 大森純子, 嶋津多恵子, 川崎千恵, 永田智子, 佐川きよみ, 小西美香子

日本公衆衛生雑誌 68 ( 8 ) 538 - 549 2021.08

Research paper (scientific journal), Joint Work, Accepted

The Use of a Public Space in a Public Housing Complex by Senior Citizens: A Qualitative Study

Matsumoto H., Kageyama M., Yamamoto-Mitani N., Nagata S.

Journal of Aging and Environment (Journal of Aging and Environment) 35 ( 2 ) 107 - 124 2021

ISSN 26892618

Recently, many community gathering spaces (CGSs) have been built as platforms for senior citizens to socialize. This study constitutes an ethnographic examination of how senior citizens use a CGS in a public housing complex in Japan. The results depicted six characteristic styles in which senior citizens used the CGS: visiting a park, attending a school, using a library, using a meeting room, shopping for commodities, and participating in events. Frequency of CGS use and group cohesion were two properties that distinguished among the six styles. Moreover, environmental features of the CGS enabled senior citizens with various physical and social conditions to use the CGS.

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Age in months and birth order in infant nonfatal injuries: A retrospective cohort study

Honda C., Yamana H., Matsui H., Nagata S., Yasunaga H., Naruse T.

Public Health in Practice (Public Health in Practice) 1 2020.11

Objective: To examine the age in months at which infants visited outpatient clinics or emergency rooms for the first time for nonfatal injuries and to identify risk factors for the occurrence of these injuries. Study design: Retrospective cohort study. Methods: We used a health insurance claims database in Japan. Infants born between April 2012 and December 2014 were identified and followed until 12 months of age. We identified their first visit to outpatient clinics or emergency rooms because of nonfatal injuries (wounds/fractures, foreign bodies, and burns). Cox regression analysis was used to examine the association of nonfatal injuries with infants’ sex, birth order, and parental age. Results: We identified 46,431 eligible infants. Of these, 7606 (16.4%) were brought to an outpatient clinic or emergency room for nonfatal injuries within 12 months of birth. Of the 7,606, 21.7% were aged ≤4 months and 44.7% ≤ 7 months. First-born infants were more likely to have wounds/fractures and burns. Conclusion: One-fifth of first nonfatal infant injuries occurred within 4 months of age. Healthcare providers should provide early education about injury prevention, especially to caregivers of first-born infants.

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A logic model for evaluation and planning in an adult day care for disabled Japanese old people

Naruse T., Kitano A., Matsumoto H., Nagata S.

International Journal of Environmental Research and Public Health (International Journal of Environmental Research and Public Health) 17 ( 6 ) 2020.03

ISSN 16617827

Adult day care (ADC) provides various services for meeting clients’ needs. Based on the mini-Delphi method with 46 ADC staff and the discussions with eight ADC administrators, this study developed and finalized a comprehensive logic model to represent the elements of ADC. For the three basic structures of a logic model—inputs/activities, outputs, and outcomes—the model contained seven core categories and 23 sub-categories. The ADC inputs/activities consisted of two core categories: “Place to stay” and “Intervention from staff”. These inputs/activities caused two kinds of outputs: “Clients’ experiences” and “Families’ experiences”. “Accumulating experiences” with repeated ADC visits was established as the link between the ADC outputs and outcomes, which were “Clients’ change” and “Families’ change”. ADC centers provide various experiences for their clients and their caregivers, ranging from the fulfillment of needs for fundamental care to psychiatric care and self-actualization. Improving various model-related inputs/interventions can produce better experiences and outcomes. The model can guide ADC administrators, policymakers, and researchers in the evaluation of a heterogeneous ADC service program that is community-based, thereby ensuring optimal care for clients with an efficient use of resources.

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訪問看護師によるPatient Safety Incidentsの認識と報告　質的記述的研究

山本なつ紀, 成瀬昂, 藤崎万裕, 松本博成, 永田智子

日本在宅ケア学会誌 23 ( 2 ) 63 - 72 2020.03

Research paper (scientific journal), Joint Work, Last author, Accepted

Home safety practices to prevent child injury and its association with family and children's daily routines in Japan: A cross-sectional study

Honda C., Naruse T., Tsuchiya-Ito R., Yamamoto N., Nagata S.

Japan Journal of Nursing Science (Japan Journal of Nursing Science) 17 ( 1 ) 2020.01

ISSN 17427932

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.

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外来看護師が患者の在宅療養支援のニーズに気づくための情報収集

前田明里,　永田智子

日本地域看護学会誌 22 ( 3 ) 17 - 25 2019.12

Research paper (scientific journal), Joint Work, Accepted

外来における在宅療養支援に関する啓発ツールの開発と有用性の検討

倉田里衣子, 田口敦子, 松永篤志, 山内悦子, 浦山美輪, 永田智子

日本医療マネジメント学会雑誌 20 ( 1 ) 27 - 31 2019.06

Research paper (scientific journal), Last author, Accepted

循環器疾患をもつ在宅療養継続者に対する病院内の多職種連携による支援に関する質的研究

劔持麻美, 松永篤志, 田口淳子, 明珍千恵, 山内悦子, 浦山美輪, 永田智子

日本地域看護学会誌 22 ( 1 ) 35 - 42 2019.04

Research paper (scientific journal), Last author, Accepted

救急外来を受診後に帰宅した患者の30日以内の再受診パターン：比較事例研究

寺本千恵, 永田智子, 成瀬昂, 横田慎一郎, 山本則子

日本看護科学会誌 38 336 - 345 2018.12

Research paper (scientific journal), Joint Work, Accepted

The structure of the perceived professional identity of Japanese public health nurses

Iwasaki Riho, Kageyama Masako, Nagata Satoko

Public Health Nursing (Public Health Nursing) 35 ( 3 ) 220 - 227 2018.05

Research paper (scientific journal), Joint Work, Accepted, ISSN 0737-1209

Objective: As health problems become more diverse and complicated, the way public health nurses (PHNs) work is changing. Research at the conceptual level of professional identity of PHNs is lacking. This study aimed to explore the structure of the perceived professional identity of Japanese PHNs. Design and Sample: Grounded theory method was used. Twenty-five PHNs in Japanese municipalities were participated in the study. Measurements: Data were collected through semistructured interviews and analyzed using open, axial, and selective coding. Results: Three categories emerged: (1) providing support to the consulter directly, (2) working as a member of the administrative organization, and (3) working for all residents to improve community development. The modality of perceived professional identity showed interindividual and intraindividual differences and was either stable or unstable. The perceived professional identities coexisted, but there was a conflict between (1) and (2). Conclusion: PHNs should be made aware of the three identities revealed in our study and the possibility of a conflict between identities. Moreover, to ensure working for all residents to improve community development, a population-based approach to education is needed with cooperation of universities and clinical practice.

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緩和ケア病棟の看護師にとっての退院支援の意味

水井翠, 蔭山正子, 御子柴直子, 横山惠子, 永田智子

日本看護科学会誌 37 ( 1 ) 170 - 178 2017.12

Research paper (scientific journal), Joint Work, Accepted

日本の病院における退院支援看護師の実践状況—2010年と2014年の全国調査の結果を比較して

戸村ひかり, 永田智子, 竹内文乃, 清水準一

日本看護科学会誌 37 ( 1 ) 150 - 160 2017.12

Research paper (scientific journal), Joint Work, Accepted, ISSN 2185-8888

Improved parental attitudes and beliefs through stepwise perinatal vaccination education

Saitoh Aya, Saitoh Akihiko, Sato Isamu, Shinozaki Tomohiro, Kamiya Hajime, Nagata Satoko

Human Vaccines and Immunotherapeutics 1 - 7 2017.10

Research paper (scientific journal), Joint Work, Accepted, ISSN 2164-5515

This study examined the effects of providing vaccination education during the perinatal period on Japanese parents' knowledge, attitudes, and beliefs about childhood vaccination. A cluster-randomized controlled-trial method was used on a sample of 160 pregnant women recruited from 9 obstetrical sites in Niigata, Japan. The treatment group received a stepwise interactive education intervention, while the control group received a general vaccination leaflet. Changes in parental attitudes toward and beliefs about infant vaccination were assessed on the child's one-month and 6-month birthdays using paper questionnaires. Of the initial 188 participants, 160 (90.4%) completed the final post-survey questionnaire. Scores on injunctive social norms (a morally neutral perception of the behavior of the majority) and descriptive social norms (a moral perception of what individuals should do) significantly increased in the treatment group (p = .02 and p = .01, respectively). There was a significant difference between the 2 groups over time in terms of perceived benefit (efficacy of available preventive actions) (p = .03), but no significant differences in perceived severity (seriousness of a disease outcome), perceived susceptibility (likelihood of getting a disease), perceived benefits, perceived behavioral control, or descriptive social norms between the groups at any time point or in the patterns of change over time (p > .31). Thus, stepwise perinatal vaccination education was found to positively influence maternal attitudes and beliefs about infant vaccination. This study suggests the importance of vaccination education during the perinatal period.

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Measurement of special access to home visit nursing services among Japanese disabled elderly people

Naruse Takashi, Matsumoto Hiroshige, Fujisaki-Sakai Mahiro, Nagata Satoko

BMC Health Services Research 17 ( 1 ) 2017.05

Research paper (scientific journal), Joint Work, Accepted, ISSN 1472-6963

Background: Home care service demands are increasing in Japan; this necessitates improved service allocation. This study examined the relationship between home visit nursing (HVN) service use and the proportion of elderly people living within 10 min' travel of HVN agencies. Methods: The population of elderly people living within reach of HVN agencies for each of 17 municipalities in one low-density prefecture was calculated using public data and geographic information systems. Multilevel logistic analysis for 2641 elderly people was conducted using medical and long-term care insurance claims data from October 2010 to examine the association between the proportion of elderly people reachable by HVNs and service usage in 13 municipalities. Municipality variables included HVN agency allocation appropriateness. Individual variables included HVN usage and demographic variables. Results: The reachable proportion of the elderly population ranged from 0.0 to 90.2% in the examined municipalities. The reachable proportion of the elderly population was significantly positively correlated with HVN use (odds ratio: 1.938; confidence interval: 1.265-2.967). Conclusions: Residents living in municipalities with a lower reachable proportion of the elderly population are less likely to use HVN services. Public health interventions should increase the reachable proportion of the elderly population in order to improve HVN service use.

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Effect of stepwise perinatal immunization education

Saitoh Aya, Saitoh Akihiko, Sato Isamu, Shinozaki Tomohiro, Kamiya Hajime, Nagata Satoko

Vaccine 35 ( 12 ) 1645 - 1651 2017.03

Research paper (scientific journal), Joint Work, Accepted, ISSN 0264-410X

Background Perinatal immunization education is important for improving the immunization outcomes of infants; however, the content of educational materials used at each perinatal period has not been carefully evaluated. We hypothesized that stepwise education offered at different perinatal periods would improve infant immunization status and enhance maternal immunization knowledge. Methods In this cluster-randomized controlled trial, pregnant women were recruited from nine obstetric sites in Niigata, Japan. The intervention group received a stepwise, interactive education intervention (prenatally, postnatally, and 1 month after birth). The control group received a leaflet containing general information on immunization. Infant immunization status was evaluated at 6 months of age, and maternal immunization knowledge was evaluated by a written survey after each intervention. Results Among 188 study participants, 151 (80.3%) replied to the final post-intervention survey. At 6 months of age, the percentage of children who completed three doses of inactivated polio, diphtheria, tetanus toxoid, and acellular pertussis (DTaP-IPV) vaccine was higher in the intervention group than in the control (p = 0.04); however, no differences between groups were observed for the Haemophilus influenzae type b (Hib) (p = 0.67) or 13-valent pneumococcal conjugate (PCV13) vaccines (p = 0.20). The duration to the completion of the third dose of the DTaP-IPV, Hib, and PCV13 vaccines was shorter in the intervention group than in the control (p = 0.03, p < 0.01, and p < 0.01, respectively). Furthermore, maternal knowledge scores exhibited significantly greater improvement in the intervention group over time compared with those of the control group (p = 0.02). Conclusions Stepwise perinatal immunization education improved immunization schedule adherence for required vaccines and improved maternal immunization knowledge.

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The association between nurses' coordination with physicians and clients' place of death

Naruse Takashi, Yamamoto Natsuki, Sugimoto Takashi, Fujisaki-Sakai Mahiro, Nagata Satoko

International Journal of Palliative Nursing 23 ( 3 ) 136 - 142 2017.03

Research paper (scientific journal), Joint Work, Accepted, ISSN 1357-6321

Aim: Over 60% of Japanese people hope to die at home; hence, assisting clients in achieving this outcome is an important responsibility of home care providers. This study investigated the effects of nurses' relational coordination with physicians on clients' place of death in home visiting nursing (HVN) agencies. Method: Secondary analysis of a public survey conducted in 2015 by local governments in Kurume city, Fukuoka prefecture, Western Japan. Manager nurses from 17 HVN agencies provided data about themselves and their relational coordination with community physicians and 85 deceased clients Results: Among 85 deceased clients, 52 (61.2%) had died at home. Four regression models showed significant positive effects of HVN nurse managers' relational coordination on clients' home death (the odds ratios (95% CI) were 2.488 (1.442-4.293) 2.111 (1.014-4.396), 2.562 (1.409-4.658) and 2.275 (1.079-4.796) in models 1-4, respectively. Conclusion: Measuring relational coordination among HVN nursing managers and physicians indicated readiness for home death among HVN clients in an agency or community.

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Nutritional status and habitual dietary intake are associated with frail skin conditions in community-dwelling older people

Iizaka Shinji, Nagata S., Sanada H.

Journal of Nutrition, Health and Aging 21 ( 2 ) 137 - 146 2017.02

Research paper (scientific journal), Joint Work, Accepted, ISSN 1279-7707

Objective: Prevention of frail skin is important in older people because frail skin is associated with a risk of injury in this population. In this study, we investigated the association of nutritional status and habitual dietary intake with skin conditions in community-dwelling older people. Design: Cross-sectional study. Setting: Three community settings in Japan from autumn to winter. Participants: Older people aged ≥65 years without care-need certification (n=118). Measurements: Malnutrition and obesity were evaluated to assess the nutritional status. Nutrient and food group intakes per 1000 kcal were evaluated using a brief self-administered diet history questionnaire. Dietary patterns based on food groups were evaluated by principal component analysis. Skin condition parameters, including stratum corneum hydration, appearance of xerosis (specific symptom sum score [SRRC score]), and dermal intensity by high-frequency ultrasonography, were measured on a lower leg. Multiple linear regression analysis was performed with adjustment for confounders. Results: The mean (standard deviation) age was 74.1 (4.8) years, and 83.1% of participants were female. A higher intake of plant fat (p=0.018) was associated with a lower SRRC score. Higher intakes of α-tocopherol (p=0.050) and vitamin C (p=0.017) were associated with increased dermal intensity. A body mass index ≥25 (p=0.016) was associated with decreased dermal intensity. A dietary pattern characterized by higher vegetable and fruit intake was associated with a better skin condition. Conclusion: Plant fat, antioxidant vitamins, and a dietary pattern characterized by vegetables and fruits showed positive and obesity showed negative associations for frail skin in community-dwelling older people.

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Home Visiting Nurse Service Duration and Factors Related to Institution Admission

Naruse Takashi, Fujisaki-Sakai Mahiro, Nagata Satoko

Home Health Care Management and Practice 29 ( 1 ) 46 - 52 2017.02

Research paper (scientific journal), Joint Work, Accepted, ISSN 1084-8223

To empirically measure the quality of home visiting nursing (HVN) agencies in Japan, we longitudinally observed the duration of clients’ HVN use and identified the factors correlated with hospitalization/institutionalization. Medical and long-term care insurance data were analyzed from 1,722 persons with disabilities aged at least 75 years who began using an HVN. At the 12-month follow-up, 67.7% of clients were no longer using the HVN; among these, 48.9% were hospitalized/institutionalized and 23.6% had died. Cox regression analysis showed that risk of hospitalization/institutionalization in HVN agencies depends on client characteristics at service commencement. Measuring the quality of HVN agencies by weighting clients’ characteristics as risk factors for hospitalization and/or institutionalization may be appropriate.

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外来看護師による在宅療養支援ニーズ把握の実態 ―一般病院を対象とした全国調査―

錦織梨紗, 永田智子

日本地域看護学会誌 20 ( 2 ) 29 - 37 2017

Research paper (scientific journal), Joint Work, Accepted

The importance of the maternal/self-role satisfaction for reducing anxiety

Iwasaki Riho, Arimoto Azusa, Naruse Takashi, Nagata Satoko, Murashima Sachiyo

Journal of UOEH 39 ( 2 ) 143 - 151 2017

Research paper (scientific journal), Joint Work, Accepted, ISSN 0387-821X

Women who rear children have two types of roles: the maternal role and the self-role. Previous studies have suggested that maternal role satisfaction is related to anxiety, but the importance of self-role satisfaction in promoting the health of mothers has received less attention. The changing roles of women in society, especially in urban areas, have altered mothers' views of child-rearing. Our primary focus was on the relationship between maternal/self-role satisfaction and anxiety in mothers. To examine this, we conducted a cross-sectional survey using self-administered questionnaires that were distributed in 2011 to 2,342 mothers attending the 18-month health checkup of their children, in 7 cities of the Tokyo metropolitan area. A total of 881 responded (effective response rate = 38.0%). Multiple regression analysis revealed that maternal role satisfaction and self-role satisfaction were both significantly and negatively associated with anxiety. Thus, self-role satisfaction should be considered alongside maternal role satisfaction in evaluating and reducing anxiety. Health care professionals in community settings should conduct comprehensive assessments of maternal role satisfaction and self-role satisfaction.

The Importance of the Maternal/Self-Role Satisfaction for Reducing Anxiety: A Cross-Sectional Survey of Japanese Mothers

Riho IWASAKI, Azusa ARIMOTO, Takashi NARUSE, Satoko NAGATA, Sachiyo MURASHIMA

Journal of UOEH 39 ( 2 ) 143 - 151 2017

Research paper (scientific journal), Joint Work, Accepted

特定機能病院における外来看護師による在宅療養支援の実態

佐藤日菜, 田口敦子, 永田智子, 山内悦子, 浦山美輪, 戸村ひかり, 鷲見尚己

日本地域看護学会誌 20 ( 2 ) 80 - 86 2017

Research paper (scientific journal), Joint Work, Accepted

保健師教育課程選択制導入前後の保健師による学生実習の技術到達度評価の比較

斉藤恵美子, 鈴木良美, 岸恵美子, 澤井美奈子, 掛本知里, 中田晴美, 五十嵐千代, 麻原きよみ, 永田智子, 森豊美, 栗原せい子

日本公衆衛生看護学会誌 6 ( 2 ) 150 - 158 2017

Research paper (scientific journal), Joint Work, Accepted

修士課程保健師コースにおける生活習慣病予防を目的とした地域診断・活動展開実習の事例山間部の高塩分食・喫茶店のモーニング文化と保健師活動

大橋由基, 新村津代子, 有本梓, 渡井いずみ, 成瀬昴, 田口敦子, 永田智子, 村嶋幸代

保健師ジャーナル 72 ( 11 ) 946-952 2016.11

Joint Work

Conformity to the neighborhood modifies the association between recreational walking and social norms among middle-aged Japanese people

Tanaka Chika, Naruse Takashi, Taguchi Atsuko, Nagata Satoko, Arimoto Azusa, Ohashi Yuki, Murashima Sachiyo

Japan Journal of Nursing Science 13 ( 4 ) 451 - 465 2016.10

Joint Work, Accepted, ISSN 1742-7932

Aim: Recreational walking benefits the health of the middle-aged population. Social norms might generate an intention–behavior gap, the state of people forming adequate intentions but failing to translate these intentions into action. People living in a community where the neighbors conform to the average behaviors of those who live in the neighborhood might restrict behaviors that stray from the neighborhood's social norms. This cross-sectional study was conducted in order to examine whether the degree of conformity to the neighbors modified the association between social norms and recreational walking among middle-aged adults in Japan. Methods: Using a questionnaire, data were collected from 730 participants in Japan. Among those who intended to recreationally walk, a multiple logistic regression was carried out separately for the participants with a high or low degree of conformity to the neighborhood social norms. Results: Of the total number of respondents, 511 (70%) reported recreational walking intentions. The descriptive norm was significantly associated with recreational walking only among the participants with a high degree of conformity. In contrast, there was no such association among the participants with a low degree of conformity. Conclusion: The results confirmed that people who live in a community where people tend to conform translated walking intentions into action when they saw their neighbors walk recreationally. Public health nurses should evaluate the degree of conformity in neighborhoods and neighbors’ descriptive norms when promoting walking.

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Factors related to physical violence experienced by parents of persons with schizophrenia in Japan

Kageyama Masako, Solomon Phyllis, Kita Sachiko, Nagata Satoko, Yokoyama Keiko, Nakamura Yukako, Kobayashi Sayaka, Fujii Chiyo

Psychiatry Research 243 439 - 445 2016.09

Research paper (scientific journal), Joint Work, Accepted, ISSN 0165-1781

Most violence by patients with mental illness is perpetuated against family members rather than the general public. However, there is insufficient research to reach a consensus on factors related to family violence for this population. Thus, the current study aimed to clarify factors related to physical violence by patients with schizophrenia towards their parents in Japan. A self-administrated survey was distributed through family groups to families with a relative with a psychiatric disorder. Questionnaires completed by 400 parents of patients with schizophrenia were analyzed. Of the 400 parents, almost two-thirds experienced “no physical violence” and close to one-third experienced “physical violence” during the past year. Results of a mixed-effects logistic regression revealed that physical violence was significantly related to the patients’ gender (female rather than male), multiple patient hospitalizations (3 or more times as compared to never hospitalized), low annual household income (less than US$20 K as compared to over US$40 K), and higher hostility and criticism of family interactions. Family violence maybe reduced through education on communication strategies for both parents and patients.

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Relational coordination among home healthcare professions and goal attainment in nursing care

Sakai Mahiro, Naruse Takashi, Nagata Satoko

Japan Journal of Nursing Science 13 ( 3 ) 402 - 410 2016.07

Research paper (scientific journal), Joint Work, Accepted, ISSN 1742-7932

Aim: To examine whether interprofessional coordination is related to goal attainment in home visit nursing care. Methods: Self-administered questionnaire surveys were administered to home visit nursing agencies in Chiba Prefecture, Japan, from July to December 2014. Nurses evaluated their interprofessional coordination with professional groups (nursing colleague and managers, home doctors, care managers, home care workers, visiting therapists, day service and day care professionals, visiting bath professionals, and short stay professionals) using the Japanese version of the Relational Coordination Scale (RCS-J). Goal attainment across all clients during the most recent 3 months was measured with a rating scale ranging from incompletely attained (0) to completely attained (10). Data were analyzed with multivariate logistic regression analysis. Results: A total of 83 nurses in 14 agencies responded, and data from 74 nurses were analyzed. The mean RCS-J and goal attainment scores were 3.59 (standard deviation = 0.47) and 6.51 (1.40), respectively. The RCS-J scores of the low and high goal attainment groups were 3.41 (0.46) and 3.73 (0.42), respectively. Multivariate logistic regression analysis revealed that RCS-J scores were positively associated with goal attainment (odds ratio, 5.71; 95% confidence interval, 1.65–19.79). Conclusion: The finding of this study suggest that well-coordinated professionals may fulfill client needs better than poorly coordinated professionals do. Future research is needed to determine whether similar results are obtained in individual clients using a well-validated goal attainment scale.

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Who prefers to age in place? Cross-sectional survey of middle-aged people in Japan

Matsumoto Hiroshige, Naruse Takashi, Sakai Mahiro, Nagata Satoko

Geriatrics and Gerontology International 16 ( 5 ) 631 - 637 2016.05

Research paper (scientific journal), Accepted, ISSN 1444-1586

Aim: Preference for aging in place among middle-aged people is an important element in estimating the future needs for community services of disabled older adults. Drawing on Litwak and Longino's typologies of relocation, the present study investigated the characteristics of middle-aged adults who prefer to age in place and those who prefer to move, at two levels of disability: being unable to walk alone and being bedridden. Methods: In the present cross-sectional study, an anonymous, self-administered questionnaire was sent to 2500 community-dwelling adults aged 40-64years. Results: If unable to walk outside alone, 43.0% of respondents would prefer to move from their own homes. If bedridden, 29.5% preferred to move. After age and sex had been adjusted for, house size, length of time living at that house, the number of people living together, and attachment to home and neighborhood were independently related to moving preferences if unable to walk outside alone. Accessibility of hospitals and supermarkets, community participation, and use of the Internet were related to moving preferences if bedridden. Conclusions: Sex, current living arrangement and geographic properties are correlated with changes in community-dwelling adults' preferences for residential relocation as physical function declines. It is necessary for municipal policymakers to understand these correlations in order to plan and develop effective community care systems. Geriatr Gerontol Int 2016; 16: 631-637.

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Effects of relational coordination among colleagues and span of control on work engagement among home-visiting nurses

Naruse Takashi, Sakai Mahiro, Nagata Satoko

Japan Journal of Nursing Science 13 ( 2 ) 240 - 246 2016.04

Research paper (scientific journal), Accepted, ISSN 1742-7932

Aim: Home-visiting nursing agencies are required to foster staff nurse's work engagement; thus, the factors related to work engagement require identification. This study examined relational coordination among colleagues and agency span of control on the work engagement of home-visiting nurses. Methods: Cross-sectional data from 93 staff nurses in 31 home-visiting nursing agencies were collected via a survey and analyzed using mixed linear regression. Results: There was no significant main effect of relational coordination among nurse colleagues on work engagement. In large agencies with a large span of control, relational coordination among nursing colleagues predicted work engagement. Nursing managers' relational coordination was found to be positively associated with staff nurse work engagement. Conclusion: Agency span of control is a moderating factor on the positive effect of relational coordination with nursing colleagues on staff nurse work engagement.

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Relationship between maternal mindfulness and anxiety 1month after childbirth

Yamamoto Natsuki, Naruse Takashi, Sakai Mahiro, Nagata Satoko

Japan Journal of Nursing Science 2016

Research paper (scientific journal), Joint Work, Accepted, ISSN 1742-7932

Aim: To investigate the relationship between maternal mindfulness and maternal anxiety 1month 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 1month post-partum, the mothers with greater mindfulness scores showed lower anxiety. Conclusions: Improvements in mindfulness could help mothers to reduce their post-partum anxiety.

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Effects of relational coordination among colleagues and span of control on work engagement among home-visiting nurses

Naruse Takashi, Sakai Mahiro, Satoko Nagata

Japan Journal of Nursing Science 13 ( 2 ) 240-246 2016

Joint Work, Accepted

Current trends and age-based differences of unintentional injury in Japanese children

Yamamoto Natsuki, Honda Chikako, Nagata Satoko

BioScience Trends 10 ( 2 ) 152-157 2016

Joint Work

Current practices and needs regarding perinatal childhood immunization education for Japanese mothers

Saitoh Aya, Saitoh Akihiko, Sato Isamu, Shinozaki Tomohiro, Nagata Satoko

Vaccine 33 ( 45 ) 6128 - 6133 2015.11

Research paper (scientific journal), Joint Work, Accepted, ISSN 0264-410X

Background: Accurate, standardized information on childhood immunization is not available in Japan. We investigated current practices in perinatal childhood immunization education in the community and the needs and interest for such education among Japanese mothers. Methods: This cross-sectional, descriptive study evaluated pregnant and postnatal women at four institutions in Niigata, Japan from May through July 2014. Data were collected using questionnaires inquiring about demographics, immunization education received, intent to receive childhood vaccines, and needs regarding information on childhood immunization. Results: Questionnaires were distributed to 300 women, and 116 (38.6%) were returned; 70 (59.6%) of the respondents were pregnant women and 46 (40.3%) were postnatal women. Fourteen (20%) of the 70 pregnant women reported receiving some form of immunization education; in contrast, 34 (73.9%) of 46 postnatal women had received such education within 1 month of delivery. The rates of respondents who felt that the information was insufficient were high: 78.6% among pregnant women and 52.9% among postnatal women. Pregnant women reported that the most important information was general concepts of immunization; in contrast, postnatal women desired more-detailed information, e.g., on immunization scheduling. Conclusions: Japanese women do not receive sufficient perinatal immunization education. The information needed during the prenatal and postnatal periods differs. Thus, educational approaches may need to provide carefully targeted information.

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Identifying Residents' Health Issues Six Weeks after the Great East Japan Earthquake

Teramoto Chie, Nagata Satoko, Okamoto Reiko, Suzuki Ruriko, Kishi Emiko, Nomura Michie, Jojima Noriko, Nishida Masumi, Koide Keiko, Kusano Emiko, Iwamoto Saori, Murashima Sachiyo

Public Health Nursing 32 ( 6 ) 654 - 661 2015.11

Research paper (scientific journal), Joint Work, Accepted, ISSN 0737-1209

Objective: The aim of this study was to identify the characteristics and health issues of residents in need of assistance in a town affected by the Great East Japan Earthquake, six weeks after the disaster, through an outreach initiative. Design and Sample: A cross-sectional qualitative design was used. Public health nurses conducted comprehensive semi-structured interviews during home visits with residents. A total of 5,082 residents from the affected town. Measures: These included demographic information, public records of the extent of the damages, and qualitative interview data to determine the urgency of the necessary interventions. Results: A total of 281 residents needed some kind of assistance and were identified as "requiring early intervention (within two weeks)" or "requiring assistance (within 12 weeks)." The most common health issue requiring early intervention was "interruption of treatment" (25.0%), followed by "need for mental care." The most frequent health issue requiring assistance within 12 weeks was the "need for mental health care" (39.7%), followed by "interruption of treatment," and "need for nursing care." Conclusions: During a disaster, it is imperative to identify cases requiring early intervention. Home-visit interviews were necessary to identify existing health concerns to prevent the development of more serious health problems.

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Cross-sectional study of social support and psychological distress among displaced earthquake survivors in Japan

Teramoto Chie, Matsunaga Atsushi, Nagata Satoko

Japan Journal of Nursing Science 12 ( 4 ) 320 - 329 2015.10

Research paper (scientific journal), Joint Work, Accepted, ISSN 1742-7932

Aim: This cross-sectional study aims to explore the relationship between different types and sources of social support and psychological distress by age and sex among survivors living in temporary housing 10 months after the Great East Japan Earthquake. Methods: Self-reported questionnaires/structured interviews administered from January to March 2012 recorded demographic characteristics, damage involving participants' families, social support, and psychological distress. Results: Data on 296 participants aged 20 years or more from nine temporary housing complexes in Otsuchi were analyzed; K6 scores indicating psychological distress averaged 5.1 (standard deviation, 5.9; range, 0-24). Multiple logistic regression analyses indicated differences among types and sources of social support with regard to psychological distress by age and sex among disaster survivors. For men aged less than 65 years, social support by family was related to lower psychological distress. For women aged 65 years or more, emotional support from family, informational and instrumental support, and social companionship from friends in their own temporary housing complexes were related to less psychological distress. Conclusion: Differences in age and sex were related to different sources of social support in relation to psychological distress. It is necessary to pay more attention to those who lost family members in the disaster, especially men aged less than 65 years. It may also be necessary to support survivors in making friends when they relocate to temporary housing, especially women aged 65 years or more.

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Rate of family violence among patients with schizophrenia in Japan

Kageyama Masako, Yokoyama Keiko, Nagata Satoko, Kita Sachiko, Nakamura Yukako, Kobayashi Sayaka, Solomon Phyllis

Asia-Pacific Journal of Public Health 27 ( 6 ) 652 - 660 2015.09

Research paper (scientific journal), Joint Work, Accepted, ISSN 1010-5395

Family violence is a serious concern in the era of deinstitutionalization in Japan. Consequently, we aimed to clarify the rate of family violence among patients with schizophrenia, and differences by sex and relationship to the patient. We asked households belonging to a family group association to complete a self-administered mail survey. Of 350 households that responded, data for 302 were analyzed. The rate of violence toward any family member was 60.9% over the lifetime and 27.2% in the past year. Order of lifetime rates for family members from highest to lowest was 51.0% for mothers, 47.0% for fathers, 30.7% for younger sisters, 23.8% for spouses, 19.5% for younger brothers, 18.2% for older sisters, 17.1% for older brothers, and none for children. Younger sisters were more likely to be victims compared to other siblings. Fathers and older brothers were likely to be victims when patients were male.

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専門性の高い看護師配置による地域包括ケア時代の新たな PFM システムの構築—福島県立医科大学会津医療センター附属病院の取り組み

児島由利江, 永田智子

看護管理 25 ( 9 ) 750 - 755 2015.09

Thesis (other), Joint Work

Promoting the Use of Visiting Nurse Services for Patients Discharged From Hospital

Nagata Satoko, Ogawa Kaoru, Taguchi Atsuko, Naruse Takashi, Murashima Sachiyo, Magilvy Joan Kathy

Home Health Care Management and Practice 27 ( 2 ) 47 - 53 2015.05

Research paper (scientific journal), Joint Work, Accepted, ISSN 1084-8223

A project to encourage the adequate use of visiting nurse services (VNS) after discharge was conducted by “K” City, Japan. Eligible individuals were inpatients of general hospital ready for discharge and assessed as potentially needing VNS, and their out-of-pocket fees for VNS within 1 month following discharge were covered by the city. To clarify this project’s effect, patient/family’s intention to use VNS and the utilization of VNS at each time point were evaluated. Eighty-eight residents used the project. Before initial hospitalization, less than one quarter of users had recognized the necessity of VNS. Many participants (88.6%) continued to use VNS even after the completion of the project period despite having to cover the VNS cost by themselves, indicating that this project had a positive impact on appropriate VNS use.

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The effect of skill mix in non-nursing assistants on work engagements among home visiting nurses in Japan

Naruse Takashi, Taguchi Atsuko, Kuwahara Yuki, Nagata Satoko, Sakai Mahiro, Watai Izumi, Murashima Sachiyo

Journal of Nursing Management 23 ( 4 ) 532 - 541 2015.05

Research paper (scientific journal), Joint Work, Accepted, ISSN 0966-0429

Aim: This study evaluated the effect of a skill-mix programme intervention on work engagement in home visiting nurses. Background: A skill-mix programme in which home visiting nurses are assisted by non-nursing workers is assumed to foster home visiting nurses' work engagement. Method: Pre- and post-intervention evaluations of work engagement were conducted using self-administered questionnaires. A skill-mix programme was introduced in the intervention group of home visiting nurses. After 6 months, their pre- and post-intervention work engagement ratings were compared with those of a control group. Result: Baseline questionnaires were returned by 174 home visiting nurses (44 in the intervention group, 130 in the control group). Post-intervention questionnaires were returned by 38 and 97 home visiting nurses from each group. The intervention group's average work engagement scores were 2.2 at baseline and 2.3 at post-intervention; the control group's were 3.3 and 2.6. Generalised linear regression showed significant between-group differences in score changes. Conclusion: The skill-mix programme might foster home visiting nurses' work engagement by improving the quality of care for each client. Future research is needed to explain the exact mechanisms that underlie its effectiveness. Implications for nursing management: In order to improve the efficiency of services provided by home visiting nurses and foster their work engagement, skill-mix programmes might be beneficial.

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Follow-up study of the general and mental health of people living in temporary housing at 10 and 20 months after the Great East Japan Earthquake

Nagata Satoko, Matsunaga Atsushi, Teramoto Chie

Japan Journal of Nursing Science 12 ( 2 ) 162 - 165 2015.04

Research paper (scientific journal), Joint Work, Accepted, ISSN 1742-7932

Aim: An earthquake of magnitude 9.0 and accompanying tsunami struck the Tohoku region in northeast Japan on 11 March 2011. The purpose of this study was to observe evacuees' health status such as general health, psychological distress, and feeling of isolation over time. Methods: The authors distributed a questionnaire survey to residents of temporary housing in January to March (time 1) and again in October to December of 2012 (time 2). Results: Two hundred respondents who filled out the questionnaire at both times were the subjects of this study. The self-reported general health in 39% and mental health status in 43.5% of the participants were poor at time 2. In addition, a higher percentage of participants felt a sense of isolation at time 2 even though more of the participants participated in community activities at that time. Conclusion: This result shows the evacuees' prolonged psychological distress and strengthening sense of isolation. It will be necessary to monitor them carefully and provide support continuously over the long term.

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療養場所の円滑な移行に向けた退院支援方策の開発とその評価

NAGATA Satoko

看護科学研究 13 ( 1 ) 18 - 21 2015

Research paper (conference, symposium, etc.), Single Work

Diseases that precede disability among latter-stage elderly individuals in Japan

Naruse Takashi, Sakai Mahiro, Matsumoto Hiroshige, Nagata Satoko

BioScience Trends 9 ( 4 ) 270 - 274 2015

Research paper (scientific journal), Joint Work, Accepted, ISSN 1881-7815

Understanding causes of disability among elderly individuals is an important public health issue, particularly because of the increasing rate of disabled elderly individuals and the social costs in a rapidly aging society. Accordingly, we aimed to describe the diseases that precede disability and investigate the types of diseases that are related to severe disability among Japanese elderly individuals aged over 75 years. Using claim data from the latterstage elderly healthcare system and long-term care insurance system, we identified 76,265 elderly individuals over 75 years old who did not qualify as disabled on April 1, 2011. Among them, 3,715 elderly individuals who had been newly qualified as disabled between April 1, 2011 and March 31, 2012 were selected. Disease codes from the medical claim data in the 6 months prior to disability were collected. All descriptions were developed separately for six groups divided by gender and disability level (low, middle, and high). The results of the ordinal logistic analysis including sex and age revealed that men tended to have significantly higher levels of disability (β = 0.417, p < 0.001) than women. Cerebrovascular disorder (CVD) was the most common disease in almost all age and disability level groups. In low-level disability groups, cancer in men (12.8%) and arthropathy and fracture in women (11.9% and 13.5%, respectively) were as common as cerebrovascular disorder (12.2% and 9.7%, in men and women, respectively). Stroke was the most common disease for all genders and disability levels. The diseases preceding low-level disability differed by gender. This study demonstrated the need to consider arthropathy and fracture as well as CVD in order to prevent disability.

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Essential skill achievement levels of public health nursing students, as evaluated by students, faculties, and public health nurses in Tokyo 23 city

Suzuki Yoshimi, Saito Emiko, Sawai Minako, Kishi Emiko, Kakemoto Satori, Nakada Harumi, Igarashi Chiyo, Miyoshi Tomomi, Asahara Kiyomi, Nagata Satoko, Mori Toyomi, Kaguraoka Sumi

[Nihon koshu eisei zasshi] Japanese journal of public health 62 ( 12 ) 729 - 737 2015

Research paper (scientific journal), Joint Work, Accepted, ISSN 0546-1766

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訪問看護必要性アセスメントシートの一般化可能性および活用可能性の検討

田口敦子, 永田智子, 成瀬昂, 桒原雄樹, 山口拓洋, 村嶋幸代

日本医療・病院管理学会誌 52 ( 2 ) 67 - 77 2015

Research paper (scientific journal), Joint Work

終末期在宅療養の実現可能性に関する地方中核都市と郡部在住の住民の認識とその関連要因

柳瀬裕貴, 成瀬昂, 田口敦子, 永田智子

日本地域看護学会誌 18 ( 2-3 ) 23 - 32 2015

Research paper (scientific journal), Joint Work, Accepted

大学病院における退院支援スクリーニング指標の基準関連妥当性の検討

田口敦子, 奥田春花, 吉田和子, 五十嵐ひとみ, 佐藤裕子, 佐々木夫起子, 山内かず子, 永田智子

東北大学医学部保健学科紀要 24 ( 1 ) 19 - 27 2015

Research paper (bulletin of university, research institution), Joint Work

Characteristics of Clients Using Home Visiting Nursing Services at Nighttime and Early Morning in Japan

Taguchi Atsuko, Naruse Takashi, Kuwahara Yuki, Matsunaga Atsushi, Nagata Satoko, Murashima Sachiyo

Home Health Care Management and Practice 26 ( 4 ) 250 - 256 2014.11

Research paper (scientific journal), Joint Work, Accepted, ISSN 1084-8223

Our objectives were to classify the characteristics of clients such as their diseases and the period of services provided to clients who are using home visiting nurse agency (HVNA) services at nighttime. The nighttime HVNA services provided to 31 clients were analyzed. Two major reasons for cancellation of nighttime and early morning HVNA service were identified: (1) cancellation due to death, and (2) cancellation as a result of achieving goals for receiving the service. As to the former reason, those who died of terminal cancer used the service for approximately 2 months, whereas those who died of other causes used the service for approximately 11 months. The establishment of such a service system requires the development of a method to achieve stable management of an HVNA.

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Identification of the need for home visiting nurse

Taguchi Atsuko, Nagata Satoko, Naruse Takashi, Kuwahara Yuki, Yamaguchi Takuhiro, Murashima Sachiyo

International Journal of Integrated Care 14 ( 1 ) 2014.01

Research paper (scientific journal), Joint Work, Accepted, ISSN 1568-4156

Objective: To develop a Home Visiting Nursing Service Need Assessment Form (HVNS-NAF) to standardize the decision about the need for home visiting nursing service. Methods: The sample consisted of older adults who had received coordinated services by care managers. We defined the need for home visiting nursing service by elderly individuals as the decision of the need by a care manager so that the elderly can continue to live independently. Explanatory variables included demographic factors, medical procedure, severity of illness, and caregiver variables. Multiple logistic regression was carried out after univariate analyses to decide the variables to include and the weight of each variable in the HVNS-NAF. We then calculated the sensitivity and specificity of each cutoff value, and defined the score with the highest sensitivity and specificity as the cutoff value. Results: Nineteen items were included in the final HVNS-NAF. When the cutoff value was 2 points, the sensitivity was 77.0%, specificity 68.5%, and positive predictive value 56.8%. Conclusions: HVNS-NAF is the first validated standard based on characteristics of elderly clients who required home visiting nursing service. Using the HVNS-NAF may result in reducing the unmet need for home visiting nursing service and preventing hospitalization.

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Work engagement and attitudes toward caring for dying patients and families among home-visiting nurses in Japan

Mahiro Sakai, Takashi Naruse, Satoko Nagata

International Journal of Palliative Nursing 20 ( 7 ) 343 - 348 2014

Research paper (scientific journal), Joint Work, Accepted, ISSN 1357-6321

Background: Nurses with higher levels of work engagement tend to be highly efficient in their work and more willing to keep working and to provide patient-centred care. However, whether more engaged nurses provide end-of-life care more proactively has not been examined in the home-care setting. Aim: This study aimed to examine work engagement among home-visiting nurses in Japan and its relationship with their attitudes toward caring for dying patients and their families. Methods: A total of 343 nurses working in 62 agencies across Chiba prefecture, eastern Japan, received an anonymous self-administered questionnaire from July to August 2012. The authors performed multiple regression analysis to explore the relationships between home-visiting nurses" work engagement and attitudes. Results: Data from 184 nurses (53.6%) was analysed. Work engagement was significantly positively related to the nurses" attitudes toward caring for dying patients and their families. Conclusion: As more engaged nurses tend to have more positive attitudes toward caring for dying patients and their families, further research is needed to identify the factors that might help nursing managers to enhance their staffs engagement and perhaps thereby improve their attitudes, with the ultimate aim of achieving better outcomes for patients and families.

Reliability and validity of the Japanese version of the Relational Coordination Scale

Naruse Takashi, Sakai Mahiro, Nagata Satoko

[Nihon kōshū eisei zasshi] Japanese journal of public health 61 ( 9 ) 565 - 573 2014

Research paper (scientific journal), Joint Work, Accepted, ISSN 0546-1766

OBJECTIVES: The Relational Coordination Scale is used to measure teamwork with specific subjects about specific tasks. We translated the scale into Japanese (J-RCS) and examined its reliability and validity.METHODS: We translated the scale into Japanese. In July 2013, we conducted an internet survey for 124 home visiting nurses of 11 agencies in Shiga prefecture. The J-RCS items asked about teamwork with physicians, care managers, and colleague nurses.RESULTS: Eighty-one home visiting nurses (65.3%) answered the survey, and 70 (56.5% of the responders) answered the re-test survey. Cronbach's alpha coefficients of J-RCS were 0.770 to 0.859, and the intraclass correlation coefficients for test-retest reliability were 0.673 to 0.830 (P<0.001). In the confirmatory factor analysis, only J-RCS ［physicians］ met the well fit indices and showed factorial validity. Concurrent validity was supported by correlations of J-RCS and the degree of confidence about collaboration (r=0.559 to 0.585, P<0.001) and social support (r=0.549 to 0.789, P<0.001).CONCLUSION: While issues such as factorial validity and the concentration of responses on some scale items will be a topic for further research, the J-RCS has been shown to have an acceptable level of reliability and validity.

The tsunami's impact on mortality in a town severely damaged by the 2011 Great East Japan Earthquake

Nagata Satoko, Teramoto Chie, Okamoto Reiko, Koide Keiko, Nishida Masumi, Suzuki Ruriko, Nomura Michie, Tada Toshiko, Kishi Emiko, Sakai Yoko, Jojima Noriko, Kusano Emiko, Iwamoto Saori, Saito Miki, Murashima Sachiyo

Disasters 38 ( SUPPL2 ) 2014

Research paper (scientific journal), Joint Work, Accepted, ISSN 0361-3666

This study identifies the relationship between tsunami damage and mortality through a demographic pyramid of a town severely damaged by the tsunami following the Great East Japan Earthquake of 11 March 2011. It uses cross-sectional data collection. Volunteers visited all households, including shelters, and asked residents about the whereabouts of family members and neighbours. The information was collated with lists of evacuees and the dead to confirm the whereabouts of all residents about 50 days after the disaster. Demographic pyramids for the whole population based on pre- and post-disaster data were drawn. In all, 1,412 (8.8 per cent) were dead or missing, 60.2 per cent of whom were aged 65 and over and 37.5 per cent aged 75 and over, suggesting that the very old should be located beyond the reach of tsunamis. The mortality rate of children was lower than that in other studies, which may indicate the efficacy of disaster evacuation drills.

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Unmet needs for visiting nurse services among older people after hospital discharge and related factors in Japan

Nagata Satoko, Taguchi Atsuko, Naruse Takashi, Kuwahara Yuki, Murashima Sachiyo

Japan Journal of Nursing Science 10 ( 2 ) 242 - 254 2013.12

Research paper (scientific journal), Joint Work, Accepted, ISSN 1742-7932

Aim: Studies have suggested that some home care recipients have unmet needs for visiting nurse services. In particular, such needs are greater just after hospital discharge than at other times. Thus, there is concern that there exist unmet needs for visiting nurse services among patients after hospital discharge. The purpose of this study was to investigate the current situation of unmet needs for visiting nurse services among older patients discharged from acute hospitals. Methods: This was a cross-sectional correlation study. Participants were patients aged 65 years or over who had been discharged from the general units in all hospitals in four prefectures in Japan after a hospital stay of 14 days or more. Nursing staff gathered the patients' information and assessed unmet needs for visiting nurse services after discharge. Results: There were 1594 eligible participants; 190 (11.9%) utilized visiting nurse services after discharge and 87 (5.4%) were judged to have no visiting nurse services despite a need for such services. Need for assistance in activities of daily living, presence of a respiratory disease, need for continued medical/nursing care after discharge, inadequate capacity for family caregiving, and implementation of discharge planning were related to use of, and need for, visiting nurse services. Conclusion: After controlling for other factors, implementation of discharge planning determined the utilization of, and the need for, nursing care after discharge. Therefore, an adequate discharge planning screening system is necessary.

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Home Visiting Nurse Agencies for Community Dwelling Elderly at Nighttime in Japan

Taguchi Atsuko, Naruse Takashi, Kuwahara Yuki, Nagata Satoko, Murashima Sachiyo

Home Health Care Management and Practice 25 ( 6 ) 256 - 263 2013.12

Research paper (scientific journal), Accepted, ISSN 1084-8223

Our objectives were to describe the care provided during the nighttime and to discuss the characteristics of individuals who are more likely to be cared for at nighttime by visiting nurses of home visiting nurse agencies (HVNAs). Thirty-one clients participated in this study. Eight clients were physically independent and 23 clients were chair/bed bound. Among the physically independent group, the contents of the care at scheduled times were insulin injection and blood sugar measurement in four clients. Among the chair/bed-bound group, the most frequently given medical treatment was sputum suction (16 clients). The majority of clients who received HVNA services at night and early in the morning required medical treatment. The disease condition of clients was unstable and assessment of changes in disease condition was desirable.

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Individual and organizational factors related to work engagement among home-visiting nurses in Japan

Naruse Takashi, Sakai Mahiro, Watai Izumi, Taguchi Atsuko, Kuwahara Yuki, Nagata Satoko, Murashima Sachiyo

Japan Journal of Nursing Science 10 ( 2 ) 267 - 272 2013.12

Research paper (scientific journal), Accepted, ISSN 1742-7932

Aim: The increasing number of elderly people has caused increased demand for home-visiting nurses. Nursing managers should develop healthy workplaces in order to grow their workforce. This study investigated the work engagement of home-visiting nurses as an index of workplace health. The aim of the present study was to reveal factors contributing to work engagement among Japanese home-visiting nurses. Methods: An anonymous, self-administered questionnaire was sent to 208 home-visiting nurses from 28 nursing agencies in three districts; 177 (85.1%) returned the questionnaires. The Job Demands-Resources model, which explains the relationship between work environment and employee well-being, was used as a conceptual guide. The authors employed three survey instruments: (i) questions on individual variables; (ii) questions on organizational variables; and (iii) the Utrecht Work Engagement Scale (Japanese version). Multiple regression analyses were performed in order to examine the relationships between individual variables, organizational variables, and work engagement. Results: Nurse managers and nurses who felt that there was a positive relationship between work and family had significantly higher work engagement levels than others. The support of a supervisor was significantly associated with work engagement. Nurses in middle-sized but not large agencies had significantly higher work engagement than nurses in small agencies. Conclusion: Supervisor support and an appropriate number of people reporting to each supervisor are important factors in fostering work engagement among home-visiting nurses.

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Measuring the efficiencies of visiting nurse service agencies using data envelopment analysis

Kuwahara Yuki, Nagata Satoko, Taguchi Atsuko, Naruse Takashi, Kawaguchi Hiroyuki, Murashima Sachiyo

Health Care Management Science 16 ( 3 ) 228 - 235 2013.09

Research paper (scientific journal), Accepted, ISSN 1386-9620

This study develops a measure of the efficiency of visiting nurse (VN) agencies in Japan, examining the issues related to the measurement of efficiency, and identifying the characteristics that influence efficiency. We have employed a data envelopment analysis to measure the efficiency of 108 VN agencies, using the numbers of 5 types of staff as the input variables and the numbers of 3 types of visits as the output variables. The median efficiency scores of the VN agencies were found to be 0.80 and 1.00 according to the constant returns to scale (CRS) and variable returns to scale (VRS) models, respectively, and the median scale efficiency score was 0.95. This study supports using both the CRS and VRS models to measure the scale efficiency of VN service agencies. We also found that relatively efficient VN agencies filled at least 30 % of staff positions with experienced workers, and so concluded that this characteristic has a direct influence on the length of visits.

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The strategies of Japanese public health nurses in medication support for high-risk tuberculosis patients

Shimamura Tamae, Taguchi Atsuko, Kobayashi Sayuri, Nagata Satoko, Magilvy Joan Kathy, Murashima Sachiyo

Public Health Nursing 30 ( 4 ) 370 - 378 2013.07

Research paper (scientific journal), Accepted, ISSN 0737-1209

Objective: The purpose of this study was to describe the support provided by Japanese public health nurses (PHNs) to high-risk tuberculosis (TB) patients, focusing specifically on the support aimed at preventing interruptions in treatment. Design and Sample: A qualitative descriptive approach was used with a convenience sample of 11 PHNs in Japan who cared for TB patients at highest risk for medication adherence problems. Measures: Semi-structured interviews were conducted to learn the scope and practice of PHNs with high-risk TB patients. Data were analyzed using a qualitative descriptive analysis process. Results: One main theme was identified: "Supporting the patients in overcoming tuberculosis, regaining health, and living a healthier life." Three categories with five subcategories described the nurses' activities: (1) empathetic and reliable support, (2) motivational strategies for medication adherence, and (3) developing a foundation for healthier life. Conclusions: The nurses interviewed described creative and extraordinary strategies used to promote medication adherence and facilitate development of a healthy posttreatment lifestyle. Their approach was patient-centered and culturally congruent. Findings may be transferrable to PHN practice in other regions as care for this economically disadvantaged and marginalized population is a critical need.

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[The prevalence and characteristics of long term care insurance clients who are judged to need frequent home visiting service by their care managers].

Naruse Takashi, Taguchi Atsuko, Nagata Satoko, Kuwahara Yuki, Murashima Sachiyo

[Nihon kōshū eisei zasshi] Japanese journal of public health 60 ( 6 ) 370 - 376 2013.06

Research paper (scientific journal), Joint Work, Accepted, ISSN 0546-1766

Perinatal immunization education improves immunization rates and knowledge

Saitoh Aya, Nagata Satoko, Saitoh Akihiko, Tsukahara Yuki, Vaida Florin, Sonobe Tomoyoshi, Kamiya Hajime, Naruse Takashi, Murashima Sachiyo

Preventive Medicine 56 ( 6 ) 398 - 405 2013.06

Research paper (scientific journal), Joint Work, Accepted, ISSN 0091-7435

Objectives: To determine if providing perinatal immunization education positively changes the immunization status of infants, influences the infant immunization knowledge, attitudes and beliefs of mothers and affects the intent to vaccinate children in Japan where immunization education is limited. Methods: Pregnant women were recruited from three sites in Tokyo, Japan and were assigned to two intervention (pre- or postnatal education) groups and a control group. The immunization status of infants was assessed and a written survey was performed before and after the intervention. Results: Among 119 study participants, 106 subjects replied to the post-survey. The intervention groups (34.3%) had higher immunization rates in infants at three months of age than the control group (8.3%) (P = 0.005); however, no differences were observed between the prenatal (29.4%) and postnatal groups (38.9%) (P = 0.40). The percentage of women intended to vaccinate their infants was higher in the intervention groups (61.4%) compared to the control group (33.3%) (P = 0.01). The improvement in score for basic knowledge was higher in the intervention groups, particularly in the prenatal group (mean ± S.D.: 3.4 ± 1.8) compared to the control (1.9 ± 1.9) (P = 0.003). Conclusions: Perinatal immunization education improved the immunization status of infants, increased the women's knowledge on immunization and intention to vaccinate their infants.

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Home visiting nurses' attitudes toward caring for dying patients, and related workplace factors

Sakai Mahiro, Naruse Takashi, Nagata Satoko

International Journal of Palliative Nursing 19 ( 4 ) 195 - 204 2013.04

Research paper (scientific journal), Joint Work, Accepted, ISSN 1357-6321

Aim: To identify workplace factors related to home visiting nurses' (HVNs) positive attitudes toward caring for dying patients. Methods: In this cross-sectional study, 343 HVNs working in 62 agencies across Chiba prefecture, eastern Japan, received an anonymous self-administered questionnaire from July to August 2012. Results: 304 questionnaires (88.6%) were returned, and the data of 206 HVNs (60.1%) in 54 different agencies was analysed. Multiple regression analysis showed that attendance at terminal care seminars, agency support of schedule organisation enabling attendance at terminal care seminars, and positive feedback from patients and families were significantly positively associated with HVNs' attitudes toward terminal care. Conclusion: These results may give useful interventional methods for nursing managers to enhance HVNs' terminal care practices.

Effects of Nonnursing Assistance on Home Visit Nurses' Time Spent In Japan

Naruse Takashi, Taguchi Atsuko, Kuwahara Yuki, Nagata Satoko, Murashima Sachiyo

Home Health Care Management and Practice 25 ( 1 ) 18 - 22 2013.02

Research paper (scientific journal), Joint Work, Accepted, ISSN 1084-8223

To determine means of improving the efficiency of home nursing services, we conducted an experimental pretest-posttest study to compare the time spent by home visiting nurses (HVNs) on providing care with or without assistance. HVNs' job-related satisfaction levels were also compared. Forty-four clients in six visiting nursing offices in Fukuoka prefecture were selected for this study, which was conducted between July 2009 and January 2010. With assistance, HVNs' total care time and time spent performing trivial tasks decreased and time spent on communicating or teaching increased. Furthermore, HVNs were more satisfied with providing care than with their usual visits. We conclude that introduction of a skill mix might improve home visiting nursing service efficiency through shortening the HVNs' length of stay at a client's home.

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Relationship between perceived time pressure during visits and burnout among home visiting nurses in Japan

Naruse Takashi, Taguchi Atsuko, Kuwahara Yuki, Nagata Satoko, Watai Izumi, Murashima Sachiyo

Japan Journal of Nursing Science 9 ( 2 ) 185 - 194 2012.12

Research paper (scientific journal), Joint Work, Accepted, ISSN 1742-7932

Aim: The rapidly rising number of older people has inevitably caused an increasing demand for home visiting nurses. Nursing managers must develop a healthy workplace to recruit and retain a workforce of nurses. This study focused on home visiting nurses' perceptions of time pressure as a changeable work demand. The aim was to investigate perceptions of time pressure and reveal the relationship between perceived time pressure and burnout among home visiting nurses. Methods: From 32 agencies in three districts, 28 home visiting nurses agreed to participate in this study. Two hundred and eight home visiting nurses received an anonymous self-administered questionnaire by mail, and 177 (85.1%) filled out and returned the questionnaire to the researchers. The Job Demands-Resources model for burnout, which explains the relationship between a work environment and employee well-being, was used as a conceptual guide. Three survey instruments were employed: questions on sociodemographic variables and worksite environments, including time pressure; the Japanese burnout inventory; and a Japanese version of the job content questionnaire. Multiple regression analyses were performed to examine the relationships between time pressure and burnout inventory scores. Results: About 30% of home visiting nurses perceived time pressure frequently. When home visiting nurses perceived time pressure more frequently, they experienced higher emotional exhaustion and depersonalization. Conclusion: Time pressure was often perceived as another job demand and had a significant relationship with burnout. This indicates the importance of lessening time pressure to develop healthy work places for community health nurses.

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Effects of a multi-method discharge planning educational program for medical staff nurses

Suzuki Shigemi, Nagata Satoko, Zerwekh Joyce, Yamaguchi Takuhiro, Tomura Hikari, Takemura Yukie, Murashima Sachiyo

Japan Journal of Nursing Science 9 ( 2 ) 201 - 215 2012.12

Research paper (scientific journal), Joint Work, Accepted, ISSN 1742-7932

Aim: To evaluate the effects of an educational program on discharge planning for staff nurses that was developed to improve their knowledge, attitudes, and practice as well as the organizational climate regarding discharge planning. Methods: Quasi-experimental design was used. Participants were 256 staff nurses on general internal medicine units in a 1210-bed national university hospital in the Tokyo area. Two groups were studied: an education group consisting of 102 nurses from 4 units and a control group consisting of 154 nurses from 6 units. The 3-month education program included study meetings, periodic conferences, and home visits following discharge. The control group received no education. Both groups answered an anonymous self-administered questionnaire before and after the intervention period. For post-intervention group comparisons, analysis of covariance was used. Results: We analyzed the data obtained from 87 education group nurses (response rate: 85.3%) and 104 control group nurses (response rate: 67.5%). In the education group, knowledge increased post intervention regarding home visiting nursing services, the hospital discharge planning department, and two relevant Japanese laws related to discharge planning. In addition, the education group showed improvement in attitudes towards discharge planning. Likewise, co-workers' recognition of discharge planning needs and their support for discharge planning were significantly improved in education-group units compared with control-group units. Conclusion: This education program was successful in strengthening knowledge of various systems related to discharge planning, improving the nurses' attitudes towards discharge planning, and impacting the climate of entire units; therefore, it was found to be effective.

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Evaluation of doctoral nursing programs by doctoral students in Japan

Miki Yuko, Gregg Misuzu F., Arimoto Azusa, Nagata Satoko, Murashima Sachiyo

Japan Journal of Nursing Science 9 ( 2 ) 160 - 168 2012.12

Research paper (scientific journal), Joint Work, Accepted, ISSN 1742-7932

Aim: The purpose of this study was to examine the current state and issues of doctoral nursing programs from the perspective of recipients of the educational process. Methods: All 46 doctoral nursing programs in Japan in 2008 were asked to participate in this study and 28 programs agreed to participate. The questionnaire had 3 sections that evaluated the quality of doctoral education, which are 17 items on the program features, 12 items on the quality of faculty, and 9 items on resources. Results: The questionnaire was distributed to 304 graduate students and 127 students returned by mail. Most of the students agreed that the program goal and curriculum were consistent with the philosophy and mission of the university. The quality of the faculty and of the resources, such as library and computing facilities, were highly rated, while faculty mentorship and support staff for student research were viewed as areas for improvement. Only 30% of the students reported that a periodic assessment of the doctoral program was available in the university, and even when such an assessment did exist, students and graduates were not often involved in the program evaluation. Conclusions: To improve the quality of doctoral nursing education in Japan, there is an urgent need for faculty development and the provision of research support services for faculty and students including more technical and support staff. Furthermore, it is imperative to conduct periodic evaluation of doctoral nursing programs in Japan.

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Institutional trust in the national social security and municipal healthcare systems for the elderly in Japan

Murayama Hiroshi, Taguchi Atsuko, Ryu Shuhei, Nagata Satoko, Murashima Sachiyo

Health Promotion International 27 ( 3 ) 394 - 404 2012.08

Research paper (scientific journal), Joint Work, Accepted, ISSN 0957-4824

Japanese social security systems and institutions for the elderly, as well as the general attitude toward elderly care services among the Japanese population, have been undergoing a dramatic change. By examining the association between institutional trust, which is a representative element of social capital, and anxiety regarding receiving elderly care, we can uncover clues toward building a more robust social security system for the elderly. This study examines the relationship between institutional trust, in the national social security and municipal healthcare systems for the elderly, and anxiety with respect to receiving elderly care among the general Japanese population. A cross-sectional survey was conducted using a self-administered questionnaire that was returned by mail in January and February 2005. The target population was 4735 community residents aged 2075 years, who lived in the city of Koka, Shiga, Japan. A total of 2264 questionnaires were included in the analysis. A binominal logistic regression analysis showed that responses of 'trust' [odds ratio (OR): 2.09, 95 confidence interval (95 CI): 1.014.30] and 'strongly trust' (OR: 3.80, 95 CI: 1.559.31) for the national system were associated with not having anxiety regarding elderly care, compared with the reference category of feeling strongly distrust. However, trust in the municipal system showed no association with this anxiety. These results indicate the importance of developing strategies to increase a common trust in the national care services for the elderly to reduce the anxiety people feel regarding whether they will be able to receive elderly care when required.

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Evaluation of doctoral nursing programs in Japan by faculty members and their educational and research activities

Arimoto Azusa, Gregg Misuzu F., Nagata Satoko, Miki Yuko, Murashima Sachiyo

Nurse Education Today 32 ( 5 ) 2012.07

Research paper (scientific journal), Joint Work, Accepted, ISSN 0260-6917

Evaluation of doctoral programs in nursing is becoming more important with the rapid increase in the programs in Japan. This study aimed to evaluate doctoral nursing programs by faculty members and to analyze the relationship of the evaluation with educational and research activities of faculty members in Japan. Target settings were all 46 doctoral nursing programs. Eighty-five faculty members from 28 programs answered the questionnaire, which included 17 items for program evaluation, 12 items for faculty evaluation, 9 items for resource evaluation, 3 items for overall evaluations, and educational and research activities. A majority gave low evaluations for sources of funding, the number of faculty members and support staff, and administrative systems. Faculty members who financially supported a greater number of students gave a higher evaluation for extramural funding support, publication, provision of diverse learning experiences, time of supervision, and research infrastructure. The more time a faculty member spent on advising doctoral students, the higher were their evaluations on the supportive learning environment, administrative systems, time of supervision, and timely feedback on students' research. The findings of this study indicate a need for improvement in research infrastructure, funding sources, and human resources to achieve quality nursing doctoral education in Japan.

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Evaluation of doctoral nursing education in Japan by students, graduates, and faculty

Nagata Satoko, Gregg Misuzu F., Miki Yuko, Arimoto Azusa, Murashima Sachiyo, Kim Mi Ja

Nurse Education Today 32 ( 4 ) 361 - 367 2012.05

Research paper (scientific journal), Joint Work, Accepted, ISSN 0260-6917

Evaluation of doctoral education in nursing is needed with the rapid increase in doctoral nursing programs in Japan. This study aimed to compare the evaluations of doctoral nursing education by students, graduates, and faculty. All 46 doctoral nursing programs in Japan were target settings. 127 students who had been in the doctoral program, 24 graduates and 87 faculty members had responded to the survey. A questionnaire with 17 items for program evaluation, 12 items for faculty evaluation, 9 items for resource evaluation, and 3 for overall evaluations was distributed in November and December 2008. Responses to 1 program evaluation item, 2 faculty evaluation items and 4 resource evaluation items indicated significant differences among evaluators. While 79.2% of graduates responded positively that the number of faculty members was sufficient to facilitate learning, only 36.1% of faculty members and 49.6% of students responded affirmatively. Graduates' ratings were the most positive and faculty members were the least positive, especially for infrastructure or equipment such as libraries, computers, and the number of technical and support staff. The significant differences among the evaluators suggested that having evaluators in various roles is important to evaluate the quality of doctoral nursing education.

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[Health behavior for prevention of knee pain among young-old persons living in a rural area

Sakai Y., Nagata Satoko, Watanabe Maiko, Dai Yuka, Hoshi Misako, Murashima Sachiyo

[Nihon kōshū eisei zasshi] Japanese journal of public health 59 ( 1 ) 19 - 30 2012.01

Research paper (scientific journal), Joint Work, Accepted, ISSN 0546-1766

To determine the prevalence of knee pain, and implementation status of health behavior for knee pain among young-old persons living in a rural area in Japan by sex, and to study related factors. An anonymous self-administered questionnaire covering demographic variables, lifestyle such as smoking, drinking, farm work, snow removal, 'ochanomi' (tea break with friends), hospital visits, knee pain, JKOM (Japanese knee osteoarthritis measure) and health behavior was distributed to 2,758 persons aged 65 to 74 years living in Minamiaizu town, a rural and snowy town of Fukushima Prefecture in November, 2008. Valid responses were obtained from 1,415 (response rate: 51.3%). The prevalence of knee pain was 35.1%, and twice as many women as men had pain in their knees. People with knee pain had a higher body mass index, higher risk of motor deterioration, lower frequency of going out, and more hospital visits than people without knee pain. Health behavior was emphasized by 657 persons (46.3%), and the rate was higher in people with knee pain. As to companions and information source for health behaviors, 'ochanomi' friends were popular for women and family members for men. Walking was more common and exercise and diet were less common in men than in women. Among the women with knee pain, the implementation rate of health behavior was higher in non-smokers, farm workers, and 'ochanomi' participants than in others. Among men without knee pain, the implementation rate was higher in non-smokers and in people with high scores on the JKOM subscale of "pain or stiffness" and "health status". Among women without knee pain, more people living alone and going out once or more a week focused on health behavior more than the other people. The prevalence of knee pain in this study was similar to that in a previous study on elderly living in a mountain area. Type, information source, companion and related factors of health behavior differed by sex and presence of knee pain; therefore, approaches for encouraging health behavior should be suited to the target population's characteristics. Many people obtain information from non-professionals, so health care workers should provide details about adequate methods for health behavior in a careful manner.

The effects of an intervention program for promoting interorganizational network building between multidisciplinary agencies and community-based organizations

Murayama Hiroshi, Yamaguchi Takuhiro, Nagata Satoko, Murashima Sachiyo

BMC Public Health 12 ( 1 ) 2012

Research paper (scientific journal), Joint Work, Accepted, ISSN 1471-2458

Background: Strengthening interorganizational relationships in the community has become an increasingly valued strategy for improving public health in recent years. However, no intervention strategy to foster an interorganizational network in the community has yet been devised. The purpose of this study was to examine the effects on members of an organization of an intervention program designed to promote interorganizational network building between multidisciplinary agencies and community-based organizations (CBOs). Methods. The program was conducted in Setagaya and Suginami wards, Tokyo, Japan, for staff of community comprehensive support centers (CCSCs), which are multidisciplinary organizations responsible for the support of the elderly. A cluster non-randomized design with a CCSC as a cluster unit (N = 47) was used. The intervention group comprised 20 centers and the control group 27 centers. Those 27 centers declined to participate in program sessions, but did participate through completing pre- and post-intervention surveys. In total, 158 staff members were eligible to participate in this study, 73 from the intervention group and 85 from the control group. Of the 73 members in the intervention group, 19 participated in the monthly program sessions, over a period of 10 months. Attendees participated in group discussions during the sessions. The effects of the intervention were examined by comparing three groups (attendees and non-attendees of the program from the intervention group, and the control group) and between two groups (intervention group and control group). Results: We found no significant difference in any outcome between the intervention group and the control group. However, among the three groups, a significant effect was found in the recognition of knowledge and skills for building networks with CBOs. Recognition of knowledge and skills increased significantly among the attendees compared to non-attendees in the intervention group and the control group. In addition, there was a significant effect, particularly on those with relatively low baseline scores, for the recognition of knowledge and skills. Conclusions: The tested intervention proved effective for attendees regarding their recognition of knowledge and skills for promoting interorganizational network building with CBOs.

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Characteristics of family caregivers with sleep dissatisfaction in Japan

Naruse Takashi, Nagata Satoko, Taguchi Atsuko, Kuwahara Yuki, Murashima Sachiyo

BioScience Trends 6 ( 1 ) 10 - 18 2012

Research paper (scientific journal), Accepted, ISSN 1881-7815

The rapid increase in the population of the elderly has raised several social issues. The current study focused on sleep dissatisfaction in family caregivers to identify family caregivers with a heavy care burden. This study aimed to detect the characteristics of caregivers who are most likely to have sleep dissatisfaction. A chi-squared automatic interaction detection technique was used to analyze data collected from 92 research care managers who collected demographic and sleep dissatisfaction information from 280 caregivers and their care recipients. Caregivers whose care recipients were unstable and bedridden were most likely to have sleep dissatisfaction. When care recipients were not stable or non-bedridden, had severe dementia symptoms, and were physically independent, their caregivers were the second most likely to have sleep dissatisfaction. When care recipients were not stable or non-bedridden, had moderate dementia symptoms, and did not need help in transferring, their caregivers had the lowest risk of sleep dissatisfaction. Although many recent studies have found a high prevalence of insomnia among the elderly, describing the characteristics of caregivers who are most likely to have sleep dissatisfaction is a significant challenge. When care recipients are physically independent, the severity of the recipient's dementia symptoms relates to the caregiver's dissatisfaction with his/her sleep. In physically dependent care recipients, the severity of the recipient's dementia did not contribute to the caregiver's dissatisfaction with his/her sleep.

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Expansion of discharge planning system in Japan

Nagata Satoko, Tomura Hikari, Murashima Sachiyo

BMC Health Services Research 12 ( 1 ) 2012

Research paper (scientific journal), Joint Work, Accepted, ISSN 1472-6963

Background: In response to the rapid aging of the population in Japan, many care systems have been created in quick succession. Establishment of discharge planning departments (DPDs) in hospitals is one of them. In this study, we compared the distribution and characteristics of DPDs and the characteristics of the hospitals that have DPDs between 2001 and 2010 in Japan. Methods: We mailed a questionnaire about the characteristics of hospitals and existence and situation of DPDs to all general hospitals with 100 or more general beds in 2001 and in 2010. Results: In 2001, of the 3,268 hospitals queried, 1,568 (48.0%) responded and 1,357 (41.5%) were selected for data analysis. In 2010, among 2,600 hospitals, 940 hospitals (36.1%) responded and 913 (35.1%) met the inclusion criteria. The percentage of hospitals with DPDs increased from 30% to more than 70% between the two surveys. More departments were under the direct control of the hospital director and more physicians participated in discharge planning activities in 2010 than in 2001. In 2001, private hospitals and hospitals with an affiliated institution or agency tended to have a DPD; however, the relationship between these factors and the presence of a DPD had disappeared in 2010. Larger hospitals and hospitals with more nurses per patient tended to have a DPD both in 2001 and 2010. Conclusions: Since 2008, the establishment of a DPD has been directly connected to medical fees so hospital administrators might have recognized the DPD as a 'necessary and paid for' department. Having a DPD was the majority's policy in Japan, and we must recognize the importance of quality assurance through DPDs from now on, especially in small hospitals.

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